[Barriers to evidence-based medicine encountered among GPs - an issue based on misunderstanding? A qualitative study in the general practice setting].

PubMed

Bölter, Regine; Kühlein, Thomas; Ose, Dominik; Götz, Katja; Freund, Tobias; Szecsenyi, Joachim; Miksch, Antje

2010-01-01

The Chronic Care Model (CCM) is a framework for the structured care of patients with chronic conditions. It requires access of both physicians and patients to scientific evidence in order to facilitate shared treatment decision-making on the basis of the patient's individual needs and the best available external evidence. The aim of this study was to find out whether general practitioners (GP) actually make use of evidence-based information and guidelines and whether and how they communicate this information to their patients. We interviewed 14 general practitioners and conducted a content analysis. The majority of these GPs take a sceptical view towards evidence-based guidelines. Their main point of criticism is that guidelines disregard the individual patient's reality and life style. Instead, GPs emphasize the relevance of their own knowledge of the personal and medical history of and the continual care for their patients. Since GPs themselves often do not accept guidelines, they seldom impart their content to their patients. According to the GPs' experience there are contradictions between guideline-conformant therapy and individual treatment. The integrative character of evidence-based medicine is not recognized. The reason is that evidence-based medicine is equated with guidelines and trial results by the majority of the GPs interviewed. To facilitate guideline implementation in everyday practice GPs need to be provided with adequate access to scientific evidence and an understanding of the intentions of guidelines. If the doctors themselves do not accept guidelines, they will not share them with their patients. It must be made clear that guidelines are not intended as normative demands for a specific therapy for every patient, but are rather meant to assist the physician with his struggle for the best therapy for individual patients. Copyright © 2010. Published by Elsevier GmbH.

Unprofessional content on Facebook accounts of US urology residency graduates.

PubMed

Koo, Kevin; Ficko, Zita; Gormley, E Ann

2017-06-01

To characterize unprofessional content on public Facebook accounts of contemporary US urology residency graduates. Facebook was queried with the names of all urologists who graduated from US urology residency programmes in 2015 to identify publicly accessible profiles. Profiles were assessed for unprofessional or potentially objectionable content using a prospectively designed rubric, based on professionalism guidelines by the American Urological Association, the American Medical Association, and the Accreditation Council for Graduate Medical Education. Content authorship (self vs other) was determined, and profiles were reviewed for self-identification as a urologist. Of 281 graduates, 223 (79%) were men and 267 (95%) held MD degrees. A total of 201 graduates (72%) had publicly identifiable Facebook profiles. Of these, 80 profiles (40%) included unprofessional or potentially objectionable content, including 27 profiles (13%) reflecting explicitly unprofessional behaviour, such as depictions of intoxication, uncensored profanity, unlawful behaviour, and confidential patient information. When unprofessional content was found, the content was self-authored in 82% of categories. Among 85 graduates (42%) who self-identified as a urologist on social media, nearly half contained concerning content. No differences in content were found between men and women, MD and DO degree-holders, or those who did or did not identify as a urologist (all P > 0.05). The majority of recent residency graduates had publicly accessible Facebook profiles, and a substantial proportion contained self-authored unprofessional content. Of those identifying as urologists on Facebook, approximately half violated published professionalism guidelines. Greater awareness of trainees' online identities is needed. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Accessible information for people with complex communication needs.

PubMed

Owens, Janet S

2006-09-01

Information can be empowering if it is accessible. While a number of known information access barriers have been reported for the broader group of people with disabilities, specific information issues for people with complex communication needs have not been previously reported. In this consumer-focused study, the accessibility of information design and dissemination practices were discussed by 17 people with complex communication needs; by eight parents, advocates, therapists, and agency representatives in focus groups; and by seven individuals in individual interviews. Participants explored issues and made recommendations for content, including language, visual and audio supports; print accessibility; physical access; and human support for information access. Consumer-generated accessibility guidelines were an outcome of this study.

Multi-tool accessibility assessment of government department websites:a case-study with JKGAD.

PubMed

Ismail, Abid; Kuppusamy, K S; Nengroo, Ab Shakoor

2017-08-02

Nature of being accessible to all categories of users is one of the primary factors for enabling the wider reach of the resources published through World Wide Web. The accessibility of websites has been analyzed through W3C guidelines with the help of various tools. This paper presents a multi-tool accessibility assessment of government department websites belonging to the Indian state of Jammu and Kashmir. A comparative analysis of six accessibility tools is also presented with 14 different parameters. The accessibility analysis tools used in this study for analysis are aChecker, Cynthia Says, Tenon, wave, Mauve, and Hera. These tools provide us the results of selected websites accessibility status on Web Content Accessibility Guidelines (WCAG) 1.0 and 2.0. It was found that there are variations in accessibility analysis results when using different accessibility metrics to measure the accessibility of websites. In addition to this, we have identified the guidelines which have frequently been violated. It was observed that there is a need for incorporating the accessibility component features among the selected websites. This paper presents a set of suggestions to improve the accessibility status of these sites so that the information and services provided by these sites shall reach a wider spectrum of audience without any barrier. Implications for rehabilitation The following points indicates that this case study of JKGAD websites comes under Rehabilitation focused on Visually Impaired users. Due to the universal nature of web, it should be accessible to all according to WCAG guidelines framed by World Wide Web Consortium. In this paper we have identified multiple accessibility barriers for persons with visual impairment while browsing the Jammu and Kashmir Government websites. Multi-tool analysis has been done to pin-point the potential barriers for persons with visually Impaired. Usability analysis has been performed to check whether these websites are suitable for persons with visual impairment. We provide some valuable suggestions which can be followed by developers and designers to minimize these potential accessibility barriers.Based on aforementioned key points, this article helps the persons with disability especially Visually Impaired Users to access the web resources better with the implementation of identified suggestions.

Indexing. ERIC Processing Manual, Section VII.

ERIC Educational Resources Information Center

Houston, Jim, Ed.

Rules and guidelines are provided for subject indexing in the ERIC system. The principle of "subject access" is discussed with particular reference to "coordinate indexing," which involves designating subject content by unit terms (or tags) that may be put together or "coordinated" for subsequent retrieval. The nature…

Research ethics for a globalised world: the revised CIOMS international guidelines.

PubMed

Ehni, Hans-Jöerg; Wiesing, Urban

2017-01-01

On December 6, 2016, the Council of International Organisations of Medical Sciences published a new version of its guidelines with the title "International Ethical Guidelines for Health-related Research Involving Humans." In this article we briefly describe the revision process and the structure and content of these guidelines. We outline some of its main guidelines such as the ones on social value, post-trial access, and risk-benefit ratio. In our overall evaluation we come to the conclusion that the CIOMS guidelines manage to strike a balance between the protection of human participants in health-related research and the promotion of such research activities in an exemplary way. The guidelines combine key principles with a guide to their application based on the state of the art in research ethics. Thus they represent a timely and indispensable orientation for researchers, ethics committees, and other stakeholders in health-related research.

Making our offices universally accessible: guidelines for physicians

PubMed Central

Jones, K E; Tamari, I E

1997-01-01

OBJECTIVE: To develop recommendations for office-based physicians who wish to make their offices accessible to all patients. OPTIONS: Include taking steps to make offices more accessible, or not; offices may be accessible to varying degrees. OUTCOMES: Outcomes of accessibility involve patient-care, economic, ethical and legal issues. Stakeholders in these outcomes include patients, physicians, government and society. EVIDENCE: Data were obtained from a series of searches of MEDLINE, CINAHL and Healthstar (previously Health) databases for articles on disability and family medicine, primary (health) care and family practice, and on access and offices, and health services accessibility, and from a telephone survey of 50 stakeholders. VALUES: A high value was placed on services to persons with disabilities and on stakeholder input. Universal accessibility was valued as an overall goal; improved accessibility was also highly valued. BENEFITS, HARMS AND COSTS: Benefits to patients include improved access to care as guaranteed by the Canada Health Act and in keeping with provincial Human Rights Codes. Benefits to physicians include contact with a broader patient population and freedom from fear of litigation. Costs of improved accessibility vary depending on individual circumstances and on whether an office is being built or renovated; some improvement costs are minimal. RECOMMENDATIONS: All physicians should take measures to improve practice accessibility. Improved access should be considered in each of the following areas: transportation and entrance to the facility, entrance to the office, waiting rooms, rest rooms, examination rooms, general building features and other features. VALIDATION: No similar guidelines exist. To assess the content validity of these guidelines, the authors had a draft document reviewed by 18 stakeholders. All specific recommendations met the minimum criterion of adherence to current legislation, including national and provincial building codes. The specific recommendations are endorsed by the Canadian Paraplegic Association (national and Ontario offices), the DisAbled Women's Network (Ontario) and the Centre for Independent Living (Toronto). SPONSORS: Development of these guidelines was supported in part by the Department of Family and Community Medicine, Toronto Hospital, Toronto, Ont. PMID:9068570

Sign Support Guidelines for Accessible Assessments: Insights from Cognitive Labs

ERIC Educational Resources Information Center

Shyyan, Vitaliy; Christensen, Laurene L.; Rogers, Christopher; Kincaid, Aleksis

2014-01-01

Students who are deaf or hard of hearing (Deaf/HH) and communicate using American Sign Language (ASL) may benefit from sign accommodations on state assessments. However, there have been challenges in standardizing assessment content including how items should be signed. Technology enhanced assessment offers the opportunity to provide standardized…

36 CFR 1191.1 - Accessibility guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Accessibility guidelines... COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR BUILDINGS AND FACILITIES; ARCHITECTURAL BARRIERS ACT (ABA) ACCESSIBILITY GUIDELINES § 1191.1 Accessibility guidelines. (a) The...

Assesment of access to bibliographic databases and telemetry databases in Astronomy: A groundswell for development.

NASA Astrophysics Data System (ADS)

Diaz-Merced, Wanda Liz; Casado, Johanna; Garcia, Beatriz; Aarnio, Alicia; Knierman, Karen; Monkiewicz, Jacqueline; Alicia Aarnio.

2018-01-01

Big Data" is a subject that has taken special relevance today, particularly in Astrophysics, where continuous advances in technology are leading to ever larger data sets. A multimodal approach in perception of astronomical data data (achieved through sonification used for the processing of data) increases the detection of signals in very low signal-to-noise ratio limits and is of special importance to achieve greater inclusion in the field of Astronomy. In the last ten years, different software tools have been developed that perform the sonification of astronomical data from tables or databases, among them the best known and in multiplatform development are Sonification Sandbox, MathTrack, and xSonify.In order to determine the accessibility of software we propose to start carrying out a conformity analysis of ISO (International Standard Organization) 9241-171171: 2008. This standard establishes the general guidelines that must be taken into account for accessibility in software design, and it is applied to software used in work, public places, and at home. To analyze the accessibility of web databases, we take into account the "Web Content Content Accessibility Guidelines (WCAG) 2.0", accepted and published by ISO in the ISO / IEC 40500: 2012 standard.In this poster, we present a User Centered Design (UCD), Human Computer Interaction (HCI), and User Experience (UX) framework to address a non-segregational provision of access to bibliographic databases and telemetry databases in Astronomy. Our framework is based on an ISO evaluation on a selection of data bases such as ADS, Simbad and SDSS. The WCAG 2.0 and ISO 9241-171171: 2008 should not be taken as absolute accessibility standards: these guidelines are very general, are not absolute, and do not address particularities. They are not to be taken as a substitute for UCD, HCI, UX design and evaluation. Based on our results, this research presents the framework for a focus group and qualitative data analysis aimed to lay the foundations for the employment of UCD functionalities on astronomical databases.

What influences the implementation of the New Zealand stroke guidelines for physiotherapists and occupational therapists?

PubMed

Mudge, Suzie; Hart, Anna; Murugan, Sankaran; Kersten, Paula

2017-03-01

Purpose To explore perceived barriers and facilitators to the use of the New Zealand (NZ) stroke guidelines by occupational therapists and physiotherapists. Methods A qualitative descriptive methodology was used. Eligible physiotherapists and occupational therapists (NZ registered, working in one of two hospitals, treating at least 10 patients with stroke in the previous year) were invited to participate in semi-structured interviews to elicit their perceptions of the utility and feasibility of the NZ stroke guidelines and identify barriers and facilitators to their implementation. All interviews were audio-recorded and transcribed. Conventional content analysis with constant comparative methods was used for coding and analysis. Results The main themes influencing guideline implementation were resources and characteristics of the guidelines, the organization, the patient and family and the therapist. Insufficient resources were a major barrier that crossed many of the themes. Participants suggested a range of strategies relating to the organization to improve therapists' alignment to the guidelines. Conclusion Alignment to the guidelines in NZ is influenced both positively and negatively by a range of interacting factors, consistent with other studies. Alignment might be improved by the introduction of some relatively simple strategies, such as ring-fencing time for access to resources and training in the use of the guidelines. Many of the barriers and related interventions are likely to be more complex. Implications for rehabilitation Alignment with stroke guidelines has been shown to improve patient outcomes. Therapist alignment with the implementation of the New Zealand stroke guidelines is influenced by guideline characteristics, organizational characteristics, resources, patient and family characteristics and therapist characteristics. Frequently encountered barriers related to limited resources, particularly time. Ring-fencing regular time for access to resources and training in the use of guidelines are examples of simple strategies that may reduce barriers.

Practice guidelines in the context of primary care, learning and usability in the physicians' decision-making process--a qualitative study.

PubMed

Ingemansson, Maria; Bastholm-Rahmner, Pia; Kiessling, Anna

2014-08-20

Decision-making is central for general practitioners (GP). Practice guidelines are important tools in this process but implementation of them in the complex context of primary care is a challenge. The purpose of this study was to explore how GPs approach, learn from and use practice guidelines in their day-to-day decision-making process in primary care. A qualitative approach using focus-group interviews was chosen in order to provide in-depth information. The participants were 22 GPs with a median of seven years of experience in primary care, representing seven primary healthcare centres in Stockholm, Sweden in 2011. The interviews focused on how the GPs use guidelines in their decision-making, factors that influence their decision how to approach these guidelines, and how they could encourage the learning process in routine practice.Data were analysed by qualitative content analysis. Meaning units were condensed and grouped in categories. After interpreting the content in the categories, themes were created. Three themes were conceptualized. The first theme emphasized to use guidelines by interactive contextualized dialogues. The categories underpinning this theme: 1. Feedback by peer-learning 2. Feedback by collaboration, mutual learning, and equality between specialties, identified important ways to achieve this learning dialogue. Confidence was central in the second theme, learning that establishes confidence to provide high quality care. Three aspects of confidence were identified in the categories of this theme: 1. Confidence by confirmation, 2. Confidence by reliability and 3. Confidence by evaluation of own results. In the third theme, learning by use of relevant evidence in the decision-making process, we identified two categories: 1. Design and lay-out visualizing the evidence 2. Accessibility adapted to the clinical decision-making process as prerequisites for using the practice guidelines. Decision-making in primary care is a dual process that involves use of intuitive and analytic thinking in a balanced way in order to provide high quality care. Key aspects of effective learning in this clinical decision-making process were: contextualized dialogue, which was based on the GPs' own experiences, feedback on own results and easy access to short guidelines perceived as trustworthy.

Format guidelines to make them vivid, intuitive, and visual: use simple formatting rules to optimize usability and accessibility of clinical practice guidelines.

PubMed

Versloot, Judith; Grudniewicz, Agnes; Chatterjee, Ananda; Hayden, Leigh; Kastner, Monika; Bhattacharyya, Onil

2015-06-01

We present simple formatting rules derived from an extensive literature review that can improve the format of clinical practice guidelines (CPGs), and potentially increase the likelihood of being used. We recently conducted a review of the literature from medicine, psychology, design, and human factors engineering on characteristics of guidelines that are associated with their use in practice, covering both the creation and communication of content. The formatting rules described in this article are derived from that review. The formatting rules are grouped into three categories that can be easily applied to CPGs: first, Vivid: make it stand out; second, Intuitive: match it to the audience's expectations, and third, Visual: use alternatives to text. We highlight rules supported by our broad literature review and provide specific 'how to' recommendations for individuals and groups developing evidence-based materials for clinicians. The way text documents are formatted influences their accessibility and usability. Optimizing the formatting of CPGs is a relatively inexpensive intervention and can be used to facilitate the dissemination of evidence in healthcare. Applying simple formatting principles to make documents more vivid, intuitive, and visual is a practical approach that has the potential to influence the usability of guidelines and to influence the extent to which guidelines are read, remembered, and used in practice.

75 FR 58023 - Guidelines Establishing Test Procedures for the Analysis of Pollutants Under the Clean Water Act...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-23

... http://www.regulations.gov or e-mail. The http://www.regulations.gov Web site is an ``anonymous access... preceding FOR FURTHER INFORMATION CONTACT section. B. What should I consider as I prepare my comments for... VCSB: Voluntary Consensus Standards Body WET: Whole Effluent Toxicity Table of Contents I. Statutory...

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

PubMed Central

von Karsa, L.; Patnick, J.; Segnan, N.; Atkin, W.; Halloran, S.; Lansdorp-Vogelaar, I.; Malila, N.; Minozzi, S.; Moss, S.; Quirke, P.; Steele, R. J.; Vieth, M.; Aabakken, L.; Altenhofen, L.; Ancelle-Park, R.; Antoljak, N.; Anttila, A.; Armaroli, P.; Arrossi, S.; Austoker, J.; Banzi, R.; Bellisario, C.; Blom, J.; Brenner, H.; Bretthauer, M.; Camargo Cancela, M.; Costamagna, G.; Cuzick, J.; Dai, M.; Daniel, J.; Dekker, E.; Delicata, N.; Ducarroz, S.; Erfkamp, H.; Espinàs, J. A.; Faivre, J.; Faulds Wood, L.; Flugelman, A.; Frkovic-Grazio, S.; Geller, B.; Giordano, L.; Grazzini, G.; Green, J.; Hamashima, C.; Herrmann, C.; Hewitson, P.; Hoff, G.; Holten, I.; Jover, R.; Kaminski, M. F.; Kuipers, E. J.; Kurtinaitis, J.; Lambert, R.; Launoy, G.; Lee, W.; Leicester, R.; Leja, M.; Lieberman, D.; Lignini, T.; Lucas, E.; Lynge, E.; Mádai, S.; Marinho, J.; Maučec Zakotnik, J.; Minoli, G.; Monk, C.; Morais, A.; Muwonge, R.; Nadel, M.; Neamtiu, L.; Peris Tuser, M.; Pignone, M.; Pox, C.; Primic-Zakelj, M.; Psaila, J.; Rabeneck, L.; Ransohoff, D.; Rasmussen, M.; Regula, J.; Ren, J.; Rennert, G.; Rey, J.; Riddell, R. H.; Risio, M.; Rodrigues, V.; Saito, H.; Sauvaget, C.; Scharpantgen, A.; Schmiegel, W.; Senore, C.; Siddiqi, M.; Sighoko, D.; Smith, R.; Smith, S.; Suchanek, S.; Suonio, E.; Tong, W.; Törnberg, S.; Van Cutsem, E.; Vignatelli, L.; Villain, P.; Voti, L.; Watanabe, H.; Watson, J.; Winawer, S.; Young, G.; Zaksas, V.; Zappa, M.; Valori, R.

2015-01-01

Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines. PMID:23212726

Personalized Guideline-Based Treatment Recommendations Using Natural Language Processing Techniques.

PubMed

Becker, Matthias; Böckmann, Britta

2017-01-01

Clinical guidelines and clinical pathways are accepted and proven instruments for quality assurance and process optimization. Today, electronic representation of clinical guidelines exists as unstructured text, but is not well-integrated with patient-specific information from electronic health records. Consequently, generic content of the clinical guidelines is accessible, but it is not possible to visualize the position of the patient on the clinical pathway, decision support cannot be provided by personalized guidelines for the next treatment step. The Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) provides common reference terminology as well as the semantic link for combining the pathways and the patient-specific information. This paper proposes a model-based approach to support the development of guideline-compliant pathways combined with patient-specific structured and unstructured information using SNOMED CT. To identify SNOMED CT concepts, a software was developed to extract SNOMED CT codes out of structured and unstructured German data to map these with clinical pathways annotated in accordance with the systematized nomenclature.

Search, Read and Write: An Inquiry into Web Accessibility for People with Dyslexia.

PubMed

Berget, Gerd; Herstad, Jo; Sandnes, Frode Eika

2016-01-01

Universal design in context of digitalisation has become an integrated part of international conventions and national legislations. A goal is to make the Web accessible for people of different genders, ages, backgrounds, cultures and physical, sensory and cognitive abilities. Political demands for universally designed solutions have raised questions about how it is achieved in practice. Developers, designers and legislators have looked towards the Web Content Accessibility Guidelines (WCAG) for answers. WCAG 2.0 has become the de facto standard for universal design on the Web. Some of the guidelines are directed at the general population, while others are targeted at more specific user groups, such as the visually impaired or hearing impaired. Issues related to cognitive impairments such as dyslexia receive less attention, although dyslexia is prevalent in at least 5-10% of the population. Navigation and search are two common ways of using the Web. However, while navigation has received a fair amount of attention, search systems are not explicitly included, although search has become an important part of people's daily routines. This paper discusses WCAG in the context of dyslexia for the Web in general and search user interfaces specifically. Although certain guidelines address topics that affect dyslexia, WCAG does not seem to fully accommodate users with dyslexia.

Healthy by Design: an innovative planning tool for the development of safe, accessible and attractive environments.

PubMed

Sutherland, Emma; Carlisle, Rachel

2007-01-01

The Healthy by Design guidelines were developed by the National Heart Foundation of Australia in 2004 to assist planners to deliver plans for residential developments that support active living. This article provides an overview of the contents of this resource. It also provides examples of its application and influence in the planning sector.

Cystic fibrosis on the Internet: a survey of site adherence to AMA guidelines.

PubMed

Anselmo, Mark A; Lash, Katherine M; Stieb, Elisabeth S; Haver, Kenan E

2004-07-01

The Internet permits unprecedented and mostly unrestricted access to medical knowledge; however, concerns exist regarding viewer privacy, accountability of authorship, accuracy of information, and patient safety. To address these issues, the American Medical Association (AMA) has developed guidelines concerning web site content and visitor rights. Cystic fibrosis (CF) is the most common genetically inherited lethal disease in North America. Many Internet sites that provide information on CF have been developed, although adherence to validated guidelines for online health information is not required. The purpose of this study was to assess systematically web sites with content pertaining to CF for adherence to the published AMA guidelines. The search term "cystic fibrosis" was entered into a commonly used search engine (Google), and the first 100 eligible sites were reviewed. Each site was examined for adherence to the AMA Guidelines for Medical and Health Information Sites on the Internet using a series of adapted questions. There were 15 questions divided into the following main categories: 1) site structure and viewer privacy, 2) author accountability, 3) scientific citation, and 4) patient safety. The number of positives for each question was tabulated. With respect to site structure, fewer than half (45%) of the reviewed sites indicated a date of last revision. Only 11 (11%) carried an explicit privacy policy. A responsible author or group was listed in only 43 (43%) of 100 sites. Presented data regarding CF was supported by references, sources, or expert review in only 38 (38%) of 100 sites. A medical disclaimer noting that information provided does not substitute for evaluation by a health care team was evident in only 37 (37%) sites. The majority of easily accessible CF informational web sites do not adhere to guidelines published by the AMA. Patients and families who use the Internet as a CF information resource should examine the web sites carefully and be familiar with the guidelines established by the AMA. Personal information is not protected, and few sites provide explicit privacy guarantees. Finally, CF care teams should inquire about Internet use by patients and families and be prepared to discuss findings from the Internet to heighten patient safety and awareness.

Development of new canine and feline preventive healthcare guidelines designed to improve pet health.

PubMed

2011-01-01

The American Veterinary Medical Association (AVMA) and American Animal Hospital Association (AAHA) have jointly introduced the first Canine and Feline Preventive Healthcare Guidelines. These consensus statements provide veterinarians with a new resource for improving patient care by emphasizing the value and scope of regular pet examinations. The two guidelines provide complete recommendations for comprehensive preventive healthcare programs, published as accessible, single-page documents. The guidelines are based on the subjective-objective-assessment-plan (SOAP) methodology of case management, a proven approach traditionally used with sick or injured patients. This logical and disciplined process is equally applicable to healthy patients and is designed to consistently deliver optimal patient care. The guidelines recommend visits for health examinations on at least an annual basis, recognizing that for many pets, more frequent visits may be appropriate, depending on the individual needs of the patient. The guidelines also provide detailed diagnostic, therapeutic, prevention, and follow up plans, to be accompanied by appropriate documentation. The inclusive content and concise format of the guidelines are designed to maximize their practical value and make them easy to implement.

Variation in access to sugar-sweetened beverages in vending machines across rural, town and urban high schools

PubMed Central

Adachi-Mejia, A.M.; Longacre, M.R.; Skatrud-Mickelson, M.; Li, Z.; Purvis, L.A.; Titus, L.J.; Beach, M.L.; Dalton, M.A.

2013-01-01

SUMMARY Objectives The 2010 Dietary Guidelines for Americans include reducing consumption of sugar-sweetened beverages. Among the many possible routes of access for youth, school vending machines provide ready availability of sugar-sweetened beverages. The purpose of this study was to determine variation in high school student access to sugar-sweetened beverages through vending machines by geographic location – urban, town or rural – and to offer an approach for analysing school vending machine content. Study design Cross-sectional observational study. Methods Between October 2007 and May 2008, trained coders recorded beverage vending machine content and machine-front advertising in 113 machines across 26 schools in New Hampshire and Vermont, USA. Results Compared with town schools, urban schools were significantly less likely to offer sugar-sweetened beverages (P=0.002). Rural schools also offered more sugar-sweetened beverages than urban schools, but this difference was not significant. Advertisements for sugar-sweetened beverages were highly prevalent in town schools. Conclusions High school students have ready access to sugar-sweetened beverages through their school vending machines. Town schools offer the highest risk of exposure; school vending machines located in towns offer up to twice as much access to sugar-sweetened beverages in both content and advertising compared with urban locations. Variation by geographic region suggests that healthier environments are possible and some schools can lead as inspirational role models. PMID:23498924

Improving access to clinical practice guidelines with an interactive graphical interface using an iconic language

PubMed Central

2014-01-01

Background Clinical practice guidelines are useful for physicians, and guidelines are available on the Internet from various websites such as Vidal Recos. However, these guidelines are long and difficult to read, especially during consultation. Similar difficulties have been encountered with drug summaries of product characteristics. In a previous work, we have proposed an iconic language (called VCM, for Visualization of Concepts in Medicine) for representing patient conditions, treatments and laboratory tests, and we have used these icons to design a user interface that graphically indexes summaries of product characteristics. In the current study, our objective was to design and evaluate an iconic user interface for the consultation of clinical practice guidelines by physicians. Methods Focus groups of physicians were set up to identify the difficulties encountered when reading guidelines. Icons were integrated into Vidal Recos, taking human factors into account. The resulting interface includes a graphical summary and an iconic indexation of the guideline. The new interface was evaluated. We compared the response times and the number of errors recorded when physicians answered questions about two clinical scenarios using the interactive iconic interface or a textual interface. Users’ perceived usability was evaluated with the System Usability Scale. Results The main difficulties encountered by physicians when reading guidelines were obtaining an overview and finding recommendations for patients corresponding to “particular cases”. We designed a graphical interface for guideline consultation, using icons to identify particular cases and providing a graphical summary of the icons organized by anatomy and etiology. The evaluation showed that physicians gave clinical responses more rapidly with the iconic interface than the textual interface (25.2 seconds versus 45.6, p < 0.05). The physicians appreciated the new interface, and the System Usability Scale score value was 75 (between good and excellent). Conclusion An interactive iconic interface can provide physicians with an overview of clinical practice guidelines, and can decrease the time required to access the content of such guidelines. PMID:25158762

Improving access to clinical practice guidelines with an interactive graphical interface using an iconic language.

PubMed

Pereira, Suzanne; Hassler, Sylvain; Hamek, Saliha; Boog, César; Leroy, Nicolas; Beuscart-Zéphir, Marie-Catherine; Favre, Madeleine; Venot, Alain; Duclos, Catherine; Lamy, Jean-Baptiste

2014-08-26

Clinical practice guidelines are useful for physicians, and guidelines are available on the Internet from various websites such as Vidal Recos. However, these guidelines are long and difficult to read, especially during consultation. Similar difficulties have been encountered with drug summaries of product characteristics. In a previous work, we have proposed an iconic language (called VCM, for Visualization of Concepts in Medicine) for representing patient conditions, treatments and laboratory tests, and we have used these icons to design a user interface that graphically indexes summaries of product characteristics. In the current study, our objective was to design and evaluate an iconic user interface for the consultation of clinical practice guidelines by physicians. Focus groups of physicians were set up to identify the difficulties encountered when reading guidelines. Icons were integrated into Vidal Recos, taking human factors into account. The resulting interface includes a graphical summary and an iconic indexation of the guideline. The new interface was evaluated. We compared the response times and the number of errors recorded when physicians answered questions about two clinical scenarios using the interactive iconic interface or a textual interface. Users' perceived usability was evaluated with the System Usability Scale. The main difficulties encountered by physicians when reading guidelines were obtaining an overview and finding recommendations for patients corresponding to "particular cases". We designed a graphical interface for guideline consultation, using icons to identify particular cases and providing a graphical summary of the icons organized by anatomy and etiology. The evaluation showed that physicians gave clinical responses more rapidly with the iconic interface than the textual interface (25.2 seconds versus 45.6, p < 0.05). The physicians appreciated the new interface, and the System Usability Scale score value was 75 (between good and excellent). An interactive iconic interface can provide physicians with an overview of clinical practice guidelines, and can decrease the time required to access the content of such guidelines.

24 CFR 200.929a - Fair Housing Accessibility Guidelines.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Guidelines. 200.929a Section 200.929a Housing and Urban Development Regulations Relating to Housing and Urban... Fair Housing Accessibility Guidelines. Builders and developers may use the Department's Fair Housing Accessibility Guideline when designing or constructing covered multifamily dwelling units in order to comply...

76 FR 77738 - Telecommunications Act Accessibility Guidelines; Electronic and Information Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-14

... Telecommunications Act Accessibility Guidelines and its Electronic and Information Technology Accessibility Standards... electronic and information technology covered by Section 508 of the Rehabilitation Act Amendments of 1998. 76.... 2011-07] RIN 3014-AA37 Telecommunications Act Accessibility Guidelines; Electronic and Information...

The effect of an educational program for vascular access care on nurses' knowledge at dialysis centers in Khartoum State, Sudan.

PubMed

Yousif, Kalthoum Ibrahim; Abu-Aisha, Hasan; Abboud, Omar Ibrahim

2017-01-01

End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD) is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses' knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group). Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI) clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82). Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses' knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001). The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.

The Importance of Process-Oriented Accessibility Guidelines for Web Developers.

PubMed

Steen-Hansen, Linn; Fagernes, Siri

2016-01-01

Current accessibility research shows that in the web development, the process itself may lead to inaccessible web sites and applications. Common practices typically do not allow sufficient testing. The focus is mainly on complying with minimum standards, and treating accessibility compliance as a sort of bug-fixing process, missing the user perspective. In addition, there is an alarming lack of knowledge and experience with accessibility issues. It has also been argued that bringing accessibility into the development process at all stages is the only way to achieve the highest possible level of accessibility. The work presented in this paper is based on a previous project focusing on guidelines for developing accessible rich Internet applications. The guidelines were classified as either process-oriented or technology-oriented. In this paper, we examine the process-oriented guidelines and give a practical perspective on how these guidelines will make the development process more accessibility-friendly.

The urgent matter of online pro-eating disorder content and children: clinical practice.

PubMed

Custers, Kathleen

2015-04-01

During the last decade, much concern has been expressed about online pro-eating disorder communities (e.g., pro-anorexia websites and blogs) which encourage their users to engage in disordered eating behavior. The aim of the current paper is to reemphasize the importance of pro-eating disorder communities in light of the recent changes in the media landscape. With the increase of social networking sites, pro-anorexia messages have transplanted to more volatile and constantly changing media, such as Snapchat, Twitter, Facebook, Instagram, Pinterest, and many others. Most parents, educators, and health professionals are unaware of the sheer scope and nature of such pro-anorexia messages in these new contexts. The current paper will provide a review of pro-eating disorder websites, overview the effects of such websites on young people's health, examine the emergence of these messages on social media platforms, and highlight a number of guidelines for clinicians and parents. The dissemination of online pro-eating disorder content to different types of social networking sites is becoming an urgent issue. • Existing research on pro-eating disorder websites examines the prevalence and the content of these websites, and the effects of pro-eating disorder content on both clinical (eating disordered individuals) and non-clinical samples (non-eating disordered individuals). • The scope and nature of such anorexia messages is unknown to most adults, and many people (including parents and medical professionals) are insufficiently aware of the ease with which young people access, navigate, and use a wide range of online platforms. • Pro-anorexia messages are no longer limited to websites that can be easily monitored, but instead have been transplanted to more volatile and constantly changing media such as Snapchat, Twitter, Facebook, Pinterest, and Tumblr which makes pro-eating disorder content much more easily accessible. • This paper wants to emphasize the implications of the presence of pro-eating disorder content on websites and social media. A number of guidelines for parents and clinicians are provided.

76 FR 44663 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... buildings, facilities, rail passenger cars, and vehicles are accessible in terms of architecture and design... Compliance Board 36 CFR Part 1190 Accessibility Guidelines for Pedestrian Facilities in the Public Right- of... [Docket No. ATBCB 2011-04] RIN 3014-AA26 Accessibility Guidelines for Pedestrian Facilities in the Public...

Implementing Recommendations From Web Accessibility Guidelines: Would They Also Provide Benefits to Nondisabled Users.

PubMed

Schmutz, Sven; Sonderegger, Andreas; Sauer, Juergen

2016-06-01

We examined the consequences of implementing Web accessibility guidelines for nondisabled users. Although there are Web accessibility guidelines for people with disabilities available, they are rarely used in practice, partly due to the fact that practitioners believe that such guidelines provide no benefits, or even have negative consequences, for nondisabled people, who represent the main user group of Web sites. Despite these concerns, there is a lack of empirical research on the effects of current Web accessibility guidelines on nondisabled users. Sixty-one nondisabled participants used one of three Web sites differing in levels of accessibility (high, low, and very low). Accessibility levels were determined by following established Web accessibility guidelines (WCAG 2.0). A broad methodological approach was used, including performance measures (e.g., task completion time) and user ratings (e.g., perceived usability). A high level of Web accessibility led to better performance (i.e., task completion time and task completion rate) than low or very low accessibility. Likewise, high Web accessibility improved user ratings (i.e., perceived usability, aesthetics, workload, and trustworthiness) compared to low or very low Web accessibility. There was no difference between the very low and low Web accessibility conditions for any of the outcome measures. Contrary to some concerns in the literature and among practitioners, high conformance with Web accessibility guidelines may provide benefits to users without disabilities. The findings may encourage more practitioners to implement WCAG 2.0 for the benefit of users with disabilities and nondisabled users. © 2016, Human Factors and Ergonomics Society.

Variation in access to sugar-sweetened beverages in vending machines across rural, town and urban high schools.

PubMed

Adachi-Mejia, A M; Longacre, M R; Skatrud-Mickelson, M; Li, Z; Purvis, L A; Titus, L J; Beach, M L; Dalton, M A

2013-05-01

The 2010 Dietary Guidelines for Americans include reducing consumption of sugar-sweetened beverages. Among the many possible routes of access for youth, school vending machines provide ready availability of sugar-sweetened beverages. The purpose of this study was to determine variation in high school student access to sugar-sweetened beverages through vending machines by geographic location - urban, town or rural - and to offer an approach for analysing school vending machine content. Cross-sectional observational study. Between October 2007 and May 2008, trained coders recorded beverage vending machine content and machine-front advertising in 113 machines across 26 schools in New Hampshire and Vermont, USA. Compared with town schools, urban schools were significantly less likely to offer sugar-sweetened beverages (P = 0.002). Rural schools also offered more sugar-sweetened beverages than urban schools, but this difference was not significant. Advertisements for sugar-sweetened beverages were highly prevalent in town schools. High school students have ready access to sugar-sweetened beverages through their school vending machines. Town schools offer the highest risk of exposure; school vending machines located in towns offer up to twice as much access to sugar-sweetened beverages in both content and advertising compared with urban locations. Variation by geographic region suggests that healthier environments are possible and some schools can lead as inspirational role models. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Analysis of the Accuracy of Weight Loss Information Search Engine Results on the Internet

PubMed Central

Shokar, Navkiran K.; Peñaranda, Eribeth; Nguyen, Norma

2014-01-01

Objectives. We systematically identified and evaluated the quality and comprehensiveness of online information related to weight loss that users were likely to access. Methods. We evaluated the content quality, accessibility of the information, and author credentials for Web sites in 2012 that were identified from weight loss specific queries that we generated. We scored the content with respect to available evidence-based guidelines for weight loss. Results. One hundred three Web sites met our eligibility criteria (21 commercial, 52 news/media, 7 blogs, 14 medical, government, or university, and 9 unclassified sites). The mean content quality score was 3.75 (range = 0–16; SD = 2.48). Approximately 5% (4.85%) of the sites scored greater than 8 (of 12) on nutrition, physical activity, and behavior. Content quality score varied significantly by type of Web site; the medical, government, or university sites (mean = 4.82, SD = 2.27) and blogs (mean = 6.33, SD = 1.99) had the highest scores. Commercial (mean = 2.37, SD = 2.60) or news/media sites (mean = 3.52, SD = 2.31) had the lowest scores (analysis of variance P < .005). Conclusions. The weight loss information that people were likely to access online was often of substandard quality because most comprehensive and quality Web sites ranked too low in search results. PMID:25122030

Use of performance metrics for the measurement of universal coverage for maternal care in Mexico.

PubMed

Serván-Mori, Edson; Contreras-Loya, David; Gomez-Dantés, Octavio; Nigenda, Gustavo; Sosa-Rubí, Sandra G; Lozano, Rafael

2017-06-01

This study provides evidence for those working in the maternal health metrics and health system performance fields, as well as those interested in achieving universal and effective health care coverage. Based on the perspective of continuity of health care and applying quasi-experimental methods to analyse the cross-sectional 2009 National Demographic Dynamics Survey (n = 14 414 women), we estimated the middle-term effects of Mexico's new public health insurance scheme, Seguro Popular de Salud (SPS) (vs women without health insurance) on seven indicators related to maternal health care (according to official guidelines): (a) access to skilled antenatal care (ANC); (b) timely ANC; (c) frequent ANC; (d) adequate content of ANC; (e) institutional delivery; (f) postnatal consultation and (g) access to standardized comprehensive antenatal and postnatal care (or the intersection of the seven process indicators). Our results show that 94% of all pregnancies were attended by trained health personnel. However, comprehensive access to ANC declines steeply in both groups as we move along the maternal healthcare continuum. The percentage of institutional deliveries providing timely, frequent and adequate content of ANC reached 70% among SPS women (vs 64.7% in the uninsured), and only 57.4% of SPS-affiliated women received standardized comprehensive care (vs 53.7% in the uninsured group). In Mexico, access to comprehensive antenatal and postnatal care as defined by Mexican guidelines (in accordance to WHO recommendations) is far from optimal. Even though a positive influence of SPS on maternal care was documented, important challenges still remain. Our results identified key bottlenecks of the maternal healthcare continuum that should be addressed by policy makers through a combination of supply side interventions and interventions directed to social determinants of access to health care. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Regulatory assessment of proposed accessibility guidelines for pedestrians in the public right-of-way

DOT National Transportation Integrated Search

2011-06-30

This report assesses the potential costs and benefits of proposed accessibility guidelines issued by the Access Board for pedestrian facilities in the public right-of-way. The report also analyzes the potential impacts of the proposed guidelines on s...

"If You Tell People That You Had Sex with a Fellow Man, It Is Hard to Be Helped and Treated": Barriers and Opportunities for Increasing Access to HIV Services among Men Who Have Sex with Men in Uganda.

PubMed

Wanyenze, Rhoda K; Musinguzi, Geofrey; Matovu, Joseph K B; Kiguli, Juliet; Nuwaha, Fred; Mujisha, Geoffrey; Musinguzi, Joshua; Arinaitwe, Jim; Wagner, Glenn J

2016-01-01

Despite the high HIV prevalence among men who have sex with men (MSM) in sub-Saharan Africa, little is known about their access to HIV services. This study assessed barriers and opportunities for expanding access to HIV services among MSM in Uganda. In October-December 2013, a cross-sectional qualitative study was conducted in 12 districts of Uganda. Semi-structured in-depth interviews were conducted with 85 self-identified MSM by snowball sampling and 61 key informants including HIV service providers and policy makers. Data were analysed using manifest content analysis and Atlas.ti software. Three quarters of the MSM (n = 62, 72.9%) were not comfortable disclosing their sexual orientation to providers and 69 (81.1%) felt providers did not respect MSM. Half (n = 44, 51.8%) experienced difficulties in accessing health services. Nine major barriers to access were identified, including: (i) unwelcoming provider behaviours; (ii) limited provider skills and knowledge; (iii) negative community perceptions towards MSM; (iv) fear of being exposed as MSM; (v) limited access to MSM-specific services; (vi) high mobility of MSM, (vii) lack of guidelines on MSM health services; viii) a harsh legal environment; and ix) HIV related stigma. Two-thirds (n = 56, 66%) participated in MSM social networks and 86% of these (48) received support from the networks to overcome barriers to accessing services. Negative perceptions among providers and the community present barriers to service access among MSM. Guidelines, provider skills building and use of social networks for mobilization and service delivery could expand access to HIV services among MSM in Uganda.

Fate of Articles That Warranted Retraction Due to Ethical Concerns: A Descriptive Cross-Sectional Study

PubMed Central

Elia, Nadia; Wager, Elizabeth; Tramèr, Martin R.

2014-01-01

Objective To study journals' responses to a request from the State Medical Association of Rheinland-Pfalz, Germany, to retract 88 articles due to ethical concerns, and to check whether the resulting retractions followed published guidelines. Design Descriptive cross-sectional study. Population 88 articles (18 journals) by the anaesthesiologist Dr. Boldt, that warranted retraction. Method According to the recommendations of the Committee on Publication Ethics, we regarded a retraction as adequate when a retraction notice was published, linked to the retracted article, identified the title and authors of the retracted article in its heading, explained the reason and who took responsibility for the retraction, and when the retracted article was freely accessible and marked using a transparent watermark that preserved original content. Two authors extracted data independently (January 2013) and contacted editors-in-chief and publishers for clarification in cases of inadequate retraction. Results Five articles (6%) fulfilled all criteria for adequate retraction. Nine (10%) were not retracted (no retraction notice published, full text article not marked). 79 (90%) retraction notices were published, 76 (86%) were freely accessible, but only 15 (17%) were complete. 73 (83%) full text articles were marked as retracted, of which 14 (16%) had an opaque watermark hiding parts of the original content, and 11 (13%) had all original content deleted. 59 (67%) retracted articles were freely accessible. One editor-in-chief stated personal problems as a reason for incomplete retractions, eight blamed their publishers. Two publishers cited legal threats from Dr. Boldt's co-authors which prevented them from retracting articles. Conclusion Guidelines for retracting articles are incompletely followed. The role of publishers in the retraction process needs to be clarified and standards are needed on marking retracted articles. It remains unclear who should check that retractions are done properly. Legal safeguards are required to allow retraction of articles against the wishes of authors. PMID:24465744

Assessing evidence of inequalities in access to medication for diabetic populations in low- and middle-income countries: a systematic review

PubMed Central

Christiani, Yodi; Dhippayom, Teerapon; Chaiyakunapruk, Nathorn

2016-01-01

Background Inequalities in access to medications among people diagnosed with diabetes inlow- and middle-income countries (LMICs) is a public health concern since untreated diabetes can lead to severe complications and premature death. Objective To assess evidence of inequalities in access to medication for diabetes in adult populations of people with diagnosed diabetes in LMICs. Design We conducted a systematic review of the literature using the PRISMA-Equity guidelines. A search of five databases – PubMed, Cochrane, CINAHL, PsycINFO, and EMBASE – was conducted from inception to November 2015. Using deductive content analysis, information extracted from the selected articles was analysed according to the PRISMA-Equity guidelines, based on exposure variables (place of residence, race/ethnicity, occupation, gender, religion, education, socio-economic status, social capital, and others). Results Fifteen articles (seven quantitative and eight qualitative studies) are included in this review. There were inconsistent findings between studies conducted in different countries and regions although financial and geographic barriers generally contributed to inequalities in access to diabetes medications. The poor, those with relatively low education, and people living in remote areas had less access to diabetes medications. Furthermore, we found that the level of government political commitment through primary health care and in the provision of essential medicines was an important factor in promoting access to medications. Conclusions The review indicates that inequalities exist in accessing medication among diabetic populations, although this was not evident in all LMICs. Further research is needed to assess the social determinants of health and medication access for people with diabetes in LMICs. PMID:27938647

Mobile Phone Apps for Smoking Cessation: Quality and Usability Among Smokers With Psychosis.

PubMed

Ferron, Joelle C; Brunette, Mary F; Geiger, Pamela; Marsch, Lisa A; Adachi-Mejia, Anna M; Bartels, Stephen J

2017-03-03

Smoking is one of the top preventable causes of mortality in people with psychotic disorders such as schizophrenia. Cessation treatment improves abstinence outcomes, but access is a barrier. Mobile phone apps are one way to increase access to cessation treatment; however, whether they are usable by people with psychotic disorders, who often have special learning needs, is not known. Researchers reviewed 100 randomly selected apps for smoking cessation to rate them based on US guidelines for nicotine addiction treatment and to categorize them based on app functions. We aimed to test the usability and usefulness of the top-rated apps in 21 smokers with psychotic disorders. We identified 766 smoking cessation apps and randomly selected 100 for review. Two independent reviewers rated each app with the Adherence Index to US Clinical Practice Guideline for Treating Tobacco Use and Dependence. Then, smokers with psychotic disorders evaluated the top 9 apps within a usability testing protocol. We analyzed quantitative results using descriptive statistics and t tests. Qualitative data were open-coded and analyzed for themes. Regarding adherence to practice guidelines, most of the randomly sampled smoking cessation apps scored poorly-66% rated lower than 10 out of 100 on the Adherence Index (Mean 11.47, SD 11.8). Regarding usability, three common usability problems emerged: text-dense content, abstract symbols on the homepage, and subtle directions to edit features. In order for apps to be effective and usable for this population, developers should utilize a balance of text and simple design that facilitate ease of navigation and content comprehension that will help people learn quit smoking skills. ©Joelle C Ferron, Mary F Brunette, Pamela Geiger, Lisa A Marsch, Anna M Adachi-Mejia, Stephen J Bartels. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 03.03.2017.

Mobile Phone Apps for Smoking Cessation: Quality and Usability Among Smokers With Psychosis

PubMed Central

Brunette, Mary F; Geiger, Pamela; Marsch, Lisa A; Adachi-Mejia, Anna M; Bartels, Stephen J

2017-01-01

Background Smoking is one of the top preventable causes of mortality in people with psychotic disorders such as schizophrenia. Cessation treatment improves abstinence outcomes, but access is a barrier. Mobile phone apps are one way to increase access to cessation treatment; however, whether they are usable by people with psychotic disorders, who often have special learning needs, is not known. Objective Researchers reviewed 100 randomly selected apps for smoking cessation to rate them based on US guidelines for nicotine addiction treatment and to categorize them based on app functions. We aimed to test the usability and usefulness of the top-rated apps in 21 smokers with psychotic disorders. Methods We identified 766 smoking cessation apps and randomly selected 100 for review. Two independent reviewers rated each app with the Adherence Index to US Clinical Practice Guideline for Treating Tobacco Use and Dependence. Then, smokers with psychotic disorders evaluated the top 9 apps within a usability testing protocol. We analyzed quantitative results using descriptive statistics and t tests. Qualitative data were open-coded and analyzed for themes. Results Regarding adherence to practice guidelines, most of the randomly sampled smoking cessation apps scored poorly—66% rated lower than 10 out of 100 on the Adherence Index (Mean 11.47, SD 11.8). Regarding usability, three common usability problems emerged: text-dense content, abstract symbols on the homepage, and subtle directions to edit features. Conclusions In order for apps to be effective and usable for this population, developers should utilize a balance of text and simple design that facilitate ease of navigation and content comprehension that will help people learn quit smoking skills. PMID:28258047

78 FR 38102 - Passenger Vessels Accessibility Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-25

... translation (CART) web streaming link will be posted on the Access Board's Passenger Vessels homepage at http... guidelines use mandatory language (i.e., shall) so DOT and DOJ can adopt the guidelines as accessibility... passenger vessels subject to U.S. Coast Guard regulations in 46 CFR Chapter I, Subchapters H and K.\\6...

Guidelines for medical and health information sites on the internet: principles governing AMA web sites. American Medical Association.

PubMed

Winker, M A; Flanagin, A; Chi-Lum, B; White, J; Andrews, K; Kennett, R L; DeAngelis, C D; Musacchio, R A

Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.

Exploring accessibility issues of a public building for the mobility impaired. Case study: interstate bus terminal (ISBT), Vijayawada, India.

PubMed

Alagappan, Valliappan; Hefferan, Albert; Parivallal, Aarthi

2018-04-01

Right to access in the built environment creates equal and nondiscriminatory opportunities to a person with disabilities in order to move freely around and interact positively without hindrance and barriers. The objective of the study is to understand the existing accessibility related issues and implementation of guidelines and standards for public buildings. The technical verification using onsite and offsite access audit format for current provision of facilities in the internal and external environment has been carried out with the format prepared in reference to Central Public Works Department (CPWD) accessibility guidelines for mobility impaired and elderly and American Disability Act (ADA) guidelines. The access audit format included parameters like accessibility, safety, security, comfort and convenience and it addresses the barriers faced by wheel chair users, people with crutches, prosthetics and with non-assistive devices. The study addressed accessibility compliance in three zones of the building with initiation from parking area zone, inside the building, and area outside the building premises. The findings highlight the environmental barriers encountered by mobility impaired people and represented graphically in the layout plan and physical effort required to overcome the challenges in the built environment. The overall accessibility compliance is 42% in the interstate bus terminal. Implications for rehabilitation The study identifies the environmental limitations, human and technologically facilitators with the help of Central Public Works Department (CPWD) and American Disability Act (ADA) guidelines (1990). It highlights barriers for mobility-impaired users, by demonstrating in a spatial layout and the means to facilitate easy access with minimal frustration, stress and with less physical effort. It demonstrates the need for preparation of separate guidelines for making the existing types of buildings to be access and disabled-friendly. New accessibility guidelines shall be prepared by incorporating concepts like such as relative accessibility into new bus terminal buildings. Guidelines help the disabled in the process of rehabilitation and develop inclusiveness not rather than alienation.

Bridging the Gap in Port Security; Network Centric Theory Applied to Public/Private Collaboration

DTIC Science & Technology

2007-03-01

commercial_enforcement/ ctpat /security_guideline/guideline_port.xml [Accessed January 2, 2007] 16 The four core elements of CSI include:36 • Identify high...www.cbp.gov/xp/cgov/import/commercial_enforcement/ ctpat /security_guideline/guideline_port.xml [Accessed January 2, 2007]. 17 Connecting them

Attitudes and Perceptions about Clinical Guidelines: A Qualitative Study with Spanish Physicians

PubMed Central

Solà, Ivan; Carrasco, José Miguel; Díaz del Campo, Petra; Gracia, Javier; Orrego, Carola; Martínez, Flora; Kotzeva, Anna; Guillamón, Imma; Calderón, Enrique; de Gaminde, Idoia; Louro, Arturo; Rotaeche, Rafael; Salcedo, Flavia; Velázquez, Paola; Alonso-Coello, Pablo

2014-01-01

Background Clinical guidelines (CGs) are popular for healthcare decision making but their acceptability and use by healthcare providers is influenced by numerous factors. Some of these factors are professional-related, such as knowledge and perceptions of and attitudes toward CGs in general. The aim of our study was to evaluate attitudes and perceptions of Spanish physicians towards CGs. Methods We coordinated six discussion groups with a total of 46 physicians. The participants were drawn from 12 medical specialties from both specialized and primary care. We recorded the sessions and transcribed the content verbatim. We analyzed the data using an approach based on the grounded theory. Results We identified two main constructs that defined the physicians' perceptions towards guidelines: knowledge and usefulness. “Knowledge” defined the theoretical meanings of guidelines, while “Usefulness” referred to the pragmatic approach to guidelines. These constructs were interrelated through a series of categories such as confidence, usability, accessibility, dissemination and formats. Conclusions In our study, the constructs that impacted most on physician's attitudes to clinical guidelines were knowledge and usefulness. The tension between the theoretical and the pragmatic constructs determined the attitudes and how physicians use guidelines. Groups developing guidelines should ask relevant clinical questions and develop implementable and context specific recommendations. Developers should be explicit and consistent in the development and presentation of recommendations. PMID:24505253

Design Guidelines for Provision of Median Access on Principal Arterials

DOT National Transportation Integrated Search

2000-12-01

Principal arterial class streets must move large traffic volumes while providing limited property access. Guidelines for median design and other characteristics that will maintain traffic flow potential are needed. Without such guidelines, principal ...

Management of common gastrointestinal disorders: quality criteria based on patients' views and practice guidelines

PubMed Central

Jones, Roger; Hunt, Claire; Stevens, Richard; Dalrymple, Jamie; Driscoll, Richard; Sleet, Sarah; Smith, Jonathan Blanchard

2009-01-01

Background Although gastrointestinal disorders are common in general practice, clinical guidelines are not always implemented, and few patient-generated quality criteria are available to guide management. Aim To develop quality criteria for the management of four common gastrointestinal disorders: coeliac disease, gastro-oesophageal reflux disease (GORD), inflammatory bowel disease, and irritable bowel syndrome. Design of study Qualitative study including thematic analysis of transcripts from patient focus groups and content analysis of published clinical practice guidelines. Emergent themes were synthesised by a consensus panel, into quality criteria for each condition. Setting Community-based practice in England, UK. Methods Fourteen focus groups were conducted (four for coeliac disease, irritable bowel syndrome, and inflammatory bowel disease, and two for GORD) involving a total of 93 patients (64 females, 29 males; mean age 55.4 years). Quality criteria were based on patients' views and expectations, synthesised with an analysis of clinical practice guidelines. Results A chronic disease management model was developed for each condition. Key themes included improving the timeliness and accuracy of diagnosis, appropriate use of investigations, better provision of information for patients, including access to patient organisations, better communication with, and access to, secondary care providers, and structured follow-up and regular review, particularly for coeliac disease and inflammatory bowel disease. Conclusion This study provides a model for the development of quality markers for chronic disease management in gastroenterology, which is likely to be applicable to other chronic conditions. PMID:19520018

[Legal aspects of Web 2.0 in the health field].

PubMed

Beslay, Nathalie; Jeunehomme, Marie

2009-10-01

Web 2.0 sites are considered to be hosting providers and not publishers of user-generated content. The liability of hosting providers' liability is defined by the law enacted on June 21, 2004, on confidence in the digital economy. Hosting providers must promptly remove the information they host or make its access impossible once they are informed of its illegality. They are required to obtain and retain data to enable identification of any person who has contributed to content hosted by them. The liability of hosting providers has arisen in numerous disputes about user-produced content in various situations (discussion lists, blogs, etc.). The National Board of Physicians has developed specific ethical guidelines for web sites devoted to health issues and specifically for physician-authored content. The National Board of Physicians acknowledges that physicians can present themselves, their office, and their specific practice on their web site, notwithstanding any restrictions otherwise applicable to advertising.

Design guidelines for interactive multimedia learning environments to promote social inclusion.

PubMed

Brown, D J; Powell, H M; Battersby, S; Lewis, J; Shopland, N; Yazdanparast, M

There is a continuing need for guidelines to aid in the design of Interactive Multimedia Learning Environments (IMLE) to promote effective learning. The project introduced in this paper looks at an important subset of this problem, the design of interactive learning environments to promote social inclusion. A consortium of six partners contributed toward defining learning material to develop a range of work based skills, including horticulture, IT and catering. These were then developed into IMLE prototypes. Formative evaluation of these prototypes then revealed a range of usability problems, which were grouped into generic types and frequency of occurrence. The most important and frequently occurring problems were used to distil a set of design guidelines for the development of effective IMLE. The results from this usability content analysis were also used to refine the initial prototypes to improve their usability and effectiveness. These guidelines, termed the Greenhat Design Guidelines, can be adopted for use by all multimedia developers aiming to promote the social inclusion of vulnerable or socially disadvantaged groups of people. The refined IMLE can be accessed via the Greenhat Server to improve the employment-related skills of socially excluded people.

Vascular Access Guidelines: Summary, Rationale, and Controversies.

PubMed

Sequeira, Adrian; Naljayan, Mihran; Vachharajani, Tushar J

2017-03-01

Dialysis vascular access management in the United States changed significantly after National Kidney Foundation-Kidney Disease Outcome Quality Initiative (NKF-KDOQI) clinical practice guidelines were first published in 1997. The Centers for Medicare and Medicaid Service adopted these guidelines and in collaboration with the End-Stage Renal Disease Networks established the Fistula First Breakthrough Initiative (FFBI) in 2003 to improve the rate of arteriovenous fistula use over arteriovenous graft and central venous catheter in the dialysis population. The implementation of guidelines and FFBI has led to a significant increase in the arteriovenous fistula use in the prevalent dialysis population. The guidelines are criticized for being opinion based and often impractical. Over the past 2 decades, the patient population undergoing dialysis has become older with complex comorbidities and challenges for creating an ideal vascular access. Advancing knowledge about access pathophysiology, improved treatment options, and improved process of care with team approach model point toward diminishing relevance of few of the existing guidelines. Moreover, several guidelines remain controversial and may be leading to clinical decisions that may be unfavorable to the patients. The review discusses the historical aspect of vascular access care in the United States and evolution of current practice standards and controversies surrounding few of these guidelines in the current time. Published by Elsevier Inc.

Guidelines for randomized clinical trial protocol content: a systematic review

PubMed Central

2012-01-01

Background All randomized clinical trials (RCTs) require a protocol; however, numerous studies have highlighted protocol deficiencies. Reporting guidelines may improve the content of research reports and, if developed using robust methods, may increase the utility of reports to stakeholders. The objective of this study was to systematically identify and review RCT protocol guidelines, to assess their characteristics and methods of development, and to compare recommendations. Methods We conducted a systematic review of indexed literature (MEDLINE, EMBASE and the Cochrane Methodology Register from inception to September 2010; reference lists; related article features; forward citation searching) and a targeted search of supplementary sources, including a survey of major trial funding agencies in six countries. Records were eligible if they described a content guideline in English or French relevant to RCT protocols. Guidelines were excluded if they specified content for protocols for trials of specific procedures or conditions or were intended to assess trial quality. We extracted guideline characteristics and methods. Content was mapped for a subset of guidelines that described development methods or had institutional endorsement. Results Forty guidelines published in journals, books and institutional reports were included in the review; seven were specific to RCT protocols. Only eight (20%) described development methods which included informal consensus methods, pilot testing and formal validation; no guideline described all of these methods. No guideline described formal consensus methods or a systematic retrieval of empirical evidence to inform its development. The guidelines included a median of 23 concepts per guideline (interquartile range (IQR) = 14 to 34; range = 7 to 109). Among the subset of guidelines (n = 23) for which content was mapped, approximately 380 concepts were explicitly addressed (median concepts per guideline IQR = 31 (24,80); range = 16 to 150); most concepts were addressed in a minority of guidelines. Conclusions Existing guidelines for RCT protocol content varied substantially in their recommendations. Few reports described the methods of guideline development, limiting comparisons of guideline validity. Given the importance of protocols to diverse stakeholders, we believe a systematically developed, evidence-informed guideline for clinical trial protocols is needed. PMID:23006870

Guidelines for randomized clinical trial protocol content: a systematic review.

PubMed

Tetzlaff, Jennifer M; Chan, An-Wen; Kitchen, Jessica; Sampson, Margaret; Tricco, Andrea C; Moher, David

2012-09-24

All randomized clinical trials (RCTs) require a protocol; however, numerous studies have highlighted protocol deficiencies. Reporting guidelines may improve the content of research reports and, if developed using robust methods, may increase the utility of reports to stakeholders. The objective of this study was to systematically identify and review RCT protocol guidelines, to assess their characteristics and methods of development, and to compare recommendations. We conducted a systematic review of indexed literature (MEDLINE, EMBASE and the Cochrane Methodology Register from inception to September 2010; reference lists; related article features; forward citation searching) and a targeted search of supplementary sources, including a survey of major trial funding agencies in six countries. Records were eligible if they described a content guideline in English or French relevant to RCT protocols. Guidelines were excluded if they specified content for protocols for trials of specific procedures or conditions or were intended to assess trial quality. We extracted guideline characteristics and methods. Content was mapped for a subset of guidelines that described development methods or had institutional endorsement. Forty guidelines published in journals, books and institutional reports were included in the review; seven were specific to RCT protocols. Only eight (20%) described development methods which included informal consensus methods, pilot testing and formal validation; no guideline described all of these methods. No guideline described formal consensus methods or a systematic retrieval of empirical evidence to inform its development. The guidelines included a median of 23 concepts per guideline (interquartile range (IQR) = 14 to 34; range = 7 to 109). Among the subset of guidelines (n = 23) for which content was mapped, approximately 380 concepts were explicitly addressed (median concepts per guideline IQR = 31 (24,80); range = 16 to 150); most concepts were addressed in a minority of guidelines. Existing guidelines for RCT protocol content varied substantially in their recommendations. Few reports described the methods of guideline development, limiting comparisons of guideline validity. Given the importance of protocols to diverse stakeholders, we believe a systematically developed, evidence-informed guideline for clinical trial protocols is needed.

Naturalistic study of guideline implementation tool use via evaluation of website access and physician survey.

PubMed

Armstrong, Melissa J; Gronseth, Gary S; Dubinsky, Richard; Potrebic, Sonja; Penfold Murray, Rebecca; Getchius, Thomas S D; Rheaume, Carol; Gagliardi, Anna R

2017-01-13

Clinical guidelines support decision-making at the point-of-care but the onus is often on individual users such as physicians to implement them. Research shows that the inclusion of implementation tools in or with guidelines (GItools) is associated with guideline use. However, there is little research on which GItools best support implementation by individual physicians. The purpose of this study was to investigate naturalistic access and use of GItools produced by the American Academy of Neurology (AAN) to inform future tool development. Website accesses over six months were summarized for eight AAN guidelines and associated GItools published between July 2012 and August 2013. Academy members were surveyed about use of tools accompanying the sport concussion guideline. Data were analyzed using summary statistics and the Chi-square test. The clinician summary was accessed more frequently (29.0%, p < 0.001) compared with the slide presentation (26.8%), patient summary (23.2%) or case study (20.9%), although this varied by guideline topic. For the sport concussion guideline, which was accompanied by a greater variety of GItools, the mobile phone quick reference check application was most frequently accessed, followed by the clinician summary, patient summary, and slide presentation. For the sports concussion guideline survey, most respondents (response rate 21.8%, 168/797) were aware of the guideline (88.1%) and had read the guideline (78.6%). For GItool use, respondents indicated reading the reference card (51.2%), clinician summary (45.2%), patient summary (28.0%), mobile phone application (26.2%), and coach/athletic trainer summary (20.2%). Patterns of sports concussion GItool use were similar between respondents who said they had and had not yet implemented the guideline. Developers faced with resource limitations may wish to prioritize the development of printable or mobile application clinician summaries, which were accessed significantly more than other types of GItools. Further research is needed to understand how to optimize the design of such GItools.

Evaluation of educational content of YouTube videos relating to neurogenic bladder and intermittent catheterization.

PubMed

Ho, Matthew; Stothers, Lynn; Lazare, Darren; Tsang, Brian; Macnab, Andrew

2015-01-01

Many patients conduct internet searches to manage their own health problems, to decide if they need professional help, and to corroborate information given in a clinical encounter. Good information can improve patients' understanding of their condition and their self-efficacy. Patients with spinal cord injury (SCI) featuring neurogenic bladder (NB) require knowledge and skills related to their condition and need for intermittent catheterization (IC). Information quality was evaluated in videos accessed via YouTube relating to NB and IC using search terms "neurogenic bladder intermittent catheter" and "spinal cord injury intermittent catheter." Video content was independently rated by 3 investigators using criteria based on European Urological Association (EAU) guidelines and established clinical practice. In total, 71 videos met the inclusion criteria. Of these, 12 (17%) addressed IC and 50 (70%) contained information on NB. The remaining videos met inclusion criteria, but did not contain information relevant to either IC or NB. Analysis indicated poor overall quality of information, with some videos with information contradictory to EAU guidelines for IC. High-quality videos were randomly distributed by YouTube. IC videos featuring a healthcare narrator scored significantly higher than patient-narrated videos, but not higher than videos with a merchant narrator. About half of the videos contained commercial content. Some good-quality educational videos about NB and IC are available on YouTube, but most are poor. The videos deemed good quality were not prominently ranked by the YouTube search algorithm, consequently user access is less likely. Study limitations include the limit of 50 videos per category and the use of a de novo rating tool. Information quality in videos with healthcare narrators was not higher than in those featuring merchant narrators. Better material is required to improve patients' understanding of their condition.

The Role of Evidence in the Decision-Making Process of Selecting Essential Medicines in Developing Countries: The Case of Tanzania

PubMed Central

Mori, Amani Thomas; Kaale, Eliangiringa Amos; Ngalesoni, Frida; Norheim, Ole Frithjof; Robberstad, Bjarne

2014-01-01

Background Insufficient access to essential medicines is a major health challenge in developing countries. Despite the importance of Standard Treatment Guidelines and National Essential Medicine Lists in facilitating access to medicines, little is known about how they are updated. This study aims to describe the process of updating the Standard Treatment Guidelines and National Essential Medicine List in Tanzania and further examines the criteria and the underlying evidence used in decision-making. Methods This is a qualitative study in which data were collected by in-depth interviews and document reviews. Interviews were conducted with 18 key informants who were involved in updating the Standard Treatment Guidelines and National Essential Medicine List. We used a thematic content approach to analyse the data. Findings The Standard Treatment Guidelines and National Essential Medicine List was updated by committees of experts who were recruited mostly from referral hospitals and the Ministry of Health and Social Welfare. Efficacy, safety, availability and affordability were the most frequently utilised criteria in decision-making, although these were largely based on experience rather than evidence. In addition, recommendations from international guidelines and medicine promotions also influenced decision-making. Cost-effectiveness, despite being an important criterion for formulary decisions, was not utilised. Conclusions Recent decisions about the selection of essential medicines in Tanzania were made by committees of experts who largely used experience and discretionary judgement, leaving evidence with only a limited role in decision-making process. There may be several reasons for the current limited use of evidence in decision-making, but one hypothesis that remains to be explored is whether training experts in evidence-based decision-making would lead to a better and more explicit use of evidence. PMID:24416293

The role of evidence in the decision-making process of selecting essential medicines in developing countries: the case of Tanzania.

PubMed

Mori, Amani Thomas; Kaale, Eliangiringa Amos; Ngalesoni, Frida; Norheim, Ole Frithjof; Robberstad, Bjarne

2014-01-01

Insufficient access to essential medicines is a major health challenge in developing countries. Despite the importance of Standard Treatment Guidelines and National Essential Medicine Lists in facilitating access to medicines, little is known about how they are updated. This study aims to describe the process of updating the Standard Treatment Guidelines and National Essential Medicine List in Tanzania and further examines the criteria and the underlying evidence used in decision-making. This is a qualitative study in which data were collected by in-depth interviews and document reviews. Interviews were conducted with 18 key informants who were involved in updating the Standard Treatment Guidelines and National Essential Medicine List. We used a thematic content approach to analyse the data. The Standard Treatment Guidelines and National Essential Medicine List was updated by committees of experts who were recruited mostly from referral hospitals and the Ministry of Health and Social Welfare. Efficacy, safety, availability and affordability were the most frequently utilised criteria in decision-making, although these were largely based on experience rather than evidence. In addition, recommendations from international guidelines and medicine promotions also influenced decision-making. Cost-effectiveness, despite being an important criterion for formulary decisions, was not utilised. Recent decisions about the selection of essential medicines in Tanzania were made by committees of experts who largely used experience and discretionary judgement, leaving evidence with only a limited role in decision-making process. There may be several reasons for the current limited use of evidence in decision-making, but one hypothesis that remains to be explored is whether training experts in evidence-based decision-making would lead to a better and more explicit use of evidence.

Truck facility access design guidelines statewide.

DOT National Transportation Integrated Search

2011-06-01

The overall purpose of this project is to develop design guidelines for truck access to truck stop facilities adjoining interstate highways and accessed by interchanges in Louisiana. The specific objectives of the research are to: 1. Identify existin...

Exploring the Use of Individualized, Reflective Guidance In an Educational Multi-User Virtual Environment

NASA Astrophysics Data System (ADS)

Nelson, Brian C.

2007-02-01

This study examines the patterns of use and potential impact of individualized, reflective guidance in an educational Multi-User Virtual Environment (MUVE). A guidance system embedded within a MUVE-based scientific inquiry curriculum was implemented with a sample of middle school students in an exploratory study investigating (a) whether access to the guidance system was associated with improved learning, (b) whether students viewing more guidance messages saw greater improvement on content tests than those viewing less, and (c) whether there were any differences in guidance use among boys and girls. Initial experimental findings showed that basic access to individualized guidance used with a MUVE had no measurable impact on learning. However, post-hoc exploratory analyses indicated that increased use of the system among those with access to it was positively associated with content test score gains. In addition, differences were found in overall learning outcomes by gender and in patterns of guidance use by boys and girls, with girls outperforming boys across a spectrum of guidance system use. Based on these exploratory findings, the paper suggests design guidelines for the development of guidance systems embedded in MUVEs and outlines directions for further research.

Sustained Assessment Metadata as a Pathway to Trustworthiness of Climate Science Information

NASA Astrophysics Data System (ADS)

Champion, S. M.; Kunkel, K.

2017-12-01

The Sustained Assessment process has produced a suite of climate change reports: The Third National Climate Assessment (NCA3), Regional Surface Climate Conditions in CMIP3 and CMIP5 for the United States: Differences, Similarities, and Implications for the U.S. National Climate Assessment, Impacts of Climate Change on Human Health in the United States: A Scientific Assessment, The State Climate Summaries, as well as the anticipated Climate Science Special Report and Fourth National Climate Assessment. Not only are these groundbreaking reports of climate change science, they are also the first suite of climate science reports to provide access to complex metadata directly connected to the report figures and graphics products. While the basic metadata documentation requirement is federally mandated through a series of federal guidelines as a part of the Information Quality Act, Sustained Assessment products are also deemed Highly Influential Scientific Assessments, which further requires demonstration of the transparency and reproducibility of the content. To meet these requirements, the Technical Support Unit (TSU) for the Sustained Assessment embarked on building a system for not only collecting and documenting metadata to the required standards, but one that also provides consumers unprecedented access to the underlying data and methods. As our process and documentation have evolved, the value of both continue to grow in parallel with the consumer expectation of quality, accessible climate science information. This presentation will detail the how the TSU accomplishes the mandated requirements with their metadata collection and documentation process, as well as the technical solution designed to demonstrate compliance while also providing access to the content for the general public. We will also illustrate how our accessibility platforms guide consumers through the Assessment science at a level of transparency that builds trust and confidence in the report content.

Comparison of the nutrient content of children's menu items at US restaurant chains, 2010-2014.

PubMed

Deierlein, Andrea L; Peat, Kay; Claudio, Luz

2015-08-15

To determine changes in the nutritional content of children's menu items at U.S. restaurant chains between 2010 and 2014. The sample consisted of 13 sit down and 16 fast-food restaurant chains ranked within the top 50 US chains in 2009. Nutritional information was accessed in June-July 2010 and 2014. Descriptive statistics were calculated for nutrient content of main dishes and side dishes, as well as for those items that were added, removed, or unchanged during the study period. Nutrient content of main dishes did not change significantly between 2010 and 2014. Approximately one-third of main dishes at fast-food restaurant chains and half of main dishes at sit down restaurant chains exceeded the 2010 Dietary Guidelines for Americans recommended levels for sodium, fat, and saturated fat in 2014. Improvements in nutrient content were observed for side dishes. At sit down restaurant chains, added side dishes contained over 50% less calories, fat, saturated fat, and sodium, and were more likely to contain fruits/vegetables compared to removed sides (p < 0.05 for all comparisons). Added side dishes at fast-food restaurant chains contained less saturated fat (p < 0.05). The majority of menu items, especially main dishes, available to children still contain high amounts of calories, fat, saturated fat, and sodium. Efforts must be made by the restaurant industry and policy makers to improve the nutritional content of children's menu items at restaurant chains to align with the Dietary Guidelines for Americans. Additional efforts are necessary to help parents and children make informed choices when ordering at restaurant chains.

Implementation of national body contouring surgery guidelines following massive weight loss: A national cross-sectional survey of commissioning in England.

PubMed

Dunne, Jonathan A; Wormald, Justin C R; Ghedia, Reshma; Soldin, Mark

2017-01-01

National guidelines for commissioning of body contouring surgery (BCS) following massive weight loss (MWL) in England were published in 2014. Nearly three-quarters of patients who have MWL seek BCS; however, access is known to vary according to the region. The aim of national guidelines was to standardise access. The purpose of this study was to determine implementation of the national guidelines by clinical commissioning groups (CCGs) in England. A cross-sectional, web-based survey was sent to all CCG chairs in England. Of 211 potential respondents, 108 completed the survey or provided funding guidelines (response rate = 52%). Eight CCGs (7%) had implemented the guidelines. A total of 69 CCGs were aware of the new guidelines (64%), and 66 CCGs stated that they fund BCS after MWL (61%). A total of 81 CCGs (75%) identified local funding guidelines, while 15 CCGs (14%) cited individual funding requests (IFRs) as the means of accessing funding. To improve patient access to BCS; 58 of 65 respondents (89%) stated cost-effectiveness, whereas 56 of 75 respondents (75%) thought patient-reported outcome measures were key. Qualitative data to improve access included an integrated pathway from bariatric surgery to BCS, an improved evidence base and greater CCG finances. One CCG stated that it cannot afford to fund cosmetic procedures. The purpose of national guidelines was to simplify the pathway to BCS after MWL and create fair distribution of funds across the country to needy patients; however, their uptake has been poor. Access to funding for BCS across England varies according to the location. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A Qualitative Study of Provider Perceptions of Influences on Uptake of Pediatric Hospital Guidelines in Lao PDR.

PubMed

Gray, Amy Z; Soukaloun, Douangdao; Soumphonphakdy, Bandith

2017-08-01

Strategies to improve the quality of hospital care are needed if ongoing gains in child health and survival are to be made. We previously reported on improvements in the quality of case management in hospitals following a guideline-based intervention in Lao PDR, with variation in the degree of change achieved between clinical conditions. This study aims to understand the factors that influenced the uptake of the guideline-based intervention, and its impact on care. This qualitative study was embedded in a mixed-methods evaluation of guideline implementation in nine hospitals in Lao PDR. Focus groups and individual interviews were conducted with 70 health staff from central, provincial, and district hospitals. The interview guide was based on the Theoretical Domains Framework. Inductive content analysis was performed on interview transcripts to identify themes, supported by field notes from the intervention. Findings were triangulated against previously reported quantitative outcomes using driver diagrams. Key influences on guidelines uptake related to the guideline and intervention (filling a void, physical accessibility, comprehensibility, training in guideline use), health staff (behavior regulation, trust in guidelines, and beliefs about consequences), and the environment (social influences particularly consensus and incorporation into clinical norms). The major barrier was family preference for treatments in conflict with guideline recommendations. This study identifies contextual factors that explain, as well as validate previously identified improvements in care following guideline implementation in Lao PDR. It provides novel understanding of why the same intervention may have a differential impact on different clinical conditions.

Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles. Final rule.

PubMed

2016-12-14

The Architectural and Transportation Barriers Compliance Board (Access Board or Board) is issuing a final rule that revises its existing accessibility guidelines for non-rail vehicles--namely, buses, over-the-road buses, and vans--acquired or remanufactured by entities covered by the Americans with Disabilities Act. The revised guidelines ensure that such vehicles are readily accessible to, and usable by, individuals with disabilities. The U.S. Department of Transportation (DOT) is required to revise its accessibility standards for transportation vehicles acquired or remanufactured by entities covered by the Americans with Disabilities Act (ADA) to be consistent with the final rule.

Computer-Based Access to Patient Care Guidelines

PubMed Central

Oliver, Diane E.; Estey, Greg; Ford, Penny; Burke, Sheila M.; Teplick, Richard S.; Zielstorff, Rita D.; Barnett, G. Octo

1990-01-01

As health care becomes more complex and expensive, interest in the potential benefits of developing and implementing patient care guidelines has emerged. We propose that a hypertext-based system designed to deal with patient-specific problems can provide a valuable method of access to such guidelines. Because intensive care medicine is one area which has become extraordinarily complex in recent years, we have chosen this as an area in which the need exists for readily accessible expertise. More specifically, in this project we are focusing on the development and implementation of guidelines for troubleshooting problems associated with the of a pulmonary artery catheter.

The Effectiveness of a Computer-Tailored E-Learning Program for Practice Nurses to Improve Their Adherence to Smoking Cessation Counseling Guidelines: Randomized Controlled Trial.

PubMed

de Ruijter, Dennis; Candel, Math; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2018-05-22

Improving practice nurses' (PN) adherence to smoking cessation counseling guidelines will benefit the quality of smoking cessation care and will potentially lead to higher smoking abstinence rates. However, support programs to aid PNs in improving their guideline uptake and adherence do not exist yet. The aim of this study was to assess the effects of a novel computer-tailored electronic learning (e-learning) program on PNs' smoking cessation guideline adherence. A Web-based randomized controlled trial (RCT) was conducted in which an intervention group (N=147) with full access to the e-learning program for 6 months was compared with a control group (N=122) without access. Data collection was fully automated at baseline and 6-month follow-up via online questionnaires, assessing PNs' demographics, work-related factors, potential behavioral predictors based on the I-Change model, and guideline adherence. PNs also completed counseling checklists to retrieve self-reported counseling activities for each consultation with a smoker (N=1175). To assess the program's effectiveness in improving PNs' guideline adherence (ie, overall adherence and adherence to individual counseling guideline steps), mixed linear and logistic regression analyses were conducted, thus accommodating for the smokers being nested within PNs. Potential effect moderation by work-related factors and behavioral predictors was also examined. After 6 months, 121 PNs in the intervention group (82.3%, 121/147) and 103 in the control group (84.4%, 103/122) completed the follow-up questionnaire. Mixed linear regression analysis revealed that counseling experience moderated the program's effect on PNs' overall guideline adherence (beta=.589; 95% CI 0.111-1.068; P Holm-Bonferroni =.048), indicating a positive program effect on adherence for PNs with a more than average level of counseling experience. Mixed logistic regression analyses regarding adherence to individual guideline steps revealed a trend toward moderating effects of baseline levels of behavioral predictors and counseling experience. More specifically, for PNs with less favorable scores on behavioral predictors (eg, low baseline self-efficacy) and high levels of counseling experience, the program significantly increased adherence. Results from our RCT showed that among PNs with more than average counseling experience, the e-learning program resulted in significantly better smoking cessation guideline adherence. Experienced PNs might have been better able to translate the content of our e-learning program into practically applicable counseling strategies compared with less experienced colleagues. Less favorable baseline levels of behavioral predictors among PNs possibly contributed to this effect, as there was more room for improvement by consulting the tailored content of the e-learning program. To further substantiate the effectiveness of e-learning programs on guideline adherence by health care professionals (HCPs), it is important to assess how to support a wider range of HCPs. Netherlands Trial Register NTR4436; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4436 (Archived by WebCite at http://www.webcitation.org/6zJQuSRq0). ©Dennis de Ruijter, Math Candel, Eline Suzanne Smit, Hein de Vries, Ciska Hoving. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.05.2018.

78 FR 10110 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way; Shared Use Paths

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... guidelines would apply to the design, construction, and alteration of pedestrian facilities in the public... guidelines for the design, construction, and alteration of facilities covered by the Americans with... required to adopt accessibility standards for the design, construction, and alteration of facilities...

Americans with Disabilities Act: Accessibility Guidelines for Buildings and Facilities, Transportation Facilities, Transportation Vehicles.

ERIC Educational Resources Information Center

Architectural and Transportation Barriers Compliance Board, Washington, DC.

Guidelines are presented regarding accessibility to buildings and facilities, transportation facilities, and transportation vehicles by individuals with disabilities, under the Americans with Disabilities Act of 1990. These guidelines are to be applied during building design, construction, and alteration. Part 1 offers detailed facility…

A review of guidance on fish consumption in pregnancy: is it fit for purpose?

PubMed

Taylor, Caroline M; Emmett, Pauline M; Emond, Alan M; Golding, Jean

2018-03-26

Public health messages to reduce Hg exposure for pregnant women have focused exclusively on advice on fish consumption to limit Hg exposure, with little account being taken of the positive contribution of fish to nutritional quality. The aim of the present review was to compare and contrast the content and presentation of national guidelines on fish consumption in pregnancy, and comment on their evidence base and impact on consumption. We searched for national and international guidelines on fish consumption in pregnancy using Internet search strategies. The detailed content and style of presentation of the guidelines were compared. The evidence base for the guidelines, and evidence for the impact of the guidelines on fish consumption levels, were assessed. We identified nineteen national guidelines and three international guidelines. There was great variation in the content, complexity and presentation style. The guidelines were based largely on the Hg content of fish with far less consideration being given to the positive beneficial effects of nutrients provided by fish. The complexity of the guidelines may lead to pregnant women reducing their fish intake, or not eating fish at all. Guidelines on fish consumption in pregnancy should take the beneficial effects of fish into account. Guidelines need to be clear and memorable, and appropriately disseminated, to achieve impact. Guidelines could include visual rather than narrative content. Use of technology, for example apps, could enable women to record their fish consumption in real time and log compliance with guidance over a week or other time period.

Investigating the use of NICE guidelines and IAPT services in the treatment of depression

PubMed Central

2012-01-01

Background There is evidence that the National Institute for Health and Clinical Excellence (NICE) guidelines for mental health disorders are used to varying degrees in primary care. A lack of access to cognitive–behavioural therapy (CBT) has been found to be a barrier to their implementation. The Improving Access to Psychological Therapies (IAPT) initiative was created in 2007 to increase the availability of NICE-recommended psychological treatments for depression and anxiety disorders within the National Health Service in England. Aim This study aims to investigate whether general practitioners (GPs) who have access to IAPT services and use NICE guidelines are more likely to use NICE concordant treatments for depression than those who do not. Depression was chosen as it is the most common mental health problem facing primary care physicians. Method Questionnaires were sent to 830 GPs in southeast England and six GPs were interviewed. The response rate to the questionnaires was 27% (n = 222). Results Ninety-five per cent of GPs were aware of the NICE guidelines for depression, and 76% had read them. Concordance with the guidelines was significantly higher when GPs had access to a local IAPT service or had read the NICE guidelines. Conclusions The interviews revealed favourable views to IAPT services when used, although access to treatments was still a common barrier to the implementation of the NICE guidelines for depression. PMID:23997821

78 FR 44311 - Unified Agenda of Federal Regulatory and Deregulatory Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

... Identifier No. 235 Americans With 3014-AA11 Disabilities Act (ADA) Accessibility Guidelines for Passenger... (ATBCB) Long-Term Actions 235. Americans With Disabilities Act (Ada) Accessibility Guidelines for... vessels covered by the Americans With Disabilities Act (ADA) are accessible to and usable by individuals...

EBMPracticeNet: A Bilingual National Electronic Point-Of-Care Project for Retrieval of Evidence-Based Clinical Guideline Information and Decision Support

PubMed Central

2013-01-01

Background In Belgium, the construction of a national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, health care providers, evidence-based medicine (EBM) partners, and vendors of electronic health records (EHR) is unique to this project. All Belgian health care professionals get free access to an up-to-date database of validated Belgian and nearly 1000 international guidelines, incorporated in a portal that also provides EBM information from other sources than guidelines, including computerized clinical decision support that is integrated in the EHRs. Objective The objective of this paper was to describe the development strategy, the overall content, and the management of EBMPracticeNet which may be of relevance to other health organizations creating national or regional electronic point-of-care information services. Methods Several candidate providers of comprehensive guideline solutions were evaluated and one database was selected. Translation of the guidelines to Dutch and French was done with translation software, post-editing by translators and medical proofreading. A strategy is determined to adapt the guideline content to the Belgian context. Acceptance of the computerized clinical decision support tool has been tested and a randomized controlled trial is planned to evaluate the effect on process and patient outcomes. Results Currently, EBMPracticeNet is in "work in progress" state. Reference is made to the results of a pilot study and to further planned research including a randomized controlled trial. Conclusions The collaboration of government, health care providers, EBM partners, and vendors of EHRs is unique. The potential value of the project is great. The link between all the EHRs from different vendors and a national database held on a single platform that is controlled by all EBM organizations in Belgium are the strengths of EBMPracticeNet. PMID:23842038

Privacy and health in the information age: a content analysis of health web site privacy policy statements.

PubMed

Rains, Stephen A; Bosch, Leslie A

2009-07-01

This article reports a content analysis of the privacy policy statements (PPSs) from 97 general reference health Web sites that was conducted to examine the ways in which visitors' privacy is constructed by health organizations. PPSs are formal documents created by the Web site owner to describe how information regarding site visitors and their behavior is collected and used. The results show that over 80% of the PPSs in the sample indicated automatically collecting or requesting that visitors voluntarily provide information about themselves, and only 3% met all five of the Federal Trade Commission's Fair Information Practices guidelines. Additionally, the results suggest that the manner in which PPSs are framed and the use of justifications for collecting information are tropes used by health organizations to foster a secondary exchange of visitors' personal information for access to Web site content.

[Cancer pain management: Systematic review and critical appraisal of clinical practice guidelines].

PubMed

Martínez-Nicolás, I; Ángel-García, D; Saturno, P J; López-Soriano, F

2016-01-01

Although several clinical practice guidelines have been developed in the last decades, cancer pain management is still deficient. The purpose of this work was to carry out a comprehensive and systematic literature review of current clinical practice guidelines on cancer pain management, and critically appraise their methodology and content in order to evaluate their quality and validity to cope with this public health issue. A systematic review was performed in the main databases, using English, French and Spanish as languages, from 2008 to 2013. Reporting and methodological quality was rated with the Appraisal of Guidelines, Research and Evaluation II (AGREE-II) tool, including an inter-rater reliability analysis. Guideline recommendations were extracted and classified into several categories and levels of evidence, aiming to analyse guidelines variability and evidence-based content comprehensiveness. Six guidelines were included. A wide variability was found in both reporting and methodological quality of guidelines, as well as in the content and the level of evidence of their recommendations. The Scottish Intercollegiate Guidelines Network guideline was the best rated using AGREE-II, while the Sociedad Española de Oncología Médica guideline was the worst rated. The Ministry of Health Malaysia guideline was the most comprehensive, and the Scottish Intercollegiate Guidelines Network guideline was the second one. The current guidelines on cancer pain management have limited quality and content. We recommend Ministry of Health Malaysia and Scottish Intercollegiate Guidelines Network guidelines, whilst Sociedad Española de Oncología Médica guideline still needs to improve. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Improved access to life insurance after genetic diagnosis of familial hypercholesterolaemia: cross-sectional postal questionnaire study

PubMed Central

Huijgen, Roeland; Homsma, Sietske JM; Hutten, Barbara A; Kindt, Iris; Vissers, Maud N; Kastelein, John JP; van Rijckevorsel, Jan LA

2012-01-01

A decade ago, in the initial stage of genetic testing for familial hypercholesterolaemia (FH) in The Netherlands, it was reported that such screening decreased access to affordable life insurance for mutation carriers. In 2003, in order to improve access to insurance for FH mutation carriers, insurers agreed to underwrite according to a set of guidelines. In this cross-sectional study, we assessed whether access to insurance has improved since the advent of these guidelines. We approached 2825 subjects that had participated in the genetic testing for FH between 1998 and 2003. We compared unconditional acceptance rates before and after FH diagnosis and before and after the guidelines were issued by means of logistic regression analysis. Our study outcome pertains to 414 FH patients who applied for life insurance. Unconditional acceptance of a policy before DNA diagnosis and before the issue of guidelines occurred in 182 out of 255 (71%) cases, versus 27 out of 35 (77%) cases after DNA diagnosis, but before the issue of guidelines. De facto, 107 out of 124 (86%) patients received unconditional acceptance after DNA diagnosis and after the issue of guidelines (P for trend=0.002). Access to life insurance improved for FH patients after molecular diagnosis and it improved even further after the guidelines were issued. Therefore, we argue that limited access to life insurance on the basis of ‘DNA discrimination' is no longer a valid argument against genetic cascade testing for FH, at least not in our country. PMID:22293687

78 FR 1622 - Unified Agenda of Federal Regulatory and Deregulatory Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-08

... Identifier No. 370 Americans With 3014-AA11 Disabilities Act (ADA) Accessibility Guidelines for Passenger... Stage 370. Americans with Disabilities Act (ADA) Accessibility Guidelines for Passenger Vessels...

Social networking profiles and professionalism issues in residency applicants: an original study-cohort study.

PubMed

Ponce, Brent A; Determann, Jason R; Boohaker, Hikel A; Sheppard, Evan; McGwin, Gerald; Theiss, Steven

2013-01-01

To determine the frequency of social networking, the degree of information publicly disclosed, and whether unprofessional content was identified in applicants from the 2010 Residency Match. Medical professionalism is an essential competency for physicians to learn, and information found on social networking sites may be hazardous to the doctor-patient relationship and an institution's public perception. No study has analyzed the social network content of applicants applying for residency. Online review of social networking Facebook profiles of graduating medical students applying for a residency in orthopedic surgery. Evidence of unprofessional content was based upon Accreditation Council for Graduate Medical Education guidelines. Additional recorded applicant data included as follows: age, United States Medical Licensing Examination part I score, and residency composite score. Relationship between professionalism score and recorded data points was evaluated using an analysis of variance. Nearly half of all applicants, 46% (200/431), had a Facebook profile. The majority of profiles (85%) did not restrict online access to their profile. Unprofessional content was identified in 16% of resident applicant profiles. Variables associated with lower professionalism scores included unmarried relationship status and lower residency composite scores. It is critical for healthcare professionals to recognize both the benefits and risks present with electronic communication and to vigorously protect the content of material allowed to be publically accessed through the Internet. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

78 FR 69793 - Voluntary Remedial Actions and Guidelines for Voluntary Recall Notices

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

... (Commission, CPSC, or we) proposes an interpretive rule to set forth principles and guidelines for the content... setting forth the Commission's principles and guidelines regarding the content of voluntary recall notices..., ``Principles and Guidelines for Voluntary Recall Notices,'' in part 1115 of title 16 of the Code of Federal...

Enhancement of a Virtual Reality Wheelchair Simulator to Include Qualitative and Quantitative Performance Metrics

ERIC Educational Resources Information Center

Harrison, C. S.; Grant, P. M.; Conway, B. A.

2010-01-01

The increasing importance of inclusive design and in particular accessibility guidelines established in the U.K. 1996 Disability Discrimination Act (DDA) has been a prime motivation for the work on wheelchair access, a subset of the DDA guidelines, described in this article. The development of these guidelines mirrors the long-standing provisions…

Standardization of search methods for guideline development: an international survey of evidence-based guideline development groups.

PubMed

Deurenberg, Rikie; Vlayen, Joan; Guillo, Sylvie; Oliver, Thomas K; Fervers, Beatrice; Burgers, Jako

2008-03-01

Effective literature searching is particularly important for clinical practice guideline development. Sophisticated searching and filtering mechanisms are needed to help ensure that all relevant research is reviewed. To assess the methods used for the selection of evidence for guideline development by evidence-based guideline development organizations. A semistructured questionnaire assessing the databases, search filters and evaluation methods used for literature retrieval was distributed to eight major organizations involved in evidence-based guideline development. All of the organizations used search filters as part of guideline development. The medline database was the primary source accessed for literature retrieval. The OVID or SilverPlatter interfaces were used in preference to the freely accessed PubMed interface. The Cochrane Library, embase, cinahl and psycinfo databases were also frequently used by the organizations. All organizations reported the intention to improve and validate their filters for finding literature specifically relevant for guidelines. In the first international survey of its kind, eight major guideline development organizations indicated a strong interest in identifying, improving and standardizing search filters to improve guideline development. It is to be hoped that this will result in the standardization of, and open access to, search filters, an improvement in literature searching outcomes and greater collaboration among guideline development organizations.

Physicians’ Perspectives on the Uncertainties and Implications of Chromosomal Microarray Testing of Children and Families

PubMed Central

Reiff, Marian; Ross, Kathryn; Mulchandani, Surabhi; Propert, Kathleen Joy; Pyeritz, Reed E.; Spinner, Nancy B.; Bernhardt, Barbara A.

2012-01-01

Chromosomal microarray analysis (CMA) has improved the diagnostic rate of genomic disorders in pediatric populations, but can produce uncertain and unexpected findings. This paper explores clinicians’ perspectives and identifies challenges in effectively interpreting results and communicating with families about CMA. Responses to an online survey were obtained from 40 clinicians who had ordered CMA. Content included practice characteristics and perceptions, and queries about a hypothetical case involving uncertain and incidental findings. Data were analyzed using non-parametric statistical tests. Clinicians’ comfort levels differed significantly for explaining uncertain, abnormal, and normal CMA results, with lowest levels for uncertain results. Despite clinical guidelines recommending informed consent, many clinicians did not consider it pertinent to discuss the potential for CMA to reveal information concerning biological parentage or predisposition to late-onset disease, in a hypothetical case. Many non-genetics professionals ordering CMA did not feel equipped to interpret the results for patients, and articulated needs for education and access to genetics professionals. This exploratory study highlights key challenges in the practice of genomic medicine, and identifies needs for education, disseminated practice guidelines, and access to genetics professionals, especially when dealing with uncertain or unexpected findings. PMID:22989118

Alcohol Marketing on Twitter and Instagram: Evidence of Directly Advertising to Youth/Adolescents.

PubMed

Barry, Adam E; Bates, Austin M; Olusanya, Olufunto; Vinal, Cystal E; Martin, Emily; Peoples, Janiene E; Jackson, Zachary A; Billinger, Shanaisa A; Yusuf, Aishatu; Cauley, Daunte A; Montano, Javier R

2016-07-01

Assess whether alcohol companies restrict youth/adolescent access, interaction, and exposure to their marketing on Twitter and Instagram. Employed five fictitious male and female Twitter (n = 10) and Instagram (n = 10) user profiles aged 13, 15, 17, 19 and/or 21. Using cellular smartphones, we determined whether profiles could (a) interact with advertising content-e.g. retweet, view video or picture content, comment, share URL; and/or (b) follow and directly receive advertising material updates from the official Instagram and Twitter pages of 22 alcohol brands for 30 days. All user profiles could fully access, view, and interact with alcohol industry content posted on Instagram and Twitter. Twitter's age-gate, which restricts access for those under 21, successfully prevented underage profiles from following and subsequently receiving promotional material/updates. The two 21+ profiles collectively received 1836 alcohol-related tweets within 30 days. All Instagram profiles, however, were able to follow all alcohol brand pages and received an average of 362 advertisements within 30 days. The quantity of promotional updates increased throughout the week, reaching their peak on Thursday and Friday. Representatives/controllers of alcohol brand Instagram pages would respond directly to our underage user's comments. The alcohol industry is in violation of their proposed self-regulation guidelines for digital marketing communications on Instagram. While Twitter's age-gate effectively blocked direct to phone updates, unhindered access to post was possible. Everyday our fictitious profiles, even those as young as 13, were bombarded with alcohol industry messages and promotional material directly to their smartphones. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Content, Accessibility, and Dissemination of Disaster Information via Social Media During the 2016 Louisiana Floods.

PubMed

Scott, Katherine K; Errett, Nicole A

Social media is becoming increasingly integrated into disaster response communication strategies of public health and emergency response agencies. We sought to assess the content, accessibility, and dissemination of social media communications made by government agencies during a disaster response. A cross-sectional analysis of social media posts made by federal, state, and local government, public health and emergency management agencies before, during, and after the 2016 Louisiana floods was conducted to determine their content, accessibility, and dissemination by level of government and time relative to disaster onset. Facebook and/or Twitter posts made by public agencies involved in the response to the 2016 Louisiana Flooding events (FEMA Disaster Declaration [DR-4277]) published between August 4 and September 16, 2016, publicly available online between February 21 and March 31, 2017, were included in the analysis. Content: The text of each post was assessed to determine whether it contained information on provision of situational awareness; addressing misconception, actionable requests; mental, behavioral, and emotional support; and/or recovery and rebuilding resources. Accessibility: A Flesh-Kincaid grade level of each post was calculated, and information on post language, originality, hyperlinks, visuals, videos, or hash tag was recorded. Dissemination: The average number of reacts/likes, shares/retweets, and comments per post was calculated. Most posts contained information related to situational awareness and recovery resources. There was an increase in messages during the first week of the disaster at all levels. Few posts were made in languages other than English. Compared with state and federal posts, local Facebook posts averaged fewer reacts, comments, and shares throughout the analysis period. Government agencies may maximize the use of social media platforms for disaster communications by establishing their social media network in advance of a disaster and by applying established guidelines on disaster social media use.

Sharing with More Caring: Coordinating and Improving the Ethical Governance of Data and Biomaterials Obtained from Children.

PubMed

Longstaff, Holly; Khramova, Vera; Portales-Casamar, Elodie; Illes, Judy

2015-01-01

Research on complex health conditions such as neurodevelopmental disorders increasingly relies on large-scale research and clinical studies that would benefit from data sharing initiatives. Organizations that share data stand to maximize the efficiency of invested research dollars, expedite research findings, minimize the burden on the patient community, and increase citation rates of publications associated with the data. This study examined ethics and governance information on websites of databases involving neurodevelopmental disorders to determine the availability of information on key factors crucial for comprehension of, and trust and participation in such initiatives. We identified relevant databases identified using online keyword searches. Two researchers reviewed each of the websites and identified thematic content using principles from grounded theory. The content for each organization was interrogated using the gap analysis method. Sixteen websites from data sharing organizations met our inclusion criteria. Information about types of data and tissues stored, data access requirements and procedures, and protections for confidentiality were significantly addressed by data sharing organizations. However, special considerations for minors (absent from 63%), controls to check if data and tissues are being submitted (absent from 81%), disaster recovery plans (absent from 81%), and discussions of incidental findings (absent from 88%) emerged as major gaps in thematic website content. When present, content pertaining to special considerations for youth, along with other ethics guidelines and requirements, were scattered throughout the websites or available only from associated documents accessed through live links. The complexities of sharing data acquired from children and adolescents will only increase with advances in genomic and neuro science. Our findings suggest that there is a need to improve the consistency, depth and accessibility of governance and policies on which these collaborations can lean specifically for vulnerable young populations.

DynaMed Plus®: An Evidence-Based Clinical Reference Resource.

PubMed

Charbonneau, Deborah H; James, LaTeesa N

2018-01-01

DynaMed Plus ® from EBSCO Health is an evidence-based tool that health professionals can use to inform clinical care. DynaMed Plus content undergoes a review process, and the evidence is synthesized in detailed topic overviews. A unique three-level rating scale is used to assess the quality of available evidence. Topic overviews summarize current evidence and provide recommendations to support health providers at the point-of-care. Additionally, DynaMed Plus content can be accessed via a desktop computer or mobile platforms. Given this, DynaMed Plus can be a time-saving resource for health providers. Overall, DynaMed Plus provides evidence summaries using an easy-to-read bullet format, and the resource incorporates images, clinical calculators, patient handouts, and practice guidelines in one place.

[Essential competencies in training in obstetrics].

PubMed

Duarte, Sebastião Junior Henrique; Machado, Richardson Miranda

2016-11-01

Analyze international reports related to training in obstetrics and present guidelines to help leading educational institutions to develop curriculum guidelines for the teaching of obstetrics and advanced nursing practice in this specialty. A narrative review was conducted of documents from the World Health Organization and the International Confederation of Midwives. The search used the descriptors midwifery and education. All official reports that guide midwife education policies, published from 2009 to 2015 in English and Spanish, and available online, were included. Reports that did not specifically refer to training were excluded. Five reports were selected. Analysis and synthesis of their respective objectives and contents were based on three themes: requirements for professional qualification, continuing education, and guidelines for skilled training in obstetrics, taking into account accepted core competencies for this specialty. Analysis of reports related to training in obstetrics identified that key tasks are being implemented for both educators and midwives. The reports represent a solid basis to develop educational policies that can contribute to universal access and coverage in health and to reducing maternal and neonatal mortality, and potentially can be used to guide international policies.

Healthcare professionals' and policy makers' views on implementing a clinical practice guideline of hypertension management: a qualitative study.

PubMed

Lee, Ping Yein; Liew, Su May; Abdullah, Adina; Abdullah, Nurdiana; Ng, Chirk Jenn; Hanafi, Nik Sherina; Chia, Yook Chin; Lai, Pauline S M; Wong, Stalia S L; Khoo, Ee Ming

2015-01-01

Most studies have reported barriers to guideline usage mainly from doctors' perspective; few have reported the perspective of other stakeholders. This study aimed to determine the views and barriers to adherence of a national clinical practice guideline (CPG) on management of hypertension from the perspectives of policymakers, doctors and allied healthcare professionals. This study used a qualitative approach with purposive sampling. Seven in depth interviews and six focus group discussions were conducted with 35 healthcare professionals (policy makers, doctors, pharmacists and nurses) at a teaching hospital in Kuala Lumpur, Malaysia, between February and June 2013. All interviews were audio-recorded, transcribed verbatim and checked. Thematic approach was used to analyse the data. Two main themes and three sub-themes emerged from this study. The main themes were (1) variation in the use of CPG and (2) barriers to adherence to CPG. The three sub-themes for barriers were issues inherent to the CPG, systems and policy that is not supportive of CPG use, and attitudes and behaviour of stakeholders. The main users of the CPG were the primary care doctors. Pharmacists only partially use the guidelines, while nurses and policy makers were not using the CPG at all. Participants had suggested few strategies to improve usage and adherence to CPG. First, update the CPG regularly and keep its content simple with specific sections for allied health workers. Second, use technology to facilitate CPG accessibility and provide protected time for implementation of CPG recommendations. Third, incorporate local CPG in professional training, link CPG adherence to key performance indicators and provide incentives for its use. Barriers to the use of CPG hypertension management span across all stakeholders. The development and implementation of CPG focused mainly on doctors with lack of involvement of other healthcare stakeholders. Guidelines should be made simple, current, reliable, accessible, inclusive of all stakeholders and with good policy support.

Adolescents and access to health care.

PubMed Central

Klein, J. D.; Slap, G. B.; Elster, A. B.; Cohn, S. E.

1993-01-01

The developmental characteristics and health behaviors of adolescents make the availability of certain services--including reproductive health services, diagnosis and treatment of sexually transmitted disease, mental health and substance abuse counseling and treatment--critically important. Furthermore, to serve adolescents appropriately, services must be available in a wide range of health care settings, including community-based adolescent health, family planning and public health clinics, school-based and school-linked health clinics, physicians' offices, HMOs, and hospitals. National, authoritative content standards (for example, the American Medical Association's Guidelines for Adolescent Preventive Services (GAPS), a multispecialty, interdisciplinary guideline for a package of clinical preventive services for adolescents may increase the possibility that insurers will cover adolescent preventive services, and that these services will become part of health professionals' curricula and thus part of routine practice. However, additional and specific guidelines mandating specific services that must be available to adolescents in clinical settings (whether in schools or in communities) are also needed. Although local government, parents, providers, and schools must assume responsibility for ensuring that health services are available and accessible to adolescents, federal and state financing mandates are also needed to assist communities and providers in achieving these goals. The limitations in what even comprehensive programs currently are able to provide, and the dismally low rates of preventive service delivery to adolescents, suggests that adolescents require multiple points of access to comprehensive, coordinated services, and that preventive health interventions must be actively and increasingly integrated across health care, school, and community settings. Unless access issues are dealt with in a rational, coordinated fashion, America's adolescents will not have access to appropriate health services. Current efforts to minimize current health care expenditures through managed care programs inevitably conflict with efforts to deliver comprehensive preventive services to all adolescents. Use of multiple sites may not represent inadequate access to care. However, as managed care reimbursement continues to expand, school-based clinics and free-standing adolescent health programs increasingly report decreases in reimbursement without a change in demand for services. The Office of Technology Assessment study called for explicit funding and expansion of services for America's youth; since then, a federal Office of Adolescent Health has been authorized, and, by the time this reaches print, should have received appropriations and been staffed. Dryfoos has called for expansion to nearly 5000 comprehensive programs in the coming years.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:8148842

A Standardization Framework for Electronic Government Service Portals

NASA Astrophysics Data System (ADS)

Sarantis, Demetrios; Tsiakaliaris, Christos; Lampathaki, Fenareti; Charalabidis, Yannis

Although most eGovernment interoperability frameworks (eGIFs) cover adequately the technical aspects of developing and supporting the provision of electronic services to citizens and businesses, they do not exclusively address several important areas regarding the organization, presentation, accessibility and security of the content and the electronic services offered through government portals. This chapter extends the scope of existing eGIFs presenting the overall architecture and the basic concepts of the Greek standardization framework for electronic government service portals which, for the first time in Europe, is part of a country's eGovernment framework. The proposed standardization framework includes standards, guidelines and recommendations regarding the design, development and operation of government portals that support the provision of administrative information and services to citizens and businesses. By applying the guidelines of the framework, the design, development and operation of portals in central, regional and municipal government can be systematically addressed resulting in an applicable, sustainable and ever-expanding framework.

Considerations for Developing Interfaces for Collecting Patient-Reported Outcomes That Allow the Inclusion of Individuals With Disabilities

PubMed Central

Harniss, Mark; Amtmann, Dagmar; Cook, Debbie; Johnson, Kurt

2010-01-01

PROMIS (Patient-Reported Outcome Measurement Information System) is developing a set of tools for collecting patient reported outcomes, including computerized adaptive testing that can be administered using different modes, such as computers or phones. The user interfaces for these tools will be designed using the principles of universal design to ensure that it is accessible to all users, including those with disabilities. We review the rationale for making health assessment instruments accessible to users with disabilities, briefly review the standards and guidelines that exist to support developers in the creation of user interfaces with accessibility in mind, and describe the usability and accessibility testing PROMIS will conduct with content experts and users with and without disabilities. Finally, we discuss threats to validity and reliability presented by universal design principles. We argue that the social and practical benefits of interfaces designed to include a broad range of potential users, including those with disabilities, seem to outweigh the need for standardization. Suggestions for future research are also included. PMID:17443119

Evaluation of educational content of YouTube videos relating to neurogenic bladder and intermittent catheterization

PubMed Central

Ho, Matthew; Stothers, Lynn; Lazare, Darren; Tsang, Brian; Macnab, Andrew

2015-01-01

Introduction: Many patients conduct internet searches to manage their own health problems, to decide if they need professional help, and to corroborate information given in a clinical encounter. Good information can improve patients’ understanding of their condition and their self-efficacy. Patients with spinal cord injury (SCI) featuring neurogenic bladder (NB) require knowledge and skills related to their condition and need for intermittent catheterization (IC). Methods: Information quality was evaluated in videos accessed via YouTube relating to NB and IC using search terms “neurogenic bladder intermittent catheter” and “spinal cord injury intermittent catheter.” Video content was independently rated by 3 investigators using criteria based on European Urological Association (EAU) guidelines and established clinical practice. Results: In total, 71 videos met the inclusion criteria. Of these, 12 (17%) addressed IC and 50 (70%) contained information on NB. The remaining videos met inclusion criteria, but did not contain information relevant to either IC or NB. Analysis indicated poor overall quality of information, with some videos with information contradictory to EAU guidelines for IC. High-quality videos were randomly distributed by YouTube. IC videos featuring a healthcare narrator scored significantly higher than patient-narrated videos, but not higher than videos with a merchant narrator. About half of the videos contained commercial content. Conclusions: Some good-quality educational videos about NB and IC are available on YouTube, but most are poor. The videos deemed good quality were not prominently ranked by the YouTube search algorithm, consequently user access is less likely. Study limitations include the limit of 50 videos per category and the use of a de novo rating tool. Information quality in videos with healthcare narrators was not higher than in those featuring merchant narrators. Better material is required to improve patients’ understanding of their condition. PMID:26644803

Quality of Author Guidelines in Nursing Journals

PubMed Central

Nicoll, Leslie H.; Chinn, Peggy L.; Conklin, Jamie L.; McCarty, Midori; Amarasekara, Sathya

2018-01-01

Abstract Purpose The aims of this study were to (a) describe the information provided in author guidelines in nursing journals, (b) assess the completeness of this information, and (c) identify the extent and types of reporting guidelines used in nursing journals. Design Content analysis of author guidelines for 245 nursing journals included in the Directory of Nursing Journals maintained at the International Academy of Nursing Editors website. Methods Using Research Electronic Data Capture, data on 19 criteria for completeness were extracted from published author guidelines. Additional details about journal requirements, such as allowed length of manuscripts and format for the abstract, were also recorded. Reliability was established by simultaneous review of 25 journals (10%) by the research assistant and a senior member of the research team. Findings Author guidelines were easily accessible at journal websites or through links to download the information. A majority (73.5%) had completeness scores of 75% or higher; six journals had guidelines that were 100% complete. Half of the journals used the American Psychological Association reference style, and 26.3% used the American Medical Association style. Less than one fourth had stated requirements to use reporting guidelines such as Consolidated Standards of Reporting Trials (CONSORT) and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). Conclusions Author guidelines for nursing journals are generally complete and informative. Although specific reporting guidelines such as CONSORT and PRISMA improve the accuracy and completeness of manuscripts on various types of studies, most nursing journals do not indicate use of these for manuscript preparation. Editors who want to improve their author guidelines should use the 19 criteria for completeness as a gauge for updating and revision. Clinical Relevance Nurses rely on the published literature to inform their practice and ensure that it is based on evidence. Guidelines for publishing in the scholarly literature assist clinicians and scholars to ensure that published articles are complete, current, concise, and accurate. PMID:29645403

Quality of Author Guidelines in Nursing Journals.

PubMed

Oermann, Marilyn H; Nicoll, Leslie H; Chinn, Peggy L; Conklin, Jamie L; McCarty, Midori; Amarasekara, Sathya

2018-04-12

The aims of this study were to (a) describe the information provided in author guidelines in nursing journals, (b) assess the completeness of this information, and (c) identify the extent and types of reporting guidelines used in nursing journals. Content analysis of author guidelines for 245 nursing journals included in the Directory of Nursing Journals maintained at the International Academy of Nursing Editors website. Using Research Electronic Data Capture, data on 19 criteria for completeness were extracted from published author guidelines. Additional details about journal requirements, such as allowed length of manuscripts and format for the abstract, were also recorded. Reliability was established by simultaneous review of 25 journals (10%) by the research assistant and a senior member of the research team. Author guidelines were easily accessible at journal websites or through links to download the information. A majority (73.5%) had completeness scores of 75% or higher; six journals had guidelines that were 100% complete. Half of the journals used the American Psychological Association reference style, and 26.3% used the American Medical Association style. Less than one fourth had stated requirements to use reporting guidelines such as Consolidated Standards of Reporting Trials (CONSORT) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Author guidelines for nursing journals are generally complete and informative. Although specific reporting guidelines such as CONSORT and PRISMA improve the accuracy and completeness of manuscripts on various types of studies, most nursing journals do not indicate use of these for manuscript preparation. Editors who want to improve their author guidelines should use the 19 criteria for completeness as a gauge for updating and revision. Nurses rely on the published literature to inform their practice and ensure that it is based on evidence. Guidelines for publishing in the scholarly literature assist clinicians and scholars to ensure that published articles are complete, current, concise, and accurate. © 2018 The Authors. Journal of Nursing Scholarship published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

Diabetes prevention information in Japanese magazines with the largest print runs. Content analysis using clinical guidelines as a standard.

PubMed

Noda, Emi; Mifune, Taka; Nakayama, Takeo

2013-01-01

To characterize information on diabetes prevention appearing in Japanese general health magazines and to examine the agreement of the content with that in clinical practice guidelines for the treatment of diabetes in Japan. We used the Japanese magazines' databases provided by the Media Research Center and selected magazines with large print runs published in 2006. Two medical professionals independently conducted content analysis based on items in the diabetes prevention guidelines. The number of pages for each item and agreement with the information in the guidelines were determined. We found 63 issues of magazines amounting to 8,982 pages; 484 pages included diabetes prevention related content. For 23 items included in the diabetes prevention guidelines, overall agreement of information printed in the magazines with that in the guidelines was 64.5% (471 out of 730). The number of times these items were referred to in the magazines varied widely, from 247 times for food items to 0 times for items on screening for pregnancy-induced diabetes, dyslipidemia, and hypertension. Among the 20 items that were referred to at least once, 18 items showed more than 90% agreement with the guidelines. However, there was poor agreement for information on vegetable oil (2/14, 14%) and for specific foods (5/247, 2%). For the fatty acids category, "fat" was not mentioned in the guidelines; however, the term frequently appeared in magazines. "Uncertainty" was never mentioned in magazines for specific food items. The diabetes prevention related content in the health magazines differed from that defined in clinical practice guidelines. Most information in the magazines agreed with the guidelines, however some items were referred to inappropriately. To disseminate correct information to the public on diabetes prevention, health professionals and the media must collaborate.

The essence of the Japan Radiological Society/Japanese College of Radiology Imaging Guideline.

PubMed

Yamashita, Yasuyuki; Murayama, Sadayuki; Okada, Masahiro; Watanabe, Yoshiyuki; Kataoka, Masako; Kaji, Yasushi; Imamura, Keiko; Takehara, Yasuo; Hayashi, Hiromitsu; Ohno, Kazuko; Awai, Kazuo; Hirai, Toshinori; Kojima, Kazuyuki; Sakai, Shuji; Matsunaga, Naofumi; Murakami, Takamichi; Yoshimitsu, Kengo; Gabata, Toshifumi; Matsuzaki, Kenji; Tohno, Eriko; Kawahara, Yasuhiro; Nakayama, Takeo; Monzawa, Shuichi; Takahashi, Satoru

2016-01-01

Diagnostic imaging is undoubtedly important in modern medicine, and final clinical decisions are often made based on it. Fortunately, Japan has the highest numbers of diagnostic imaging instruments, such as CT and MRI devices, and boasts easy access to them as well as a high level of diagnostic accuracy. In consequence, a very large number of imaging examinations are performed, but diagnostic instruments are installed in so many medical facilities that expert management of these examinations tends to be insufficient. Particularly, in order to avoid risks, clinicians have recently become indifferent to indications of imaging modalities and tend to rely on CT or MRI resulting in increasing the number of imaging examinations in Japan. This is a serious problem from the viewpoints of avoidance of unnecessary exposure and medical economy. Under these circumstances, the Japan Radiological Society and Japanese College of Radiology jointly initiated the preparation of new guidelines for diagnostic imaging. However, the field of diagnostic imaging is extremely wide, and it is impossible to cover all diseases. Therefore, in drafting the guidelines, we selected important diseases and focused on "showing evidence and suggestions in the form of clinical questions (CQs)" concerning clinically encountered questions and "describing routine imaging techniques presently considered to be standards to guarantee the quality of imaging examinations". In so doing, we adhered to the basic principles of assuming the readers to be "radiologists specializing in diagnostic imaging", "simultaneously respecting the global standards and attending to the situation in Japan", and "making the guidelines consistent with those of other scientific societies related to imaging". As a result, the guidelines became the largest ever, consisting of 152 CQs, nine areas of imaging techniques, and seven reviews, but no other guidelines in the world summarize problems concerning diagnostic imaging in the form of CQs. In this sense, the guidelines are considered to reflect the abilities of diagnostic radiologists in Japan. The contents of the guidelines are essential knowledge for radiologists, but we believe that they are also of use to general clinicians and clinical radiological technicians. While the number and contents of CQs are still insufficient, and while chapters such as those on imaging in children and emergency imaging need to be supplemented, the guidelines will be serially improved through future revisions. Lastly, we would like to extend our sincere thanks to the 153 members of the drafting committee who authored the guidelines, 12 committee chairpersons who coordinated their efforts, six members of the secretariat, and affiliates of related scientific societies who performed external evaluation.

Challenges in developing national HIV guidelines: experience from the eastern Mediterranean

PubMed Central

De Weggheleire, Anja; Bortolotti, Veronique; Zolfo, Maria; Crowley, Siobhan; Colebunders, Robert; Riedner, Gabriele

2011-01-01

Abstract Objective To appraise the process of development and clinical content of national human immunodeficiency virus (HIV) clinical practice guidelines of countries in the eastern Mediterranean and to formulate recommendations for future guideline development and adaptation. Methods Twenty-three countries in the World Health Organization (WHO) Eastern Mediterranean and United Nations Children’s Fund Middle East and North Africa regions were invited to submit national HIV clinical practice guidelines for review. The guideline development methodology was assessed using an adaptation of the Appraisal of Guidelines Research and Evaluation (AGREE) instrument and guideline content, using a checklist to evaluate concordance with WHO 2006 generic guidelines. Findings Twelve countries submitted 20 guidelines developed between 2004 and 2009. Median scores were poor (i.e. < 0.6) for the methodological quality domains of rigour of development, stakeholder involvement and applicability and flexibility. Scores were better for the domains of scope and purpose (median: 0.82, interquartile range, IQR: 0.58–0.89) and clarity and presentation (median: 0.67, IQR: 0.50–0.78). Concerning guideline content, recommended first-line treatment and eligibility criteria for antiretroviral therapy (ART) in adults were in line with WHO recommendations in most guidelines. However, recommendations on antiretroviral prophylaxis for the prevention of vertical HIV transmission, diagnosis and treatment of HIV infection in infants, monitoring patients on ART, treatment failure and co-morbidities were often lacking. Conclusion The large majority of national HIV clinical practice guidelines had methodological weaknesses and content inaccuracies. Countries require assistance with the adaptation process to ensure that guidelines are valid and up to date and accurately reflect WHO global clinical care recommendations for patients with HIV. PMID:21673860

Healthier vending machines in workplaces: both possible and effective.

PubMed

Gorton, Delvina; Carter, Julie; Cvjetan, Branko; Ni Mhurchu, Cliona

2010-03-19

To develop healthier vending guidelines and assess their effect on the nutrient content and sales of snack products sold through hospital vending machines, and on staff satisfaction. Nutrition guidelines for healthier vending machine products were developed and implemented in 14 snack vending machines at two hospital sites in Auckland, New Zealand. The guidelines comprised threshold criteria for energy, saturated fat, sugar, and sodium content of vended foods. Sales data were collected prior to introduction of the guidelines (March-May 2007), and again post-introduction (March-May 2008). A food composition database was used to assess impact of the intervention on nutrient content of purchases. A staff survey was also conducted pre- and post-intervention to assess acceptability. Pre-intervention, 16% of staff used vending machines once a week or more, with little change post-intervention (15%). The guidelines resulted in a substantial reduction in the amount of energy (-24%), total fat (-32%), saturated fat (-41%), and total sugars (-30%) per 100 g product sold. Sales volumes were not affected, and the proportion of staff satisfied with vending machine products increased. Implementation of nutrition guidelines in hospital vending machines led to substantial improvements in nutrient content of vending products sold. Wider implementation of these guidelines is recommended.

Impact of electronic clinical decision support on adherence to guideline-recommended treatment for hyperlipidaemia, atrial fibrillation and heart failure: protocol for a cluster randomised trial

PubMed Central

Kessler, Maya Elizabeth; Cook, David A; Kor, Daryl Jon; McKie, Paul M; Pencille, Laurie J; Scheitel, Marianne R; Chaudhry, Rajeev

2017-01-01

Introduction Clinical practice guidelines facilitate optimal clinical practice. Point of care access, interpretation and application of such guidelines, however, is inconsistent. Informatics-based tools may help clinicians apply guidelines more consistently. We have developed a novel clinical decision support tool that presents guideline-relevant information and actionable items to clinicians at the point of care. We aim to test whether this tool improves the management of hyperlipidaemia, atrial fibrillation and heart failure by primary care clinicians. Methods/analysis Clinician care teams were cluster randomised to receive access to the clinical decision support tool or passive access to institutional guidelines on 16 May 2016. The trial began on 1 June 2016 when access to the tool was granted to the intervention clinicians. The trial will be run for 6 months to ensure a sufficient number of patient encounters to achieve 80% power to detect a twofold increase in the primary outcome at the 0.05 level of significance. The primary outcome measure will be the percentage of guideline-based recommendations acted on by clinicians for hyperlipidaemia, atrial fibrillation and heart failure. We hypothesise care teams with access to the clinical decision support tool will act on recommendations at a higher rate than care teams in the standard of care arm. Ethics and dissemination The Mayo Clinic Institutional Review Board approved all study procedures. Informed consent was obtained from clinicians. A waiver of informed consent and of Health Insurance Portability and Accountability Act (HIPAA) authorisation for patients managed by clinicians in the study was granted. In addition to publication, results will be disseminated via meetings and newsletters. Trial registration number NCT02742545. PMID:29208620

Teacher-Generated Final Exams in High School Science: Content, Rigor, and Assessment Literacy

NASA Astrophysics Data System (ADS)

Lach, Michael

This study investigates a large collection of teacher-generated end-of-semester final exams from Chicago Public School high school science classrooms in order to explore the depth and breadth of content that students learn in science classrooms. Teachers focus on a specific set of scientific content that is driven by district guidelines and popular textbooks but not particularly aligned to standards. To most teachers, rigor means coverage instead of intellectual press. The assessments, while unsophisticated, seem to be delivering what is expected of them---a way to mimic the most basic format of the ACT exam quickly. There was little variation among high poverty and low poverty schools, matching national data and indicating issues that are more due to a particular culture of science teaching and learning than driven by particular contexts. The study identifies implications for the observed homogeneity of final exam rigor and content, identifies gaps between how the routine of final exams are design and implemented in schools, and discusses similar methodological efforts that could enhance the ability of schools and districts to access useful information about the technical core of instruction.

77 FR 50068 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1192 [Docket No. ATBCB 2010-0004] RIN 3014-AA38 Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles AGENCY: Architectural and Transportation Barriers Compliance Board. ACTION: Notice of public...

78 FR 39649 - Passenger Vessels Accessibility Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-02

... ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1196 [Docket No. ATBCB-2013-0003] RIN 3014-AA11 Passenger Vessels Accessibility Guidelines Correction In proposed rule document 2013-14367, appearing on pages 38102- 38159 in the issue of Tuesday, June 25, 2013, make the following...

Do guidelines on euthanasia and physician-assisted suicide in Dutch hospitals and nursing homes reflect the law? A content analysis.

PubMed

Hesselink, B A M; Onwuteaka-Philipsen, B D; Janssen, A J G M; Buiting, H M; Kollau, M; Rietjens, J A C; Pasman, H R W

2012-01-01

To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process.

Task shifting and integration of HIV care into primary care in South Africa: The development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention

PubMed Central

2011-01-01

Background Task shifting and the integration of human immunodeficiency virus (HIV) care into primary care services have been identified as possible strategies for improving access to antiretroviral treatment (ART). This paper describes the development and content of an intervention involving these two strategies, as part of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) pragmatic randomised controlled trial. Methods: Developing the intervention The intervention was developed following discussions with senior management, clinicians, and clinic staff. These discussions revealed that the establishment of separate antiretroviral treatment services for HIV had resulted in problems in accessing care due to the large number of patients at ART clinics. The intervention developed therefore combined the shifting from doctors to nurses of prescriptions of antiretrovirals (ARVs) for uncomplicated patients and the stepwise integration of HIV care into primary care services. Results: Components of the intervention The intervention consisted of regulatory changes, training, and guidelines to support nurse ART prescription, local management teams, an implementation toolkit, and a flexible, phased introduction. Nurse supervisors were equipped to train intervention clinic nurses in ART prescription using outreach education and an integrated primary care guideline. Management teams were set up and a STRETCH coordinator was appointed to oversee the implementation process. Discussion Three important processes were used in developing and implementing this intervention: active participation of clinic staff and local and provincial management, educational outreach to train nurses in intervention sites, and an external facilitator to support all stages of the intervention rollout. The STRETCH trial is registered with Current Control Trials ISRCTN46836853. PMID:21810242

Precise definition of anonymization in genetic polymorphism studies.

PubMed

Hamajima, Nobuyuki; Atsuta, Yoshiko; Niwa, Yoshimitsu; Nishio, Kazuko; Tanaka, Daisuke; Yamamoto, Kazuhito; Tamakoshi, Akiko

2004-01-01

Anonymization is an essential tool to protect privacy of participants in epidemiological studies. This paper classifies types of anonymization in genetic polymorphism studies, providing precise definitions. They are: 1) unlinkable anonymization at enrollment without a participant list; 2) unlinkable anonymization before genotyping with a participant list; 3) linkable anonymization; 4) unlinkable anonymization for outsiders; and 5) linkable anonymization for outsiders. The classification in view of accessibility to a table including genotype data with directly identifiable data such as names is important; if such tables exist, staff may obtain genotype information about participants. The first three modes are defined here as anonymization unaccessible to genotype data with directly identifiable information for research staff. Anonymization with a key code held by participants is possible with any of the above anonymization modes, by which participants can access to their own genotypes through telephone or internet. A guideline issued on March 29, 2001 with collaboration of three Ministries in Japan defines "anonymization in a linkable fashion" and "anonymization in an unlinkable fashion", "for the purpose of preventing the personal information from being divulged externally in violation of law, the present guidelines or a research protocol", but the contents are not clear in practice. The proposed definitions will be useful when we describe and discuss the preferable mode of anonymization for a given polymorphism study.

School lunch: a comparison of the fat and cholesterol content with dietary guidelines.

PubMed

Whitaker, R C; Wright, J A; Finch, A J; Deyo, R A; Psaty, B M

1993-12-01

To compare the fat and cholesterol content of the foods offered and selected in an elementary school lunch program with current dietary guidelines. For 105 school days we recorded the food items selected by elementary school students in an entire school district (262,851 meals) who were given a choice between two entrees. The nutrient content of foods was assessed with a computerized nutrient data base supplemented by the food manufacturers' data. Sixteen elementary schools in the Bellevue (Washington) School District. The number of students eating school lunch averaged 2500 per day, of whom 25% were from households with incomes less than 185% of poverty. None. We determined the nutritional content of the average meal selected; the proportion of days when one of the two offered entrees met fat and cholesterol guidelines; and the proportion of children selecting the entrees that met the guidelines. The average lunch selected had 35.9% of calories from total fat and 12.6% from saturated fat, exceeding the guidelines of 30% and 10%, respectively. Lunch contained an average of 57 mg cholesterol (106 mg/1000 kcal) and met guidelines. One of the two daily entree choices met guidelines for both total fat and saturated fat on 20% of days, and met both fat and cholesterol guidelines on 14% of days. When available, entrees meeting the fat guidelines were chosen by 37% of students, and entrees meeting both fat and cholesterol guidelines were chosen by 34% of students. In this school district the average lunch selected did not meet the current guidelines for dietary fat; when given the choice, more than one third of students selected the entrees that met these guidelines.

36 CFR 1191.1 - Accessibility guidelines.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Accessibility guidelines. 1191.1 Section 1191.1 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS... to provide at least one automatic or power-assisted door complying with section 404.3 of ABAAS at...

Planning for Accessibility.

ERIC Educational Resources Information Center

Spoor, Dana L.

1997-01-01

Argues that barrier-free designs should be incorporated in the first steps of school facility planning to avoid the difficulties in meeting Americans with Disabilities Act (ADA) guidelines during renovations. Explains why not all barriers need be removed to make a facility accessible to everyone. Discusses issues involving ADA guidelines and child…

Spanish Clinical Guidelines on Vascular Access for Haemodialysis.

PubMed

Ibeas, José; Roca-Tey, Ramon; Vallespín, Joaquín; Moreno, Teresa; Moñux, Guillermo; Martí-Monrós, Anna; Del Pozo, José Luis; Gruss, Enrique; Ramírez de Arellano, Manel; Fontseré, Néstor; Arenas, María Dolores; Merino, José Luis; García-Revillo, José; Caro, Pilar; López-Espada, Cristina; Giménez-Gaibar, Antonio; Fernández-Lucas, Milagros; Valdés, Pablo; Fernández-Quesada, Fidel; de la Fuente, Natalia; Hernán, David; Arribas, Patricia; Sánchez de la Nieta, María Dolores; Martínez, María Teresa; Barba, Ángel

2017-11-01

Vascular access for haemodialysis is key in renal patients both due to its associated morbidity and mortality and due to its impact on quality of life. The process, from the creation and maintenance of vascular access to the treatment of its complications, represents a challenge when it comes to decision-making, due to the complexity of the existing disease and the diversity of the specialities involved. With a view to finding a common approach, the Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology [S.E.N.], vascular surgery [SEACV], vascular and interventional radiology [SERAM-SERVEI], infectious diseases [SEIMC] and nephrology nursing [SEDEN]), along with the methodological support of the Cochrane Center, has updated the Guidelines on Vascular Access for Haemodialysis, published in 2005. These guidelines maintain a similar structure, in that they review the evidence without compromising the educational aspects. However, on one hand, they provide an update to methodology development following the guidelines of the GRADE system in order to translate this systematic review of evidence into recommendations that facilitate decision-making in routine clinical practice, and, on the other hand, the guidelines establish quality indicators which make it possible to monitor the quality of healthcare. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Evidence flowers: An innovative, visual method of presenting "best evidence" summaries to health professional and lay audiences.

PubMed

Babatunde, O O; Tan, V; Jordan, J L; Dziedzic, K; Chew-Graham, C A; Jinks, C; Protheroe, J; van der Windt, D A

2018-06-01

Barriers to dissemination and engagement with evidence pose a threat to implementing evidence-based medicine. Understanding, retention, and recall can be enhanced by visual presentation of information. The aim of this exploratory research was to develop and evaluate the accessibility and acceptability of visual summaries for presenting evidence syntheses with multiple exposures or outcomes to professional and lay audiences. "Evidence flowers" were developed as a visual method of presenting data from 4 case scenarios: 2 complex evidence syntheses with multiple outcomes, Cochrane reviews, and clinical guidelines. Petals of evidence flowers were coloured according to the GRADE evidence rating system to display key findings and recommendations from the evidence summaries. Application of evidence flowers was observed during stakeholder workshops. Evaluation and feedback were conducted via questionnaires and informal interviews. Feedback from stakeholders on the evidence flowers collected from workshops, questionnaires, and interviews was encouraging and helpful for refining the design of the flowers. Comments were made on the content and design of the flowers, as well as the usability and potential for displaying different types of evidence. Evidence flowers are a novel and visually stimulating method for presenting research evidence from evidence syntheses with multiple exposures or outcomes, Cochrane reviews, and clinical guidelines. To promote access and engagement with research evidence, evidence flowers may be used in conjunction with other evidence synthesis products, such as (lay) summaries, evidence inventories, rapid reviews, and clinical guidelines. Additional research on potential adaptations and applications of the evidence flowers may further bridge the gap between research evidence and clinical practice. Copyright © 2018 John Wiley & Sons, Ltd.

False gold: Safely navigating open access publishing to avoid predatory publishers and journals.

PubMed

McCann, Terence V; Polacsek, Meg

2018-04-01

The aim of this study was to review and discuss predatory open access publishing in the context of nursing and midwifery and develop a set of guidelines that serve as a framework to help clinicians, educators and researchers avoid predatory publishers. Open access publishing is increasingly common across all academic disciplines. However, this publishing model is vulnerable to exploitation by predatory publishers, posing a threat to nursing and midwifery scholarship and practice. Guidelines are needed to help researchers recognize predatory journals and publishers and understand the negative consequences of publishing in them. Discussion paper. A literature search of BioMed Central, CINAHL, MEDLINE with Full Text and PubMed for terms related to predatory publishing, published in the period 2007-2017. Lack of awareness of the risks and pressure to publish in international journals, may result in nursing and midwifery researchers publishing their work in dubious open access journals. Caution should be taken prior to writing and submitting a paper, to avoid predatory publishers. The advantage of open access publishing is that it provides readers with access to peer-reviewed research as soon as it is published online. However, predatory publishers use deceptive methods to exploit open access publishing for their own profit. Clear guidelines are needed to help researchers navigate safely open access publishing. A deeper understanding of the risks of predatory publishing is needed. Clear guidelines should be followed by nursing and midwifery researchers seeking to publish their work in open access journals. © 2017 John Wiley & Sons Ltd.

AthenaTV: an authoring tool of educational applications for TV using android-based interface design patterns

NASA Astrophysics Data System (ADS)

Vásquez-Ramírez, Raquel; Alor-Hernández, Giner; Sánchez-Ramírez, Cuauhtémoc; Guzmán-Luna, Jaime; Zatarain-Cabada, Ramón; Barrón-Estrada, María-Lucía

2014-07-01

Education has become a key component of any society since it is the means by which humanity functions and governs itself. It allows individuals to appropriately integrate into a given community. For this reason, new ways of interaction between students and educational contents are emerging in order to improve the quality of education. In this context, devices such as computers, smartphones, or electronic tablets represent new ways of accessing educational resources which do not limit students to their usage merely inside the classroom since these devices are available anywhere. Nowadays, television has become one of these technological tools able to support the teaching-learning process through documentary films or movies, among others. However, two main issues appear. First, some of these educational contents are not those needed by a professor since information is restricted, and second, the development of TV-based applications requires an integrative approach involving the support of several specialists in education who provide the guidelines needed to build high-quality contents, as well as application designers and developers who are able to deliver the educational applications demanded by students. This work presents a system called AthenaTV to generate android-based educational applications for TV. AthenaTV takes into account the 10-foot design scheme used by Google to develop interfaces based on interface design patterns established in Google TV, and it is based on the android development guidelines and HTML5 standard.

Guidelines for Health Assessment and Intervention Techniques for 3, 4, and 5 Year Old Children.

ERIC Educational Resources Information Center

Bentley, Judy K.

These guidelines were developed to help registered nurses identify preschoolers with potential handicaps in the course of health assessments. Contents include guidelines on 3-, 4-, and 5-year-olds. Contents are organized within age levels in terms of functioning levels and anticipatory guidance. Functional areas covered include physical,…

[Medical habilitation in German-speaking countries : Quantitative assessment of content and elaboration of habilitation guidelines].

PubMed

Weineck, S B; Koelblinger, D; Kiesslich, T

2015-04-01

Habilitation defines the qualification to conduct self-contained university teaching and is the key for access to a professorship at German, Austrian and Swiss universities. Despite all changes implemented in the European higher education systems during the Bologna process, it is the highest qualification level issued through the process of an university examination and remains the core concept of scientific careers in these countries. In the field of medicine, this applies not only to scientific staff at the universities but also to those medical doctors aiming at a clinical career track. To provide a quantitative analysis of the scientific, didactic, and procedural criteria for medical habilitation in German-speaking countries. Based on the guidelines of all 43 medical academic institutions, the criteria which candidates are required to fulfil prior to habilitation as well as formal requirements related to the habilitation procedure itself have been acquired and quantitatively analyzed. Having evaluated all habilitation guidelines by means of 87 items, the quantitative analysis revealed significant differences in terms of number, kind and scale of criteria stated therein. Most habilitation guidelines scarcely define the capabilities applicants have to prove: concerning the scientific qualifications on types of publications for instance, no item was mentioned in more than half of all habilitation guidelines. Based on this data analysis, the authors discuss the related literature and describe five main distinguishing areas of habilitation guidelines in terms of the set of the formal and procedural framework as well as the prequalification and postqualification criteria imposed on habilitation candidates. There are therefore substantial differences in the organization of the habilitation for medicine.

Guidelines as rationing tools: a qualitative analysis of psychosocial patient selection criteria for cardiac procedures

PubMed Central

Giacomini, Mita K.; Cook, Deborah J.; Streiner, David L.; Anand, Sonia S.

2001-01-01

Background Cardiac procedure guidelines often include psychosocial criteria for selecting patients that potentially introduce social value judgements into clinical decisions and decisions about the rationing of care. The aim of this study was to investigate the terms and justifications for and the meanings of psychosocial patient characteristics used in cardiac procedure guidelines. Methods We selected English-language guidelines published since 1990 and chapters in textbooks published since 1989. These guidelines amalgamated multiple sources of evidence and expertise and made recommendations regarding patient selection for specific procedures. A multidisciplinary team of physicians and social scientists extracted passages regarding psychosocial criteria and developed categories and conceptual relationships to describe and interpret their content. Results Sixty-five papers met the criteria for inclusion in the study. Forty-five (69%) mentioned psychosocial criteria as procedure indications or contraindications. The latter fell into several categories, including behavioural and psychological issues, relationships with significant others, financial resources, social roles and environmental circumstances. Interpretation Psychosocial characteristics are portrayed as having 2 roles in patient selection: as risk factors intrinsic to the candidate or as indicators of need for special intervention. Guidelines typically simply list psychosocial contraindications without clarifying their specific nature or providing any justification for their use. Psychosocial considerations can help in the evaluation of patients for cardiac procedures, but they become ethically controversial when used to restrict access. The use of psychosocial indications and contraindications could be improved by more precise descriptions of the psychosocial problem at issue, explanations regarding why the criterion matters and justification of the characteristic using a biological rationale or research evidence. PMID:11258209

The dialysis outcomes quality initiative: history, impact, and prospects.

PubMed

Eknoyan, G; Levin, N W; Steinberg, E P

2000-04-01

Rigorously developed clinical practice guidelines have the potential to improve patient outcomes. It is toward that end that the National Kidney Foundation (NKF) launched in March 1995 the Dialysis Outcome Quality Initiative (DOQI), an ambitious effort to develop evidence-based clinical practice guidelines for the care of patients with end-stage renal disease (ESRD). Independent, interdisciplinary work groups conducted a structured review of the content and methodologic rigor of all the published literature pertinent to four selected topics: hemodialysis adequacy, peritoneal dialysis adequacy, vascular access, and anemia. Following expert, organizational, and public review, the guidelines were issued in September and October 1997. An implementation plan that called for widespread dissemination of the guidelines and facilitation of adoption of them has resulted in their broad acceptance and Integration into quality improvement efforts. Additional guidelines on nutrition have recently been completed, while others on bone disease, hypertension, and hyperlipidemia are in various stages of planning or development. A major determinant of poor outcome of maintenance dialysis patients is the debilitated state of many individuals with ESRD at the time that they commence dialysis therapy. The recognition of this problem has stimulated an interest in extending the guidelines to management of patients with less severe renal insufficiency, well before they need renal replacement therapy; and to the early detection of renal insufficiency by a proteinuria and albuminuria risk assessment, detection, and elimination (PARADE) program. What started as an initiative to improve the quality of care of dialysis patients has evolved into a considerably expanded effort to making lives better for all individuals with any level of renal insufficiency.

A survey of manufacturing and handling practices for monoclonal antibodies by pharmacy, nursing and medical personnel.

PubMed

Alexander, M; King, J; Lingaratnam, S; Byrne, J; MacMillan, K; Mollo, A; Kirsa, S; Green, M

2016-04-01

There is a paucity of data available to assess the occupational health and safety risk associated with exposure to monoclonal antibodies. Industry standards and published guidelines are conflicting or outdated. Guidelines offer contrary recommendations based on an array of methodological approaches. This survey aimed to describe current practices, beliefs and attitudes relating to the handling of monoclonal antibodies by Australian medical, nursing and pharmacy clinicians. An electronic survey was distributed between June and September 2013. Respondents were surveyed on three focus areas: institutional guideline availability and content, current practices and attitudes. Demographic data relating to respondent and primary place of practice were also collected. A total of 222 clinicians completed the survey, with representation from all targeted professional groups and from a variety of geographic locations. 92% of respondents reported that their institution prepared or administered monoclonal antibodies, with 87% specifically handling anti-cancer monoclonal antibodies. Monoclonal antibodies were mostly prepared onsite (84-90%) and mostly within pharmacy clean-rooms (75%) and using cytotoxic cabinets (61%). 43% of respondents reported access to institutional monoclonal antibody handling guidelines with risk reduction strategies including training and education (71%), spill and waste management (71%), procedures for transportation (57%) and restricted handling (50%). Nurses had a stronger preference towards pharmacy manufacturing than both doctors and pharmacists for a range of clinical scenarios. 95% of all respondents identified that professional or regulatory body guidelines are an important resource when considering handling practices. Monoclonal antibodies are most commonly handled according to cytotoxic drug standards and often in the absence of formal guidelines. © The Author(s) 2014.

Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

PubMed

Choma, Kim; McKeever, Amy E

2015-02-01

The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

Curricular Guidelines in Gross Anatomy.

ERIC Educational Resources Information Center

Horn, Stanton D.; And Others

1981-01-01

An outline of AADS curricular guidelines for gross anatomy in dental education includes primary educational goals, prerequisites, core content, specific course objectives for each section of content, sequencing, faculty requirements, and facility and equipment needs. (MSE)

Development of a novel, multilayered presentation format for clinical practice guidelines.

PubMed

Kristiansen, Annette; Brandt, Linn; Alonso-Coello, Pablo; Agoritsas, Thomas; Akl, Elie A; Conboy, Tara; Elbarbary, Mahmoud; Ferwana, Mazen; Medani, Wedad; Murad, Mohammad Hassan; Rigau, David; Rosenbaum, Sarah; Spencer, Frederick A; Treweek, Shaun; Guyatt, Gordon; Vandvik, Per Olav

2015-03-01

Bridging the gap between clinical research and everyday health-care practice requires effective communication strategies. To address current shortcomings in conveying practice recommendations and supporting evidence, we are creating and testing presentation formats for clinical practice guidelines (CPGs). We carried out multiple cycles of brainstorming and sketching, developing a prototype. Physicians participating in the user testing viewed CPG formats linked to clinical scenarios and engaged in semistructured interviews applying a think-aloud method for exploring important aspects of user experience. We developed a multilayered presentation format that allows clinicians to successively view more in-depth information. Starting with the recommendations, clinicians can, on demand, access a rationale and a key information section containing statements on quality of the evidence, balance between desirable and undesirable consequences, values and preferences, and resource considerations. We collected feedback from 27 stakeholders and performed user testing with 47 practicing physicians from six countries. Advisory group feedback and user testing of the first version revealed problems with conceptual understanding of underlying CPG methodology, as well as difficulties with the complexity of the layout and content. Extensive revisions made before the second round of user testing resulted in most participants expressing overall satisfaction with the final presentation format. We have developed an electronic, multilayered, CPG format that enhances the usability of CPGs for frontline clinicians. We have implemented the format in electronic guideline tools that guideline organizations can now use when authoring and publishing their guidelines.

Proposed Performance Measures and Strategies for Implementation of the Fatigue Risk Management Guidelines for Emergency Medical Services.

PubMed

Martin-Gill, Christian; Higgins, J Stephen; Van Dongen, Hans P A; Buysse, Daniel J; Thackery, Ronald W; Kupas, Douglas F; Becker, David S; Dean, Bradley E; Lindbeck, George H; Guyette, Francis X; Penner, Josef H; Violanti, John M; Lang, Eddy S; Patterson, P Daniel

2018-02-15

Performance measures are a key component of implementation, dissemination, and evaluation of evidence-based guidelines (EBGs). We developed performance measures for Emergency Medical Services (EMS) stakeholders to enable the implementation of guidelines for fatigue risk management in the EMS setting. Panelists associated with the Fatigue in EMS Project, which was supported by the National Highway Traffic Safety Administration (NHTSA), used an iterative process to develop a draft set of performance measures linked to 5 recommendations for fatigue risk management in EMS. We used a cross-sectional survey design and the Content Validity Index (CVI) to quantify agreement among panelists on the wording and content of draft measures. An anonymous web-based tool was used to solicit the panelists' perceptions of clarity and relevance of draft measures. Panelists rated the clarity and relevance separately for each draft measure on a 4-point scale. CVI scores ≥0.78 for clarity and relevance were specified a priori to signify agreement and completion of measurement development. Panelists judged 5 performance measures for fatigue risk management as clear and relevant. These measures address use of fatigue and/or sleepiness survey instruments, optimal duration of shifts, access to caffeine as a fatigue countermeasure, use of napping during shift work, and the delivery of education and training on fatigue risk management for EMS personnel. Panelists complemented performance measures with suggestions for implementation by EMS agencies. Performance measures for fatigue risk management in the EMS setting will facilitate the implementation and evaluation of the EBG for Fatigue in EMS.

Analysis of on-line clinical laboratory manuals and practical recommendations.

PubMed

Beckwith, Bruce; Schwartz, Robert; Pantanowitz, Liron

2004-04-01

On-line clinical laboratory manuals are a valuable resource for medical professionals. To our knowledge, no recommendations currently exist for their content or design. To analyze publicly accessible on-line clinical laboratory manuals and to propose guidelines for their content. We conducted an Internet search for clinical laboratory manuals written in English with individual test listings. Four individual test listings in each manual were evaluated for 16 data elements, including sample requirements, test methodology, units of measure, reference range, and critical values. Web sites were also evaluated for supplementary information and search functions. We identified 48 on-line laboratory manuals, including 24 academic or community hospital laboratories and 24 commercial or reference laboratories. All manuals had search engines and/or test indices. No single manual contained all 16 data elements evaluated. An average of 8.9 (56%) elements were present (range, 4-14). Basic sample requirements (specimen and volume needed) were the elements most commonly present (98% of manuals). The frequency of the remaining data elements varied from 10% to 90%. On-line clinical laboratory manuals originate from both hospital and commercial laboratories. While most manuals were user-friendly and contained adequate specimen-collection information, other important elements, such as reference ranges, were frequently absent. To ensure that clinical laboratory manuals are of maximal utility, we propose the following 13 data elements be included in individual test listings: test name, synonyms, test description, test methodology, sample requirements, volume requirements, collection guidelines, transport guidelines, units of measure, reference range, critical values, test availability, and date of latest revision.

"We Have a Right to Know": Exploring Consumer Opinions on Content, Design and Acceptability of Enhanced Alcohol Labels.

PubMed

Vallance, Kate; Romanovska, Inna; Stockwell, Tim; Hammond, David; Rosella, Laura; Hobin, Erin

2018-01-01

This study aimed to refine content and design of an enhanced alcohol label to provide information that best supports informed drinking and to gauge consumer acceptability of enhanced alcohol labels among a subset of consumers. Five focus groups (n = 45) were conducted with stakeholders and the general public (age 19+) across one jurisdiction in northern Canada. Interviews were transcribed and analyzed using NVivo software. The majority of participants showed strong support for enhanced alcohol labels with an emphasis on the consumers' right to know about the health risks related to alcohol. Participants preferred larger labels that included standard drink (SD) information, national low-risk drinking guidelines presented as a chart with pictograms, cancer health messaging and a pregnancy warning. Supporting introduction of the labels with a web resource and an educational campaign was also recommended. Displaying enhanced labels on alcohol containers that include SD information, low-risk drinking guidelines and other health messaging in an accessible format may be an effective way to better inform drinkers about their consumption and increase awareness of alcohol-related health risks. Introduction of enhanced labels shows potential for consumer support. Focus group findings indicate strong support for enhanced alcohol labels displaying SD information, national drinking guidelines, health messaging and a pregnancy warning. Introduction of enhanced alcohol labels in tandem with an educational campaign may be an effective way to better inform Canadian drinkers and shows potential for consumer support. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

The confusing world of dietary sugars: definitions, intakes, food sources and international dietary recommendations.

PubMed

Hess, Jennifer; Latulippe, Marie E; Ayoob, Keith; Slavin, Joanne

2012-05-01

Government and health organizations worldwide have issued dietary guidelines for sugars. These guidelines vary considerably in the recommended or suggested intakes and the types of sugars specified. Despite access to the same published literature, recommendations vary greatly and create confusion for nutrition practitioners who offer dietary guidance. Some of the confusion in this field is linked to differences in definitions for sugar and methods to measure total sugars. Additionally, although dietary guidance typically recommends foods high in sugar, fruits and dairy products, other advice suggests strict limits on intake of "added sugar". Added sugar cannot be analytically determined and must be calculated so nutrient databases generally contain values for total sugar and do not differentiate between sugars naturally occurring in foods and those added in processing. This review defines sugars, provides the sugar content of major food sources, summarizes health concerns about dietary sugars, and compiles dietary guidelines for sugars issued by various organizations. Dietary recommendations from various health organizations are based on different means of assessment, and thus vary considerably. In general, the use of added sugars is cautioned, especially when it contributes to calories in excess of needs for an individual.

10 CFR 436.102 - General operations plan format and content.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false General operations plan format and content. 436.102... PROGRAMS Guidelines for General Operations Plans § 436.102 General operations plan format and content. (a... effective date of these guidelines, a general operations 10-year plan which shall consist of two parts, an...

[Indications and approaches in rehabilitation with children].

PubMed

Petermann, F; Bauer, C-P

2011-04-01

Against the background of rising prevalence of chronic diseases in childhood and adolescence, the rehabilitation of children and adolescents plays a major role in medical treatment. Early diagnosis and multimodal intervention are necessary to prevent a chronic course of disease and disease consequences for those affected and their families. In recent years, significant content and structural improvement of child and youth rehabilitation has been observed; currently some trends that affect not only the access to rehabilitation but also the quality of outcomes are becoming apparent. These include salutogenetic approaches, the development of specific diagnostic and treatment guidelines, the establishment of networks, integrated care, modularization, and flexibility of rehabilitation measures.

The quality of orthodontic practice websites.

PubMed

Parekh, J; Gill, D S

2014-05-01

To evaluate orthodontic practice websites for the reliability of information presented, accessibility, usability for patients and compliance to General Dental Council (GDC) regulations on ethical advertising. World Wide Web. The term 'orthodontic practice' was entered into three separate search engines. The 30 websites from the UK were selected and graded according to the LIDA tool (a validated method of evaluating healthcare websites) for accessibility, usability of the website and reliability of information on orthodontic treatment. The websites were then evaluated against the GDC's Principles for ethical advertising in nine different criteria. On average, each website fulfilled six out of nine points of the GDC's criteria, with inclusion of a complaints policy being the most poorly fulfilled criteria. The mean LIDA score (a combination of usability, reliability and accessibility) was 102/144 (standard deviation 8.38). The websites scored most poorly on reliability (average 43% SD 11.7), with no single website reporting a clear, reliable method of content production. Average accessibility was 81% and usability 73%. In general, websites did not comply with GDC guidelines on ethical advertising. Furthermore, practitioners should consider reporting their method of information production, particularly when making claims about efficiency and speed of treatment in order to improve reliability.

32 CFR 147.7 - Guideline E-Personal conduct.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Guideline E-Personal conduct. 147.7 Section 147... CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Adjudication § 147.7 Guideline E—Personal conduct. (a) The concern. Conduct involving questionable judgment...

32 CFR 147.9 - Guideline G-Alcohol consumption.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Guideline G-Alcohol consumption. 147.9 Section... AND CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Adjudication § 147.9 Guideline G—Alcohol consumption. (a) The concern. Excessive alcohol consumption often...

PREVENTION GUIDELINES SYSTEM/DATABASE

EPA Science Inventory

The Prevention Guidelines System gives public health practitioners quick access to the most current CDC recommendations and guidelines for the prevention, control, treatment and detection of infectious and chronic diseases, environmental hazards, natural or human-generated disast...

76 FR 75844 - Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way; Reopening of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... additional time to review and more fully assess the proposed rule. In addition, just prior to the closing of...: Notice of proposed rulemaking; reopening of comment period. SUMMARY: The Architectural and Transportation... notice entitled ``Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way,'' that...

Development and promotion of a national website to improve dissemination of information related to the prevention of mother-to-child HIV transmission (PMTCT) in Tanzania.

PubMed

Stephan, Gudila; Hoyt, Mary Jo; Storm, Deborah S; Shirima, Sylvia; Matiko, Charles; Matechi, Emmanuel

2015-10-22

Websites that address national public health issues provide an important mechanism to improve health education and services in resource limited countries. This article describes the development, promotion and initial evaluation of a national website to increase access to information and resources about prevention of mother-to-child transmission of HIV (PMTCT) among healthcare workers and PMTCT stakeholders in Tanzania. A participatory approach, involving the Tanzania Ministry of Health and Social Welfare (MOHSW) and key PMTCT stakeholders, was used to develop and manage the online PMTCT National Resource Center (NRC), http://pmtct.or.tz/ . The website was created with a content management system software system that does not require advanced computer skills and facilitates content updates and site management. The PMTCT NRC hosts related regularly updated PMTCT-related news, resources and publications. Website implementation, access and performance were evaluated over two years using Google Analytics data about visits, page views, downloads, bounce rates and location of visitors, supplemented by anecdotal feedback. Following its launch in July 2013, the PMTCT NRC website received a total of 28,400 visits, with 66,463 page views, over 2 years; 30 % of visits were from returning visitors. During year 1, visits increased by 80 % from the first to second 6 month period and then declined slightly (9-11 %) but remained stable in Year 2. Monthly visits spiked by about 70 % during October 2013 and January 2014 in response to the release and promotion of revised national PMTCT guidelines and training manuals. The majority of visitors came from primarily urban areas in Tanzania (50 %) and from other African countries (16 %). By year 2, over one-third of visitors used mobile devices to access the site. The successfully implemented PMTCT NRC website provides centralized, easily accessed information designed to address the needs of clinicians, educators and program partners in Tanzania. Ongoing involvement of the MOHSW and key stakeholders are essential ensure the website's growth, effectiveness and sustainability. Additional efforts are needed to expand use of the PMTCT NRC throughout the country. Future evaluations should examine the role of the website in supporting implementation of national PMTCT guidelines and services in Tanzania.

Knee joint replacement

MedlinePlus

... Knee joint replacement - series References American Academy of Orthopedic Surgeons (AAOS) website. Treatment of osteoarthritis of the knee: evidence-based guideline 2nd edition (summary) . www.aaos.org/research/guidelines/TreatmentofOsteoarthritisoftheKneeGuideline.pdf . Updated May 18, 2013. Accessed ...

The health care and life sciences community profile for dataset descriptions

PubMed Central

Alexiev, Vladimir; Ansell, Peter; Bader, Gary; Baran, Joachim; Bolleman, Jerven T.; Callahan, Alison; Cruz-Toledo, José; Gaudet, Pascale; Gombocz, Erich A.; Gonzalez-Beltran, Alejandra N.; Groth, Paul; Haendel, Melissa; Ito, Maori; Jupp, Simon; Juty, Nick; Katayama, Toshiaki; Kobayashi, Norio; Krishnaswami, Kalpana; Laibe, Camille; Le Novère, Nicolas; Lin, Simon; Malone, James; Miller, Michael; Mungall, Christopher J.; Rietveld, Laurens; Wimalaratne, Sarala M.; Yamaguchi, Atsuko

2016-01-01

Access to consistent, high-quality metadata is critical to finding, understanding, and reusing scientific data. However, while there are many relevant vocabularies for the annotation of a dataset, none sufficiently captures all the necessary metadata. This prevents uniform indexing and querying of dataset repositories. Towards providing a practical guide for producing a high quality description of biomedical datasets, the W3C Semantic Web for Health Care and the Life Sciences Interest Group (HCLSIG) identified Resource Description Framework (RDF) vocabularies that could be used to specify common metadata elements and their value sets. The resulting guideline covers elements of description, identification, attribution, versioning, provenance, and content summarization. This guideline reuses existing vocabularies, and is intended to meet key functional requirements including indexing, discovery, exchange, query, and retrieval of datasets, thereby enabling the publication of FAIR data. The resulting metadata profile is generic and could be used by other domains with an interest in providing machine readable descriptions of versioned datasets. PMID:27602295

[Preoperative fasting and fluid management in pediatric patients].

PubMed

Sumiyoshi, Rieko

2013-09-01

Preoperative fasting is principally intended to minimize the risk of pulmonary aspiration of gastric contents and facilitate the safe and efficient conduct of anesthesia. Liberalization of fasting guidelines has been implemented in most countries. In general, clear fluids are allowed up to 2h before anesthesia, and light meals up to 6h. In infants, most recommendations now allow breast milk feeding up to 4h and other kinds of milk up to 6h. Recently, the concept of preoperative oral rehydration using a carbohydrate-rich beverage up to 2h has also gained support. Drinking carbohydrate-rich fluids before elective surgery may reduce dehydration, improve hemodynamic stability under anesthesia, facilitate intravenous access, maintain glucose homeostasis, reduce patient irritability, and improve child and parent satisfaction. These guidelines apply to healthy children only. Exclusion criteria included obesity, diabetes, gastroesophageal reflux, ileus, bowel obstruction and emergency care. In particular, trauma and other emergency cases are at higher risk for aspiration regardless of fasting interval and should be managed appropriately.

Internationalization of regulatory requirements.

PubMed

Juillet, Y

2003-02-01

The aim of harmonisation of medicines regulatory requirements is to allow the patient quicker access to new drugs and to avoid animal and human duplications. Harmonisation in the European Union (EU) is now completed, and has led to the submission of one dossier in one language study leading to European marketing authorizations, thanks in particular to efficacy guidelines published at the European level. With the benefit of the European experience since 1989, more than 40 guidelines have been harmonised amongst the EU, Japan and the USA through the International Conference on Harmonisation (ICH). ICH is a unique process gathering regulators and industry experts from the three regions. Its activity is built on expertise and trust. The Common Technical Document (CTD), an agreed common format for application in the three regions, is a logical follow-up to the ICH first phase harmonising the content of the dossier. The CTD final implementation in July 2003 will have considerable influence on the review process and on the exchange of information in the three regions.

An European framework for the long term preservation of EO data

NASA Astrophysics Data System (ADS)

Forcada, E.; Albani, M.; Beruti, V.

2009-04-01

The need for accessing historical Earth Observation (EO) data series strongly increased in the last ten years, mainly for long term science and environmental monitoring applications. This trend is likely to increase even more in the future in particular for the growing interest on global change monitoring that requires data time-series spanning 20 years and more, and for the need to support the United Nations Framework Convention on Climate Change (UNFCCC). Content of EO data archives is extending from a few years to decades and their scientific value is continuously increasing hence is well recognized the need to preserve them without time limitation and to keep the archived EO data well accessible and exploitable as they constitute a humankind asset. The large amount of new Earth Observation missions upcoming in the next years will moreover lead to a major increase of EO data volumes. This fact, together with the increased demands from the scientific user community, marks a challenge for Earth Observation satellite operators, Space Agencies and EO data providers regarding coherent data preservation and optimum availability and accessibility of the different data products. Traditionally in Europe, there has been poor cooperation in this field with no common approach for long term preservation and access to EO space data even if cooperation and sharing are key aspects to be pursued for the benefit of the user community. Single organizations have difficulties to afford data preservation in the long term that calls for the need of optimising costs and efforts, identifying commonalities. In 2006, the European Space Agency (ESA) initiated a coordination action to share among all the European (and Canadian) stakeholders a common approach to the long term preservation of Earth Observation data. During 2007, the Agency started consultations with its Member States presenting an EO Long Term Data Preservation (LTDP) strategy targeting the preservation of all European (including Canada) EO data for an unlimited time-span ensuring and facilitating their accessibility and usability through the implementation of a cooperative and harmonized collective approach among the EO data owners. Such European Long Term Data Preservation Framework should be implemented through the application of European LTDP Common Guidelines and sustained through cooperative (multi-source) long term funding schemes. The Long Term Data Preservation Working Group with representatives from ASI, CNES, CSA, DLR and ESA was formed at the end of 2007 within the Ground Segment Coordination Body (GSCB, http://earth.esa.int/gscb/) with the goal to define and promote, with the involvement of all the European EO data and archive owners, the LTDP Common Guidelines. During the 1st Earth Observation Long Term Data Preservation workshop in May 2008, the guidelines and the framework were presented and debated by all European and Canadian EO data owners, data providers and archive holders. The participants discussed and developed a joint strategy to move ahead technically and programmatically concerning the Long Term Data Preservation of EO Data and recognized the need and benefits of a common approach. Furthermore all the participants identified and agreed the LTDP Guidelines presented at the workshop as a first concrete and fundamental step to move ahead in creating the Long Term Data Preservation Framework. ESA is already planning to apply the Long Term Data Preservation Common Guidelines to its own missions and the consolidated LTDP guidelines will be promoted within CEOS and GEO.

A study of information flow in hospice interdisciplinary team meetings

PubMed Central

DEMIRIS, GEORGE; WASHINGTON, KARLA; OLIVER, DEBRA PARKER; WITTENBERG-LYLES, ELAINE

2009-01-01

The aim of this study was to explore the information flow of hospice interdisciplinary meetings focusing on information access, exchange and documentation. The study participants were members of four hospice interdisciplinary teams in the Midwestern United States. Team members included a diverse range of professionals including physicians, nurses, social workers, bereavement counselors, and others. A total of 81 patient care discussions were videotaped and transcribed. A content analysis revealed several themes that needed to be addressed to improve the overall information flow, such as access to and recording of information, documentation of services, obtaining information from absent team members, data redundancy and updating of recorded information. On average, 5% of all utterances when discussing a patient case were focused on soliciting information from the member who had access to the patient chart. In 12.3% of all discussions, members referred to an absent member who could have provided additional information. In 8.6% of all discussions the same facts were repeated three times or more. Based on the findings we propose guidelines that can address potential informational gaps and enhance team communication in hospice. PMID:19012142

The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa.

PubMed

Scheffler, Elsje; Visagie, Surona; Schneider, Marguerite

2015-06-19

Health care access is complex and multi-faceted and, as a basic right, equitable access and services should be available to all user groups. The aim of this article is to explore how service delivery impacts on access to healthcare for vulnerable groups in an urban primary health care setting in South Africa. A descriptive qualitative study design was used. Data were collected through semi-structured interviews with purposively sampled participants and analysed through thematic content analysis. Service delivery factors are presented against five dimensions of access according to the ACCESS Framework. From a supplier perspective, the organisation of care in the study setting resulted in available, accessible, affordable and adequate services as measured against the DistrictHealth System policies and guidelines. However, service providers experienced significant barriers in provision of services, which impacted on the quality of care, resulting in poor client and provider satisfaction and ultimately compromising acceptability of service delivery. Although users found services to be accessible, the organisation of services presented them with challenges in the domains of availability, affordability and adequacy, resulting in unmet needs, low levels of satisfaction and loss of trust. These challenges fuelled perceptions of unacceptable services. Well developed systems and organisation of services can create accessible, affordable and available primary healthcare services, but do not automatically translate into adequate and acceptable services. Focussing attention on how services are delivered might restore the balance between supply (services) and demand (user needs) and promote universal and equitable access.

32 CFR 147.5 - Guideline C-Foreign preference.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Guideline C-Foreign preference. 147.5 Section... AND CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Adjudication § 147.5 Guideline C—Foreign preference. (a) The concern. When an individual acts in such a way as...

32 CFR 147.4 - Guideline B-Foreign influence.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Guideline B-Foreign influence. 147.4 Section 147... CIVILIAN ADJUDICATIVE GUIDELINES FOR DETERMINING ELIGIBILITY FOR ACCESS TO CLASSIFIED INFORMATION Adjudication § 147.4 Guideline B—Foreign influence. (a) The concern. A security risk may exist when an...

Setting Housing Standards to Improve Global Health

PubMed Central

Howden-Chapman, Philippa; Roebbel, Nathalie

2017-01-01

Developing World Health Organization international guidelines is a highly formal process. Yet the resulting guidelines, which Member States are encouraged, but not required to adopt, are a powerful way of developing rigorous policy and fostering implementation. Using the example of the housing and health guidelines, which are currently being finalised, this paper outlines the process for developing WHO guidelines. This includes: forming a Guidelines Review Group that represents all regions of the world, and ensures gender balance and technical expertise; identifying key health outcomes of interest; commissioning systematic reviews of the evidence; assessing the evidence; and formulating recommendations. The strength of each recommendation is assessed based on the quality of the evidence, along with consideration of issues such as equity, acceptability, and feasibility of the implementation of the recommendation. The proposed housing guidelines will address: cold and hot indoor temperatures, home injuries, household crowding, accessibility and access to active travel infrastructure. PMID:29232827

Toward Privacy-preserving Content Access Control for Information Centric Networking

DTIC Science & Technology

2014-03-01

REPORT Toward Privacy-preserving Content Access Control for Information Centric Networking 14. ABSTRACT 16. SECURITY CLASSIFICATION OF: Information...regardless the security mechanisms provided by different content hosting servers. However, using ABE has a drawback that the enforced content access...Encryption (ABE) is a flexible approach to enforce the content access policies regardless the security mechanisms provided by different content hosting

Risky messages in alcohol advertising, 2003-2007: results from content analysis.

PubMed

Rhoades, Elizabeth; Jernigan, David H

2013-01-01

To assess the content of alcohol advertising in youth-oriented U.S. magazines, with specific attention to subject matter pertaining to risk and sexual connotations and to youth exposure to these ads. This study consisted of a content analysis of a census of 1,261 unique alcohol advertisements ("creatives") recurring 2,638 times ("occurrences") in 11 U.S. magazines with disproportionately youthful readerships between 2003 and 2007. Advertisements were assessed for content relevant to injury, overconsumption, addiction, and violations of industry guidelines (termed "risk" codes), as well as for sexism and sexual activity. During the 5-year study period, more than one-quarter of occurrences contained content pertaining to risk, sexism, or sexual activity. Problematic content was concentrated in a minority of brands, mainly beer and spirits brands. Those brands with higher youth-to-adult viewership ratios were significantly more likely to have a higher percentage of occurrences with addiction content and violations of industry guidelines. Ads with violations of industry guidelines were more likely to be found in magazines with higher youth readerships. The prevalence of problematic content in magazine alcohol advertisements is concentrated in advertising for beer and spirits brands, and violations of industry guidelines and addiction content appear to increase with the size of youth readerships, suggesting that individuals aged <21 years may be more likely to see such problematic content than adults. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Predoctoral Curriculum Guidelines for Biomaterials.

ERIC Educational Resources Information Center

Journal of Dental Education, 1986

1986-01-01

The American Association of Dental Schools' predoctoral guidelines for biomaterials curricula includes notes on interrelationships between this and other fields, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives for each content area, and information on sequencing, faculty and…

Clinical guidelines on central venous catheterisation. Swedish Society of Anaesthesiology and Intensive Care Medicine.

PubMed

Frykholm, P; Pikwer, A; Hammarskjöld, F; Larsson, A T; Lindgren, S; Lindwall, R; Taxbro, K; Oberg, F; Acosta, S; Akeson, J

2014-05-01

Safe and reliable venous access is mandatory in modern health care, but central venous catheters (CVCs) are associated with significant morbidity and mortality, This paper describes current Swedish guidelines for clinical management of CVCs The guidelines supply updated recommendations that may be useful in other countries as well. Literature retrieval in the Cochrane and Pubmed databases, of papers written in English or Swedish and pertaining to CVC management, was done by members of a task force of the Swedish Society of Anaesthesiology and Intensive Care Medicine. Consensus meetings were held throughout the review process to allow all parts of the guidelines to be embraced by all contributors. All of the content was carefully scored according to criteria by the Oxford Centre for Evidence-Based Medicine. We aimed at producing useful and reliable guidelines on bleeding diathesis, vascular approach, ultrasonic guidance, catheter tip positioning, prevention and management of associated trauma and infection, and specific training and follow-up. A structured patient history focused on bleeding should be taken prior to insertion of a CVCs. The right internal jugular vein should primarily be chosen for insertion of a wide-bore CVC. Catheter tip positioning in the right atrium or lower third of the superior caval vein should be verified for long-term use. Ultrasonic guidance should be used for catheterisation by the internal jugular or femoral veins and may also be used for insertion via the subclavian veins or the veins of the upper limb. The operator inserting a CVC should wear cap, mask, and sterile gown and gloves. For long-term intravenous access, tunnelled CVC or subcutaneous venous ports are preferred. Intravenous position of the catheter tip should be verified by clinical or radiological methods after insertion and before each use. Simulator-assisted training of CVC insertion should precede bedside training in patients. Units inserting and managing CVC should have quality assertion programmes for implementation and follow-up of routines, teaching, training and clinical outcome. Clinical guidelines on a wide range of relevant topics have been introduced, based on extensive literature retrieval, to facilitate effective and safe management of CVCs. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Adherence of healthcare professionals to evidence-based clinical practice guidelines in the management of hemodialysis patients, Khartoum State, Sudan.

PubMed

Abdelwahab, Hisham; Shigidi, Mazin; El-Tohami, Alyaa; Ibrahim, Lamees

2013-05-01

Hemodialysis (HD) is a complex procedure with many specifications and requires adherence to a set of particular clinical practice guidelines. These guidelines had already been established by globally acclaimed renal authorities and their implementation was shown to correlate with patients' morbidity and mortality. This study was conducted to evaluate the adherence of healthcare professionals to the evidence-based clinical practice patterns in Khartoum State HD units. A cross-sectional study was conducted in Khartoum State HD units during the period from September 2010 to January of 2011. Data was collected from the healthcare professionals using a specially designed checklist. The checklist included the evidence-based clinical practice guidelines for the HD vascular access, HD adequacy, anemia of chronic kidney disease (CKD), nutrition, cardiovascular risk assessment, and hepatitis B and C virus infection control. Implementation of these guidelines was evaluated, and further graded using a Likert-type scale. Four randomly selected HD units were included in the study. The rate of implementation of the HD vascular access guidelines was 54.8%, adequacy guidelines 57%, anemia of CKD 68.8%, nutrition 58.4%, cardiovascular risk assessment 57%, and hepatitis B and C infection control guidelines was 79.2%. Overall, the four HD units assessed showed moderate deviations from the practice guidelines of anemia of CKD and hepatitis B and C infection control. Extreme deviations from the clinical practice guidelines were seen in HD vascular access practices, adequacy assessments, nutrition and cardiovascular risk assessment. Hemodialysis services in Khartoum State are in need of great improvements regarding adherence to protocols and the standards of care.

Efficient Access Control in Multimedia Social Networks

NASA Astrophysics Data System (ADS)

Sachan, Amit; Emmanuel, Sabu

Multimedia social networks (MMSNs) have provided a convenient way to share multimedia contents such as images, videos, blogs, etc. Contents shared by a person can be easily accessed by anybody else over the Internet. However, due to various privacy, security, and legal concerns people often want to selectively share the contents only with their friends, family, colleagues, etc. Access control mechanisms play an important role in this situation. With access control mechanisms one can decide the persons who can access a shared content and who cannot. But continuously growing content uploads and accesses, fine grained access control requirements (e.g. different access control parameters for different parts in a picture), and specific access control requirements for multimedia contents can make the time complexity of access control to be very large. So, it is important to study an efficient access control mechanism suitable for MMSNs. In this chapter we present an efficient bit-vector transform based access control mechanism for MMSNs. The proposed approach is also compatible with other requirements of MMSNs, such as access rights modification, content deletion, etc. Mathematical analysis and experimental results show the effectiveness and efficiency of our proposed approach.

Protocol for the development of a CONSORT-equity guideline to improve reporting of health equity in randomized trials.

PubMed

Welch, Vivian; Jull, J; Petkovic, J; Armstrong, R; Boyer, Y; Cuervo, L G; Edwards, Sjl; Lydiatt, A; Gough, D; Grimshaw, J; Kristjansson, E; Mbuagbaw, L; McGowan, J; Moher, D; Pantoja, T; Petticrew, M; Pottie, K; Rader, T; Shea, B; Taljaard, M; Waters, E; Weijer, C; Wells, G A; White, H; Whitehead, M; Tugwell, P

2015-10-21

Health equity concerns the absence of avoidable and unfair differences in health. Randomized controlled trials (RCTs) can provide evidence about the impact of an intervention on health equity for specific disadvantaged populations or in general populations; this is important for equity-focused decision-making. Previous work has identified a lack of adequate reporting guidelines for assessing health equity in RCTs. The objective of this study is to develop guidelines to improve the reporting of health equity considerations in RCTs, as an extension of the Consolidated Standards of Reporting Trials (CONSORT). A six-phase study using integrated knowledge translation governed by a study executive and advisory board will assemble empirical evidence to inform the CONSORT-equity extension. To create the guideline, the following steps are proposed: (1) develop a conceptual framework for identifying "equity-relevant trials," (2) assess empirical evidence regarding reporting of equity-relevant trials, (3) consult with global methods and content experts on how to improve reporting of health equity in RCTs, (4) collect broad feedback and prioritize items needed to improve reporting of health equity in RCTs, (5) establish consensus on the CONSORT-equity extension: the guideline for equity-relevant trials, and (6) broadly disseminate and implement the CONSORT-equity extension. This work will be relevant to a broad range of RCTs addressing questions of effectiveness for strategies to improve practice and policy in the areas of social determinants of health, clinical care, health systems, public health, and international development, where health and/or access to health care is a primary outcome. The outcomes include a reporting guideline (CONSORT-equity extension) for equity-relevant RCTs and a knowledge translation strategy to broadly encourage its uptake and use by journal editors, authors, and funding agencies.

Impact of the Canadian Diabetes Association guideline dissemination strategy on clinician knowledge and behaviour change outcomes.

PubMed

Yu, Catherine H; Lillie, Erin; Mascarenhas-Johnson, Alekhya; Gall Casey, Carolyn; Straus, Sharon E

2018-04-04

Implementation of clinical practice guideline (CPG) into clinical practice remains limited. Using the Knowledge-To-Action framework, a guideline dissemination and implementation strategy for the Canadian Diabetes Association's 2013 CPG was developed and launched to clinicians and people with diabetes. The RE-AIM framework guided evaluation of this strategy clinician; we report here one aspect of the effectiveness dimension using mixed methods. We measured impact of the strategy on clinican knowledge and behaviour change constructs using evaluation forms, national online survey and individual interviews. After attending a lecture, clinician confidence (n = 915) increased (3.7(SD 0.7) to 4.5 (SD 0.6) on a 5-point scale (p < 0.001)), with 55% (n = 505) intending to make a practice change (e.g. clinical management regarding glycemic control). Ninety-four percent of survey respondents (n = 907) were aware of the guidelines, attributed to communications from professional associations, continuing professional development events, and colleagues. Forty to 98% of respondents (total n 462-485) were correct in their interpretation of CPG messages, and 33-65%(total n 351-651) reported that they had made changes to their practice. Interviews with 28 clinicians revealed that organizational credibility, online access to tools, clarity of tool content, and education sessions facilitated uptake; lack of time, team-based consensus, and seamless integration into care and patient complexity were barriers. The complexity of diabetes care requires systemic adoption of organization of care interventions, including interprofessional collaboration and consensus. Augmenting our strategy to include scalable models for professional development, integration of guidelines into electronic medical records, and expansion of our target audience to include health care teams and patients, may optimize guideline uptake. Copyright © 2018 Elsevier B.V. All rights reserved.

Guidelines for computer security in general practice.

PubMed

Schattner, Peter; Pleteshner, Catherine; Bhend, Heinz; Brouns, Johan

2007-01-01

As general practice becomes increasingly computerised, data security becomes increasingly important for both patient health and the efficient operation of the practice. To develop guidelines for computer security in general practice based on a literature review, an analysis of available information on current practice and a series of key stakeholder interviews. While the guideline was produced in the context of Australian general practice, we have developed a template that is also relevant for other countries. Current data on computer security measures was sought from Australian divisions of general practice. Semi-structured interviews were conducted with general practitioners (GPs), the medical software industry, senior managers within government responsible for health IT (information technology) initiatives, technical IT experts, divisions of general practice and a member of a health information consumer group. The respondents were asked to assess both the likelihood and the consequences of potential risks in computer security being breached. The study suggested that the most important computer security issues in general practice were: the need for a nominated IT security coordinator; having written IT policies, including a practice disaster recovery plan; controlling access to different levels of electronic data; doing and testing backups; protecting against viruses and other malicious codes; installing firewalls; undertaking routine maintenance of hardware and software; and securing electronic communication, for example via encryption. This information led to the production of computer security guidelines, including a one-page summary checklist, which were subsequently distributed to all GPs in Australia. This paper maps out a process for developing computer security guidelines for general practice. The specific content will vary in different countries according to their levels of adoption of IT, and cultural, technical and other health service factors. Making these guidelines relevant to local contexts should help maximise their uptake.

Guidelines for Inclusion: Ensuring Access to Education for All

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization (UNESCO), 2005

2005-01-01

These guidelines were created by UNESCO to assist countries in making National Plans for Education more inclusive, recognizing that there was a lack of guidelines to assist in this important process. This document thus provides guidelines and concepts for rendering National Education Plans / Education for All (EFA) more inclusive, with the…

Design Guidelines: Study of Handicapped Accessibility in South Carolina State Parks.

ERIC Educational Resources Information Center

South Carolina State Dept. of Parks, Recreation, and Tourism, Columbia. Div. of Engineering and Planning.

The publication provides guidelines for the design of new facilities or rehabilitation of existing facilities to accommodate physically handicapped persons in the South Carolina State Parks system. The guidelines are also recommended for use in regional, special district, county, and municipal parks within the state. The guidelines were developed…

Proposed Guidelines for Operating Counselor Education and Supervision Training Clinics

ERIC Educational Resources Information Center

Lauka, Justin D.; McCarthy, Amanda K.

2013-01-01

The purpose of this article is to justify and present a set of guidelines for the effective and ethical administration of counselor education and supervision training clinics. Responding directly to a call for creating guidelines, the authors address core issues surrounding their development. Benefits for clear and accessible guidelines and risks…

36 CFR 1193.31 - Accessibility and usability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Accessibility and usability... COMPLIANCE BOARD TELECOMMUNICATIONS ACT ACCESSIBILITY GUIDELINES Requirements for Accessibility and Usability § 1193.31 Accessibility and usability. When required by § 1193.21, telecommunications equipment and...

36 CFR 1193.31 - Accessibility and usability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Accessibility and usability... COMPLIANCE BOARD TELECOMMUNICATIONS ACT ACCESSIBILITY GUIDELINES Requirements for Accessibility and Usability § 1193.31 Accessibility and usability. When required by § 1193.21, telecommunications equipment and...

36 CFR 1193.31 - Accessibility and usability.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Accessibility and usability... COMPLIANCE BOARD TELECOMMUNICATIONS ACT ACCESSIBILITY GUIDELINES Requirements for Accessibility and Usability § 1193.31 Accessibility and usability. When required by § 1193.21, telecommunications equipment and...

36 CFR 1193.31 - Accessibility and usability.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Accessibility and usability... COMPLIANCE BOARD TELECOMMUNICATIONS ACT ACCESSIBILITY GUIDELINES Requirements for Accessibility and Usability § 1193.31 Accessibility and usability. When required by § 1193.21, telecommunications equipment and...

How to evaluate the quality of health related websites.

PubMed

Gattoni, Filippo; Sicola, Chiara

2005-03-01

To establish reliable quality criteria for medical websites is of foremost importance in relation to the increasing number of Internet users, both health professionals and lay people, searching for medical information in the mass of these sites. Quality in general refers to a set of features that distinguish one person or thing from others of the same type. The quality of a website is usually related to its content and usability. The first criteria we considered are contents and readability, which must be targeted to the intended type of user. Other important criteria include: transparency, consistency, honesty, references to sources, accountability, respect of privacy, currency of content material, responsibility, and accessibility. Technical criteria are the use of consolidated and standard technologies, soft colours, short page download time. Good medical websites should also follow the suggestions of organizations such as the World Health Organization, the Food and Drug Administration, the European Communities. Another organization, Health On Net Foundation, has issued some guidelines for medical websites, summarized in eight points, fundamental to assign real scientific value to a site. We believe, in agreement with the literature, that it is unnecessary to apply strict rules to medical website developers. We want to stress the importance of guidelines and recommendations to be modified with the development of web technology and the cultural evolution of patient and physicians. In the near future the presence on the Internet of websites certified by national or international medical web authorities will lead users to trust and give their preference to such sites, leading to the self-regulation of website developers and users.

Taking care of your vascular access for hemodialysis

MedlinePlus

... blood through the access. This is called stenosis. Day-to-day Care of Your Vascular Access Following these guidelines ... pulse (also called thrill) in your access every day. Your health care provider will show you how. ...

Implementation of a Mobile Clinical Decision Support Application to Augment Local Antimicrobial Stewardship.

PubMed

Hoff, Brian M; Ford, Diana C; Ince, Dilek; Ernst, Erika J; Livorsi, Daniel J; Heintz, Brett H; Masse, Vincent; Brownlee, Michael J; Ford, Bradley A

2018-01-01

Medical applications for mobile devices allow clinicians to leverage microbiological data and standardized guidelines to treat patients with infectious diseases. We report the implementation of a mobile clinical decision support (CDS) application to augment local antimicrobial stewardship. We detail the implementation of our mobile CDS application over 20 months. Application utilization data were collected and evaluated using descriptive statistics to quantify the impact of our implementation. Project initiation focused on engaging key stakeholders, developing a business case, and selecting a mobile platform. The preimplementation phase included content development, creation of a pathway for content approval within the hospital committee structure, engaging clinical leaders, and formatting the first version of the guide. Implementation involved a media campaign, staff education, and integration within the electronic medical record and hospital mobile devices. The postimplementation phase required ongoing quality improvement, revision of outdated content, and repeated staff education. The evaluation phase included a guide utilization analysis, reporting to hospital leadership, and sustainability and innovation planning. The mobile application was downloaded 3056 times and accessed 9259 times during the study period. The companion web viewer was accessed 8214 times. Successful implementation of a customizable mobile CDS tool enabled our team to expand beyond microbiological data to clinical diagnosis, treatment, and antimicrobial stewardship, broadening our influence on antimicrobial prescribing and incorporating utilization data to inspire new quality and safety initiatives. Further studies are needed to assess the impact on antimicrobial utilization, infection control measures, and patient care outcomes.

Clinical practice guidelines within the Southern African development community: a descriptive study of the quality of guideline development and concordance with best evidence for five priority diseases

PubMed Central

2012-01-01

Background Reducing the burden of disease relies on availability of evidence-based clinical practice guidelines (CPGs). There is limited data on availability, quality and content of guidelines within the Southern African Development Community (SADC). This evaluation aims to address this gap in knowledge and provide recommendations for regional guideline development. Methods We prioritised five diseases: HIV in adults, malaria in children and adults, pre-eclampsia, diarrhoea in children and hypertension in primary care. A comprehensive electronic search to locate guidelines was conducted between June and October 2010 and augmented with email contact with SADC Ministries of Health. Independent reviewers used the AGREE II tool to score six quality domains reporting the guideline development process. Alignment of the evidence-base of the guidelines was evaluated by comparing their content with key recommendations from accepted reference guidelines, identified with a content expert, and percentage scores were calculated. Findings We identified 30 guidelines from 13 countries, publication dates ranging from 2003-2010. Overall the 'scope and purpose' and 'clarity and presentation' domains of the AGREE II instrument scored highest, median 58%(range 19-92) and 83%(range 17-100) respectively. 'Stakeholder involvement' followed with median 39%(range 6-75). 'Applicability', 'rigour of development' and 'editorial independence' scored poorly, all below 25%. Alignment with evidence was variable across member states, the lowest scores occurring in older guidelines or where the guideline being evaluated was part of broader primary healthcare CPG rather than a disease-specific guideline. Conclusion This review identified quality gaps and variable alignment with best evidence in available guidelines within SADC for five priority diseases. Future guideline development processes within SADC should better adhere to global reporting norms requiring broader consultation of stakeholders and transparency of process. A regional guideline support committee could harness local capacity to support context appropriate guideline development. PMID:22221856

Inequities in access to inpatient rehabilitation after stroke: an international scoping review.

PubMed

Lynch, Elizabeth A; Cadilhac, Dominique A; Luker, Julie A; Hillier, Susan L

2017-12-01

Background Inequities in accessing inpatient rehabilitation after stroke have been reported in many countries and impact on patient outcomes. Objective To explore variation in international recommendations regarding which patients should receive inpatient rehabilitation after stroke and to describe reported access to rehabilitation. Methods A scoping review was conducted to identify clinical guidelines with recommendations regarding which patients should access inpatient rehabilitation after stroke, and data regarding the proportion of patients accessing stroke rehabilitation. Four bibliographic databases and grey literature were searched. Results Twenty-eight documents were included. Selection criteria for post-acute inpatient rehabilitation were identified for 14 countries or regions and summary data on the proportion of patients receiving inpatient rehabilitation were identified for 14 countries. In Australia, New Zealand, and the United Kingdom, it is recommended that all patients with stroke symptoms should access rehabilitation, whereas guidelines from the United States, Canada, and Europe did not consistently recommend rehabilitation for people with severe stroke. Access to inpatient rehabilitation ranged from 13% in Sweden to 57% in Israel. Differences in availability of early supported discharge/home rehabilitation programs and variations in reporting methods may influence the ability to reliably compare access to rehabilitation between regions. Conclusion Recommendations regarding which patients with moderate and severe strokes should access ongoing rehabilitation are inconsistent. Clinical practice guidelines from different countries regarding post-stroke rehabilitation do not always reflect the evidence regarding the likely benefits to people with stroke. Inequity in access to rehabilitation after stroke is an international issue.

Curricular Guidelines for Pharmacy Education: Substance Abuse and Addictive Disease.

ERIC Educational Resources Information Center

Baldwin, Jeffrey N.; And Others

1991-01-01

American Association of Colleges of Pharmacy guidelines for required and elective instructional content concerning substance abuse for pharmacy students is presented. Recommended required content includes psychosocial aspects of drug use; pharmacology and toxicology; identification, intervention, and treatment of addiction; and legal issues.…

Transgender Inmates in Prisons.

PubMed

Routh, Douglas; Abess, Gassan; Makin, David; Stohr, Mary K; Hemmens, Craig; Yoo, Jihye

2017-05-01

Transgender inmates provide a conundrum for correctional staff, particularly when it comes to classification, victimization, and medical and health issues. Using LexisNexis and WestLaw and state Department of Corrections (DOC) information, we collected state statutes and DOC policies concerning transgender inmates. We utilized academic legal research with content analysis to determine whether a statute or policy addressed issues concerning classification procedures, access to counseling services, the initiation and continuation of hormone therapy, and sex reassignment surgery. We found that while more states are providing either statutory or policy guidelines for transgender inmates, a number of states are lagging behind and there is a shortage of guidance dealing with the medical issues related to being transgender.

Value of XML in the implementation of clinical practice guidelines--the issue of content retrieval and presentation.

PubMed

Hoelzer, S; Schweiger, R K; Boettcher, H A; Tafazzoli, A G; Dudeck, J

2001-01-01

The purpose of guidelines in clinical practice is to improve the effectiveness and efficiency of clinical care. It is known that nationally or internationally produced guidelines which, in particular, do not involve medical processes at the time of consultation, do not take local factors into account, and have no consistent implementation strategy, have limited impact in changing either the behaviour of physicians, or patterns of care. The literature provides evidence for the effectiveness of computerization of CPGs for increasing compliance and improving patient outcomes. Probably the most effective concepts are knowledge-based functions for decision support or monitoring that are integrated in clinical information systems. This approach is mostly restricted by the effort required for development and maintenance of the information systems and the limited number of implemented medical rules. Most of the guidelines are text-based, and are primarily published in medical journals and posted on the internet. However, internet-published guidelines have little impact on the behaviour of physicians. It can be difficult and time-consuming to browse the internet to find (a) the correct guidelines to an existing diagnosis and (b) and adequate recommendation for a specific clinical problem. Our objective is to provide a web-based guideline service that takes as input clinical data on a particular patient and returns as output a customizable set of recommendations regarding diagnosis and treatment. Information in healthcare is to a very large extent transmitted and stored as unstructured or slightly structured text such as discharge letters, reports, forms, etc. The same applies for facilities containing medical information resources for clinical purposes and research such as text books, articles, guidelines, etc. Physicians are used to obtaining information from text-based sources. Since most guidelines are text-based, it would be practical to use a document-based solution that preserves the original cohesiveness. The lack of structure limits the automatic identification and extraction of the information contained in these resources. For this reason, we have chosen a document-based approach using eXtensible Markup Language (XML) with its schema definition and related technologies. XML empowers the applications for in-context searching. In addition it allows the same content to be represented in different ways. Our XML reference clinical data model for guidelines has been realized with the XML schema definition. The schema is used for structuring new text-based guidelines and updating existing documents. It is also used to establish search strategies on the document base. We hypothesize that enabling the physicians to query the available CPGs easily, and to get access to selected and specific information at the point of care will foster increased use. Based on current evidence we are confident that it will have substantial impact on the care provided, and will improve health outcomes.

Recommendations from the Council of Residency Directors (CORD) Social Media Committee on the Role of Social Media in Residency Education and Strategies on Implementation

PubMed Central

Pearson, David; Cooney, Robert; Bond, Michael C.

2015-01-01

Social media (SM) is a form of electronic communication through which users create online communities and interactive platforms to exchange information, ideas, messages, podcasts, videos, and other user-generated content. Emergency medicine (EM) has embraced the healthcare applications of SM at a rapid pace and continues to explore the potential benefit for education. Free Open Access Meducation has emerged from the ever-expanding collection of SM interactions and now represents a virtual platform for sharing educational media. This guidance document constitutes an expert consensus opinion for best practices in the use of SM in EM residency education. The goals are the following: 1) Recommend adoption of SM as a valuable graduate medical education (GME) tool, 2) Provide advocacy and support for SM as a GME tool, and 3) Recommend best practices of educational deliverables using SM. These guidelines are intended for EM educators and residency programs for the development and use of a program-specific SM presence for residency education, taking into account appropriate SM stewardship that adheres to institution-specific guidelines, content management, Accreditation Council for GME milestone requirements, and integration of SM in EM residency curriculum to enhance the learner’s experience. Additionally, potential obstacles to the uptake of SM as an educational modality are discussed with proposed solutions. PMID:26265962

Recommendations from the Council of Residency Directors (CORD) Social Media Committee on the Role of Social Media in Residency Education and Strategies on Implementation.

PubMed

Pearson, David; Cooney, Robert; Bond, Michael C

2015-07-01

Social media (SM) is a form of electronic communication through which users create online communities and interactive platforms to exchange information, ideas, messages, podcasts, videos, and other user-generated content. Emergency medicine (EM) has embraced the healthcare applications of SM at a rapid pace and continues to explore the potential benefit for education. Free Open Access Meducation has emerged from the ever-expanding collection of SM interactions and now represents a virtual platform for sharing educational media. This guidance document constitutes an expert consensus opinion for best practices in the use of SM in EM residency education. The goals are the following: 1) Recommend adoption of SM as a valuable graduate medical education (GME) tool, 2) Provide advocacy and support for SM as a GME tool, and 3) Recommend best practices of educational deliverables using SM. These guidelines are intended for EM educators and residency programs for the development and use of a program-specific SM presence for residency education, taking into account appropriate SM stewardship that adheres to institution-specific guidelines, content management, Accreditation Council for GME milestone requirements, and integration of SM in EM residency curriculum to enhance the learner's experience. Additionally, potential obstacles to the uptake of SM as an educational modality are discussed with proposed solutions.

Guidelines for Developing Competency-Based Curriculum.

ERIC Educational Resources Information Center

Goodson, Ludy

1979-01-01

Presents guidelines for the development of competency-based curriculum formulated as a result of an automotive mechanics curriculum workshop. Listed are specific guidelines for content development, writing style, and illustration. (LRA)

Morphology, production, and chemical content performance of black rice Matesih accession with several comparisons

NASA Astrophysics Data System (ADS)

Nandariyah; Purwanto, E.; Meidini, A. N.

2018-03-01

Rice (Oryza sativa L.) is an important food crop in Indonesia. In Matesih area, Karanganyar, recently found new varieties of black rice cultured by local farmers which morphology and chemical content have not yet identified. The purpose of this research was to obtain information of morphology, production, and chemical content of black rice matesih accession and to compare the appearance in order to detect the superiority of black rice matesih accession with the comparison of other accession of black rice. There were four accessions of black rice tested, namely Matesih Accession, Klaten Accession, Toraja, and Cempo. Research data were divided into qualitative data which processed by scoring, and quantitative data are processed with simple descriptive statistic. The kinship test was done by using NTSYSpc program with SIMQual and SIMInt function. The observation of qualitative properties indicates that accession matesih has a form that is relatively similar to other accessions. Qualitatively, accession matesih superior at leaf length, leaf width, plant height and culm diameter. Klaten accession has higher production than accession matesih. Matesih accession has the advantage of having shorter period on heading time and harvest time than other accessions. Matesih accession has the highest amylose content, lower protein content than klaten accession and lower content of anthocyanin than toraja accession. The kinship analysis showed that matesih accession and klaten accession has close kinship.

Content and Quality of Information Provided on Canadian Dementia Websites

PubMed Central

Dillon, Whitney A.; Prorok, Jeanette C.; Seitz, Dallas P.

2013-01-01

Purpose Information about dementia is important for persons with dementia (PWD) and their caregivers and the Internet has become the key source of health information. We reviewed the content and quality of information provided on Canadian websites for Alzheimer’s disease (AD). Methods We used the terms “dementia” and “Alzheimer” in Google to identify Canadian dementia websites. The contents of websites were compared to 16 guideline recommendations provided in Canadian Consensus Conference on Diagnosis and Treatment of Dementia. The quality of information provided on websites was evaluated using the DISCERN instrument. The content and quality of information provided on selected websites were then described. Results Seven websites were identified, three of which provided relatively comprehensive and high-quality information on dementia. Websites frequently provided information about diagnosis of dementia, its natural course, and types of dementia, while other topics were less commonly addressed. The quality of information provided on the websites varied, and many websites had several areas where the quality of information provided was relatively low according to the DISCERN instrument. Conclusions There is variation in the content and quality of dementia websites, although some websites provide high-quality and relatively comprehensive information which would serve as a useful resource for PWD, caregivers, and healthcare providers. Improvements in the content and quality of information provided on AD websites would provide PWD and their caregivers with access to better information. PMID:23440180

Adherence to guidelines for cardiovascular screening in current high school preparticipation evaluation forms.

PubMed

Rausch, Christopher M; Phillips, George C

2009-10-01

We compared the content of the cardiac screening questions on US state high school athletic association preparticipation evaluation forms with current consensus recommendations. We reviewed the high school athletic association's approved, recommended, or required sports preparticipation form from each of the 50 US states and the District of Columbia, and compared the content of the personal and family history components with current recommendations for cardiac screening questions. We found that 85% of the preparticipation forms in current use contain all elements of the formerly recommended guidelines, but only 17% contain all elements of the new consensus guidelines. We conclude that although there appears to be some improvement in the content of the preparticipation forms in current use compared with previous studies, the vast majority of these forms are incomplete compared with current consensus guidelines.

Guidelines for the Design of Computers and Information Processing Systems to Increase Their Access by Persons with Disabilities. Version 2.0.

ERIC Educational Resources Information Center

Vanderheiden, Gregg C.; Lee, Charles C.

Many low-cost and no-cost modifications to computers would greatly increase the number of disabled individuals who could use standard computers without requiring custom modifications, and would increase the ability to attach special input and output systems. The purpose of the Guidelines is to provide an awareness of these access problems and a…

Are medical educators following General Medical Council guidelines on obesity education: if not why not?

PubMed Central

2013-01-01

Background Although the United Kingdom’s (UK’s) General Medical Council (GMC) recommends that graduating medical students are competent to discuss obesity and behaviour change with patients, it is difficult to integrate this education into existing curricula, and clinicians report being unprepared to support patients needing obesity management in practice. We therefore aimed to identify factors influencing the integration of obesity management education within medical schools. Methods Twenty-seven UK and Irish medical school educators participated in semi-structured interviews. Grounded theory principles informed data collection and analysis. Themes emerging directly from the dataset illustrated key challenges for educators and informed several suggested solutions. Results Factors influencing obesity management education included: 1) Diverse and opportunistic learning and teaching, 2) Variable support for including obesity education within undergraduate medical programmes, and 3) Student engagement in obesity management education. Findings suggest several practical solutions to identified challenges including clarifying recommended educational agendas; improving access to content-specific guidelines; and implementing student engagement strategies. Conclusions Students’ educational experiences differ due to diverse interpretations of GMC guidelines, educators’ perceptions of available support for, and student interest in obesity management education. Findings inform the development of potential solutions to these challenges which may be tested further empirically. PMID:23578257

Use of Global initiative for asthma (GINA) guidelines in asthma management among paediatric residents in a Sub Saharan African country: a cross-sectional descriptive study.

PubMed

Chikaodinaka Ayuk, Adaeze; Ubesie, Agozie; Laura Odimegwu, Chioma; Iloh, Kenechukwu

2017-01-01

Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Despite abundance of asthma guidelines, prevalence has continued to increase globally. There is need to assess how the contents of asthma guidelines are put to clinical use by doctors in the management of children with asthma. This study aims at evaluating the clinical practice of paediatric residents in applying GINA guidelines. Cross-sectional descriptive study of paediatric residents from 23 university teaching hospitals in Nigeria using structured questionnaire. Data analyses were with Statistical Package for Social Sciences (SPSS) version 19 (Chicago IL). Chi square was used to assess for any significant associations between categorical variables. A p < 0.05 was regarded to be statistically significant. Sixty-six paediatric residents aged 27- 40 years were enrolled into the study (37 females and 29 males). One-third had spent more than three years in residency training. Fifty-eight residents (87.9%) were aware of the GINA guidelines while 46 (69.7%) were familiar with its contents. Only 39 (59.1%) residents adhered to the GINA guidelines. Twenty of the 35 junior residents (57.1%) compared to 26 of 31 (83.9%) senior residents were familiar with the GINA guidelines (p=0.031) while 15 of 35 junior residents (42.9%) compared to 24 of 31 senior residents (77.4%) consistently follow the GINA guidelines (p=0.006). Adherence to GINA guidelines was not influenced significantly by years of graduation or training (p>0.05). The use of the GINA guidelines was poor among paediatric residents. Application of contents rather than just availability of asthma guidelines may partly account for increasing asthma prevalence globally.

28 CFR 513.32 - Guidelines for disclosure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Guidelines for disclosure. 513.32 Section 513.32 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL MANAGEMENT AND ADMINISTRATION ACCESS TO RECORDS Release of Information General Provisions and Procedures § 513.32 Guidelines for...

How equity is addressed in clinical practice guidelines: a content analysis

PubMed Central

Shi, Chunhu; Tian, Jinhui; Wang, Quan; Petkovic, Jennifer; Ren, Dan; Yang, Kehu; Yang, Yang

2014-01-01

Objectives Considering equity into guidelines presents methodological challenges. This study aims to qualitatively synthesise the methods for incorporating equity in clinical practice guidelines (CPGs). Setting Content analysis of methodological publications. Eligibility criteria for selecting studies Methodological publications were included if they provided checklists/frameworks on when, how and to what extent equity should be incorporated in CPGs. Data sources We electronically searched MEDLINE, retrieved references, and browsed guideline development organisation websites from inception to January 2013. After study selection by two authors, general characteristics and checklists items/framework components from included studies were extracted. Based on the questions or items from checklists/frameworks (unit of analysis), content analysis was conducted to identify themes and questions/items were grouped into these themes. Primary outcomes The primary outcomes were methodological themes and processes on how to address equity issues in guideline development. Results 8 studies with 10 publications were included from 3405 citations. In total, a list of 87 questions/items was generated from 17 checklists/frameworks. After content analysis, questions were grouped into eight themes (‘scoping questions’, ‘searching relevant evidence’, ‘appraising evidence and recommendations’, ‘formulating recommendations’, ‘monitoring implementation’, ‘providing a flow chart to include equity in CPGs’, and ‘others: reporting of guidelines and comments from stakeholders’ for CPG developers and ‘assessing the quality of CPGs’ for CPG users). Four included studies covered more than five of these themes. We also summarised the process of guideline development based on the themes mentioned above. Conclusions For disadvantaged population-specific CPGs, eight important methodological issues identified in this review should be considered when including equity in CPGs under the guidance of a scientific guideline development manual. PMID:25479795

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

Perspectives of basic wheelchair users on improving their access to wheelchair services in Kenya and Philippines: a qualitative study.

PubMed

Williams, Emma; Hurwitz, Elizabeth; Obaga, Immaculate; Onguti, Brenda; Rivera, Adovich; Sy, Tyrone Reden L; Kirby, R Lee; Noon, Jamie; Tanuku, Deepti; Gichangi, Anthony; Bazant, Eva

2017-08-17

The United Nations has called for countries to improve access to mobility devices when needed. The World Health Organization has published guidelines on the provision of manual wheelchairs in less-resourced settings. Yet little is known about the extent to which appropriate wheelchairs are available and provided according to international guidelines. This study's purpose was to describe wheelchair users' experiences receiving services and acquiring wheelchair skills in urban and peri-urban areas of Kenya and the Philippines. Local researchers in Nairobi and Manila interviewed 48 adult basic wheelchair users, with even distribution of those who had and had not received wheelchair services along with their wheelchair. Recordings were transcribed in the local language and translated into English. The study team coded transcripts for predetermined and emergent themes, using Atlas-ti software. A qualitative content analysis approach was taken with the WHO service delivery process as an organizing framework. Wheelchair users frequently described past experiences with ill-fitting wheelchairs and little formal training to use wheelchairs effectively. Through exposure to multiple wheelchairs and self-advocacy, they learned to select wheelchairs suitable for their needs. Maintenance and repair services were often in short supply. Participants attributed shorter duration of wheelchair use to lack of repair. Peer support networks emerged as an important source of knowledge, resources and emotional support. Most participants acknowledged that they received wheelchairs that would have been difficult or impossible for them to pay for, and despite challenges, they were grateful to have some means of mobility. Four themes emerged as critical for understanding the implementation of wheelchair services: barriers in the physical environment, the need for having multiple chairs to improve access, perceived social stigma, and the importance of peer support. Interventions are needed to provide wheelchairs services efficiently, at scale, in an environment facilitating physical access and peer support, and reduced social stigma. Not applicable since this was a descriptive study.

Comprehension of Fish Consumption Guidelines Among Older Male Anglers in Wisconsin.

PubMed

Christensen, Krista Y; Raymond, Michelle R; Thompson, Brooke A; Schrank, Candy S; Williams, Meghan C W; Anderson, Henry A

2016-02-01

Although awareness of Wisconsin's fish consumption guidelines is high among older male anglers, little is known about comprehension of guideline content, and many anglers have levels of contaminants high enough to be associated with adverse health outcomes. The Environmental Protection Agency Great Lakes Restoration Initiative supported evaluation and revision of Wisconsin's fish consumption guideline program, using a web based survey of male Wisconsin anglers over the age of 50. A total of 3740 men completed the online survey; the median age of respondents was 62 years, and nearly all had lived and fished in Wisconsin for over 10 years. Comprehension of guideline content was relatively high, although two knowledge gaps were identified, one relating to mercury exposures and fish preparation, and the other to polychlorinated biphenyl content of certain fish species. The fishing regulations booklet distributed with annual fishing licenses and warning signs posted at fishing locations were commonly reported sources of guideline information in Wisconsin. Residents of coastal counties and consumers of Great Lakes fish were more likely to report guideline knowledge and behavior changes reflective of guideline knowledge, when compared to inland residents and those not consuming Great Lakes fish, respectively. In general, Wisconsin's consumption guidelines do not appear to discourage men from eating the fish they catch; rather, the most common behavioral changes included modifying the species eaten or the water body source of their meals. Continued efforts to educate anglers about the risks and benefits of fish consumption are needed.

Research Guidelines in the Era of Large-scale Collaborations: An Analysis of Genome-wide Association Study Consortia

PubMed Central

Austin, Melissa A.; Hair, Marilyn S.; Fullerton, Stephanie M.

2012-01-01

Scientific research has shifted from studies conducted by single investigators to the creation of large consortia. Genetic epidemiologists, for example, now collaborate extensively for genome-wide association studies (GWAS). The effect has been a stream of confirmed disease-gene associations. However, effects on human subjects oversight, data-sharing, publication and authorship practices, research organization and productivity, and intellectual property remain to be examined. The aim of this analysis was to identify all research consortia that had published the results of a GWAS analysis since 2005, characterize them, determine which have publicly accessible guidelines for research practices, and summarize the policies in these guidelines. A review of the National Human Genome Research Institute’s Catalog of Published Genome-Wide Association Studies identified 55 GWAS consortia as of April 1, 2011. These consortia were comprised of individual investigators, research centers, studies, or other consortia and studied 48 different diseases or traits. Only 14 (25%) were found to have publicly accessible research guidelines on consortia websites. The available guidelines provide information on organization, governance, and research protocols; half address institutional review board approval. Details of publication, authorship, data-sharing, and intellectual property vary considerably. Wider access to consortia guidelines is needed to establish appropriate research standards with broad applicability to emerging forms of large-scale collaboration. PMID:22491085

An evaluation of the objective quality and perceived usefulness of maternity clinical practice guidelines at a tertiary maternity unit.

PubMed

Trollope, Helena; Leung, Joyce Pui Yee; Wise, Michelle; Farquhar, Cynthia; Sadler, Lynn

2018-03-05

Compliance with maternity clinical practice guidelines developed by National Women's Health has been found to be low at audit. To explore the reasons for poor compliance with maternity guidelines by evaluating the quality of a sample of National Women's Health guidelines using a validated instrument and assessing local guideline users' perceptions of and attitudes toward guidelines. Five independent reviewers evaluated the quality of 10 purposively selected guidelines for adherence to the Appraisal of Guidelines Research & Evaluation (AGREE) II instrument standards. A self-administered questionnaire for staff was undertaken regarding views of and barriers to guideline use. None of the guidelines attained a score over 50% for the following domains: stakeholder involvement, rigour of development, applicability, editorial independence. The highest scoring domain was clarity of presentation (mean 69%). All guidelines scored the minimum possible for editorial independence. Survey respondents had positive attitudes toward guidelines, believed that their use could improve quality of care within the service, and felt that encouragement from senior staff members and peers would encourage their use. Accessibility was the most commonly cited of many barriers identified. The National Women's Health guidelines evaluated in this study cannot be considered to be high quality, and could be improved by reporting on methodology of the development process. Although poor guideline development may contribute to failure of the local maternity guidelines, it appears that accessibility is a major barrier to their use and implementation. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

National Economic Development Procedures Manual - Urban Flood Damage. Volume 2: Primer for Surveying Flood Damage for Residential Structures and Contents

DTIC Science & Technology

1991-10-01

procedures and techniques to measure flood damage and to further implement the Principles and Guidelines of the U.S. Water Resources Council. This manual... guidelines for using the OMB approved questionnaires are provided in Engineer Regulation 1105-2-100. The compendium provides the analyst with a helpful...question content, the analyst must also comply with OMB guidelines concerning implementation of the Privacy Act of 1974 (P.L. 93-579). This Act requires

A review of clinical practice guidelines for lung cancer

PubMed Central

Ball, David; Silvestri, Gerard A.

2013-01-01

Clinical practice guidelines are important evidence-based resources to guide complex clinical decision making. However, it is challenging for health professionals to keep abreast available guidelines and to know how and where to access relevant guidelines. This review examines currently available guidelines for lung cancer published in the English language. Important key features are listed for each identified guideline. The methodology, approaches to dissemination and implementation, and associated resources are summarised. General challenges in the area of guideline development are highlighted. The potential to collaborate more widely across lung cancer guideline developers by sharing literature searches and assessments is discussed. PMID:24163752

No global consensus: a cross-sectional survey of maternal weight policies

PubMed Central

2014-01-01

Background Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines. Methods This cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight. Results Fifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that within their country, policies were not widely known. Conclusions These results suggest that maternal weight is a concern throughout the world. However, we found a lack of international consensus on the content of guidelines. Further research is needed to understand which recommendations or interventions work best with respect to maternal weight in different country settings, and how pregnancy weight policies impact clinical practices and health outcomes for the mother and child. PMID:24884985

NCCN Frameworks for Resource Stratification of NCCN Guidelines: Adult Cancer Pain and Palliative Care.

PubMed

Swarm, Robert A; Dans, Maria

2018-05-01

The NCCN Framework aims to provide adapted guidelines for low- and middle-resource countries to improve the experience of patients with cancer. In particular, the NCCN Frameworks for Adult Cancer Pain and Palliative Care and were designed to help expand access to pain management and palliative care for patients in low-resource countries. The NCCN Framework is one of several tools that can improve cancer care in the developing world. The NCCN Harmonized Guidelines for Sub-Saharan Africa, a collaborative effort between NCCN, American Cancer Society, Clinton Health Access Initiative, and African Cancer Coalition, was developed to harmonize NCCN recommendations with local guidelines across Africa and to make best use of available services and resources. Copyright © 2018 by the National Comprehensive Cancer Network.

75 FR 5633 - Notice of Extension of Comment Period for NUREG-1921, EPRI/NRC-RES Fire Human Reliability...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

..., EPRI/NRC- RES Fire Human Reliability Analysis Guidelines, Draft Report for Comment AGENCY: Nuclear... Human Reliability Analysis Guidelines, Draft Report for Comment'' (December 11, 2009; 74 FR 65810). This... Human Reliability Analysis Guidelines'' is available electronically under ADAMS Accession Number...

75 FR 4380 - Draft Test Guidelines; Notice of Availability and Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPP-2009-0681; FRL-8437-2] Draft Test Guidelines; Notice...: Notice. SUMMARY: EPA is announcing the availability of four draft test guidelines for Product Performance... holidays. The Docket Facility telephone number is (703) 305-5805. Electronic access to the OPPTS Test...

Sex and Gender in the Social Sciences: Reassessing the Introductory Course, Principles in Microeconomics.

ERIC Educational Resources Information Center

Gappa, Judith M.; Pearce, Janice

Developed to help faculty teaching introductory courses in microeconomics, psychology, and sociology in colleges and universities incorporate existing knowledge about women into their course content and teaching practices, this report is organized into two sets of guidelines. The first, "Content Guidelines: Sex and Gender in the Introductory…

Saturday Morning Children's Television Advertising: A Longitudinal Content Analysis.

ERIC Educational Resources Information Center

Byrd-Bredbenner, Carol

2002-01-01

Content of ads on Saturday children's television programs in 1993 (n=378) and 1999 (n=385) was compared with dietary recommendations and advertising guidelines. Cereals and foods high in sugar or fat dominated ads. Results were compared with earlier studies, finding that over 30 years, ads adhered to advertising guidelines but did not reflect…

Guidelines for the Selection of Topical Content in ESL Programs

ERIC Educational Resources Information Center

Deckert, Glenn

2004-01-01

The author contends that the topical content of ESL lesson materials in schools and universities is of ethical significance. Based on an established model for ethical judgment in social services, five guidelines for ethical selection of lesson topics are proposed and illustrated. Lesson topics must help ESL students: (a) adjust to local…

Adherence of Pharmaceutical Advertisements in Medical Journals to FDA Guidelines and Content for Safe Prescribing

PubMed Central

Korenstein, Deborah; Keyhani, Salomeh; Mendelson, Ali; Ross, Joseph S.

2011-01-01

Background Physician-directed pharmaceutical advertising is regulated in the United States by the Food and Drug Administration (FDA); adherence to current FDA guidelines is unknown. Our objective was to determine adherence rates of physician-directed print advertisements in biomedical journals to FDA guidelines and describe content important for safe prescribing. Methods and Findings Cross-sectional analysis of November 2008 pharmaceutical advertisements within top U.S.-based biomedical journals publishing original research. We excluded advertisements for devices, over the counter medications, and disease awareness. We utilized FDA guideline items identifying unique forms of advertisement bias to categorize advertisements as adherent to FDA guidelines, possibly non-adherent to at least 1 item, or non-adherent to at least 1 item. We also evaluated advertisement content important for safe prescribing, including benefit quantification, risk information and verifiable references. All advertisements were evaluated by 2 or more investigators, with differences resolved by discussion. Twelve journals met inclusion criteria. Nine contained pharmaceutical advertisements, including 192 advertisements for 82 unique products; median 2 per product (range 1–14). Six “teaser” advertisements presented only drug names, leaving 83 full unique advertisements. Fifteen advertisements (18.1%) adhered to all FDA guidelines, 41 (49.4%) were non-adherent with at least one form of FDA-described bias, and 27 (32.5%) were possibly non-adherent due to incomplete information. Content important for safe prescribing was often incomplete; 57.8% of advertisements did not quantify serious risks, 48.2% lacked verifiable references and 28.9% failed to present adequate efficacy quantification. Study limitations included its focus on advertisements from a single month, the subjectivity of FDA guidelines themselves, and the necessary subjectivity of determinations of adherence. Conclusions Few physician-directed print pharmaceutical advertisements adhere to all FDA guidelines; over half fail to quantify serious risks. The FDA could better protect public health by creating new more objective advertisement guidelines requiring transparent presentation of basic safety and efficacy information. PMID:21858076

Adherence of pharmaceutical advertisements in medical journals to FDA guidelines and content for safe prescribing.

PubMed

Korenstein, Deborah; Keyhani, Salomeh; Mendelson, Ali; Ross, Joseph S

2011-01-01

Physician-directed pharmaceutical advertising is regulated in the United States by the Food and Drug Administration (FDA); adherence to current FDA guidelines is unknown. Our objective was to determine adherence rates of physician-directed print advertisements in biomedical journals to FDA guidelines and describe content important for safe prescribing. Cross-sectional analysis of November 2008 pharmaceutical advertisements within top U.S.-based biomedical journals publishing original research. We excluded advertisements for devices, over the counter medications, and disease awareness. We utilized FDA guideline items identifying unique forms of advertisement bias to categorize advertisements as adherent to FDA guidelines, possibly non-adherent to at least 1 item, or non-adherent to at least 1 item. We also evaluated advertisement content important for safe prescribing, including benefit quantification, risk information and verifiable references. All advertisements were evaluated by 2 or more investigators, with differences resolved by discussion. Twelve journals met inclusion criteria. Nine contained pharmaceutical advertisements, including 192 advertisements for 82 unique products; median 2 per product (range 1-14). Six "teaser" advertisements presented only drug names, leaving 83 full unique advertisements. Fifteen advertisements (18.1%) adhered to all FDA guidelines, 41 (49.4%) were non-adherent with at least one form of FDA-described bias, and 27 (32.5%) were possibly non-adherent due to incomplete information. Content important for safe prescribing was often incomplete; 57.8% of advertisements did not quantify serious risks, 48.2% lacked verifiable references and 28.9% failed to present adequate efficacy quantification. Study limitations included its focus on advertisements from a single month, the subjectivity of FDA guidelines themselves, and the necessary subjectivity of determinations of adherence. Few physician-directed print pharmaceutical advertisements adhere to all FDA guidelines; over half fail to quantify serious risks. The FDA could better protect public health by creating new more objective advertisement guidelines requiring transparent presentation of basic safety and efficacy information.

Proper management of rheumatoid arthritis in Latin America. What the guidelines say?

PubMed

Brenol, Claiton V; Nava, Jorge Ivan Gamez; Soriano, Enrique R

2015-03-01

To analyze characteristics of clinical practice guidelines (CPGs) for the management of rheumatoid arthritis (RA) developed in Latin American (LA) countries and to describe the knowledge, use, and barriers for their implementation perceived among LA rheumatologists, a comprehensive literature search including Medline, PubMed, Cochrane Library, LILACS and Scielo was performed. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was applied for evaluation. A survey was sent to PANLAR members containing questions related to knowledge about guidelines, application of the recommendations, and difficulties in implementing CPGs. Eight guidelines were identified. Most guidelines were evidence based (62 %), but in only 37 % a systematic literature search was done. None of the guidelines included patients' views and preferences, and only few of them stated an updating procedure. Funding body independence and disclosure of conflicts of interest were rarely reported. The survey was answered by 214 rheumatologists from all Latin American countries. Most rheumatologist reported knowledge and use of clinical guidelines, mainly international ones. In general, rheumatologist felt that guidelines apply to only a minority of patients seen in daily clinical practice. Limited access expensive drugs, suggested by the guidelines, was the most frequent barrier to guidelines implementation that was reported. A good number of guidelines on the treatment of rheumatoid arthritis have been developed in Latin America. Most of them are lacking some of the components recognized for high-quality clinical guidelines development. In spite that most rheumatologist know and apply guidelines, access to drugs is still a very important barrier to their implementation in Latin America.

Information and Communication Technology (ICT) Standards and Guidelines. Final rule.

PubMed

2017-01-18

We, the Architectural and Transportation Barriers Compliance Board (Access Board or Board), are revising and updating, in a single rulemaking, our standards for electronic and information technology developed, procured, maintained, or used by Federal agencies covered by section 508 of the Rehabilitation Act of 1973, as well as our guidelines for telecommunications equipment and customer premises equipment covered by Section 255 of the Communications Act of 1934. The revisions and updates to the section 508-based standards and section 255-based guidelines are intended to ensure that information and communication technology covered by the respective statutes is accessible to and usable by individuals with disabilities.

Patient's access to healthcare and treatment in rheumatoid arthritis: the views of stakeholders in Portugal.

PubMed

Laires, Pedro A; Mesquita, Rui; Veloso, Luís; Martins, Ana Paula; Cernadas, Rui; Fonseca, João Eurico

2013-09-25

The access to healthcare and treatment by rheumatoid arthritis (RA) patients, particularly to biologics, differs significantly among European countries.We aimed to explore the views and experiences of Portuguese healthcare stakeholders on key barriers which limit the access to treatment, and ultimately to biologics, by RA patients and to find potential solutions (leverage points) to overcome the identified barriers. This was a qualitative research consisting of semi-structured face-to-face interviews with key stakeholders in RA framework. Thirty four individuals from eight groups of stakeholders were interviewed: rural and urban general practitioners (GPs), rheumatologists, hospital managers, hospital pharmacists, budget holders, representatives from the Portuguese Rheumatology Society and the RA Patient Association. Interviews were conducted between May and June 2011. Conventional content analysis with research triangulation was used. The key barriers identified were related to the accessibility to primary healthcare services, difficulties in RA diagnosis among GPs, inefficient referral to secondary healthcare and controlled process of biologics prescription in public hospitals. The leverage points identified included the improvement of epidemiological and clinical knowledge about RA in Portugal, a better understanding of the disease among patients and GPs, the clarification of biologics benefits among budget holders and a raised awareness of the current treatment guidelines. In order to further address the leverage points, the following key initiatives were proposed: optimization of RA national registry; dissemination of information on rheumatic symptoms in primary care facilities and among the general public; increase interaction between rheumatologists and GPs through clinical discussions of successfully treated patients or workshops; broader utilization of disease diagnosis and monitoring tools, such as DAS28, and implementation of hospital-based research to collect real-world data. Most of the key barriers limiting the access to treatment, including biologics, in RA in Portugal are upstream of rheumatology practice. Our findings suggest that future actions should be focused on the primary care level to improve referral to rheumatologists. In addition, the collection of real-world data seems essential to characterise the RA population, to improve disease management and to increase compliance with current treatment guidelines.

36 CFR 910.51 - Access.

Code of Federal Regulations, 2014 CFR

2014-07-01

... AREA Glossary of Terms § 910.51 Access. Access, when used in reference to parking or loading, means... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Access. 910.51 Section 910.51 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION GENERAL GUIDELINES AND...

36 CFR 910.51 - Access.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AREA Glossary of Terms § 910.51 Access. Access, when used in reference to parking or loading, means... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Access. 910.51 Section 910.51 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION GENERAL GUIDELINES AND...

36 CFR 910.51 - Access.

Code of Federal Regulations, 2012 CFR

2012-07-01

... AREA Glossary of Terms § 910.51 Access. Access, when used in reference to parking or loading, means... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Access. 910.51 Section 910.51 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION GENERAL GUIDELINES AND...

36 CFR 910.51 - Access.

Code of Federal Regulations, 2011 CFR

2011-07-01

... AREA Glossary of Terms § 910.51 Access. Access, when used in reference to parking or loading, means... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Access. 910.51 Section 910.51 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION GENERAL GUIDELINES AND...

Linking guidelines to Electronic Health Record design for improved chronic disease management.

PubMed

Barretto, Sistine A; Warren, Jim; Goodchild, Andrew; Bird, Linda; Heard, Sam; Stumptner, Markus

2003-01-01

The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and workflow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR.

Linking Guidelines to Electronic Health Record Design for Improved Chronic Disease Management

PubMed Central

Barretto, Sistine A.; Warren, Jim; Goodchild, Andrew; Bird, Linda; Heard, Sam; Stumptner, Markus

2003-01-01

The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and work-flow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR. PMID:14728135

Diet and cancer

MedlinePlus

... html . Accessed July 13, 2017. US Department of Agriculture, Dietary Guidelines Advisory Committee. Scientific Report of the ... Health and Human Services and US Department of Agriculture. 2015 - 2020 Dietary Guidelines for Americans. 8th ed. ...

Foods - fresh vs. frozen or canned

MedlinePlus

... and U.S. Department of Agriculture website. 2015-2020 Dietary Guidelines for Americans. 8th Edition. December 2015. health.gov/dietaryguidelines/2015/resources/2015-2020_Dietary_Guidelines.pdf . Accessed July 13,2017.

The Content of Statistical Requirements for Authors in Biomedical Research Journals

PubMed Central

Liu, Tian-Yi; Cai, Si-Yu; Nie, Xiao-Lu; Lyu, Ya-Qi; Peng, Xiao-Xia; Feng, Guo-Shuang

2016-01-01

Background: Robust statistical designing, sound statistical analysis, and standardized presentation are important to enhance the quality and transparency of biomedical research. This systematic review was conducted to summarize the statistical reporting requirements introduced by biomedical research journals with an impact factor of 10 or above so that researchers are able to give statistical issues’ serious considerations not only at the stage of data analysis but also at the stage of methodological design. Methods: Detailed statistical instructions for authors were downloaded from the homepage of each of the included journals or obtained from the editors directly via email. Then, we described the types and numbers of statistical guidelines introduced by different press groups. Items of statistical reporting guideline as well as particular requirements were summarized in frequency, which were grouped into design, method of analysis, and presentation, respectively. Finally, updated statistical guidelines and particular requirements for improvement were summed up. Results: Totally, 21 of 23 press groups introduced at least one statistical guideline. More than half of press groups can update their statistical instruction for authors gradually relative to issues of new statistical reporting guidelines. In addition, 16 press groups, covering 44 journals, address particular statistical requirements. The most of the particular requirements focused on the performance of statistical analysis and transparency in statistical reporting, including “address issues relevant to research design, including participant flow diagram, eligibility criteria, and sample size estimation,” and “statistical methods and the reasons.” Conclusions: Statistical requirements for authors are becoming increasingly perfected. Statistical requirements for authors remind researchers that they should make sufficient consideration not only in regards to statistical methods during the research design, but also standardized statistical reporting, which would be beneficial in providing stronger evidence and making a greater critical appraisal of evidence more accessible. PMID:27748343

The Content of Statistical Requirements for Authors in Biomedical Research Journals.

PubMed

Liu, Tian-Yi; Cai, Si-Yu; Nie, Xiao-Lu; Lyu, Ya-Qi; Peng, Xiao-Xia; Feng, Guo-Shuang

2016-10-20

Robust statistical designing, sound statistical analysis, and standardized presentation are important to enhance the quality and transparency of biomedical research. This systematic review was conducted to summarize the statistical reporting requirements introduced by biomedical research journals with an impact factor of 10 or above so that researchers are able to give statistical issues' serious considerations not only at the stage of data analysis but also at the stage of methodological design. Detailed statistical instructions for authors were downloaded from the homepage of each of the included journals or obtained from the editors directly via email. Then, we described the types and numbers of statistical guidelines introduced by different press groups. Items of statistical reporting guideline as well as particular requirements were summarized in frequency, which were grouped into design, method of analysis, and presentation, respectively. Finally, updated statistical guidelines and particular requirements for improvement were summed up. Totally, 21 of 23 press groups introduced at least one statistical guideline. More than half of press groups can update their statistical instruction for authors gradually relative to issues of new statistical reporting guidelines. In addition, 16 press groups, covering 44 journals, address particular statistical requirements. The most of the particular requirements focused on the performance of statistical analysis and transparency in statistical reporting, including "address issues relevant to research design, including participant flow diagram, eligibility criteria, and sample size estimation," and "statistical methods and the reasons." Statistical requirements for authors are becoming increasingly perfected. Statistical requirements for authors remind researchers that they should make sufficient consideration not only in regards to statistical methods during the research design, but also standardized statistical reporting, which would be beneficial in providing stronger evidence and making a greater critical appraisal of evidence more accessible.

Guidelines for the management of hepatitis C in general practice: a semi-qualitative interview survey of GPs' views regarding content and implementation.

PubMed

Cullen, W; O'Leary, M; Langton, D; Stanley, J; Kelly, Y; Bury, G

2005-01-01

Hepatitis C is a common infection among people who attend GPs for methadone maintenance treatment. To determine the views of GPs towards clinical guidelines for the management of hepatitis C among current or former injecting drug users in advance of their implementation. A purposive sample of 14 GPs (10% of the total prescribing methadone at the time the guidelines were developed) was invited to review a pre-publication draft of the guidelines and interviewed regarding content, presentation, perceived barriers to implementation and suggested interventions to facilitate effective implementation of the guidelines. GPs indicated the guidelines were useful but suggested aspects of presentation should be clarified. Organisational issues were identified as the principal barriers to effective implementation, with the provision of additional nursing support the principal intervention suggested to facilitate implementation. Interviewing intended recipients may be an important step in ensuring clinical practice guidelines are effectively implemented.

Multi-sensory storytelling for persons with profound intellectual and multiple disabilities: an analysis of the development, content and application in practice.

PubMed

ten Brug, Annet; van der Putten, Annette; Penne, Anneleen; Maes, Bea; Vlaskamp, Carla

2012-07-01

Multi-sensory storytelling (MSST) books are individualized stories, which involve sensory stimulation in addition to verbal text. Despite the frequent use of MSST in practice, little research is conducted into its structure, content and effectiveness. This study aims at the analysis of the development, content and application in practice of the MSST books in persons with profound intellectual and multiple disabilities (PIMD). Forty-nine persons with PIMD and their direct support person participated. We analysed if the books are constructed and read according to guidelines. Content and used stimuli were related to age. Of the books 84% were constructed according to guidelines. In just 1.3% of the sessions, the story was read as intended. Regarding content, 67.4% of the stories focused on daily life excursions. Tactile stimuli were used most. Age related to stimuli choice, but not to content. Although most books were properly constructed, guidelines were barely followed during reading which may negatively influence the effectiveness. © 2012 Blackwell Publishing Ltd.

A study of the effect of ADA accessibility on Kansas roundabouts.

DOT National Transportation Integrated Search

2008-11-01

The Access Board, with authority to enforce provisions of the American Disabilities Act (ADA), initially determined : that roundabouts are not accessible by blind pedestrians and drafted proposed guidelines to require pedestrian : signals at all roun...

Screen time and children

MedlinePlus

... is considered unhealthy screen time. Current Screen Time Guidelines Children under age 2 should have no screen ... RSS Follow us Disclaimers Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for EHRs For Developers ...

Five Steps to an Accessible Classroom Website

ERIC Educational Resources Information Center

Amundson, Linda

2009-01-01

When teachers or technology coordinators publish a website, they are providing a product for a diverse group of people. That's why website design should follow accessibility guidelines. Websites should be accessible to those with visual, hearing, movement, cognitive, and speech disabilities. Good design means greater accessibility for all. This…

50 CFR 660.310 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Access Fisheries § 660.310 Purpose and scope. This subpart covers the Pacific Coast Groundfish open access fishery. The open access fishery, as defined at § 660.11, Subpart C, is the fishery composed of commercial vessels using open access gear fished pursuant to the harvest guidelines, quotas, and other...

Palliative care content on cancer center websites.

PubMed

Vater, Laura B; Rebesco, Gina; Schenker, Yael; Torke, Alexia M; Gramelspacher, Gregory

2018-03-01

Professional guidelines recommend that palliative care begin early in advanced cancer management, yet integration of palliative and cancer care remains suboptimal. Cancer centers may miss opportunities to provide palliative care information online. In this study, we described the palliative care content on cancer center websites. We conducted a systematic content analysis of 62 National Cancer Institute- (NCI) designated cancer center websites. We assessed the content of center homepages and analyzed search results using the terms palliative care, supportive care, and hospice. For palliative and supportive care webpages, we assessed services offered and language used to describe care. Two researchers analyzed all websites using a standardized coding manual. Kappa values ranged from 0.78 to 1. NCI-designated cancer center homepages presented information about cancer-directed therapy (61%) more frequently than palliative care (5%). Ten percent of cancer centers had no webpage with palliative care information for patients. Among centers with information for patients, the majority (96%) defined palliative or supportive care, but 30% did not discuss delivery of palliative care alongside curative treatment, and 14% did not mention provision of care early in the disease process. Cancer center homepages rarely mention palliative care services. While the majority of centers have webpages with palliative care content, they sometimes omit information about early use of care. Improving accessibility of palliative care information and increasing emphasis on early provision of services may improve integration of palliative and cancer care.

The design and content of orthodontic practise websites in the UK is suboptimal and does not correlate with search ranking.

PubMed

Patel, Annika; Cobourne, Martyn T

2015-08-01

This study investigated standards of ethical advertising; design and content; and information quality associated with UK dental practice websites offering orthodontic treatment. The World Wide Web was searched from a UK-based computer using the Google search engine combined with the term 'orthodontic braces'. The first 100 UK-based dental practice websites were pooled and saved following duplicate removal. Websites were evaluated for compliance with current General Dental Council ethical advertising guidelines; accessibility, usability, and reliability using the LIDA instrument (a validated outcome tool for healthcare website design and content evaluation); and quality of information using the DISCERN toolkit (a validated method of quality assessment for online written patient information). Nine per cent of websites demonstrated full compliance with current guidelines on ethical advertising. Mean total LIDA score was 110/144 (76%) [range: 51-135; 35-94%]. Eleven websites reached a gold standard of 90% or more for total LIDA score. Mean total DISCERN score was 48/75 (64%) [range: 19-73; 25-97%]. Five websites achieved a total DISCERN score above 90%. Spearman's rank correlation coefficients demonstrated no significant correlations between LIDA (0.1669; P = 0.4252, confidence interval [CI]: -0.2560 to 0.5362) or DISCERN (0.3572; P = 0.0796, CI: -0.0565 to 0.663) score and ranking amongst the 25 highest ranked websites. Most UK websites offering orthodontic services are not fully compliant with national guidelines relating to ethical advertising. Validated measures of website design (LIDA) and information quality (DISCERN) showed wide variation amongst sites. No correlation existed between ranking amongst the highest 25 sites and either of these measures. This investigation was limited to a subsample of UK-only websites; and whilst not representative of European-wide sites, it does suggest that in the UK at least website quality can be improved. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Adopting and implementing nutrition guidelines in recreational facilities: Public and private sector roles. A multiple case study

PubMed Central

2012-01-01

Background Recreational facilities are an important community resource for health promotion because they provide access to affordable physical activities. However, despite their health mandate, many have unhealthy food environments that may paradoxically increase the risk of childhood obesity. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are government-initiated, voluntary guidelines intended to facilitate children’s access to healthy food and beverage choices in schools, childcare and recreational facilities, however few recreational facilities are using them. Methods We used mixed methods within an exploratory multiple case study to examine factors that influenced adoption and implementation of the ANGCY and the nature of the food environment within three cases: an adopter, a semi-adopter and a non-adopter of the ANGCY. Diffusion of Innovations theory provided the theoretical platform for the study. Qualitative data were generated through interviews, observations, and document reviews, and were analysed using directed content analysis. Set theoretic logic was used to identify factors that differentiated adopters from the non-adopter. Quantitative sales data were also collected, and the quality of the food environment was scored using four complementary tools. Results The keys to adoption and implementation of nutrition guidelines in recreational facilities related to the managers’ nutrition-related knowledge, beliefs and perceptions, as these shaped his decisions and actions. The manager, however, could not accomplish adoption and implementation alone. Intersectoral linkages with schools and formal, health promoting partnerships with industry were also important for adoption and implementation to occur. The food environment in facilities that had adopted the ANGCY did not appear to be superior to the food environment in facilities that had not adopted the ANGCY. Conclusions ANGCY uptake may continue to falter under the current voluntary approach, as the environmental supports for voluntary action are poor. Where ANGCY uptake does occur, changes to the food environment may be relatively minor. Stronger government measures may be needed to require recreational facilities to improve their food environments and to limit availability of unhealthy foods. PMID:22632384

A critical analysis of Australian policies and guidelines for water immersion during labour and birth.

PubMed

Cooper, Megan; McCutcheon, Helen; Warland, Jane

2017-10-01

Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women's autonomy. The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth. Phase one of a three-phase mixed-methods study critically analysed 25 Australian water immersion policies/guidelines using critical discourse analysis. Policies/guidelines pertaining to the practice of water immersion reflect subjective opinions and views of the current literature base in favour of the risk-focused obstetric and biomedical discursive practices. Written with hegemonic influence, policies and guidelines impact on the autonomy of both women and practitioners. Policies and guidelines pertaining to water immersion, particularly for birth reflect opinion and varied interpretations of the current literature base. A degree of hegemonic influence was noted prompting recommendations for future maternity care policy and guidelines'. The Human Research Ethics Committee of the University of South Australia approved the research. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

78 FR 48159 - Preliminary 2012 Effluent Guidelines Program Plan and 2011 Annual Effluent Guidelines Review Report

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

... . 3. Internet access. Copies of the supporting documents are available at http://water.epa.gov.... See the supporting documents available at http://water.epa.gov/lawsregs/lawsguidance/cwa/304m/index... Annual Effluent Guidelines Review Report, and solicits public comment on both. Clean Water Act (CWA...

ADAAG Review Federal Advisory Committee Recommendations for a New ADAAG. Final Report.

ERIC Educational Resources Information Center

Architectural and Transportation Barriers Compliance Board, Washington, DC.

This report presents the final recommendations, in the form of a new set of guidelines, of a federal advisory committee concerning revisions to the Americans with Disabilities Act Accessibility Guidelines (ADAAG). The guidelines provide scoping and technical requirements for the design, construction, and alteration of sites, facilities, buildings,…

How Accessible Are Public Libraries' Web Sites? A Study of Georgia Public Libraries

ERIC Educational Resources Information Center

Ingle, Emma; Green, Ravonne A.; Huprich, Julia

2009-01-01

One issue that public librarians must consider when planning Web site design is accessibility for patrons with disabilities. This article reports a study of Web site accessibility of public libraries in Georgia. The focus of the report is whether public libraries use accessible guidelines and standards in making their Web sites accessible. An…

Guidelines for Documentation of Computer Programs and Automated Data Systems. (Category: Software; Subcategory: Documentation).

ERIC Educational Resources Information Center

Federal Information Processing Standards Publication, 1976

1976-01-01

These guidelines provide a basis for determining the content and extent of documentation for computer programs and automated data systems. Content descriptions of ten document types plus examples of how management can determine when to use the various types are included. The documents described are (1) functional requirements documents, (2) data…

Canadian Practice Guidelines for Comprehensive Community Treatment for Schizophrenia and Schizophrenia Spectrum Disorders.

PubMed

Addington, Donald; Anderson, Elizabeth; Kelly, Martina; Lesage, Alain; Summerville, Chris

2017-09-01

The objective of this review is to identify the features and components of a comprehensive system of services for people living with schizophrenia. A comprehensive system was conceived as one that served the full range of people with schizophrenia and was designed with consideration of the incidence and prevalence of schizophrenia. The system should provide access to the full range of evidence-based services, should be recovery oriented, and should provide patient-centred care. A systematic search was conducted for published guidelines for schizophrenia and schizophrenia spectrum disorders. The guidelines were rated by at least 2 raters, and recommendations adopted were primarily drawn from the National Institute for Clinical Excellence (2014) Guideline on Psychosis and Schizophrenia in adults and the Scottish Intercollegiate Guidelines Network guidelines on management of schizophrenia. The recommendations adapted for Canada cover the range of services required to provide comprehensive services. Comprehensive services for people with schizophrenia can be organized and delivered to improve the quality of life of people with schizophrenia and their carers. The services need to be organized in a system that provides access to those who need them.

Estimating dissemination of Centers for Disease Control and Prevention Sexually Transmitted Disease Treatment Guidelines from a survey of physicians.

PubMed

Hogben, Matthew; Wimberly, Yolanda H; Moore, Sandra

2007-05-01

Periodically, the Centers for Disease Control and Prevention (CDC) produce guidelines for the treatment of sexually transmitted diseases (STDs) in the USA. To date, few evaluations of the dissemination of these guidelines exist. A paper and pencil survey was distributed via priority mail to a sample of Atlanta-area physicians, 416 (34%) of whom responded with complete data. Physicians were drawn from private practice, managed-care settings and public settings. In all, 85% of respondents treated STD, with a further 10% referring cases. Of those treating STD, 56% owned a copy of the 2002 CDC Treatment Guidelines, and 26% knew how to access them. The corresponding figures for physicians not treating STD were 25% and 30%. Of the physicians who did have copies, half had accessed the internet for their copies. Acquisition of, or the knowledge of how to acquire, the CDC STD Treatment Guidelines was widespread. The internet may be an effective and cost-saving means of disseminating the guidelines, although the continued need for print distribution should not be discounted.

A service oriented approach for guidelines-based clinical decision support using BPMN.

PubMed

Rodriguez-Loya, Salvador; Aziz, Ayesha; Chatwin, Chris

2014-01-01

Evidence-based medical practice requires that clinical guidelines need to be documented in such a way that they represent a clinical workflow in its most accessible form. In order to optimize clinical processes to improve clinical outcomes, we propose a Service Oriented Architecture (SOA) based approach for implementing clinical guidelines that can be accessed from an Electronic Health Record (EHR) application with a Web Services enabled communication mechanism with the Enterprise Service Bus. We have used Business Process Modelling Notation (BPMN) for modelling and presenting the clinical pathway in the form of a workflow. The aim of this study is to produce spontaneous alerts in the healthcare workflow in the diagnosis of Chronic Obstructive Pulmonary Disease (COPD). The use of BPMN as a tool to automate clinical guidelines has not been previously employed for providing Clinical Decision Support (CDS).

The Impact of Policy Guidelines on Hospital Antibiotic Use over a Decade: A Segmented Time Series Analysis

PubMed Central

Chandy, Sujith J.; Naik, Girish S.; Charles, Reni; Jeyaseelan, Visalakshi; Naumova, Elena N.; Thomas, Kurien; Lundborg, Cecilia Stalsby

2014-01-01

Introduction Antibiotic pressure contributes to rising antibiotic resistance. Policy guidelines encourage rational prescribing behavior, but effectiveness in containing antibiotic use needs further assessment. This study therefore assessed the patterns of antibiotic use over a decade and analyzed the impact of different modes of guideline development and dissemination on inpatient antibiotic use. Methods Antibiotic use was calculated monthly as defined daily doses (DDD) per 100 bed days for nine antibiotic groups and overall. This time series compared trends in antibiotic use in five adjacent time periods identified as ‘Segments,’ divided based on differing modes of guideline development and implementation: Segment 1– Baseline prior to antibiotic guidelines development; Segment 2– During preparation of guidelines and booklet dissemination; Segment 3– Dormant period with no guidelines dissemination; Segment 4– Booklet dissemination of revised guidelines; Segment 5– Booklet dissemination of revised guidelines with intranet access. Regression analysis adapted for segmented time series and adjusted for seasonality assessed changes in antibiotic use trend. Results Overall antibiotic use increased at a monthly rate of 0.95 (SE = 0.18), 0.21 (SE = 0.08) and 0.31 (SE = 0.06) for Segments 1, 2 and 3, stabilized in Segment 4 (0.05; SE = 0.10) and declined in Segment 5 (−0.37; SE = 0.11). Segments 1, 2 and 4 exhibited seasonal fluctuations. Pairwise segmented regression adjusted for seasonality revealed a significant drop in monthly antibiotic use of 0.401 (SE = 0.089; p<0.001) for Segment 5 compared to Segment 4. Most antibiotic groups showed similar trends to overall use. Conclusion Use of overall and specific antibiotic groups showed varied patterns and seasonal fluctuations. Containment of rising overall antibiotic use was possible during periods of active guideline dissemination. Wider access through intranet facilitated significant decline in use. Stakeholders and policy makers are urged to develop guidelines, ensure active dissemination and enable accessibility through computer networks to contain antibiotic use and decrease antibiotic pressure. PMID:24647339

Developing Local Board of Health Guidelines to Promote Healthy Food Access — King County, Washington, 2010–2012

PubMed Central

Johnson, Donna B.; Krieger, James; MacDougall, Erin; Payne, Elizabeth; Chan, Nadine L.

2015-01-01

Policies that change environments are important tools for preventing chronic diseases, including obesity. Boards of health often have authority to adopt such policies, but few do so. This study assesses 1) how one local board of health developed a policy approach for healthy food access through vending machine guidelines (rather than regulations) and 2) the impact of the approach. Using a case study design guided by “three streams” policy theory and RE-AIM, we analyzed data from a focus group, interviews, and policy documents. The guidelines effectively supported institutional policy development in several settings. Recognition of the problem of chronic disease and the policy solution of vending machine guidelines created an opening for the board to influence nutrition environments. Institutions identified a need for support in adopting vending machine policies. Communities could benefit from the study board’s approach to using nonregulatory evidence-based guidelines as a policy tool. PMID:25927606

Non-vitamin K antagonist oral anticoagulants and atrial fibrillation guidelines in practice: barriers to and strategies for optimal implementation

PubMed Central

Camm, A. John; Pinto, Fausto J.; Hankey, Graeme J.; Andreotti, Felicita; Hobbs, F.D. Richard

2015-01-01

Stroke is a leading cause of morbidity and mortality worldwide. Atrial fibrillation (AF) is an independent risk factor for stroke, increasing the risk five-fold. Strokes in patients with AF are more likely than other embolic strokes to be fatal or cause severe disability and are associated with higher healthcare costs, but they are also preventable. Current guidelines recommend that all patients with AF who are at risk of stroke should receive anticoagulation. However, despite this guidance, registry data indicate that anticoagulation is still widely underused. With a focus on the 2012 update of the European Society of Cardiology (ESC) guidelines for the management of AF, the Action for Stroke Prevention alliance writing group have identified key reasons for the suboptimal implementation of the guidelines at a global, regional, and local level, with an emphasis on access restrictions to guideline-recommended therapies. Following identification of these barriers, the group has developed an expert consensus on strategies to augment the implementation of current guidelines, including practical, educational, and access-related measures. The potential impact of healthcare quality measures for stroke prevention on guideline implementation is also explored. By providing practical guidance on how to improve implementation of the ESC guidelines, or region-specific modifications of these guidelines, the aim is to reduce the potentially devastating impact that stroke can have on patients, their families and their carers. PMID:26116685

Exaggerating Accessible Differences: When Gender Stereotypes Overestimate Actual Group Differences.

PubMed

Eyal, Tal; Epley, Nicholas

2017-09-01

Stereotypes are often presumed to exaggerate group differences, but empirical evidence is mixed. We suggest exaggeration is moderated by the accessibility of specific stereotype content. In particular, because the most accessible stereotype contents are attributes perceived to differ between groups, those attributes are most likely to exaggerate actual group differences due to regression to the mean. We tested this hypothesis using a highly accessible gender stereotype: that women are more socially sensitive than men. We confirmed that the most accessible stereotype content involves attributes perceived to differ between groups (pretest), and that these stereotypes contain some accuracy but significantly exaggerate actual gender differences (Experiment 1). We observe less exaggeration when judging less accessible stereotype content (Experiment 2), or when judging individual men and women (Experiment 3). Considering the accessibility of specific stereotype content may explain when stereotypes exaggerate actual group differences and when they do not.

Improving Web Accessibility in a University Setting

ERIC Educational Resources Information Center

Olive, Geoffrey C.

2010-01-01

Improving Web accessibility for disabled users visiting a university's Web site is explored following the World Wide Web Consortium (W3C) guidelines and Section 508 of the Rehabilitation Act rules for Web page designers to ensure accessibility. The literature supports the view that accessibility is sorely lacking, not only in the USA, but also…

Development of the AGREE II, part 2: assessment of validity of items and tools to support application

PubMed Central

Brouwers, Melissa C.; Kho, Michelle E.; Browman, George P.; Burgers, Jako S.; Cluzeau, Françoise; Feder, Gene; Fervers, Béatrice; Graham, Ian D.; Hanna, Steven E.; Makarski, Julie

2010-01-01

Background We established a program of research to improve the development, reporting and evaluation of practice guidelines. We assessed the construct validity of the items and user’s manual in the β version of the AGREE II. Methods We designed guideline excerpts reflecting high-and low-quality guideline content for 21 of the 23 items in the tool. We designed two study packages so that one low-quality and one high-quality version of each item were randomly assigned to each package. We randomly assigned 30 participants to one of the two packages. Participants reviewed and rated the guideline content according to the instructions of the user’s manual and completed a survey assessing the manual. Results In all cases, content designed to be of high quality was rated higher than low-quality content; in 18 of 21 cases, the differences were significant (p < 0.05). The manual was rated by participants as appropriate, easy to use, and helpful in differentiating guidelines of varying quality, with all scores above the mid-point of the seven-point scale. Considerable feedback was offered on how the items and manual of the β-AGREE II could be improved. Interpretation The validity of the items was established and the user’s manual was rated as highly useful by users. We used these results and those of our study presented in part 1 to modify the items and user’s manual. We recommend AGREE II (available at www.agreetrust.org) as the revised standard for guideline development, reporting and evaluation. PMID:20513779

Guidelines for Outsourcing Remote Access.

ERIC Educational Resources Information Center

Hassler, Ardoth; Neuman, Michael

1996-01-01

Discusses the advantages and disadvantages of outsourcing remote access to campus computer networks and the Internet, focusing on improved service, cost-sharing, partnerships with vendors, supported protocols, bandwidth, scope of access, implementation, support, network security, and pricing. Includes a checklist for a request for proposals on…

A Plea for a Statewide Content Continuum.

ERIC Educational Resources Information Center

Swiers, Alma

1979-01-01

Suggests that elementary self-contained classroom teachers be provided with specific statewide content guidelines. The content should be based upon Piaget's theory of cognitive development. (Author/KC)

12 CFR Appendix B to Part 30 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2011 CFR

2011-01-01

... Establishing Information Security Standards Table of Contents I. Introduction A. Scope B. Preservation of... Security Program B. Objectives III. Development and Implementation of Customer Information Security Program.... Introduction The Interagency Guidelines Establishing Information Security Standards (Guidelines) set forth...

EuroFIR Guideline on calculation of nutrient content of foods for food business operators.

PubMed

Machackova, Marie; Giertlova, Anna; Porubska, Janka; Roe, Mark; Ramos, Carlos; Finglas, Paul

2018-01-01

This paper presents a Guideline for calculating nutrient content of foods by calculation methods for food business operators and presents data on compliance between calculated values and analytically determined values. In the EU, calculation methods are legally valid to determine the nutrient values of foods for nutrition labelling (Regulation (EU) No 1169/2011). However, neither a specific calculation method nor rules for use of retention factors are defined. EuroFIR AISBL (European Food Information Resource) has introduced a Recipe Calculation Guideline based on the EuroFIR harmonized procedure for recipe calculation. The aim is to provide food businesses with a step-by-step tool for calculating nutrient content of foods for the purpose of nutrition declaration. The development of this Guideline and use in the Czech Republic is described and future application to other Member States is discussed. Limitations of calculation methods and the importance of high quality food composition data are discussed. Copyright © 2017. Published by Elsevier Ltd.

Evaluation of Implementation, Adaptation and Use of the Recently Proposed Urea Cycle Disorders Guidelines.

PubMed

Häberle, Johannes; Huemer, Martina

2015-01-01

Implementation of guidelines and assessment of their adaptation is not an extensively investigated process in the field of rare diseases. However, whether targeted recipients are reached and willing and able to follow the recommendations has significant impact on the efficacy of guidelines. In 2012, a guideline for the management of urea cycle disorders (UCDs) has been published. We evaluate the efficacy of implementation, adaptation, and use of the UCD guidelines by applying different strategies. (i) Download statistics from online sources were recorded. (ii) Facilities relevant for the implementation of the guidelines were assessed in pediatric units in Germany and Austria. (iii) The guidelines were evaluated by targeted recipients using the AGREE instrument. (iv) A regional networking-based implementation process was evaluated. (i) Download statistics revealed high access with an increase in downloads over time. (ii) In 18% of hospitals ammonia testing was not available 24/7, and emergency drugs were often not available. (iii) Recipient criticism expressed in the AGREE instrument focused on incomplete inclusion of patients' perspectives. (iv) The implementation process improved the availability of ammonia measurements and access to emergency medication, patient care processes, and cooperation between nonspecialists and specialists. Interest in the UCD guidelines is high and sustained, but more precise targeting of the guidelines is advisable. Surprisingly, many hospitals do not possess all facilities necessary to apply the guidelines. Regional network and awareness campaigns result in the improvement of both facilities and knowledge.

Managing heart failure in the long-term care setting: nurses' experiences in Ontario, Canada.

PubMed

Strachan, Patricia H; Kaasalainen, Sharon; Horton, Amy; Jarman, Hellen; D'Elia, Teresa; Van Der Horst, Mary-Lou; Newhouse, Ian; Kelley, Mary Lou; McAiney, Carrie; McKelvie, Robert; Heckman, George A

2014-01-01

Implementation of heart failure guidelines in long-term care (LTC) settings is challenging. Understanding the conditions of nursing practice can improve management, reduce suffering, and prevent hospital admission of LTC residents living with heart failure. The aim of the study was to understand the experiences of LTC nurses managing care for residents with heart failure. This was a descriptive qualitative study nested in Phase 2 of a three-phase mixed methods project designed to investigate barriers and solutions to implementing the Canadian Cardiovascular Society heart failure guidelines into LTC homes. Five focus groups totaling 33 nurses working in LTC settings in Ontario, Canada, were audiorecorded, then transcribed verbatim, and entered into NVivo9. A complex adaptive systems framework informed this analysis. Thematic content analysis was conducted by the research team. Triangulation, rigorous discussion, and a search for negative cases were conducted. Data were collected between May and July 2010. Nurses characterized their experiences managing heart failure in relation to many influences on their capacity for decision-making in LTC settings: (a) a reactive versus proactive approach to chronic illness; (b) ability to interpret heart failure signs, symptoms, and acuity; (c) compromised information flow; (d) access to resources; and (e) moral distress. Heart failure guideline implementation reflects multiple dynamic influences. Leadership that addresses these factors is required to optimize the conditions of heart failure care and related nursing practice.

Regulation of genomic and biobanking research in Africa: a content analysis of ethics guidelines, policies and procedures from 22 African countries.

PubMed

de Vries, Jantina; Munung, Syntia Nchangwi; Matimba, Alice; McCurdy, Sheryl; Ouwe Missi Oukem-Boyer, Odile; Staunton, Ciara; Yakubu, Aminu; Tindana, Paulina

2017-02-02

The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research based on sharing, causing confusion about what is allowed, where and when. In order to understand better the ethics regulatory landscape around genomic research and biobanking, we conducted a comprehensive analysis of existing ethics guidelines, policies and other similar sources. We sourced 30 ethics regulatory documents from 22 African countries. We used software that assists with qualitative data analysis to conduct a thematic analysis of these documents. Surprisingly considering how contentious broad consent is in Africa, we found that most countries allow the use of this consent model, with its use banned in only three of the countries we investigated. In a likely response to fears about exploitation, the export of samples outside of the continent is strictly regulated, sometimes in conjunction with regulations around international collaboration. We also found that whilst an essential and critical component of ensuring ethical best practice in genomics research relates to the governance framework that accompanies sample and data sharing, this was most sparingly covered in the guidelines. There is a need for ethics guidelines in African countries to be adapted to the changing science policy landscape, which increasingly supports principles of openness, storage, sharing and secondary use. Current guidelines are not pertinent to the ethical challenges that such a new orientation raises, and therefore fail to provide accurate guidance to ethics committees and researchers.

The Value of E-Learning for the Prevention of Healthcare-Associated Infections.

PubMed

Labeau, Sonia O; Rello, Jordi; Dimopoulos, George; Lipman, Jeffrey; Sarikaya, Aklime; Oztürk, Candan; Vandijck, Dominique M; Vogelaers, Dirk; Vandewoude, Koenraad; Blot, Stijn I

2016-09-01

BACKGROUND Healthcare workers (HCWs) lack familiarity with evidence-based guidelines for the prevention of healthcare-associated infections (HAIs). There is good evidence that effective educational interventions help to facilitate guideline implementation, so we investigated whether e-learning could enhance HCW knowledge of HAI prevention guidelines. METHODS We developed an electronic course (e-course) and tested its usability and content validity. An international sample of voluntary learners submitted to a pretest (T0) that determined their baseline knowledge of guidelines, and they subsequently studied the e-course. Immediately after studying the course, posttest 1 (T1) assessed the immediate learning effect. After 3 months, during which participants had no access to the course, a second posttest (T2) evaluated the residual learning effect. RESULTS A total of 3,587 HCWs representing 79 nationalities enrolled: 2,590 HCWs (72%) completed T0; 1,410 HCWs (39%) completed T1; and 1,011 HCWs (28%) completed T2. The median study time was 193 minutes (interquartile range [IQR], 96-306 minutes) The median scores were 52% (IQR, 44%-62%) for T0, 80% (IQR, 68%-88%) for T1, and 74% (IQR, 64%-84%) for T2. The immediate learning effect (T0 vs T1) was +24% (IQR, 12%-34%; P300 minutes yielded the greatest residual effect (24%). CONCLUSIONS Moderate time invested in e-learning yielded significant immediate and residual learning effects. Decision makers could consider promoting e-learning as a supporting tool in HAI prevention. Infect Control Hosp Epidemiol 2016;37:1052-1059.

Molecular diversity and hypoglycemic polypeptide-P content of Momordica charantia in different accessions and different seasons.

PubMed

Tian, Miao; Zeng, Xiang-Qing; Song, Huan-Lei; Hu, Shan-Xin; Wang, Fu-Jun; Zhao, Jian; Hu, Zhi-Bi

2015-04-01

Momordica charantia (MC) has been used for treating diabetes mellitus from ancient times in Asia, Africa and South America. There are many MC accessions in local markets. Polypeptide-P as a main hypoglycemic component in MC was first studied in this experiment to illustrate the different contents in MC of different accessions and different harvesting times. Nineteen MC accessions collected from different regions were clustered into three groups using random amplified polymorphic DNA (RAPD) and inter-simple sequence repeat (ISSR) molecular markers. Content of polypeptide-P in the tested MC accessions was detected by western blot (WB) method. The WB results revealed that polypeptide-P was detected in MC accessions harvested in June and July but not in September and October. Furthermore, Polypeptide-P content corresponded well with the MC accessions. Our results suggest that the MC accessions and the harvesting times or the weather during harvest play significant roles in high content of polypeptide-P. © 2014 Society of Chemical Industry.

Access to safe legal abortion in Malaysia: women's insights and health sector response.

PubMed

Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey

2015-01-01

Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers. © 2014 APJPH.

Enhancement of a virtual reality wheelchair simulator to include qualitative and quantitative performance metrics.

PubMed

Harrison, C S; Grant, P M; Conway, B A

2010-01-01

The increasing importance of inclusive design and in particular accessibility guidelines established in the U.K. 1996 Disability Discrimination Act (DDA) has been a prime motivation for the work on wheelchair access, a subset of the DDA guidelines, described in this article. The development of these guidelines mirrors the long-standing provisions developed in the U.S. In order to raise awareness of these guidelines and in particular to give architects, building designers, and users a physical sensation of how a planned development could be experienced, a wheelchair virtual reality system was developed. This compares with conventional methods of measuring against drawings and comparing dimensions against building regulations, established in the U.K. under British standards. Features of this approach include the marriage of an electromechanical force-feedback system with high-quality immersive graphics as well as the potential ability to generate a physiological rating of buildings that do not yet exist. The provision of this sense of "feel" augments immersion within the virtual reality environment and also provides the basis from which both qualitative and quantitative measures of a building's access performance can be gained.

The diagnosis related groups enhanced electronic medical record.

PubMed

Müller, Marcel Lucas; Bürkle, Thomas; Irps, Sebastian; Roeder, Norbert; Prokosch, Hans-Ulrich

2003-07-01

The introduction of Diagnosis Related Groups as a basis for hospital payment in Germany announced essential changes in the hospital reimbursement practice. A hospital's economical survival will depend vitally on the accuracy and completeness of the documentation of DRG relevant data like diagnosis and procedure codes. In order to enhance physicians' coding compliance, an easy-to-use interface integrating coding tasks seamlessly into clinical routine had to be developed. A generic approach should access coding and clinical guidelines from different information sources. Within the Electronic Medical Record (EMR) a user interface ('DRG Control Center') for all DRG relevant clinical and administrative data has been built. A comprehensive DRG-related web site gives online access to DRG grouping software and an electronic coding expert. Both components are linked together using an application supporting bi-directional communication. Other web based services like a guideline search engine can be integrated as well. With the proposed method, the clinician gains quick access to context sensitive clinical guidelines for appropriate treatment of his/her patient and administrative guidelines for the adequate coding of the diagnoses and procedures. This paper describes the design and current implementation and discusses our experiences.

Predicting Regulatory Compliance in Beer Advertising on Facebook.

PubMed

Noel, Jonathan K; Babor, Thomas F

2017-11-01

The prevalence of alcohol advertising has been growing on social media platforms. The purpose of this study was to evaluate alcohol advertising on Facebook for regulatory compliance and thematic content. A total of 50 Budweiser and Bud Light ads posted on Facebook within 1 month of the 2015 NFL Super Bowl were evaluated for compliance with a self-regulated alcohol advertising code and for thematic content. An exploratory sensitivity/specificity analysis was conducted to determine if thematic content could predict code violations. The code violation rate was 82%, with violations prevalent in guidelines prohibiting the association of alcohol with success (Guideline 5) and health benefits (Guideline 3). Overall, 21 thematic content areas were identified. Displaying the product (62%) and adventure/sensation seeking (52%) were the most prevalent. There was perfect specificity (100%) for 10 content areas for detecting any code violation (animals, negative emotions, positive emotions, games/contests/promotions, female characters, minorities, party, sexuality, night-time, sunrise) and high specificity (>80%) for 10 content areas for detecting violations of guidelines intended to protect minors (animals, negative emotions, famous people, friendship, games/contests/promotions, minorities, responsibility messages, sexuality, sunrise, video games). The high prevalence of code violations indicates a failure of self-regulation to prevent potentially harmful content from appearing in alcohol advertising, including explicit code violations (e.g. sexuality). Routine violations indicate an unwillingness to restrict advertising content for public health purposes, and statutory restrictions may be necessary to sufficiently deter alcohol producers from repeatedly violating marketing codes. Violations of a self-regulated alcohol advertising code are prevalent in a sample of beer ads published on Facebook near the US National Football League's Super Bowl. Overall, 16 thematic content areas demonstrated high specificity for code violations. Alcohol advertising codes should be updated to expressly prohibit the use of such content. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

CIDR

Science.gov Websites

Related Links & Resources Access and Applications Access Applications Example Applications Project Research and Related (R&R) forms and the SF424 (R&R) Application Guide. Access to the CIDR Program Guidelines Example Applications All applications must include a Data Dictionary of phenotypic measures to be

Guidelines for maternal and neonatal "point of care": needs of and attitudes towards a computerized clinical decision support system in rural Burkina Faso.

PubMed

Zakane, S Alphonse; Gustafsson, Lars L; Tomson, Göran; Loukanova, Svetla; Sié, Ali; Nasiell, Josefine; Bastholm-Rahmner, Pia

2014-06-01

In 2010, 245,000 women died due to pregnancy-related causes in sub-Saharan Africa and southern Asia. Our study is nested into the QUALMAT project and seeks to improve the quality of maternal care services through the introduction of a computerized clinical decision support system (CDSS) to help healthcare workers in rural areas. Healthcare information technology applications in low-income countries may improve healthcare provision but recent studies demonstrate unintended consequences with underuse or resistance to CDSS and that the fit between the system and the clinical needs does present challenges. To explore and describe perceived needs and attitudes among healthcare workers to access WHO guidelines using CDSS in maternal and neonatal care in rural Burkina Faso. Data were collected with semi-structured interviews in two rural districts in Burkina Faso with 45 informants. Descriptive statistics were used for the analysis of the quantitative part of the interview corresponding to informants' background. Qualitative data were analyzed using manifest content analysis. Four main findings emerged: (a) an appreciable willingness among healthcare workers for and a great interest to adapt and use modern technologies like computers to learn more in the workplace, (b) a positive attitude to easy access of guidelines and implementation of decision-support using computers in the workplace, (c) a fear that the CDSS would require more working time and lead to double-work, and (d) that the CDSS is complicated and requires substantial computer training and extensive instructions to fully implement. The findings can be divided into aspects of motivators and barriers in relation to how the CDSS is perceived and to be used. These aspects are closely connected to each other as the motivating aspects can easily be turned into barriers if not taken care of properly in the final design, during implementation and maintenance of the CDSS at point of care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Food pattern modeling shows that the 2010 Dietary Guidelines for sodium and potassium cannot be met simultaneously

PubMed Central

Maillot, Matthieu; Monsivais, Pablo; Drewnowski, Adam

2013-01-01

The 2010 US Dietary Guidelines recommended limiting intake of sodium to 1500 mg/d for people older than 50 years, African Americans, and those suffering from chronic disease. The guidelines recommended that all other people consume less than 2300 mg sodium and 4700 mg of potassium per day. The theoretical feasibility of meeting the sodium and potassium guidelines while simultaneously maintaining nutritional adequacy of the diet was tested using food pattern modeling based on linear programming. Dietary data from the National Health and Nutrition Examination Survey 2001-2002 were used to create optimized food patterns for 6 age-sex groups. Linear programming models determined the boundary conditions for the potassium and sodium content of the modeled food patterns that would also be compatible with other nutrient goals. Linear programming models also sought to determine the amounts of sodium and potassium that both would be consistent with the ratio of Na to K of 0.49 and would cause the least deviation from the existing food habits. The 6 sets of food patterns were created before and after an across-the-board 10% reduction in sodium content of all foods in the Food and Nutrition Database for Dietary Studies. Modeling analyses showed that the 2010 Dietary Guidelines for sodium were incompatible with potassium guidelines and with nutritionally adequate diets, even after reducing the sodium content of all US foods by 10%. Feasibility studies should precede or accompany the issuing of dietary guidelines to the public. PMID:23507224

Reconciling pairs of concurrently used clinical practice guidelines using Constraint Logic Programming.

PubMed

Wilk, Szymon; Michalowski, Martin; Michalowski, Wojtek; Hing, Marisela Mainegra; Farion, Ken

2011-01-01

This paper describes a new methodological approach to reconciling adverse and contradictory activities (called points of contention) occurring when a patient is managed according to two or more concurrently used clinical practice guidelines (CPGs). The need to address these inconsistencies occurs when a patient with more than one disease, each of which is a comorbid condition, has to be managed according to different treatment regimens. We propose an automatic procedure that constructs a mathematical guideline model using the Constraint Logic Programming (CLP) methodology, uses this model to identify and mitigate encountered points of contention, and revises the considered CPGs accordingly. The proposed procedure is used as an alerting mechanism and coupled with a guideline execution engine warns the physician about potential problems with the concurrent application of two or more guidelines. We illustrate the operation of our procedure in a clinical scenario describing simultaneous use of CPGs for duodenal ulcer and transient ischemic attack.

Examining the Alignment of Chinese National Physics Curriculum Guidelines and 12th-Grade Exit Examinations: A Case Study

ERIC Educational Resources Information Center

Liang, Ling L.; Yuan, Haiquan

2008-01-01

This study reports findings from an analysis of the 2002 Chinese National Physics Curriculum Guidelines and the alignment between the curriculum guidelines and two most recent provincial-level 12th-grade exit examinations in China. Both curriculum guidelines and test content were represented using two-dimensional matrices (i.e., topic by level of…

A new independent authority is needed to issue National Health Care guidelines.

PubMed

Keyhani, Salomeh; Kim, Azalea; Mann, Micah; Korenstein, Deborah

2011-02-01

Health experts emphasize that getting doctors to follow clinical guidelines can save both lives and money. Less attention has been paid to how the guidelines are developed and the variability in the recommendations they include. We examined the quality and content of screening guidelines as a proxy for guidelines in general and found that the source of the guidelines affects their quality. Guidelines with inconsistent recommendations are unlikely to serve patients or physicians well. The creation of an independent organization that would work with multiple stakeholders to develop guidelines holds the potential to improve their quality.

Accessibility of U.S. Federal Government Home Pages: Section 508 Compliance and Site Accessibility Statements

ERIC Educational Resources Information Center

Olalere, Abiodun; Lazar, Jonathan

2011-01-01

U.S. federal websites are required to be accessible for people with impairments. However, despite the existing regulations and guidelines, many federal websites continue to be inaccessible, and accessibility policy statements available on federal websites often do not provide any useful information. This paper provides three contributions to the…

Synergies and Tradeoffs Among Environmental Impacts Under Conservation Planning of Shale Gas Surface Infrastructure

NASA Astrophysics Data System (ADS)

Milt, Austin W.; Gagnolet, Tamara; Armsworth, Paul R.

2016-01-01

Hydraulic fracturing and related ground water issues are growing features in public discourse. Few have given much attention to surface impacts from shale gas development, which result from building necessary surface infrastructure. One way to reduce future impacts from gas surface development without radically changing industry practice is by formulating simple, conservation-oriented planning guidelines. We explore how four such guidelines affect the locations of well pads, access roads, and gathering pipelines on state lands in Pennsylvania. Our four guidelines aim to (1) reduce impacts on water, reduce impacts from (2) gathering pipelines and (3) access roads, and (4) reduce impacts on forests. We assessed whether the use of such guidelines accompanies tradeoffs among impacts, and if any guidelines perform better than others at avoiding impacts. We find that impacts are mostly synergistic, such that avoiding one impact will result in avoiding others. However, we found that avoiding forest fragmentation may result in increased impacts on other environmental features. We also found that single simple planning guidelines can be effective in targeted situations, but no one guideline was universally optimal in avoiding all impacts. As such, we suggest that when multiple environmental features are important in an area, more comprehensive planning strategies and tools should be used.

Synergies and Tradeoffs Among Environmental Impacts Under Conservation Planning of Shale Gas Surface Infrastructure.

PubMed

Milt, Austin W; Gagnolet, Tamara; Armsworth, Paul R

2016-01-01

Hydraulic fracturing and related ground water issues are growing features in public discourse. Few have given much attention to surface impacts from shale gas development, which result from building necessary surface infrastructure. One way to reduce future impacts from gas surface development without radically changing industry practice is by formulating simple, conservation-oriented planning guidelines. We explore how four such guidelines affect the locations of well pads, access roads, and gathering pipelines on state lands in Pennsylvania. Our four guidelines aim to (1) reduce impacts on water, reduce impacts from (2) gathering pipelines and (3) access roads, and (4) reduce impacts on forests. We assessed whether the use of such guidelines accompanies tradeoffs among impacts, and if any guidelines perform better than others at avoiding impacts. We find that impacts are mostly synergistic, such that avoiding one impact will result in avoiding others. However, we found that avoiding forest fragmentation may result in increased impacts on other environmental features. We also found that single simple planning guidelines can be effective in targeted situations, but no one guideline was universally optimal in avoiding all impacts. As such, we suggest that when multiple environmental features are important in an area, more comprehensive planning strategies and tools should be used.

32 CFR 147.31 - Temporary eligibility for access at the top secret levels and temporary eligibility for “Q...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Temporary eligibility for access at the top secret levels and temporary eligibility for âQâ access authorization: For someone who is the subject of a... Guidelines for Temporary Access § 147.31 Temporary eligibility for access at the top secret levels and...

32 CFR 147.31 - Temporary eligibility for access at the top secret levels and temporary eligibility for “Q...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Temporary eligibility for access at the top secret levels and temporary eligibility for âQâ access authorization: For someone who is the subject of a... Guidelines for Temporary Access § 147.31 Temporary eligibility for access at the top secret levels and...

32 CFR 147.31 - Temporary eligibility for access at the top secret levels and temporary eligibility for “Q...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Temporary eligibility for access at the top secret levels and temporary eligibility for âQâ access authorization: For someone who is the subject of a... Guidelines for Temporary Access § 147.31 Temporary eligibility for access at the top secret levels and...

32 CFR 147.31 - Temporary eligibility for access at the top secret levels and temporary eligibility for “Q...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Temporary eligibility for access at the top secret levels and temporary eligibility for âQâ access authorization: For someone who is the subject of a... Guidelines for Temporary Access § 147.31 Temporary eligibility for access at the top secret levels and...

32 CFR 147.31 - Temporary eligibility for access at the top secret levels and temporary eligibility for “Q...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Guidelines for Temporary Access § 147.31 Temporary eligibility for access at the top secret levels and... 32 National Defense 1 2010-07-01 2010-07-01 false Temporary eligibility for access at the top secret levels and temporary eligibility for âQâ access authorization: For someone who is the subject of a...

Assessment of Self-Regulatory Code Violations in Brazilian Television Beer Advertisements*

PubMed Central

Vendrame, Alan; Pinsky, Ilana; Souza E Silva, Rebeca; Babor, Thomas

2010-01-01

Objective: Research suggests that alcoholic beverage advertisements may have an adverse effect on teenagers and young adults, owing to their vulnerability to suggestive message content. This study was designed to evaluate perceived violations of the content guidelines of the Brazilian alcohol marketing self-regulation code, based on ratings of the five most popular beer advertisements broadcast on television in the summer of 2005–2006 and during the 2006 FIFA (Fédération Internationale de Football Association) World Cup games. Method: Five beer advertisements were selected from a previous study showing that they were perceived to be highly appealing to a sample of Brazilian teenagers. These advertisements were evaluated by a sample of Brazilian high school students using a rating procedure designed to measure the content of alcohol advertisements covered in industry self-regulation codes. Results: All five advertisements were found to violate multiple guidelines of the Brazilian code of marketing self-regulation. The advertisement with the greatest number of violations was Antarctica's “Male Repellent,” which was perceived to violate 11 of the 16 guidelines in the code. Two advertisements had nine violations, and one had eight. The guidelines most likely to be violated by these advertisements were Guideline 1, which is aimed at protecting children and teenagers, and Guideline 2, which prohibits content encouraging excessive and irresponsible alcoholic beverage consumption. Conclusions: The five beer advertisements rated as most appealing to Brazilian teenagers were perceived by a sample of the same population to have violated numerous principles of the Brazilian self-regulation code governing the marketing of alcoholic beverages. Because of these numerous perceived code violations, it now seems important for regulatory authorities to submit industry marketing content to more systematic evaluation by young people and public health experts and for researchers to focus more on the ways in which alcohol advertising influences early onset of drinking and excessive alcohol consumption. PMID:20409439

Assessment of self-regulatory code violations in Brazilian television beer advertisements.

PubMed

Vendrame, Alan; Pinsky, Ilana; e Silva, Rebeca Souza; Babor, Thomas

2010-05-01

Research suggests that alcoholic beverage advertisements may have an adverse effect on teenagers and young adults, owing to their vulnerability to suggestive message content. This study was designed to evaluate perceived violations of the content guidelines of the Brazilian alcohol marketing self-regulation code, based on ratings of the five most popular beer advertisements broadcast on television in the summer of 2005-2006 and during the 2006 FIFA (Federation Internationale de Football Association) World Cup games. Five beer advertisements were selected from a previous study showing that they were perceived to be highly appealing to a sample of Brazilian teenagers. These advertisements were evaluated by a sample of Brazilian high school students using a rating procedure designed to measure the content of alcohol advertisements covered in industry self-regulation codes. All five advertisements were found to violate multiple guidelines of the Brazilian code of marketing self-regulation. The advertisement with the greatest number of violations was Antarctica's "Male Repellent," which was perceived to violate 11 of the 16 guidelines in the code. Two advertisements had nine violations, and one had eight. The guidelines most likely to be violated by these advertisements were Guideline 1, which is aimed at protecting children and teenagers, and Guideline 2, which prohibits content encouraging excessive and irresponsible alcoholic beverage consumption. The five beer advertisements rated as most appealing to Brazilian teenagers were perceived by a sample of the same population to have violated numerous principles of the Brazilian self-regulation code governing the marketing of alcoholic beverages. Because of these numerous perceived code violations, it now seems important for regulatory authorities to submit industry marketing content to more systematic evaluation by young people and public health experts and for researchers to focus more on the ways in which alcohol advertising influences early onset of drinking and excessive alcohol consumption.

Sex Education in Connecticut High Schools: Teachers' Reports of Content and Importance Ratings According to the SIECUS Guidelines

ERIC Educational Resources Information Center

Obloj, Wallace; Lynn, Donna

2010-01-01

The purpose of this study was to examine Connecticut teachers' reports of the sex education content taught to high school students as well as teachers' reports of the degree of importance for Connecticut high school students to understand according to the SIECUS Guidelines. The data revealed that participants (N=125) reported teaching 72% of the…

Veterinary students' usage and perception of video teaching resources.

PubMed

Roshier, Amanda L; Foster, Neil; Jones, Michael A

2011-01-10

The purpose of our study was to use a student-centred approach to develop an online video learning resource (called 'Moo Tube') at the School of Veterinary Medicine and Science, University of Nottingham, UK and also to provide guidance for other academics in the School wishing to develop a similar resource in the future. A focus group in the format of the nominal group technique was used to garner the opinions of 12 undergraduate students (3 from year-1, 4 from year-2 and 5 from year-3). Students generated lists of items in response to key questions, these responses were thematically analysed to generate key themes which were compared between the different year groups. The number of visits to 'Moo Tube' before and after an objective structured practical examination (OSPE) was also analysed to provide data on video usage. Students highlighted a number of strengths of video resources which can be grouped into four overarching themes: (1) teaching enhancement, (2) accessibility, (3) technical quality and (4) video content. Of these themes, students rated teaching enhancement and accessibility most highly. Video usage was seen to significantly increase (P < 0.05) prior to an examination and significantly decrease (P < 0.05) following the examination. The students had a positive perception of video usage in higher education. Video usage increases prior to practical examinations. Image quality was a greater concern with year-3 students than with either year-1 or 2 students but all groups highlighted the following as important issues: i) good sound quality, ii) accessibility, including location of videos within electronic libraries, and iii) video content. Based on the findings from this study, guidelines are suggested for those developing undergraduate veterinary videos. We believe that many aspects of our list will have resonance in other areas of medicine education and higher education.

[Guidelines for management of epilepsy--commentary on Scottish ("SIGN") guidelines].

PubMed

Planjar-Prvan, Miljenka; Granić, Davorka

2005-01-01

The choice of AED (antiepileptic drug), worldwide and in Croatia, is been still based on the physician's subjective decision, personal experience, knowledge and marketing pressure made by big pharmaceutical industries. Therefore, according to some opinions, there is a need of treatment guidelines for epilepsy that would provide relevant information based on scientific evidence on the efficacy, tolerability and safety of AEDs. The guidelines, published by a competent source, should be designed as to allow for easy access to the information on the best practice in specific cases. An extensive background literature review was made to identify such a type of guidelines for the management of epilepsy. The literature review revealed a number of references with the recommendations for treating epilepsy in different groups of patients and from various, specific aspects of epilepsy treatment. However, only one comprehensive set of guidelines for the diagnosis and treatment of epilepsy treatment was found, i.e. the evidence-based guidelines published by the Scottish Intercollegiate Guidelines Network (SIGN). The development of this set of guidelines is quite extensively described in order to illustrate how rigorous and long-lasting the process was, including a great number of health professionals at the national level. Such a type of well designed guidelines facilitates access to highest educational standards for all professionals involved in the primary and secondary care of people with epilepsy. However, it is clear that guidelines can fully replace the standards of clinical practice based on critical evaluation and integration of all clinical data of each individual patient. No guidelines can replace the physician's obligation to keep informed of the novel achievements in the epileptology either.

Coordinated, Collaborative and Coherent: Developing and Implementing E-Learning Guidelines within a National Tertiary Education System

ERIC Educational Resources Information Center

Suddaby, Gordon; Milne, John

2008-01-01

Purpose: The paper aims to discusses two complementary initiatives focussed on developing and implementing e-learning guidelines to support good pedagogy in e-learning practice. Design/methodology/approach: The first initiative is the development of a coherent set of open access e-learning guidelines for the New Zealand tertiary sector. The second…

Versioning System for Distributed Ontology Development

DTIC Science & Technology

2016-03-15

provides guidelines for evaluating the impact of the version changes. This page intentionally left blank. v...conformance to a clear set of development and versioning guidelines to assure that changes and extensions can be integrated back into the “main development... guidelines for evolution of an ontology would have considerably helped the users of the ontology in these situations. The currently accessible

75 FR 55577 - Clean Water Act; Contractor Access to Confidential Business Information

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-13

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9200-8] Clean Water Act; Contractor Access to Confidential... Recovery Act (RCRA). Transfer of the information will allow the contractor and subcontractors to access... contractors and subcontractors over the history of the effluent guidelines program. EPA determined that this...

Cost Analysis of Public Rights-of-Way Accessibility Guidelines

DOT National Transportation Integrated Search

2010-11-29

Accessible Pedestrian Signals (APS) provide auditory and tactile information about the : pedestrian signal phases (walk and dont walk) at signalized pedestrian crossings. : This information parallels the visual information provided by ...

User experiences of evidence-based online resources for health professionals: User testing of The Cochrane Library

PubMed Central

Rosenbaum, Sarah E; Glenton, Claire; Cracknell, Jane

2008-01-01

Background Evidence-based decision making relies on easy access to trustworthy research results. The Cochrane Library is a key source of evidence about the effect of interventions and aims to "promote the accessibility of systematic reviews to anyone wanting to make a decision about health care". We explored how health professionals found, used and experienced The Library, looking at facets of user experience including findability, usability, usefulness, credibility, desirability and value. Methods We carried out 32 one-hour usability tests on participants from Norway and the UK. Participants both browsed freely and attempted to perform individually tailored tasks while "thinking aloud". Sessions were recorded and viewed in real time by researchers. Transcriptions and videos were reviewed by one researcher and one designer. Findings reported here reflect issues receiving a high degree of saturation and that we judge to be critical to the user experience of evidence-based web sites, based on principles for usability heuristics, web guidelines and evidence-based practice. Results Participants had much difficulty locating both the site and its contents. Non-native English speakers were at an extra disadvantage when retrieving relevant documents despite high levels of English-language skills. Many participants displayed feelings of ineptitude, alienation and frustration. Some made serious mistakes in correctly distinguishing between different information types, for instance reviews, review protocols, and individual studies. Although most expressed a high regard for the site's credibility, some later displayed a mistrust of the independence of the information. Others were overconfident, thinking everything on The Cochrane Library site shared the same level of quality approval. Conclusion Paradoxically, The Cochrane Library, established to support easy access to research evidence, has its own problems of accessibility. Health professionals' experiences of this and other evidence-based online resources can be improved by applying existing principles for web usability, prioritizing the development of simple search functionality, emitting "researcher" jargon, consistent marking of site ownership, and clear signposting of different document types and different content quality. PMID:18662382

Non-vitamin K antagonist oral anticoagulants and atrial fibrillation guidelines in practice: barriers to and strategies for optimal implementation.

PubMed

Camm, A John; Pinto, Fausto J; Hankey, Graeme J; Andreotti, Felicita; Hobbs, F D Richard

2015-07-01

Stroke is a leading cause of morbidity and mortality worldwide. Atrial fibrillation (AF) is an independent risk factor for stroke, increasing the risk five-fold. Strokes in patients with AF are more likely than other embolic strokes to be fatal or cause severe disability and are associated with higher healthcare costs, but they are also preventable. Current guidelines recommend that all patients with AF who are at risk of stroke should receive anticoagulation. However, despite this guidance, registry data indicate that anticoagulation is still widely underused. With a focus on the 2012 update of the European Society of Cardiology (ESC) guidelines for the management of AF, the Action for Stroke Prevention alliance writing group have identified key reasons for the suboptimal implementation of the guidelines at a global, regional, and local level, with an emphasis on access restrictions to guideline-recommended therapies. Following identification of these barriers, the group has developed an expert consensus on strategies to augment the implementation of current guidelines, including practical, educational, and access-related measures. The potential impact of healthcare quality measures for stroke prevention on guideline implementation is also explored. By providing practical guidance on how to improve implementation of the ESC guidelines, or region-specific modifications of these guidelines, the aim is to reduce the potentially devastating impact that stroke can have on patients, their families and their carers. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

[Intraosseous infusion. An important technique also for paediatric anaesthesia].

PubMed

Weiss, M; Henze, G; Eich, C; Neuhaus, D

2009-09-01

Timely establishment of venous access in infants and toddlers can prove a particularly challenging task. Since the 1940s the technique of intraosseous infusion has established itself as a valuable alternative means for rapid, efficient and safe delivery of drugs and fluids to critically ill children. Whereas international guidelines for paediatric emergency medical care have assigned intraosseous infusion a high priority, most anaesthetists utilize this well-proven technique with great reluctance. This article describes the technique of intraosseous infusion, introduces two different cannulation systems, and discusses its potential indications in paediatric anaesthesia, based on current emergency medical care guidelines as well as some of our own case studies. In particular, children with acutely life-threatening conditions, such as circulatory arrest, laryngospasm, acute airway haemorrhage, hypovolaemic shock or hypothermia secondary to extensive burns, should receive an intraosseous cannula if intravenous access cannot be rapidly established. Future discussion may reveal whether a transiently inserted intraosseous infusion would also be indicated if the child with difficult or impossible venous access presents without acute life-threatening conditions for anaesthesia. Successful application of the intraosseous infusion technique requires immediate access to the necessary equipment, intensive education, continuous training and clear guidelines for its application in an anaesthesia department.

New Tools to Convert PDF Math Contents into Accessible e-Books Efficiently.

PubMed

Suzuki, Masakazu; Terada, Yugo; Kanahori, Toshihiro; Yamaguchi, Katsuhito

2015-01-01

New features in our math-OCR software to convert PDF math contents into accessible e-books are shown. A method for recognizing PDF is thoroughly improved. In addition, contents in any selected area including math formulas in a PDF file can be cut and pasted into a document in various accessible formats, which is automatically recognized and converted into texts and accessible math formulas through this process. Combining it with our authoring tool for a technical document, one can easily produce accessible e-books in various formats such as DAISY, accessible EPUB3, DAISY-like HTML5, Microsoft Word with math objects and so on. Those contents are useful for various print-disabled students ranging from the blind to the dyslexic.

Developing a guideline for clinical trial protocol content: Delphi consensus survey

PubMed Central

2012-01-01

Background Recent evidence has highlighted deficiencies in clinical trial protocols, having implications for many groups. Existing guidelines for randomized clinical trial (RCT) protocol content vary substantially and most do not describe systematic methodology for their development. As one of three prespecified steps for the systematic development of a guideline for trial protocol content, the objective of this study was to conduct a three-round Delphi consensus survey to develop and refine minimum content for RCT protocols. Methods Panellists were identified using a multistep iterative approach, met prespecified minimum criteria and represented key stakeholders who develop or use clinical trial protocols. They were asked to rate concepts for importance in a minimum set of items for RCT protocols. The main outcome measures were degree of importance (scale of 1 to 10; higher scores indicating higher importance) and level of consensus for items. Results were presented as medians, interquartile ranges, counts and percentages. Results Ninety-six expert panellists participated in the Delphi consensus survey including trial investigators, methodologists, research ethics board members, funders, industry, regulators and journal editors. Response rates were between 88 and 93% per round. Overall, panellists rated 63 of 88 concepts of high importance (of which 50 had a 25th percentile rating of 8 or greater), 13 of moderate importance (median 6 or 7) and 12 of low importance (median less than or equal to 5) for minimum trial protocol content. General and item-specific comments and subgroup results provided valuable insight for further discussions. Conclusions This Delphi process achieved consensus from a large panel of experts from diverse stakeholder groups on essential content for RCT protocols. It also highlights areas of divergence. These results, complemented by other empirical research and consensus meetings, are helping guide the development of a guideline for protocol content. PMID:23006145

Basic-CPR and AIDS: are volunteer life-savers prepared for a storm?

PubMed

Bierens, J J; Berden, H J

1996-10-01

Professional health care workers have access to guidelines, equipment and techniques to reduce the exposure to infectious material in case of resuscitation. The current official content of national courses for volunteer life-savers do not address this issue, as far as we know. Concern about the risks of infection due to resuscitation is increasing in this group. This article describes a rational approach of the problem, that includes data on the infection risk of basic-CPR, and an approach that accepts that the concern can not be controlled by objective data. In such an emotional approach, direct contact has to be minimised by using devices. Requirements for resuscitation devices with a barrier function are listed. Although both approaches will reduce the fear of infection, we advice a rational approach.

Multimedia Information eXchange for I-NET, Inc. at the Kennedy Space Center: A continuing study of the application of worldwideweb technology

NASA Technical Reports Server (NTRS)

Metcalf, David

1995-01-01

Multimedia Information eXchange (MIX) is a multimedia information system that accommodates multiple data types and provides consistency across platforms. Information from all over the world can be accessed quickly and efficiently with the Internet-based system. I-NET's MIX uses the World Wide Web and Mosaic graphical user interface. Mosaic is available on all platforms used at I-NET's Kennedy Space Center (KSC) facilities. Key information system design concepts and benefits are reviewed. The MIX system also defines specific configuration and helper application parameters to ensure consistent operations across the entire organization. Guidelines and procedures for other areas of importance in information systems design are also addressed. Areas include: code of ethics, content, copyright, security, system administration, and support.

Teacher Qualification Guidelines, Ecological Literacy and Outdoor Education

ERIC Educational Resources Information Center

Martin, Peter

2008-01-01

A key signpost to a profession is clarity of disciplinary knowledge. In this paper I describe the content and outcome of a process to refine the qualification guidelines for outdoor education teachers in Victorian, Australia. The guidelines, developed for the Victorian Institute of Teaching, include both practical skills and disciplinary…

American Association for Dental Schools Curricular Guidelines for Microscopic Anatomy (General and Oral).

ERIC Educational Resources Information Center

Susi, Frank; Mundell, Robert

1980-01-01

Guidelines developed by the Section on Anatomical Sciences of the American Association for Dental Schools are presented. These guidelines were drawn up as an effort to provide a general criterion-referenced standard against which a school can measure its course content in histology. (MLW)

The Development and Content of the "2008 Physical Activity Guidelines for Americans"

ERIC Educational Resources Information Center

Buchner, David M.

2014-01-01

The U.S. Department of Health and Human Services' "2008 Physical Activity Guidelines for Americans" represents a major milestone in public health efforts to address inactivity. These comprehensive federal physical activity guidelines affirm the strong scientific evidence for the health benefits of regular physical activity. The…

Surfing the Net for medical information about psychological trauma: An empirical study of the quality and accuracy of trauma-related websites

PubMed Central

BREMNER, J. DOUGLAS; QUINN, JOHN; QUINN, WILLIAM; VELEDAR, EMIR

2011-01-01

Psychological trauma is a major public-health problem, and trauma victims frequently turn to the Internet for medical information related to trauma. The Internet has many advantages for trauma victims, including low cost, privacy, use of access, and reduced direct social interactions. However, there are no regulations on what is posted on the Internet, or by whom, and little is known about the quality of information currently available related to the topic of psychological trauma. The purpose of this study was to evaluate the quality of Internet sites related to the topic of psychological trauma. The top 20 hits for searches on Google, AllTheWeb, and Yahoo were tabulated, using search words of ‘psychological trauma’, ‘stress’, ‘PTSD’, and ‘trauma’. From these searches, a list of 94 unique unsponsored hits that represented accessible websites was generated. Fourteen sites were unrelated or only peripherally related, and eight were related but were not comprehensively evaluated because they represented brochures, online book sales, etc. Seventy-two websites underwent evaluation of the content, design, disclosure, ease of use, and other factors based on published guidelines for medical information sites. Forty-two per cent of sites had inaccurate information, 82% did not provide a source of their information, and 41% did not use a mental-health professional in the development of the content. Ratings of content (e.g. accuracy, reliability, etc.) were 4 (2 SD) on a scale of 1 – 10, with 10 being the best. There were similar ratings for the other variables assessed. These findings suggest that although abundant, websites providing information about psychological trauma are often not useful, and can sometimes provide inaccurate and potentially harmful information to consumers of medical information. PMID:16954059

Surfing the net for medical information about psychological trauma: an empirical study of the quality and accuracy of trauma-related websites.

PubMed

Bremner, J Douglas; Quinn, John; Quinn, William; Veledar, Emir

2006-09-01

Psychological trauma is a major public-health problem, and trauma victims frequently turn to the Internet for medical information related to trauma. The Internet has many advantages for trauma victims, including low cost, privacy, use of access, and reduced direct social interactions. However, there are no regulations on what is posted on the Internet, or by whom, and little is known about the quality of information currently available related to the topic of psychological trauma. The purpose of this study was to evaluate the quality of Internet sites related to the topic of psychological trauma. The top 20 hits for searches on Google, AllTheWeb, and Yahoo were tabulated, using search words of 'psychological trauma', 'stress', 'PTSD', and 'trauma'. From these searches, a list of 94 unique unsponsored hits that represented accessible websites was generated. Fourteen sites were unrelated or only peripherally related, and eight were related but were not comprehensively evaluated because they represented brochures, online book sales, etc. Seventy-two websites underwent evaluation of the content, design, disclosure, ease of use, and other factors based on published guidelines for medical information sites. Forty-two per cent of sites had inaccurate information, 82% did not provide a source of their information, and 41% did not use a mental-health professional in the development of the content. Ratings of content (e.g. accuracy, reliability, etc.) were 4 (2 SD) on a scale of 1 - 10, with 10 being the best. There were similar ratings for the other variables assessed. These findings suggest that although abundant, websites providing information about psychological trauma are often not useful, and can sometimes provide inaccurate and potentially harmful information to consumers of medical information.

Support for the development and implementation of an access management program through research and analysis of collision data : final report.

DOT National Transportation Integrated Search

2015-11-11

The South Carolina Access and Roadside Management Standards (ARMS) provides standards and guidelines for : permitting access encroachments onto SCDOT right-of-way. In April, 2013, SCDOT initiated research that would be : used to update this manual wi...

Housing Adaptability Guidelines: A Concept to Make All Housing Accessible.

ERIC Educational Resources Information Center

Peoples Housing, Inc., Topanga, CA.

Specifications for making adaptable dwelling units, minimally accessible designs which can later be inexpensively remodeled for the disabled, are presented. Advantages to providing many adaptable units rather than a few accessible ones are outlined, including eliminating the marketing problem, providing a disabled person with a wider choice of…

Universal Design for Learning: Guidelines for Accessible Online Instruction

ERIC Educational Resources Information Center

Rogers-Shaw, Carol; Carr-Chellman, Davin J.; Choi, Jinhee

2018-01-01

Universal Design for Learning (UDL) is a framework for the teaching-learning transaction that conceptualizes knowledge through learner-centered foci emphasizing accessibility, collaboration, and community. Given the importance of access to achieving social justice, UDL is a promising approach to meeting all learners' needs more effectively. In…

Student Work Safety Guidelines in Roadside Applications and Work Zones : Safety Guidelines for Transportation Researchers

DOT National Transportation Integrated Search

2018-01-01

The Smart City Demonstration Program is intended to improve access through expanded mobility options in major job centers, enhance visitor experience by better connecting visitors to transportation options, stimulate regional economic prosperity and ...

Summary of the British Transplantation Society Guidelines for Management of the Failing Kidney Transplant.

PubMed

Andrews, Peter A

2014-12-15

The British Transplantation Society "Guideline for Transplantation Management of the Failing Kidney Transplant" was published in May 2014. This is the first national guideline in this field. In line with previous guidelines published by the British Transplantation Society, the guideline has used the GRADE system to rate the strength of evidence and recommendations.This article summarizes the Statements of Recommendation contained in the guideline, which provide a framework for the management of the failing kidney graft in the United Kingdom and may be of wide international interest. It is recommended that the full guideline document is consulted for details of the relevant references and evidence base. This may be accessed at: http://www.bts.org.uk/MBR/Clinical/Guidelines/Current/Member/Clinical/Current_Guidelines.aspx.

Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial.

PubMed

Bernhardsson, Susanne; Larsson, Maria E H; Eggertsen, Robert; Olsén, Monika Fagevik; Johansson, Kajsa; Nilsen, Per; Nordeman, Lena; van Tulder, Maurits; Öberg, Birgitta

2014-03-04

Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson's χ2 test and approximative z-test. 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected.

International assessment on quality and content of internet information on osteoarthritis.

PubMed

Varady, N H; Dee, E C; Katz, J N

2018-05-23

Osteoarthritis is one of the leading causes of global disability. Numerous studies have assessed the quality and content of online health information; however, how information content varies between multiple countries remains unknown. The primary objective of this study was to examine how the quality and content of online health information on osteoarthritis compares on an international scale. Internet searches for the equivalent of "knee osteoarthritis treatment" were performed in ten countries around the world. For each country, the first ten websites were evaluated using a custom scoring form examining: website type; quality and reliability using the DISCERN and Health-on-the-Net (HON) frameworks; and treatment content based on three international osteoarthritis treatment guidelines. Consistency of search results between countries speaking the same language was also assessed. Significant differences in all scoring metrics existed between countries speaking different languages. Western countries scored higher than more eastern countries, there were no differences between the United States and Mexico in any of the scoring metrics, and HON certified websites were of higher quality and reliability. Searches in different countries speaking the same language had at least 70% overlap. The quality of online health information on knee osteoarthritis varies significantly between countries speaking different languages. Differential access to quality, accurate, and safe health information online may represent a novel but important health inequality. Future efforts are needed to translate online health resources into additional languages. In the interim, patients may seek websites that display the HON seal. Copyright © 2018. Published by Elsevier Ltd.

An Evaluation of Web-Based Clinical Practice Guidelines for Managing Problems Associated with Cannabis Use

PubMed Central

Turner, Michael W; Rooke, Sally E; Langton, Julia M; Gates, Peter J

2012-01-01

Background Cannabis is the most widely used illicit substance, and multiple treatment options and avenues exist for managing its use. There has been an increase in the development of clinical practice guidelines (CPGs) to improve standards of care in this area, many of which are disseminated online. However, little is known about the quality and accessibility of these online CPGs. Objective The purpose of study 1 was to determine the extent to which cannabis-related CPGs disseminated online adhere to established methodological standards. The purpose of study 2 was to determine if treatment providers are familiar with these guidelines and to assess their perceived quality of these guidelines. Methods Study 1 involved a systematic search using the Google Scholar search engine and the National Drugs Sector Information Service (NDSIS) website of the Alcohol and Other Drugs Council of Australia (ADCA) to identify CPGs disseminated online. To be included in the current study, CPGs needed to be free of charge and provide guidance on psychological interventions for reducing cannabis use. Four trained reviewers independently assessed the quality of the 7 identified guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Study 2 assessed 166 Australian cannabis-use treatment providers’ (mean age = 45.47 years, SD 12.14) familiarity with and opinions of these 7 guidelines using an online survey. Treatment providers were recruited using online advertisements that directed volunteers to a link to complete the survey, which was posted online for 6 months (January to June 2012). Primary study outcomes included quality scores and rates of guideline familiarity, guideline use, and discovery methods. Results Based on the AGREE II, the quality of CPGs varied considerably. Across different reporting domains, adherence to methodological standards ranged from 0% to 92%. Quality was lowest in the domains of rigor of development (50%), applicability (46%), and editorial independence (30%). Although examination of AGREE II domain scores demonstrated that the quality of the 7 guidelines could be divided into 3 categories (high quality, acceptable to low quality, and very low quality), review of treatment providers’ quality perceptions indicated all guidelines fell into 1 category (acceptable quality). Based on treatment providers’ familiarity with and usage rates of the CPGs, a combination of peer/colleagues, senior professionals, workshops, and Internet dissemination was deemed to be most effective for promoting cannabis use CPGs. Lack of time, guideline length, conflicts with theoretical orientation, and prior content knowledge were identified as barriers to guideline uptake. Conclusions Developers of CPGs should improve their reporting of development processes, conflicts of interest, and CPGs’ applicability to practice, while remaining cognizant that long guidelines may deter implementation. Treatment providers need to be aware that the quality of cannabis-related CPGs varies substantially. PMID:23249447

Associations between access to alcohol outlets and alcohol intake and depressive symptoms in women from socioeconomically disadvantaged neighbourhoods in Australia.

PubMed

Lamb, Karen E; Thornton, Lukar E; Teychenne, Megan; Milte, Catherine; Cerin, Ester; Ball, Kylie

2017-01-17

This study examined associations between alcohol outlet access and alcohol intake, depressive symptoms score and risk of depression among women residing in disadvantaged neighbourhoods in Victoria, Australia. Data on depressive symptoms, alcohol intake and socio-demographic characteristics were obtained from a sample of 995 adult women from Victoria, Australia who were surveyed as part of the Resilience in Eating and Activity Despite Inequality (READI) study. The location of all licensed alcohol outlets in Victoria was obtained from the Victorian Commission for Gambling and Liquor Regulation. Participant and alcohol outlet addresses were geocoded to calculate individual alcohol outlet access, defined as the number of outlets (all and by sub-type) within 0.4 km and 3 km of participants' homes. Separate regression models with clustered standard errors were fitted to examine associations between access and alcohol intake according to national recommended limits for short- and long-term harm, frequency of consumption above long-term harm guidelines, depressive symptoms score and risk of depression. Odds of consumption within short-term harm guidelines (≤4 drinks on any day) decreased with increasing access within 3 km, irrespective of outlet type. Typically, there was no evidence to support associations between access and consumption above long-term harm guidelines (>2 drinks on any day) unless considering frequency of consumption at this level where results showed decreased odds of 'don't drink' versus frequently drinking above long-term harm guidelines (i.e., >2 drinks at least once per week) with increasing access at either distance. Although there was no evidence of an association between any of the alcohol outlet access measures and depressive symptoms score, odds of being at risk of depression decreased with increasing access within 3 km. This study found some evidence to support an association between increasing alcohol outlet densities of all types and harmful levels of alcohol consumption, and the association appears to be dependent on the distance threshold considered, among women residing in socioeconomically disadvantaged neighbourhoods within Victoria, Australia. However, higher numbers of alcohol outlets appear to be associated with a slightly lower risk of depression, with further research needed to identify the direction and mechanisms underlying this unintuitive association.

Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

PubMed

Prins, Marijn A; Verhaak, Peter F M; Smolders, Mirrian; Laurant, Miranda G H; van der Meer, Klaas; Spreeuwenberg, Peter; van Marwijk, Harm W J; Penninx, Brenda W J H; Bensing, Jozien M

2010-07-01

To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current anxiety or depressive disorder, recruited from 67 general practitioners (GPs), were included. Diagnoses according to the Diagnostic and Statistic Manual of Mental Disorders, fourth edition (DSM-IV) were made using a structured and widely validated assessment. Socio-demographic and enabling characteristics, severity of symptoms, disability, (under treatment for) chronic somatic conditions, perceived need for care, beliefs and evaluations of care were measured by questionnaires. Actual care data were derived from electronic medical records. Criteria for guideline-concordant care were based on general practice guidelines, issued by the Dutch College of General Practitioners. Two hundred and eighty-one (39%) patients received guideline-concordant care. High education level, accessibility of care, comorbidity of anxiety and depression, and severity and disability scores were positively associated with receiving guideline-concordant care in univariate analyses. In multivariate multi-level logistic regression models, significant associations with the clinical need factors disappeared. Positive evaluations of accessibility of care increased the chance (OR = 1.31; 95%-CI = 1.05-1.65; p = 0.02) of receiving guideline-concordant care, as well as perceiving any need for medication (OR = 2.99; 95%-CI = 1.84-4.85; p < 0.001), counseling (OR = 2.25; 95%-CI = 1.29-3.95; p = 0.005) or a referral (OR = 1.83; 95%-CI = 1.09-3.09; p = 0.02). A low educational level decreased the odds (OR = 0.33; 95%-CI = 0.11-0.98; p = 0.04) of receiving guideline-concordant care. This study shows that education level, accessibility of care and patients' perceived needs for care are more strongly associated with the delivery of guideline-concordant care for anxiety or depression than clinical need factors. Initiatives to improve GPs' communication skills around mental health issues, and to improve recognition of people suffering from anxiety disorders, could increase the number of patients receiving treatment for depression and anxiety in primary care.

Targeting practitioners: A review of guidelines, training, and policy in pain management

PubMed Central

Barth, Kelly S.; Guille, Constance; McCauley, Jenna; Brady, Kathleen T.

2017-01-01

This paper reviews the current literature on clinical guidelines, practitioner training, and government/payer policies that have come forth in response to the national rise in prescription opioid overdoses. A review of clinical opioid prescribing guidelines highlights the need for more research on safe and effective treatment options for chronic pain, improved guidance for the best management of post-operative pain, and evaluation of the implementation and impact of guideline recommendations on patient risk and outcomes. Although there is increasing attention to training in pain management in medical schools and medical residency programs, educational opportunities remain highly variable, and the need for additional clinician training in the recognition and treatment of pain as well as opioid use disorder has been recognized. Mandated use of private, federal and state educational and clinical initiatives such as Risk Evaluation and Mitigation Strategies (REMS) and Prescription Drug Monitoring Programs (PDMPs) generally increase utilization of these initiatives, but more research is needed to determine the impact of these initiatives on provider behaviors, treatment access, and patient outcomes. Finally, there is an acute need for more research on safe and effective treatments for chronic pain as well as an increased multi-level focus on improving training and access to evidence-based treatment for opioid use disorder as well as non-pharmacologic and non-interventional chronic pain treatments, so that these guideline-recommended interventions can become mainstream, accessible, first-line interventions for chronic pain and/or opioid use disorders. PMID:28363316

Guidelines for Assessment and Instruction in Statistics Education (GAISE): extending GAISE into nursing education.

PubMed

Hayat, Matthew J

2014-04-01

Statistics coursework is usually a core curriculum requirement for nursing students at all degree levels. The American Association of Colleges of Nursing (AACN) establishes curriculum standards for academic nursing programs. However, the AACN provides little guidance on statistics education and does not offer standardized competency guidelines or recommendations about course content or learning objectives. Published standards may be used in the course development process to clarify course content and learning objectives. This article includes suggestions for implementing and integrating recommendations given in the Guidelines for Assessment and Instruction in Statistics Education (GAISE) report into statistics education for nursing students. Copyright 2014, SLACK Incorporated.

Bus rapid transit accessibility guidelines.

DOT National Transportation Integrated Search

2006-12-01

In recent years helpful guides have appeared in both English and Spanish to assist planners : and officials to construct accessible buildings and pedestrian infrastructure which are usable : by seniors, persons with disabilities, and all others who e...

Entrustable professional activities in post-licensure training in primary care pediatrics: Necessity, development and implementation of a competency-based post-graduate curriculum.

PubMed

Fehr, Folkert; Weiß-Becker, Christoph; Becker, Hera; Opladen, Thomas

2017-01-01

There is an absence of broad-based and binding curricular requirements for structured competency-based post-graduate medical training in Germany, and thus no basis for comparing the competencies of physicians undergoing training in a medical specialty ( Ärzte im Weiterbildung ). In response, the German Society of Primary Care Pediatrics' working group on post-graduate education (DGAAP) has identified realistic entrustable professional activities (EPAs) in primary care, defined their number, scope and content, selected competency domains, specified required knowledge and skills, and described appropriate assessment methods. These guidelines are referred to as PaedCompenda and can be accessed electronically by educators in pediatric medicine; the use and effectiveness of these guidelines are monitored by the German Association for Medical Education's committee on post-graduate education (GMA). Teaching and training in pediatric medicine should take EPAs into consideration. To accomplish this, phases dedicated to primary care should be integrated into formal medical specialty training. Primary care pediatrics must enhance the sites where such training takes place into learning environments that prepare physicians trainees and turn the practicing specialists into mentoring educators.

75 FR 22256 - Difenoconazole Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-28

... http://www.gpoaccess.gov/ecfr . To access the OPPTS Harmonized Test Guidelines referenced in this document electronically, please go to http://www.epa.gov/oppts and select ``Test Methods & Guidelines'' on... food as follows: i. Acute exposure. Quantitative acute dietary exposure and risk assessments are...

A method for developing standardised interactive education for complex clinical guidelines

PubMed Central

2012-01-01

Background Although systematic use of the Perinatal Society of Australia and New Zealand internationally endorsed Clinical Practice Guideline for Perinatal Mortality (PSANZ-CPG) improves health outcomes, implementation is inadequate. Its complexity is a feature known to be associated with non-compliance. Interactive education is effective as a guideline implementation strategy, but lacks an agreed definition. SCORPIO is an educational framework containing interactive and didactic teaching, but has not previously been used to implement guidelines. Our aim was to transform the PSANZ-CPG into an education workshop to develop quality standardised interactive education acceptable to participants for learning skills in collaborative interprofessional care. Methods The workshop was developed using the construct of an educational framework (SCORPIO), the PSANZ-CPG, a transformation process and tutor training. After a pilot workshop with key target and stakeholder groups, modifications were made to this and subsequent workshops based on multisource written observations from interprofessional participants, tutors and an independent educator. This participatory action research process was used to monitor acceptability and educational standards. Standardised interactive education was defined as the attainment of content and teaching standards. Quantitative analysis of positive expressed as a percentage of total feedback was used to derive a total quality score. Results Eight workshops were held with 181 participants and 15 different tutors. Five versions resulted from the action research methodology. Thematic analysis of multisource observations identified eight recurring education themes or quality domains used for standardisation. The two content domains were curriculum and alignment with the guideline and the six teaching domains; overload, timing, didacticism, relevance, reproducibility and participant engagement. Engagement was the most challenging theme to resolve. Tutors identified all themes for revision whilst participants identified a number of teaching but no content themes. From version 1 to 5, a significant increasing trend in total quality score was obtained; participants: 55%, p=0.0001; educator: 42%, p=0.0004; tutor peers: 57%, p=0.0001. Conclusions Complex clinical guidelines can be developed into a workshop acceptable to interprofessional participants. Eight quality domains provide a framework to standardise interactive teaching for complex clinical guidelines. Tutor peer review is important for content validity. This methodology may be useful for other guideline implementation. PMID:23131137

A method for developing standardised interactive education for complex clinical guidelines.

PubMed

Vaughan, Janet I; Jeffery, Heather E; Raynes-Greenow, Camille; Gordon, Adrienne; Hirst, Jane; Hill, David A; Arbuckle, Susan

2012-11-06

Although systematic use of the Perinatal Society of Australia and New Zealand internationally endorsed Clinical Practice Guideline for Perinatal Mortality (PSANZ-CPG) improves health outcomes, implementation is inadequate. Its complexity is a feature known to be associated with non-compliance. Interactive education is effective as a guideline implementation strategy, but lacks an agreed definition. SCORPIO is an educational framework containing interactive and didactic teaching, but has not previously been used to implement guidelines. Our aim was to transform the PSANZ-CPG into an education workshop to develop quality standardised interactive education acceptable to participants for learning skills in collaborative interprofessional care. The workshop was developed using the construct of an educational framework (SCORPIO), the PSANZ-CPG, a transformation process and tutor training. After a pilot workshop with key target and stakeholder groups, modifications were made to this and subsequent workshops based on multisource written observations from interprofessional participants, tutors and an independent educator. This participatory action research process was used to monitor acceptability and educational standards. Standardised interactive education was defined as the attainment of content and teaching standards. Quantitative analysis of positive expressed as a percentage of total feedback was used to derive a total quality score. Eight workshops were held with 181 participants and 15 different tutors. Five versions resulted from the action research methodology. Thematic analysis of multisource observations identified eight recurring education themes or quality domains used for standardisation. The two content domains were curriculum and alignment with the guideline and the six teaching domains; overload, timing, didacticism, relevance, reproducibility and participant engagement. Engagement was the most challenging theme to resolve. Tutors identified all themes for revision whilst participants identified a number of teaching but no content themes. From version 1 to 5, a significant increasing trend in total quality score was obtained; participants: 55%, p=0.0001; educator: 42%, p=0.0004; tutor peers: 57%, p=0.0001. Complex clinical guidelines can be developed into a workshop acceptable to interprofessional participants. Eight quality domains provide a framework to standardise interactive teaching for complex clinical guidelines. Tutor peer review is important for content validity. This methodology may be useful for other guideline implementation.

Reliability of a rating procedure to monitor industry self-regulation codes governing alcohol advertising content.

PubMed

Babor, Thomas F; Xuan, Ziming; Proctor, Dwayne

2008-03-01

The purposes of this study were to develop reliable procedures to monitor the content of alcohol advertisements broadcast on television and in other media, and to detect violations of the content guidelines of the alcohol industry's self-regulation codes. A set of rating-scale items was developed to measure the content guidelines of the 1997 version of the U.S. Beer Institute Code. Six focus groups were conducted with 60 college students to evaluate the face validity of the items and the feasibility of the procedure. A test-retest reliability study was then conducted with 74 participants, who rated five alcohol advertisements on two occasions separated by 1 week. Average correlations across all advertisements using three reliability statistics (r, rho, and kappa) were almost all statistically significant and the kappas were good for most items, which indicated high test-retest agreement. We also found high interrater reliabilities (intraclass correlations) among raters for item-level and guideline-level violations, indicating that regardless of the specific item, raters were consistent in their general evaluations of the advertisements. Naïve (untrained) raters can provide consistent (reliable) ratings of the main content guidelines proposed in the U.S. Beer Institute Code. The rating procedure may have future applications for monitoring compliance with industry self-regulation codes and for conducting research on the ways in which alcohol advertisements are perceived by young adults and other vulnerable populations.

Information on infantile colic on the World Wide Web.

PubMed

Bailey, Shana D; D'Auria, Jennifer P; Haushalter, Jamie P

2013-01-01

The purpose of this study was to explore and describe the type and quality of information on infantile colic that a parent might access on the World Wide Web. Two checklists were used to evaluate the quality indicators of 24 Web sites and the colic-specific content. Fifteen health information Web sites met more of the quality parameters than the nine commercial sites. Eight Web sites included information about colic and infant abuse, with six being health information sites. The colic-specific content on 24 Web sites reflected current issues and controversies; however, the completeness of the information in light of current evidence varied among the Web sites. Strategies to avoid complications of parental stress or infant abuse were not commonly found on the Web sites. Pediatric professionals must guide parents to reliable colic resources that also include emotional support and understanding of infant crying. A best evidence guideline for the United States would eliminate confusion and uncertainty about which colic therapies are safe and effective for parents and professionals. Copyright © 2013 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Guideline validation in multiple trauma care through business process modeling.

PubMed

Stausberg, Jürgen; Bilir, Hüseyin; Waydhas, Christian; Ruchholtz, Steffen

2003-07-01

Clinical guidelines can improve the quality of care in multiple trauma. In our Department of Trauma Surgery a specific guideline is available paper-based as a set of flowcharts. This format is appropriate for the use by experienced physicians but insufficient for electronic support of learning, workflow and process optimization. A formal and logically consistent version represented with a standardized meta-model is necessary for automatic processing. In our project we transferred the paper-based into an electronic format and analyzed the structure with respect to formal errors. Several errors were detected in seven error categories. The errors were corrected to reach a formally and logically consistent process model. In a second step the clinical content of the guideline was revised interactively using a process-modeling tool. Our study reveals that guideline development should be assisted by process modeling tools, which check the content in comparison to a meta-model. The meta-model itself could support the domain experts in formulating their knowledge systematically. To assure sustainability of guideline development a representation independent of specific applications or specific provider is necessary. Then, clinical guidelines could be used for eLearning, process optimization and workflow management additionally.

Ohio Board of Regents Guidelines for Preparing FY 2009-FY 2014 Capital Plans

ERIC Educational Resources Information Center

Ohio Board of Regents, 2007

2007-01-01

As with past practice, publishing this set of guidelines officially launches the higher education capital planning and budgeting process for fiscal years 2009-2014. The guidelines include a schedule, definitions, planning assumptions, statewide considerations, and instructions for presenting a six year capital plan. Contents include: (1)…

Ohio Board of Regents Guidelines for Preparing FY 2007-FY 2012 Capital Plans

ERIC Educational Resources Information Center

Ohio Board of Regents, 2005

2005-01-01

As with past practice, publishing this set of guidelines officially launches the higher education capital planning and budgeting process for fiscal years 2007-2012. The guidelines include a schedule, definitions, planning assumptions, statewide considerations, and instructions for presenting a six-year capital plan. Contents include: (1)…

2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association task force on practice guidelines

USDA-ARS?s Scientific Manuscript database

This guideline is based on the Full Panel Report which is provided as a data supplement to the guideline. The Full Panel Report contains background and additional material related to content, methodology, evidence synthesis, rationale and references and is supported by the NHLBI Systematic Evidence ...

Adapting a large database of point of care summarized guidelines: a process description.

PubMed

Delvaux, Nicolas; Van de Velde, Stijn; Aertgeerts, Bert; Goossens, Martine; Fauquert, Benjamin; Kunnamo, Ilka; Van Royen, Paul

2017-02-01

Questions posed at the point of care (POC) can be answered using POC summarized guidelines. To implement a national POC information resource, we subscribed to a large database of POC summarized guidelines to complement locally available guidelines. Our challenge was in developing a sustainable strategy for adapting almost 1000 summarized guidelines. The aim of this paper was to describe our process for adapting a database of POC summarized guidelines. An adaptation process based on the ADAPTE framework was tailored to be used by a heterogeneous group of participants. Guidelines were assessed on content and on applicability to the Belgian context. To improve efficiency, we chose to first aim our efforts towards those guidelines most important to primary care doctors. Over a period of 3 years, we screened about 80% of 1000 international summarized guidelines. For those guidelines identified as most important for primary care doctors, we noted that in about half of the cases, remarks were made concerning content. On the other hand, at least two-thirds of all screened guidelines required no changes when evaluating their local usability. Adapting a large body of POC summarized guidelines using a formal adaptation process is possible, even when faced with limited resources. This can be done by creating an efficient and collaborative effort and ensuring user-friendly procedures. Our experiences show that even though in most cases guidelines can be adopted without adaptations, careful review of guidelines developed in a different context remains necessary. Streamlining international efforts in adapting international POC information resources and adopting similar adaptation processes may lessen duplication efforts and prove more cost-effective. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Handicap Accessibility: A Self-Evaluation Guidebook for ACTION and Its Grantees. Handbook 240.

ERIC Educational Resources Information Center

ACTION, Washington, DC. Office of Equal Opportunity.

This handbook is designed to assist managers of ACTION grantee programs in evaluating the degree to which the needs of persons with disabilities are incorporated into their programs for physical accessibility of buildings and facilities. After a general discussion of self-evaluation principles and accessibility guidelines, a checklist is provided…

75 FR 66110 - Guidelines for Use of Stored Specimens and Access to Ancillary Data and Proposed Cost Schedule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

... repository of datasets from completed studies, biospecimens, and ancillary data. The Division intends to make... Sharing Policy. The Division has established an internal committee, the Biospecimen Repository Access and Data Sharing Committee (BRADSC), to oversee the repository access and data sharing program. The purpose...

Developing Guidelines for Evaluating the Adaptation of Accessible Web-Based Learning Materials

ERIC Educational Resources Information Center

Radovan, Marko; Perdih, Mojca

2016-01-01

E-learning is a rapidly developing form of education. One of the key characteristics of e-learning is flexibility, which enables easier access to knowledge for everyone. Information and communications technology (ICT), which is e-learning's main component, enables alternative means of accessing the web-based learning materials that comprise the…

Medication errors as malpractice-a qualitative content analysis of 585 medication errors by nurses in Sweden.

PubMed

Björkstén, Karin Sparring; Bergqvist, Monica; Andersén-Karlsson, Eva; Benson, Lina; Ulfvarson, Johanna

2016-08-24

Many studies address the prevalence of medication errors but few address medication errors serious enough to be regarded as malpractice. Other studies have analyzed the individual and system contributory factor leading to a medication error. Nurses have a key role in medication administration, and there are contradictory reports on the nurses' work experience in relation to the risk and type for medication errors. All medication errors where a nurse was held responsible for malpractice (n = 585) during 11 years in Sweden were included. A qualitative content analysis and classification according to the type and the individual and system contributory factors was made. In order to test for possible differences between nurses' work experience and associations within and between the errors and contributory factors, Fisher's exact test was used, and Cohen's kappa (k) was performed to estimate the magnitude and direction of the associations. There were a total of 613 medication errors in the 585 cases, the most common being "Wrong dose" (41 %), "Wrong patient" (13 %) and "Omission of drug" (12 %). In 95 % of the cases, an average of 1.4 individual contributory factors was found; the most common being "Negligence, forgetfulness or lack of attentiveness" (68 %), "Proper protocol not followed" (25 %), "Lack of knowledge" (13 %) and "Practice beyond scope" (12 %). In 78 % of the cases, an average of 1.7 system contributory factors was found; the most common being "Role overload" (36 %), "Unclear communication or orders" (30 %) and "Lack of adequate access to guidelines or unclear organisational routines" (30 %). The errors "Wrong patient due to mix-up of patients" and "Wrong route" and the contributory factors "Lack of knowledge" and "Negligence, forgetfulness or lack of attentiveness" were more common in less experienced nurses. The experienced nurses were more prone to "Practice beyond scope of practice" and to make errors in spite of "Lack of adequate access to guidelines or unclear organisational routines". Medication errors regarded as malpractice in Sweden were of the same character as medication errors worldwide. A complex interplay between individual and system factors often contributed to the errors.

Variation in Organization of Transient Ischemic Attack Care in The Netherlands. A Nationwide Survey Study.

PubMed

Muller, Fenna Floortje; de Beer, Frank; Visser, Marieke Christine

2017-09-01

Previous research has shown the importance of urgent initiation of antiplatelet therapy after transient ischemic attack (TIA) to reduce the risk of stroke. Many hospitals in the Netherlands have therefore implemented rapid pathways for assessment of patients with TIA. Dutch stroke guidelines lack clear directives for organization of TIA assessment and thus allow for variation. The aim of this study was to investigate variation in organization of TIA assessment in Dutch hospitals. One neurologist per hospital (of 88 Dutch hospitals) with special interest in stroke was invited to participate in a web-based survey addressing the organization, content, and timing of TIA assessment. Seventy (80%) neurologists completed the survey, all of whom reported performing TIA assessment in their hospital. There was considerable variation in the method of application and the location of assessment. In 10% of the hospitals, patients with TIA are always admitted to the ward. The content of diagnostics is fairly similar, but hospitals vary in the extent of cardiological workup. Almost all hospitals aim for a swift start of assessment as directed by guidelines, but access time differs. Eighty-six percent of respondents reported that antiplatelet therapy is usually initiated before assessment, based on history. This study showed variation in organization of TIA assessment in Dutch hospitals, especially regarding location within the hospital, time to assessment after announcement, and cardiological workup. Further research is needed to investigate implications of this variation for quality of care. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Accessibility Guidelines for Astronomy and Astrophysics Meetings

NASA Astrophysics Data System (ADS)

Monkiewicz, Jacqueline; Murphy, Nicholas; Diaz-Merced, Wanda Liz; Aarnio, Alicia; Knierman, Karen; AAS Working Group for Accessibility and Disability

2018-01-01

Attendance at meetings and conferences is a critical component of an astronomer's professional life, providing opportunities for presenting one's work, staying current in the field, career networking, and scientific collaboration. Exclusion from these gatherings due to lack of accessibility and accommodation failure is a reality for disabled astronomers, and contributes substantially to low levels of representation in the senior-most levels of the field. We present a preview of the AAS Working Group for Accessibility and Disability's best practice recommendations for meetings accessibility. Applying the principles of universal access and barrier-free design, we model a paradigm of anticipating and removing accessibility barriers in advance, rather than putting the burden of requesting accommodation solely on disabled astronomers and students. We cite several professional and nonprofessional societies identified as meetings accessibility exemplars, and model our guidelines on their best practices. We establish standards for accessibility budgeting, venue choice, publication of policies online, designating point persons, and identifying barriers. We make recommendations for oral and poster presentations, event registration, receptions and banquets, excursions, and other typical conference activities. For meetings which are constrained by fixed budgets and venue choice, we identify a number of low cost/high reward accessibility steps which might still have a large beneficial impact. We likewise provide adapted recommendations for low budget meetings. THIS IS A POSTER LOCATED IN THE AAS BOOTH

Towards local implementation of Dutch health policy guidelines: a concept-mapping approach.

PubMed

Kuunders, Theo J M; van Bon-Martens, Marja J H; van de Goor, Ien A M; Paulussen, Theo G W M; van Oers, Hans A M

2017-02-22

To develop a targeted implementation strategy for a municipal health policy guideline, implementation targets of two guideline users [Regional Health Services (RHSs)] and guideline developers of leading national health institutes were made explicit. Therefore, characteristics of successful implementation of the guideline were identified. Differences and similarities in perceptions of these characteristics between RHSs and developers were explored. Separate concept mapping procedures were executed in two RHSs, one with representatives from partner local health organizations and municipalities, the second with RHS members only. A third map was conducted with the developers of the guideline. All mapping procedures followed the same design of generating statements up to interpretation of results with participants. Concept mapping, as a practical implementation tool, will be discussed in the context of international research literature on guideline implementation in public health. Guideline developers consider implementation successful when substantive components (health issues) of the guidelines, content are visible in local policy practice. RHSs, local organizations and municipalities view the implementation process itself within and between organizations as more relevant, and state that usability of the guideline for municipal policy and commitment by officials and municipal managers are critical targets for successful implementation. Between the RHSs, differences in implementation targets were smaller than between RHSs and guideline developers. For successful implementation, RHSs tend to focus on process targets while developers focus more on the thematic contents of the guideline. Implications of these different orientations for implementation strategies are dealt with in the discussion. © The Author 2017. Published by Oxford University Press.

Finance issue brief: direct access: year end report-2002.

PubMed

Morgan, Rachel; MacEachern, Lillian

2002-12-31

Consumer demand for a less restrictive referral system has urged legislators, as well as the managed care industry and those in the medical field, to seek the best solution to the problem. The point of service (POS) plan was an early attempt by managed care plans to provide more freedom for enrollees. But POS plans are not always available or cost effective. Several of the larger managed care organizations, in an effort to improve enrollee and provider satisfaction, have eliminated or streamlined their referral processes. The American Medical Association has recommended that primary care and other medical specialty organizations collaborate in developing guidelines for specialty referrals, urging health plans to allow direct access in network without financial penalty as long as the access conforms with the established guidelines. In the meantime, legislators have responded to constituents by enacting measures that mandate direct access for specific types of care or standing referrals for ongoing treatment.

Finance issue brief: direct access: year end report-2003.

PubMed

MacEachern, Lillian

2003-12-31

Consumer demand for a less restrictive referral system has urged legislators, as well as the managed care industry and those in the medical field, to seek the best solution to the problem. The point of service (POS) plan was an early attempt by managed care plans to provide more freedom for enrollees. But POS plans are not always available or cost effective. Several of the larger managed care organizations, in an effort to improve enrollee and provider satisfaction, have eliminated or streamlined their referral processes. The American Medical Association has recommended that primary care and other medical specialty organizations collaborate in developing guidelines for specialty referrals, urging health plans to allow direct access in network without financial penalty as long as the access conforms with the established guidelines. In the meantime, legislators have responded to constituents by enacting measures that mandate direct access for specific types of care or standing referrals for ongoing treatment.

45 CFR 1619.2 - Policy.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Policy. 1619.2 Section 1619.2 Public Welfare....2 Policy. A recipient shall adopt a procedure for affording the public appropriate access to the Act, Corporation rules, regulations and guidelines, the recipient's written policies, procedures, and guidelines...

75 FR 29908 - Prothioconazole; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

....gpoaccess.gov/ecfr . To access the harmonized test guidelines referenced in this document electronically, please go http://www.epa.gov/ocspp and select ``Test Methods and Guidelines.'' C. Can I File an Objection... dietary exposures and all other exposures for which there is reliable information.'' This includes...

ENVIRONMENTAL MONITORING FOR PUBLIC ACCESS AND COMMUNITY TRACKING (EMPACT) PROGRAM MICROBIOLOGICAL MONITORING OF RECREATIONAL WATER

EPA Science Inventory

Current Environmental Protection Agency (EPA) recommended microbiological monitoring practices for bathing beach water quality were suggested in 1968, as a part of the fecal coliform guideline developed by the Federal Water Pollution Control Administration. The guideline stated ...

For Sale: Subliminal Bias in Textbooks

ERIC Educational Resources Information Center

Britton, Gwyneth E.; Lumpkin, Margaret C.

1977-01-01

Discusses the fact that, although publishers have acknowledged the problem of sex bias in textbooks in the United States, guidelines lack specifics, timetables, and procedures for monitoring content and enforcing compliance with the guidelines. (MB)

Curriculum Guidelines for Periodontics.

ERIC Educational Resources Information Center

Journal of Dental Education, 1985

1985-01-01

Guidelines describe the interrelationships of this and other dental fields, give an overview of the curriculum and its primary educational objectives, and outline the suggested prerequisites, core content, specific behavioral objectives, sequencing, and faculty requirements. (MSE)

Addressing implementation challenges during guideline development - a case study of Swedish national guidelines for methods of preventing disease.

PubMed

Richter-Sundberg, Linda; Kardakis, Therese; Weinehall, Lars; Garvare, Rickard; Nyström, Monica E

2015-01-22

Many of the world's life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines. Seven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework. The study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues. This case study provides examples of how guideline developers perceive and approach the issue of implementation during the development and early launch of prevention guidelines. Models for guideline development could benefit from an initial assessment of how the guideline topic, its target context and stakeholders will affect the upcoming implementation.

A Theory of the Measurement of Knowledge Content, Access, and Learning.

ERIC Educational Resources Information Center

Pirolli, Peter; Wilson, Mark

1998-01-01

An approach to the measurement of knowledge content, knowledge access, and knowledge learning is developed. First a theoretical view of cognition is described, and then a class of measurement models, based on Rasch modeling, is presented. Knowledge access and content are viewed as determining the observable actions selected by an agent to achieve…

Leveled and Exclusionary Tracking: English Learners' Access to Academic Content in Middle School

ERIC Educational Resources Information Center

Umansky, Ilana M.

2016-01-01

This study examines the characteristics and determinants of English learners' (ELs') access to academic content in middle school (Grades 6-8). Following 10 years of data from a large urban school district in California, I identify two predominant characteristics of EL access to content: leveled tracking in which ELs are overrepresented in lower…

Reconciling Pairs of Concurrently Used Clinical Practice Guidelines Using Constraint Logic Programming

PubMed Central

Wilk, Szymon; Michalowski, Martin; Michalowski, Wojtek; Hing, Marisela Mainegra; Farion, Ken

2011-01-01

This paper describes a new methodological approach to reconciling adverse and contradictory activities (called points of contention) occurring when a patient is managed according to two or more concurrently used clinical practice guidelines (CPGs). The need to address these inconsistencies occurs when a patient with more than one disease, each of which is a comorbid condition, has to be managed according to different treatment regimens. We propose an automatic procedure that constructs a mathematical guideline model using the Constraint Logic Programming (CLP) methodology, uses this model to identify and mitigate encountered points of contention, and revises the considered CPGs accordingly. The proposed procedure is used as an alerting mechanism and coupled with a guideline execution engine warns the physician about potential problems with the concurrent application of two or more guidelines. We illustrate the operation of our procedure in a clinical scenario describing simultaneous use of CPGs for duodenal ulcer and transient ischemic attack. PMID:22195153

Polyphenolic Composition and Antioxidant Activities of 6 New Turmeric (Curcuma Longa L.) Accessions.

PubMed

Chinedum, Eleazu; Kate, Eleazu; Sonia, Chukwuma; Ironkwe, Adanma; Andrew, Igwe

2015-01-01

The phytochemical composition and antioxidant capacities of 6 new NRCRI turmeric (Curcuma longa L.) accessions (39, 35, 60, 30, 50 and 41) were determined using standard techniques. The moisture contents of the tumeric samples ranged from 15.75 to 47.80% and the curcumin contents of the turmeric samples fell within the range of curcumin obtained from turmeric in other countries of the world. Furthermore, the turmeric accessions contained considerable amounts of antioxidants (measured using 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical and reducing power assays), alkaloids, flavonoids, anthocyanins, and phenolics. There was significant correlation between the anthocyanin contents of the tumeric accessions versus their alkaloid (0.744) and flavonoid contents (0.986) suggesting an additive effect between the anthocyanins and alkaloids in turmeric; significant correlation between the inhibition of the turmeric accessions on DPPH radical versus their flavonoid (0.892) and anthocyanin (0.949) contents and significant correlation between the reducing power of the turmeric accessions versus their flavonoid (0.973) and anthocyanin (0.974) contents suggesting that anthocyanins as flavonoids largely contribute to the antioxidant activities of turmeric. The positive regression recorded between inhibition of DPPH radical by the turmeric accessions and quercetin versus reducing power (R2 = 0.852) suggest that any of these methods could be used to assess the antioxidant activities of tumeric. Finally, the study indicated the potentials of the turmeric accessions especially accessions 30 and 50 as promising sources of antioxidants.

Perceptions of the characteristics of the Alberta Nutrition Guidelines for Children and Youth by child care providers may influence early adoption of nutrition guidelines in child care centres.

PubMed

Nikolopoulos, Hara; Farmer, Anna; Berry, Tanya R; McCargar, Linda J; Mager, Diana R

2015-04-01

In 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth (ANGCY) as a resource for child care facilities to translate nutrition recommendations into practical food choices. Using a multiple case study method, early adoption of the guidelines was examined in two child care centres in Alberta, Canada. Key constructs from the Diffusion of Innovations framework were used to develop an interview protocol based on the perceived characteristics of the guidelines (relative advantage, compatibility, complexity, trialability and observability) by child care providers. Analysis of the ANGCY was conducted by a trained qualitative researcher and validated by an external qualitative researcher. This entailed reviewing guideline content, layout, organisation, presentation, format, comprehensiveness and dissemination to understand whether characteristics of the guidelines affect the adoption process. Data were collected through direct observation, key informant interviews and documentation of field notes. Qualitative data were analysed using content analysis. Overall, the guidelines were perceived positively by child care providers. Child care providers found the guidelines to have a high relative advantage, be compatible with current practice, have a low level of complexity, easy to try and easy to observe changes. It is valuable to understand how child care providers perceive characteristics of guidelines as this is the first step in identifying the needs of child care providers with respect to early adoption and identifying potential educational strategies important for dissemination. © 2012 Blackwell Publishing Ltd.

Toward improved guideline quality: using the COGS statement with GEM.

PubMed

Shiffman, Richard N; Michel, Georges

2004-01-01

The Conference on Guideline Standardization (COGS) was convened to create a standardized documentation checklist for clinical practice guidelines in an effort to promote guideline quality and facilitate implementation. The statement was created by a multidisciplinary panel using a rigorous consensus development methodology. The Guideline Elements Model (GEM) provides a standardized approach to representing guideline documents using XML. In this work, we demonstrate the sufficiency of GEM for describing COGS components. Using the mapping between COGS and GEM elements we built an XSLT application to examine a guideline's adherence (or non-adherence) to the COGS checklist. Once a guideline has been marked up according to the GEM hierarchy, its knowledge content can be reused in multiple ways.

Guidelines for Child Custody Evaluations in Family Law Proceedings

ERIC Educational Resources Information Center

American Psychologist, 2010

2010-01-01

Family law proceedings encompass a broad range of issues, including custody, maintenance, support, valuation, visitation, relocation, and termination of parental rights. The following guidelines address what are commonly termed child custody evaluations, involving disputes over decision making, caretaking, and access in the wake of marital or…

76 FR 17064 - Shared Use Path Accessibility Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

... industry professionals regarding matters covered in this notice. In particular, the Board invites comments... shared use path surfaces, either light-on-dark or dark-on-light. Size. Detectable warning surfaces shall... information on any additional areas that should be addressed in the guidelines. Regulatory Process Matters The...

Relieving the Confusion: Location and Access Made (Relatively) Easy

ERIC Educational Resources Information Center

Jansen, Barbara A.

2005-01-01

Students need much assistance if they are to successfully use the Location and Access procedure of problem-solving. Guidelines are presented on how classroom teachers and library media specialists can help elementary students manage this Big6 stage.

Curriculum Guidelines on Predoctoral Oral and Maxillofacial Surgery.

ERIC Educational Resources Information Center

Journal of Dental Education, 1985

1985-01-01

The American Association of Dental Schools' Curriculum Guidelines include an introduction to the discipline and its interrelationships with other disciplines, prerequisites, a core content outline, specific behavioral objectives, and notes on sequencing and faculty. (MSE)

[What's new in the 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis].

PubMed

Guan, H X

2017-10-01

The 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis has been officially published in October of 2016, five years after the publication of the previous version. Revised contents in the new guideline are summarized in this review.

Flow diagram or prose: does the format of practice guidelines matter?

PubMed

Hardern, R D; Hodgson, L C; Hamer, D W

1998-06-01

The aim of this study was to compare the performance of two formats (prose and flow diagram) of the guidelines for management of paracetamol poisoning, and to assess the likely performance without access to the guidelines. A prospective questionnaire study of the management of seven hypothetical cases of paracetamol ingestion was carried out by accident and emergency senior house officers at a regional induction course. No differences were found between the two formats. The proportion of correct answers was 37% in the flow diagram and 31% in the prose group (95% confidence interval for the difference -8% to 20%). In the group with neither format of the guideline the proportion of correct answers was lower: 19% (95% confidence interval for the difference between this group and the group with flow charts 6.9% to 30.6%, for the difference between this group and the group with the prose format 0.4% to 24.8%). The time taken to answer the questions did not vary between the groups. These data do not support the exclusive use of either format. They suggest that management of paracetamol poisoning is less likely to be correct if staff do not have access to the guidelines.

A Randomized Cadaver Study Comparing First-Attempt Success Between Tibial and Humeral Intraosseous Insertions Using NIO Device by Paramedics: A Preliminary Investigation.

PubMed

Szarpak, Lukasz; Truszewski, Zenon; Smereka, Jacek; Krajewski, Paweł; Fudalej, Marcin; Adamczyk, Piotr; Czyzewski, Lukasz

2016-05-01

Medical personnel may encounter difficulties in obtaining intravenous (IV) access during cardiac arrest. The 2015 American Heart Association guidelines and the 2015 European Resuscitation Council guidelines for cardiopulmonary resuscitation (CPR) suggest that rescuers establish intraosseous (IO) access if an IV line is not easily obtainable.The aim of the study was to compare the success rates of the IO proximal tibia and proximal humerus head access performed by paramedics using the New Intraosseous access device (NIO; Persys Medical, Houston, TX, USA) in an adult cadaver model during simulated CPR.In an interventional, randomized, crossover, single-center cadaver study, a semi-automatic spring-load driven NIO access device was investigated. In total, 84 paramedics with less than 5-year experience in Emergency Medical Service participated in the study. The trial was performed on 42 adult cadavers. In each cadaver, 2 IO accesses to the humerus head, and 2 IO accesses to the proximal tibia were obtained.The success rate of the first IO attempt was 89.3% (75/84) for tibial access, and 73.8% (62/84) for humeral access (P = 0.017). The procedure times were significantly faster for tibial access [16.8 (interquartile range, IQR, 15.1-19.9] s] than humeral access [26.7 (IQR, 22.1-30.9) s] (P < 0.001).Tibial IO access is easier and faster to put in place than humeral IO access. Humeral IO access can be an alternative method to tibial IO access. clinicaltrials.gov Identifier: NCT02700867.

Where are we now? A multicountry qualitative study to explore access to pre-antiretroviral care services: a precursor to antiretroviral therapy initiation

PubMed Central

Bukenya, Dominic; Wringe, Alison; Skovdal, Morten; Ssekubugu, Robert; Paparini, Sara; McLean, Estelle; Bonnington, Oliver; Wamoyi, Joyce; Seeley, Janet

2017-01-01

Objective To explore barriers and facilitators to accessing postdiagnosis HIV care in five sub-Saharan African countries. Methods In-depth interviews were conducted with 77 people living with HIV (PLHIV) in pre-antiretroviral therapy care or not-yet-in care and 46 healthcare workers. Participants were purposely selected from health and demographic surveillance sites in Karonga (Malawi), Manicaland (Zimbabwe), uMkhanyakude (South Africa), Kisesa (Tanzania) and Rakai and Kyamulibwa (Uganda). Thematic content analysis was conducted, guided by the constructs of affordability, availability and acceptability of care.- Results Affordability: Transport and treatment costs were a barrier to HIV care, although some participants travelled to distant clinics to avoid being seen by people who knew them or for specific services. Broken equipment and drug stock-outs in local clinics could also necessitate travel to other facilities. Availability: Some facilities did not offer full HIV care, or only offered all services intermittently. PLHIV who frequently travelled complained that care was seldom available to them in places they visited. Acceptability: Severe pain or sickness was a key driver for accessing postdiagnosis care, whereas asymptomatic PLHIV often delayed care-seeking. A belief in witchcraft was a deterrent to accessing clinical care following diagnosis. Changing antiretroviral therapy guidelines generated uncertainty among PLHIV about when to start treatment and delayed postdiagnosis care. PLHIV reported that healthcare workers’ knowledge, attitudes and behaviours, and their ability to impart health education, also influenced whether they accessed HIV care. Conclusion Despite efforts to decentralise services over the past decade, many barriers to accessing HIV care persist. There is a need to increase sustained access to care for PLHIV not yet on treatment, with initiatives that encompass biomedical aspects of care alongside considerations for individual and collective challenges they faced. A failure to do so may undermine efforts to achieve universal access to antiretroviral therapy. PMID:28615327

Cosmetic surgery in the NHS: Applying local and national guidelines.

PubMed

Breuning, Eleonore E; Oikonomou, Dimitris; Singh, Pritam; Rai, Jagdeep K; Mendonca, Derick Amith

2010-09-01

There is no worldwide consensus, as to how healthcare should be funded, in a modern society. Limited resources in the UK, have led to restrictions on cosmetic surgery in the NHS. Guidelines governing access to cosmetic surgery have been formulated. A retrospective audit has been undertaken, to assess adherence to local and national guidelines, in an NHS trust. Ninety-nine casenotes were reviewed over 1 year. Data on complications were collected. Compliance to local guidelines was 44% and to national guidelines was 22%. Complication rate was 23% in guideline compliant patients and 55% in non-compliant patients (P<0.005). Guidelines are difficult to follow in practice. Total adherence to guidelines would reduce waiting lists and complications, but some needy patients could be denied treatment. In practice, rigid adherence to guidelines is not possible. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Development and evaluation of online evidence based guideline bank system.

PubMed

Park, Myonghwa

2006-01-01

The purpose of this study was to develop and evaluate the online evidence-based nursing practice guideline bank system to support the best evidence-based decision in the clinical and community practice settings. The main homepage consisted of seven modules for introduction of site, EBN, guideline bank, guideline development, guideline review, related sites, and community. The major contents in the guidelines were purpose, developer, intended audience, method of development, target population, testing, knowledge components, and evaluation. Electronic versions of the guidelines were displayed by XML, PDF, and PDA versions. The system usability were evaluated by general users, guideline developers, and guideline reviewers on the web and the results showed high scores of satisfaction. This online evidence-based guideline bank system could support nurses' best and cost-effective clinical decision using the sharable standardized guidelines with education module of evidence based nursing.

76 FR 76640 - Telecommunications Act Accessibility Guidelines; Electronic and Information Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-08

... benefits and costs, and recommended alternatives. The Board also invites the public to identify any gaps in... guidelines, alternative policies to those presented, and information on benefits and costs. After reviewing... with considerable potential cost in relation to the benefit. Because this requirement potentially would...

77 FR 64834 - Computational Fluid Dynamics Best Practice Guidelines for Dry Cask Applications

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-23

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0250] Computational Fluid Dynamics Best Practice... public comments on draft NUREG-2152, ``Computational Fluid Dynamics Best Practice Guidelines for Dry Cask... System (ADAMS): You may access publicly-available documents online in the NRC Library at http://www.nrc...

First Steps to Talking with Families and Staff: Guidelines for Listening Effectively.

ERIC Educational Resources Information Center

Eisenberg, Eileen

2002-01-01

Presents guidelines for child care administrators to become more effective in communicating with families and staff. Suggestions for beginning a dialogue include being visible and accessible, familiar, personable, professional, ethical, and timely. Details procedures for facilitating parent and staff meeting in a confident manner. Reiterates that…

78 FR 78740 - Isopyrazam; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... access the OCSPP test guidelines referenced in this document electronically, please go to http://www.epa.gov/ocspp and select ``Test Methods and Guidelines.'' C. How can I file an objection or hearing... validity, completeness, and reliability as well as the relationship of the results of the studies to human...

Learners with Dyslexia: Exploring Their Experiences with Different Online Reading Affordances

ERIC Educational Resources Information Center

Chen, Chwen Jen; Keong, Melissa Wei Yin; Teh, Chee Siong; Chuah, Kee Man

2015-01-01

To date, empirically derived guidelines for designing accessible online learning environments for learners with dyslexia are still scarce. This study aims to explore the learning experience of learners with dyslexia when reading passages using different online reading affordances to derive some guidelines for dyslexia-friendly online text. The…

Prefabricated vertical drains, vol. I : engineering guidelines.

DOT National Transportation Integrated Search

1986-09-01

This volume presents procedures and guidelines applicable to the design and instal tion of prefabricated vertical drains to accelerate consolidation of soils. The contents represent the Consultant's interpretation of the state-of-the-art as of August...

36 CFR 1193.37 - Information pass through.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Information pass through. 1193.37 Section 1193.37 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD TELECOMMUNICATIONS ACT ACCESSIBILITY GUIDELINES Requirements for Accessibility and Usability...

36 CFR 1193.37 - Information pass through.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Information pass through. 1193.37 Section 1193.37 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD TELECOMMUNICATIONS ACT ACCESSIBILITY GUIDELINES Requirements for Accessibility and Usability...

36 CFR 1193.37 - Information pass through.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Information pass through. 1193.37 Section 1193.37 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD TELECOMMUNICATIONS ACT ACCESSIBILITY GUIDELINES Requirements for Accessibility and Usability...

36 CFR 1193.37 - Information pass through.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Information pass through. 1193.37 Section 1193.37 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD TELECOMMUNICATIONS ACT ACCESSIBILITY GUIDELINES Requirements for Accessibility and Usability...

78 FR 49248 - Passenger Vessels Accessibility Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1196 [Docket No. ATBCB-2013... Barriers Compliance Board. ACTION: Notice of proposed rulemaking; extension of comment period. SUMMARY: The Architectural and Transportation Barriers Compliance Board (Access Board) is extending until January 24, 2014...

Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial

PubMed Central

2014-01-01

Background Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. Methods An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson’s χ2 test and approximative z-test. Results 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. Conclusions A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected. PMID:24589291

Effect of cooking on the proximate composition of seven accessions of Colocasia esculenta (L.) Schott tubers growing in South Africa.

PubMed

Lewu, Muinat N; Adebola, Patrick O; Afolayan, Anthony J

2009-01-01

Colocasia esculenta (L.) Schott (cocoyam) is cultivated mainly for its edible tubers. The effect of cooking the tubers on the proximate composition of seven accessions (UFCe1-UFCe7) of the crop growing in South Africa was investigated. When compared with the uncooked, the ash and crude fibre contents of the accessions significantly decreased after cooking. The moisture content, crude protein, crude lipid, carbohydrate and caloric contents increased with cooking in all the accessions, except UFCe1 and UFCe5 where the crude lipid content reduced. The results indicate that cooking enhanced the carbohydrate, energy and protein contents of the tubers. They further showed that the tubers could be used for allergic infants, old people and invalids since the fibre contents were still appreciably high despite the slight reduction after cooking the tubers.

Implementation of study results in guidelines and adherence to guidelines in clinical practice.

PubMed

Waldfahrer, Frank

2016-01-01

Guidelines were introduced in hospital- and practice-based otorhinolaryngology in the 1990ies, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head & Neck Surgery. The society has cooperated in further 34 guidelines. The quality of the guidelines has been continuously improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V., AWMF). Since increasing digitalization has made access to scientific publications quicker and simpler, relevant study results can be incorporated in guidelines more easily today than in the analog world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines.

Implementation of study results in guidelines and adherence to guidelines in clinical practice

PubMed Central

Waldfahrer, Frank

2016-01-01

Guidelines were introduced in hospital- and practice-based otorhinolaryngology in the 1990ies, and have been undergoing further development ever since. There are currently 20 guidelines on file at the German Society of Oto-Rhino-Laryngology, Head & Neck Surgery. The society has cooperated in further 34 guidelines. The quality of the guidelines has been continuously improved by concrete specifications put forward by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V., AWMF). Since increasing digitalization has made access to scientific publications quicker and simpler, relevant study results can be incorporated in guidelines more easily today than in the analog world. S2e and S3 guidelines must be based on a formal literature search with subsequent evaluation of the evidence. The consensus procedure for S2k guidelines is also regulated. However, the implementation of guidelines in routine medical practice must still be considered inadequate, and there is still a considerable need for improvement in adherence to these guidelines. PMID:28025601

Lack of international consensus in low-risk drinking guidelines.

PubMed

Furtwaengler, Nina A F F; de Visser, Richard O

2013-01-01

To encourage moderate alcohol consumption, many governments have developed guidelines for alcohol intake, guidelines for alcohol consumption during pregnancy and legislation relating to blood alcohol limits when driving. The aim of this study was to determine the degree of international consensus within such guidelines. Official definitions of standard drinks and consumption guidelines were searched for on government websites, including all 27 European Union Member States and countries from all global geographic regions. There was a remarkable lack of agreement about what constitutes harmful or excessive alcohol consumption on a daily basis, a weekly basis and when driving, with no consensus about the ratios of consumption guidelines for men and women. International consensus in low-risk drinking guidelines is an important--and achievable--goal. Such agreement would facilitate consistent labelling of packaged products and could help to promote moderate alcohol consumption. However, there are some paradoxes related to alcohol content labelling and people's use of such information: although clearer information could increase people's capacity to monitor and regulate their alcohol consumption, not all drinkers are motivated to drink moderately or sensibly, and drinkers who intend to get drunk may use alcohol content labelling to select more alcoholic products. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Reactions on Twitter to updated alcohol guidelines in the UK: a content analysis

PubMed Central

Bignardi, Giacomo; Hollands, Gareth J; Marteau, Theresa M

2017-01-01

Objectives In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter. Methods Tweets containing the hashtag #alcoholguidelines made during 1 week following the announcement of the updated guidelines were retrieved using the Twitter Archiver tool. The source, sentiment and themes of the tweets were categorised using manual content analysis. Results A total of 3061 tweets was retrieved. 6 sources were identified, the most prominent being members of the public. Of 821 tweets expressing sentiment specifically towards the guidelines, 80% expressed a negative sentiment. 11 themes were identified, 3 of which were broadly supportive of the guidelines, 7 broadly unsupportive and 1 neutral. Overall, more tweets were unsupportive (49%) than supportive (44%). While the most common theme overall was sharing information, the most common in tweets from members of the public encouraged alcohol consumption (15%) or expressed disagreement with the guidelines (14%), reflecting reactance, resistance and misunderstanding. Conclusions This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media. PMID:28246145

A Network and Visual Quality Aware N-Screen Content Recommender System Using Joint Matrix Factorization

PubMed Central

Ullah, Farman; Sarwar, Ghulam; Lee, Sungchang

2014-01-01

We propose a network and visual quality aware N-Screen content recommender system. N-Screen provides more ways than ever before to access multimedia content through multiple devices and heterogeneous access networks. The heterogeneity of devices and access networks present new questions of QoS (quality of service) in the realm of user experience with content. We propose, a recommender system that ensures a better visual quality on user's N-screen devices and the efficient utilization of available access network bandwidth with user preferences. The proposed system estimates the available bandwidth and visual quality on users N-Screen devices and integrates it with users preferences and contents genre information to personalize his N-Screen content. The objective is to recommend content that the user's N-Screen device and access network are capable of displaying and streaming with the user preferences that have not been supported in existing systems. Furthermore, we suggest a joint matrix factorization approach to jointly factorize the users rating matrix with the users N-Screen device similarity and program genres similarity. Finally, the experimental results show that we also enhance the prediction and recommendation accuracy, sparsity, and cold start issues. PMID:24982999

Guiding the process of health technology disinvestment.

PubMed

Ibargoyen-Roteta, Nora; Gutiérrez-Ibarluzea, Iñaki; Asua, José

2010-12-01

To develop a guideline for health technology disinvestment. The Nominal Group Technique was used to determine relevant aspects of disinvestment decision-making. Ideas reaching consensus and previous Spanish guidelines on the acquisition of new health technologies (GANT) and new genetic tests (GEN) structures were used to develop the domains and contents of GuNFT (Guideline for Not Funding Health Technologies). The draft was peer reviewed by local and international experts and their suggestions were incorporated to the first GuNFT version. Thirty-five ideas reached consensus. The most relevant ones referred to the reasons for disinvesting in a technology and the key aspects that would facilitate disinvestment acceptance. Considering both consensus ideas and GANT and GEN guidelines, the first GuNFT draft was elaborated. After the review process, section numbers and contents were changed. The resulting GuNFT guideline was finally divided into six domains related to: (1) general preliminary recommendations, (2) completing the application form, (3) checking and prioritising applications, (4) assessment, (5) final decision and (6) action plan design. A software was also developed to facilitate GuNFT implementation. Disinvestment should be a guided process. Accordingly, we present the first guideline for that purpose. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Curricular Guidelines in Microbiology.

ERIC Educational Resources Information Center

Wilett, Norman P.; And Others

1984-01-01

The American Association of Dental Schools' guidelines for curriculum development in microbiology outline the scope of the subject, interrelationships with other disciplines and specialties, primary educational goals, prerequisites, core content, specific behavioral objectives in each subarea, sequencing, and faculty and facilities requirements.…

Curriculum Guidelines for Clinical Dental Hygiene.

ERIC Educational Resources Information Center

Journal of Dental Education, 1985

1985-01-01

The American Association of Dental Schools curriculum guidelines for clinical dental hygiene include definitions, notes on the interrelationship of courses, an overview of course objectives, and suggested primary educational goals, prerequisites, core content, specific objectives, sequencing, faculty, and facilities. (MSE)

Design guidelines for raised and traversable medians in urban areas.

DOT National Transportation Integrated Search

1983-01-01

Major urban and suburban streets must provide a high level of service for through traffic as well as access to abutting properties. To an extent, the provisions of traffic service and the accommodation of access needs are conflicting functions that a...

Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality.

PubMed

Nicholas, Jennifer; Larsen, Mark Erik; Proudfoot, Judith; Christensen, Helen

2015-08-17

With continued increases in smartphone ownership, researchers and clinicians are investigating the use of this technology to enhance the management of chronic illnesses such as bipolar disorder (BD). Smartphones can be used to deliver interventions and psychoeducation, supplement treatment, and enhance therapeutic reach in BD, as apps are cost-effective, accessible, anonymous, and convenient. While the evidence-based development of BD apps is in its infancy, there has been an explosion of publicly available apps. However, the opportunity for mHealth to assist in the self-management of BD is only feasible if apps are of appropriate quality. Our aim was to identify the types of apps currently available for BD in the Google Play and iOS stores and to assess their features and the quality of their content. A systematic review framework was applied to the search, screening, and assessment of apps. We searched the Australian Google Play and iOS stores for English-language apps developed for people with BD. The comprehensiveness and quality of information was assessed against core psychoeducation principles and current BD treatment guidelines. Management tools were evaluated with reference to the best-practice resources for the specific area. General app features, and privacy and security were also assessed. Of the 571 apps identified, 82 were included in the review. Of these, 32 apps provided information and the remaining 50 were management tools including screening and assessment (n=10), symptom monitoring (n=35), community support (n=4), and treatment (n=1). Not even a quarter of apps (18/82, 22%) addressed privacy and security by providing a privacy policy. Overall, apps providing information covered a third (4/11, 36%) of the core psychoeducation principles and even fewer (2/13, 15%) best-practice guidelines. Only a third (10/32, 31%) cited their information source. Neither comprehensiveness of psychoeducation information (r=-.11, P=.80) nor adherence to best-practice guidelines (r=-.02, P=.96) were significantly correlated with average user ratings. Symptom monitoring apps generally failed to monitor critical information such as medication (20/35, 57%) and sleep (18/35, 51%), and the majority of self-assessment apps did not use validated screening measures (6/10, 60%). In general, the content of currently available apps for BD is not in line with practice guidelines or established self-management principles. Apps also fail to provide important information to help users assess their quality, with most lacking source citation and a privacy policy. Therefore, both consumers and clinicians should exercise caution with app selection. While mHealth offers great opportunities for the development of quality evidence-based mobile interventions, new frameworks for mobile mental health research are needed to ensure the timely availability of evidence-based apps to the public.

Evaluation of the acceptability and usability of a decision support system to encourage safe and effective use of opioid therapy for chronic, noncancer pain by primary care providers.

PubMed

Trafton, Jodie; Martins, Susana; Michel, Martha; Lewis, Eleanor; Wang, Dan; Combs, Ann; Scates, Naquell; Tu, Samson; Goldstein, Mary K

2010-04-01

To develop and evaluate a clinical decision support system (CDSS) named Assessment and Treatment in Healthcare: Evidenced-Based Automation (ATHENA)-Opioid Therapy, which encourages safe and effective use of opioid therapy for chronic, noncancer pain. CDSS development and iterative evaluation using the analysis, design, development, implementation, and evaluation process including simulation-based and in-clinic assessments of usability for providers followed by targeted system revisions. Volunteers provided detailed feedback to guide improvements in the graphical user interface, and content and design changes to increase clinical usefulness, understandability, clinical workflow fit, and ease of completing guideline recommended practices. Revisions based on feedback increased CDSS usability ratings over time. Practice concerns outside the scope of the CDSS were also identified. Usability testing optimized the CDSS to better address barriers such as lack of provider education, confusion in dosing calculations and titration schedules, access to relevant patient information, provider discontinuity, documentation, and access to validated assessment tools. It also highlighted barriers to good clinical practice that are difficult to address with CDSS technology in its current conceptualization. For example, clinicians indicated that constraints on time and competing priorities in primary care, discomfort in patient-provider communications, and lack of evidence to guide opioid prescribing decisions impeded their ability to provide effective, guideline-adherent pain management. Iterative testing was essential for designing a highly usable and acceptable CDSS; however, identified barriers may limit the impact of the ATHENA-Opioid Therapy system and other CDSS on clinical practices and outcomes unless CDSS are paired with parallel initiatives to address these issues.

Quality Assessment of Clinical Practice Guidelines Developed by Professional Societies in Turkey.

PubMed

Yaşar, Ilknur; Kahveci, Rabia; Baydar Artantaş, Aylin; Ayhan Başer, Duygu; Gökşin Cihan, Fatma; Şencan, Irfan; Koç, Esra Meltem; Özkara, Adem

2016-01-01

Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. There is a limited number of studies on guidelines in Turkey. The quality of Ministry of Health guidelines have formerly been assessed whereas there is no information on the other guidelines developed in the country. This study aims to assess the quality of CPGs that are developed by professional societies that work for the health sector in Turkey, and compare the findings with international guidelines. Professional societies that work for the health sector were determined by using the data obtained from the Ministry of Internal Affairs. Inclusion and exclusion criteria were defined for selecting the CPGs. Guidelines containing recommendations about disease management to the doctors, accessible online, developed within the past 5 years, citing references for recommendations, about the diseases over 1% prevalence according to the "Statistical Yearbook of Turkey 2012" were included in the study. The quality of CPGs were assessed with the AGREE II instrument, which is an internationally recognized tool for this purpose. Four independent reviewers, who did not participate in the development of the selected guidelines and were trained in CPG appraisal, used the AGREE instrument for assessment of the selected guidelines. 47 professional societies were defined which provided access to CPGs in their websites; 3 of them were only open to members so these could not be reached. 8 CPGs from 7 societies were selected from a total of 401 CPGs from 44 societies. The mean scores of the domains of the guidelines which were assessed by the AGREE II tool were; 64%, stakeholder involvement: 37.9%, rigour of development: 35.3%, clarity and presentation: 77.9%, applicability: 49.0% and editorial independence: 46.0%. This is the first study in Turkey regarding quality appraisal of guidelines developed by the local professional societies. It adds to the limited amount of information in the literature that comes from Turkey as well as other developing countries.

Utilization of the American Telemedicine Association's Clinical Practice Guidelines

PubMed Central

Antoniotti, Nina; Bernard, Jordana

2013-01-01

Abstract Background: The American Telemedicine Association (ATA) Standards and Guidelines Committee develops practice standards and guidelines. Key to the Committee's mission is dissemination so the standards can be used in the practice of telemedicine. Over a 2-year period, when a standards document was accessed from the ATA Web site, a short survey was completed, but it did not assess how the documents were used once downloaded. A more formal survey was conducted to determine the impact ATA standards and guidelines are having on healthcare delivery via telemedicine. Materials and Methods: A survey was developed and distributed via SurveyMonkey to 13,177 ATA members and nonmembers in November 2011. Results were compiled and analyzed after a 90-day open period for responses to be submitted. Results: The majority of respondents (96%) believe the practice of telemedicine/telehealth should have standards and guidelines and that the ATA and other professional societies/associations should be responsible for developing them. The top uses of guidelines include guidance for clinical practice, training, gaining reimbursement, and research. Respondents indicating a need for standards and guidelines said the ATA (78.7%) and other professional societies/associations (74.5%) should be responsible for development. When asked to list specific practice guidelines or standards they are using for telehealth, the majority (21.5%) are using in-house (e.g., hospital, company)-developed guidelines, followed by those from professional associations/societies (20.4%) and those developed by the ATA (18.2%). Conclusions: Overall, the survey results indicate guidelines documents developed by the ATA and other professional societies and those developed in-house are being regularly accessed and used in both public and private sectors. Practitioners of telemedicine believe that standards and guidelines are needed for guidance for clinical practice, training, gaining reimbursement, and research, and they are to use those developed by professional organization such as the ATA as well as those developed by their own institutions. PMID:24050615

[Goals, possibilities and limits of quality evaluation of guidelines. A background report on the user manual of the "Methodological Quality of Guidelines" check list].

PubMed

Helou, A; Ollenschläger, G

1998-06-01

Recently a German appraisal instrument for clinical guidelines was published that could be used by various parties in formal evaluation of guidelines. An user's guide to the appraisal instrument was designed that contains a detailed explanation for each question to ensure that the instrument is interpreted consistently. This paper describes the purposes, format and contents of the user's guide, and reviews the key factors influencing the validity of guidelines. Taking into account international experiences, the purposes, chances and methodological limitations of a prospective assessment of clinical practice guidelines are discussed.

17 CFR 9.11 - Form, contents and delivery of notice of disciplinary or access denial action.

Code of Federal Regulations, 2010 CFR

2010-04-01

... notice of disciplinary or access denial action. 9.11 Section 9.11 Commodity and Securities Exchanges... OTHER ADVERSE ACTIONS Notice and Effective Date of Disciplinary Action or Access Denial Action § 9.11 Form, contents and delivery of notice of disciplinary or access denial action. (a) When required...

77 FR 56590 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... an information meeting in Seattle, WA on October 2, 2012 on pending rulemaking to revise and update... aisle. DATES: The information meeting will be held from 2:15 p.m. to 5:30 p.m. on October 2, 2012... and any updates to the meeting will be posted on the Access Board's Web site at http://www.access...

Development of the Virtual Visitor Center at SLAC

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

McDunn, Ruth

1999-11-17

The Virtual Visitor Center (VVC) web site (www2.slac.stanford.edu/vvc) is a ''virtual'' version of the Visitor Center, a mini science museum that opened at SLAC in 1996. The VVC was made public in December 1998. Both centers contribute to SLAC mission regarding education of the next generation and increasing scientific awareness of the public. The site is designed to mimic the real visitor center and allow a larger audience to the information. The intent was to reach the 8th-12th grade audience. Considerable effort was made to organize the content, including color-coding graphical elements for each main topic area. Tables of contents,more » a search tool, several photo tours, as well as graphical and non-graphical menu bars allow users many methods of navigating the site. The site was developed over almost two years using an estimated .95 FTE, split between a program manager, graphic designer, content provider (theoretical physicist), and a summer intern (high school teacher). As of November 1999, the site consists of 1,147 files, 935 images, 3,080 internal hyperlinks, and 190 external hyperlinks. The site has had over 1 million hits between January and mid-October 1999 and averages about 600 page views each day. Future plans include bringing the web site into compliance with the W3Cs Web Content Accessibility guidelines, thoroughly integrating the glossary terms, continued incorporation of current research at SLAC, and adding more interactivity.« less

Competencies of Thai expertise teacher and PCK

NASA Astrophysics Data System (ADS)

Chantaranima, Tarntip; Yuenyong, Chokchai

2018-01-01

Pedagogical Content Knowledge (PCK) was accepted by worldwide Educators that it is a ubiquitous word in the preparation of teachers in the past decade. This study uses Pedagogical Content Knowledge (PCK) framework as a lens for classifying the guidelines and expectations for categorizing expertise teachers. Therefore, the paper tries to clarify the relationship between competencies of Thai expertise teacher and PCK elements. To promote skillful Thai teachers by offering them academic titles, the Office of the Teacher Civil Service and Education Personal Commission were developed to provide guidelines and expectations for categorizing expertise teachers (OTEPC, 2009). This article focuses on the guideline criteria which are three areas of consideration. The first area of consideration is teacher's disciplines including virtues and professional conducts. The second area of consideration is teacher's knowledge and teaching ability. The last area of consider is teacher's performance. It seemed that the OTEPC guideline pay too much attention on the first area. However, there are some issues of PCK appearing on the OTEPC teacher competency. The paper will discuss some suggestions of fill up PCK in the OTEPC guideline. The paper may have implication for Thailand teacher education.

75 FR 33190 - Trifloxystrobin; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

....gpoaccess.gov/ecfr . To access the harmonized test guidelines referenced in this document electronically, please go http://www.epa.gov/ocspp and select ``Test Methods and Guidelines.'' C. How Can I File an... (PP 8F7487) by Bayer CropScience, 2 T.W. Alexander Drive, P.O. Box 12014, Research Triangle Park, NC...

Diabetes Burden and Access to Preventive Care in the Rural United States

ERIC Educational Resources Information Center

Krishna, Santosh; Gillespie, Kathleen N.; McBride, Timothy M.

2010-01-01

Context: National databases can be used to investigate diabetes prevalence and health care use. Guideline-based care can reduce diabetes complications and morbidity. Yet little is known about the prevalence of diabetes and compliance with diabetes care guidelines among rural residents and whether different national databases provide similar…

Guidelines for Assessing the Need for Adaptive Devices for Visually Impaired Pedestrians at Signalized Intersections.

ERIC Educational Resources Information Center

Gallagher, Brian R.; de Oca, Patricia Montes

1998-01-01

Presents guidelines for orientation and mobility instructors and traffic engineers to assess the need for adaptive devices to make crosswalks at signalized intersections accessible to pedestrians with visual impairments. The discussions of audible and tactile pedestrian devices, along with case examples, distinguish when each device should be…

Transformative Professional Development through the Eyes of Jack Mezirow and Thomas Guskey

ERIC Educational Resources Information Center

Stahl, Leslie D.

2012-01-01

The key to improving education is the classroom teacher. Students must have skillful, highly effective teachers who have consistent access to on going professional development. NCLB offers guidelines for effective professional development. States interpret these guidelines and add their own varied legislative requirements. The current result is an…

Missouri Professional Development Guidelines for Student Success.

ERIC Educational Resources Information Center

Missouri State Dept. of Elementary and Secondary Education, Jefferson City.

These guidelines help professional development chairs, administrators, and teachers collaboratively plan for the ongoing skill development and content acquisition of staff members. Section 1, "Missions, Mandates, and Regulations for Professional Development," describes the mission of professional development as supporting teachers in…

Visual Arts Education Guidelines, K-12.

ERIC Educational Resources Information Center

Georgia State Dept. of Education, Atlanta. Div. of Curriculum Development.

Guidelines are offered for implementing an art education program fostering art knowledge, art appreciation, and personal creativity. Six chapters cover goals, content, curriculum planning, resources, evaluation and administration. Chapter 1 identifies 5 objectives of art education--perceptual awareness, values development, creative development,…

Curricular Guidelines for Neuroanatomy.

ERIC Educational Resources Information Center

Journal of Dental Education, 1981

1981-01-01

Presented are the curricular guidelines for Neuroanatomy developed by the Section on Anatomical Sciences of the American Association of Dental Schools for use by individual educational institutions as curriculum development aids. Included are recommendations for primary educational goals, prerequisites, scope, content, behavioral objectives,…

“The care is the best you can give at the time”: Health care professionals’ experiences in providing gender affirming care in South Africa

PubMed Central

Spencer, Sarah; Meer, Talia

2017-01-01

Background While the provision of gender affirming care for transgender people in South Africa is considered legal, ethical, and medically sound, and is—theoretically—available in both the South African private and public health sectors, access remains severely limited and unequal within the country. As there are no national policies or guidelines, little is known about how individual health care professionals providing gender affirming care make clinical decisions about eligibility and treatment options. Method Based on an initial policy review and service mapping, this study employed semi-structured interviews with a snowball sample of twelve health care providers, representing most providers currently providing gender affirming care in South Africa. Data were analysed thematically using NVivo, and are reported following COREQ guidelines. Results Our findings suggest that, whilst a small minority of health care providers offer gender affirming care, this is almost exclusively on their own initiative and is usually unsupported by wider structures and institutions. The ad hoc, discretionary nature of services means that access to care is dependent on whether a transgender person is fortunate enough to access a sympathetic and knowledgeable health care provider. Conclusion Accordingly, national, state-sanctioned guidelines for gender affirming care are necessary to increase access, homogenise quality of care, and contribute to equitable provision of gender affirming care in the public and private health systems. PMID:28704458

Assessment and validation of managed lanes weaving and access guidelines.

DOT National Transportation Integrated Search

2010-06-01

The goal of this project was to establish spacing requirements for access points to managed lanes : with respect to the location of entrance and exit ramps on the general purpose lanes of the freeway. Traffic : entering the freeway destined for the m...

28 CFR 41.56 - General requirement concerning program accessibility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for...

28 CFR 41.56 - General requirement concerning program accessibility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for...

28 CFR 41.56 - General requirement concerning program accessibility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for...

28 CFR 41.56 - General requirement concerning program accessibility.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for...

Untangling Your Web.

ERIC Educational Resources Information Center

Coombs, Norman

2000-01-01

Provides an overview of universal Web design and discusses guidelines developed by the Web access initiative (WAI) that focus on the access needs of Web users with disabilities. Highlights include barriers for people with print disabilities or motor impairments; the role of libraries; and resources to assist Web designers. (LRW)

75 FR 54543 - Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1192 [Docket No. ATBCB 2010... Vehicles AGENCY: Architectural and Transportation Barriers Compliance Board. ACTION: Notice of public hearings. SUMMARY: The Architectural and Transportation Barriers Compliance Board (Access Board) will hold...

[Vascular access guidelines for hemodialysis].

PubMed

Rodríguez Hernández, J A; González Parra, E; Julián Gutiérrez, J M; Segarra Medrano, A; Almirante, B; Martínez, M T; Arrieta, J; Fernández Rivera, C; Galera, A; Gallego Beuter, J; Górriz, J L; Herrero, J A; López Menchero, R; Ochando, A; Pérez Bañasco, V; Polo, J R; Pueyo, J; Ruiz, Camps I; Segura Iglesias, R

2005-01-01

Quality of vascular access (VA) has a remarkable influence in hemodialysis patients outcomes. Dysfunction of VA represents a capital cause of morbi-mortality of these patients as well an increase in economical. Spanish Society of Neprhology, aware of the problem, has decided to carry out a revision of the issue with the aim of providing help in comprehensión and treatment related with VA problems, and achieving an homogenization of practices in three mayor aspects: to increase arteriovenous fistula utilization as first vascular access, to increment vascular access monitoring practice and rationalise central catheters use. We present a consensus document elaborated by a multidisciplinar group composed by nephrologists, vascular surgeons, interventional radiologysts, infectious diseases specialists and nephrological nurses. Along six chapters that cover patient education, creation of VA, care, monitoring, complications and central catheters, we present the state of the art and propose guidelines for the best practice, according different evidence based degrees, with the intention to provide help at the professionals in order to make aproppiate decissions. Several quality standars are also included.

How the Curriculum Guideline "The Cell Is to Be Studied Longitudinally" Is Expressed in Six Israeli Junior-High-School Textbooks

ERIC Educational Resources Information Center

Cohen, Rachel; Yarden, Anat

2010-01-01

The most recent science and technology curriculum for junior high school in Israel contains a new guideline stating that the cell topic is to be taught "longitudinally in conjunction with other study contents." This guideline confers a change in teaching the cell topic and provides an opportunity to form meaningful relationships between…

Do guidelines influence the implementation of health programs? — Uganda’s experience

PubMed Central

2012-01-01

Background A guideline contains processes and procedures intended to guide health service delivery. However, the presence of guidelines may not guarantee their implementation, which may be a result of weaknesses in the development process. This study was undertaken to describe the processes of developing health planning, services management, and clinical guidelines within the health sector in Uganda, with the goal of understanding how these processes facilitate or abate the utility of guidelines. Methods Qualitative and quantitative research methods were used to collect and analyze data. Data collection was undertaken at the levels of the central Ministry of Health, the district, and service delivery. Qualitative methods included review of documents, observations, and key informant interviews, as well as quantitative aspects included counting guidelines. Quantitative data were analyzed with Microsoft Excel, and qualitative data were analyzed using deductive content thematic analysis. Results There were 137 guidelines in the health sector, with programs related to Millennium Development Goals having the highest number (n = 83). The impetus for guideline development was stated in 78% of cases. Several guidelines duplicated content, and some conflicted with each other. The level of consultation varied, and some guidelines did not consider government-wide policies and circumstances at the service delivery level. Booklets were the main format of presentation, which was not tailored to the service delivery level. There was no framework for systematic dissemination, and target users were defined broadly in most cases. Over 60% of guidelines available at the central level were not available at the service delivery level, but there were good examples in isolated cases. There was no framework for systematic monitoring of use, evaluation, and review of guidelines. Suboptimal performance of the supervision framework that would encourage the use of guidelines, assess their utilization, and provide feedback was noted. Conclusions Guideline effectiveness is compromised by the development process. To ensure the production of high-quality guidelines, efforts must be employed at the country and regional levels. The regional level can facilitate pooling resources and expertise in knowledge generation, methodology development, guideline repositories, and capacity building. Countries should establish and enforce systems and guidance on guideline development. PMID:23068082

Development and Preliminary Validation of a Comprehensive Questionnaire to Assess Women’s Knowledge and Perception of the Current Weight Gain Guidelines during Pregnancy

PubMed Central

Ockenden, Holly; Gunnell, Katie; Giles, Audrey; Nerenberg, Kara; Goldfield, Gary; Manyanga, Taru; Adamo, Kristi

2016-01-01

The aim of this study was to develop and validate an electronic questionnaire, the Electronic Maternal Health Survey (EMat Health Survey), related to women’s knowledge and perceptions of the current gestational weight gain guidelines (GWG), as well as pregnancy-related health behaviours. Constructs addressed within the questionnaire include self-efficacy, locus of control, perceived barriers, and facilitators of physical activity and diet, outcome expectations, social environment and health practices. Content validity was examined using an expert panel (n = 7) and pilot testing items in a small sample (n = 5) of pregnant women and recent mothers (target population). Test re-test reliability was assessed among a sample (n = 71) of the target population. Reliability scores were calculated for all constructs (r and intra-class correlation coefficients (ICC)), those with a score of >0.5 were considered acceptable. The content validity of the questionnaire reflects the degree to which all relevant components of excessive GWG risk in women are included. Strong test-retest reliability was found in the current study, indicating that responses to the questionnaire were reliable in this population. The EMat Health Survey adds to the growing body of literature on maternal health and gestational weight gain by providing the first comprehensive questionnaire that can be self-administered and remotely accessed. The questionnaire can be completed in 15–25 min and collects useful data on various social determinants of health and GWG as well as associated health behaviours. This online tool may assist researchers by providing them with a platform to collect useful information in developing and tailoring interventions to better support women in achieving recommended weight gain targets in pregnancy. PMID:27916921

[Implementation and evaluation of a blended learning course on gastroesophageal reflux disease for physicians in Latin America].

PubMed

Cohen, Henry; Margolis, Alvaro; González, Nicolás; Martínez, Elisa; Sanguinetti, Alberto; García, Sofía; López, Antonio

2014-01-01

Integrating evidence-based clinical practice guidelines on gastroesophageal reflux disease into medical practice is of prime importance in Latin America, given its high prevalence in this region. The aim of this project was to implement and assess an educational intervention on gastroesophageal reflux disease, aimed at primary care physicians in Latin America, with contents based on current clinical guidelines. The course included initial activities, whether face-to-face or through distance learning, and a 2-month period of Internet study and interaction. A pilot test was carried out in Uruguay, which was then repeated in 5 countries (Mexico, Colombia, Venezuela, Argentina and again in Uruguay). A global template was designed, which was then adapted to each of the countries: this was done with the participation of local institutions and leaders. Local credits were given for recertification. Participation was free. Of 3,110 physicians invited to participate, 1,143 (36.8%) started the course. Of these, 587 (51.4%) accessed at least half the contents of the course and 785 (68.7%) took part in the clinical discussions. A total of 338 (29.6%) completed all the requirements of the course and received a certificate. Among physicians who took both the pre- and post-intervention knowledge tests, scores improved from 60 to 80% (P<.001). Ninety-two percent of planned changes in clinical practice were related to the pedagogic aims of the course. In conclusion, a multifaceted, 2-phase continuing education course was successfully imparted in Latin America, with an overall design that was adapted to each country. Determination of specific needs and the participation of national experts were fundamental to the success of the course. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

Wheelchair accessibility to public buildings in Istanbul.

PubMed

Evcil, A Nilay

2009-03-01

Accessibility to public environment is the human right and basic need of each citizen and is one of the fundamental considerations for urban planning. The aim of this study is to determine the compliance of public buildings in central business districts (CBD) of Istanbul, Turkey, to wheelchair accessibility to the guidelines of the instrument and identify architectural barriers faced by wheelchair users. This is a descriptive study of 26 public buildings in CBD of Istanbul. The instrument used is the adapted Useh, Moyo and Munyonga questionnaire to collect the data from direct observation and measurement. Descriptive statistics of simple percentages and means are used to explain the compliance to the guidelines of the instrument and wheelchair accessibility. The descriptive survey results indicate that wheelchair users experience many accessibility problems in public environment of the most urbanised city (cultural capital of Europe in 2010) in a developing country. It is found that the major architectural barrier is the public transportation items with the lowest mean compliance (25%). Beside this, the most compliant to the instrument is entrance to building items with 79% as mean percentage. It is also found that there is an intention to improve accessibility when building construction period is investigated. This article describes the example of the compliance of public buildings accessibility when the country has legislation, but lacking regulations about accessibility for the wheelchair users.

Designing an Online Course Content Structure Using a Design Patterns Approach

ERIC Educational Resources Information Center

Hathaway, Dawn; Norton, Priscilla

2013-01-01

Despite the central role that well organized and structured course content plays in engaging online learners with content, the authors point to the absence of guidelines for organizing content in ways that meet course learning goals. Recognizing the need for a design solution and, perhaps, the need for a new design model, "design…

Training and Sustaining Effective Teachers of Sheltered Instruction

ERIC Educational Resources Information Center

Short, Deborah

2013-01-01

This article provides guidelines for programs to deliver and sustain effective professional development on sheltered instruction to teachers who teach content to English learners. Many content area teachers have not had university coursework on second-language acquisition or the integration of language and content instruction in teacher…

Keep Up or Fall Behind

ERIC Educational Resources Information Center

Ramaswami, Rama

2007-01-01

In the race to enable information access and collaboration, institutions are taking advantage of new tools to drive content management innovation. New content management systems (CMS) features and functions are driving true innovation in content management, and enabling information access, sharing, collaboration, and tracking on a scale heretofore…

Factors affecting sugar-sweetened beverage availability in competitive venues of US secondary schools.

PubMed

Terry-McElrath, Yvonne M; O'Malley, Patrick M; Johnston, Lloyd D

2012-01-01

This study explores sugar-sweetened beverage (SSB) availability in US secondary school competitive venues during the first 3 years following the school wellness policy requirement (2007-2009). Furthermore, analyses examine associations with school policy and SSB availability. Analyses use questionnaire data from 757 middle and 762 high schools in the nationally representative Youth, Education, and Society study to examine soda and non-soda SSB availability associations with school policy including (1) beverage bottling contracts and related incentives, (2) individuals/organizations responsible for decisions regarding beverages available in vending machines, and (3) school wellness policies and nutrition guidelines. Non-soda SSBs made up the majority of SSBs in both middle and high schools. Soda was especially likely to be found in vending machines; non-soda SSBs were widely available across competitive venues. Access to soda decreased significantly over time; however, non-soda SSB access did not show a similar decrease. School policy allowing beverage supplier contractual involvement (bottling contract incentives and beverage supplier "say" in vending machine beverage choices) was related to increased SSB access. However, the existence of developed nutritional guidelines was associated with lower SSB availability. Students had high access to SSBs across competitive school venues, with non-soda SSBs making up the majority of SSB beverage options. Efforts to reduce access to SSBs in US secondary schools should include a focus on reducing both soda and non-soda SSBs, reducing beverage supplier involvement in school beverage choices, and encouraging the development of targeted nutritional guidelines for all competitive venues. © 2011, American School Health Association.

An intelligent system and a relational data base for codifying helmet-mounted display symbology design requirements

NASA Astrophysics Data System (ADS)

Rogers, Steven P.; Hamilton, David B.

1994-06-01

To employ the most readily comprehensible presentation methods and symbology with helmet-mounted displays (HMDs), it is critical to identify the information elements needed to perform each pilot function and to analytically determine the attributes of these elements. The extensive analyses of mission requirements currently performed for pilot-vehicle interface design can be aided and improved by the new capabilities of intelligent systems and relational databases. An intelligent system, named ACIDTEST, has been developed specifically for organizing and applying rules to identify the best display modalities, locations, and formats. The primary objectives of the ACIDTEST system are to provide rapid accessibility to pertinent display research data, to integrate guidelines from many disciplines and identify conflicts among these guidelines, to force a consistent display approach among the design team members, and to serve as an 'audit trail' of design decisions and justifications. A powerful relational database called TAWL ORDIR has been developed to document information requirements and attributes for use by ACIDTEST as well as to greatly augment the applicability of mission analysis data. TAWL ORDIR can be used to rapidly reorganize mission analysis data components for study, perform commonality analyses for groups of tasks, determine the information content requirement for tailored display modes, and identify symbology integration opportunities.

Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement.

PubMed

Mina, D Santa; Sabiston, C M; Au, D; Fong, A J; Capozzi, L C; Langelier, D; Chasen, M; Chiarotto, J; Tomasone, J R; Jones, J M; Chang, E; Culos-Reed, S N

2018-04-01

Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks ("pathways") that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer.

Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement

PubMed Central

Mina, D. Santa; Sabiston, C.M.; Au, D.; Fong, A.J.; Capozzi, L.C.; Langelier, D.; Chasen, M.; Chiarotto, J.; Tomasone, J.R.; Jones, J.M.; Chang, E.; Culos-Reed, S.N.

2018-01-01

Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks (“pathways”) that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer. PMID:29719431

Subscriptions Are Us: Content, Access, & Collections

ERIC Educational Resources Information Center

Thomas, Lisa Carlucci

2012-01-01

In a time of increasingly digital distribution, challenging questions arise regarding what people own, what they want to access to, and how they develop and maintain collections. What considerations influence their decision making, as individuals and libraries shift toward more subscription-oriented content? Digital access to e-books and…

Barriers to providing maternity care to women with physical disabilities: Perspectives from health care practitioners.

PubMed

Mitra, Monika; Smith, Lauren D; Smeltzer, Suzanne C; Long-Bellil, Linda M; Sammet Moring, Nechama; Iezzoni, Lisa I

2017-07-01

Women with physical disabilities are known to experience disparities in maternity care access and quality, and communication gaps with maternity care providers, however there is little research exploring the maternity care experiences of women with physical disabilities from the perspective of their health care practitioners. This study explored health care practitioners' experiences and needs around providing perinatal care to women with physical disabilities in order to identify potential drivers of these disparities. We conducted semi-structured telephone interviews with 14 health care practitioners in the United States who provide maternity care to women with physical disabilities, as identified by affiliation with disability-related organizations, publications and snowball sampling. Descriptive coding and content analysis techniques were used to develop an iterative code book related to barriers to caring for this population. Public health theory regarding levels of barriers was applied to generate broad barrier categories, which were then analyzed using content analysis. Participant-reported barriers to providing optimal maternity care to women with physical disabilities were grouped into four levels: practitioner level (e.g., unwillingness to provide care), clinical practice level (e.g., accessible office equipment like adjustable exam tables), system level (e.g., time limits, reimbursement policies), and barriers relating to lack of scientific evidence (e.g., lack of disability-specific clinical data). Participants endorsed barriers to providing optimal maternity care to women with physical disabilities. Our findings highlight the needs for maternity care practice guidelines for women with physical disabilities, and for training and education regarding the maternity care needs of this population. Copyright © 2016 Elsevier Inc. All rights reserved.

Teaching about Our World Community: Guidelines and Resources.

ERIC Educational Resources Information Center

Hoge, John Douglas; Allen, Rodney F.

1991-01-01

Offers guidelines for teaching about foreign countries in elementary school social studies lessons. Explains ways to determine content and goals, build background information, and locate instructional materials/community resources. Suggests activities for beginning, sustaining, and concluding units. Stresses importance of maintaining student…

Curriculum Guidelines for Microscopic Anatomy.

ERIC Educational Resources Information Center

Journal of Dental Education, 1993

1993-01-01

The American Association of Dental Schools' guidelines for curricula in microscopic anatomy offer an overview of the histology curriculum, note primary educational goals, outline specific content for general and oral histology, suggest prerequisites, and make recommendations for sequencing. Appropriate faculty and facilities are also suggested.…

Curriculum Guidelines for Gross Anatomy.

ERIC Educational Resources Information Center

Journal of Dental Education, 1993

1993-01-01

The American Association of Dental Schools' revised guidelines on curricula for gross anatomy suggest percentages of effort and time devoted to curricular areas, offer a rationale for anatomy instruction, note primary educational goals and prerequisites, outline content, and make recommendations for sequencing. Appropriate faculty and facilities…

An Overview of Current Guidelines for Commercial Support of Continuing Medical Education.

ERIC Educational Resources Information Center

Harrison, R. Van

1993-01-01

A number of bodies have produced guidelines concerning financial support from commercial companies for continuing medical education. Basic principles include independence of the continuing education provider, balanced content, no unusual benefits, and disclosure of potential for bias. (SK)

Curriculum Guidelines for Predoctoral Oral Radiology.

ERIC Educational Resources Information Center

Journal of Dental Education, 1987

1987-01-01

The American Association of Dental Schools' guidelines for oral radiology curricula give an overview of the field and its interrelationships with other fields and outline the primary educational objectives, prerequisites, core content, specific behavioral objectives, sequencing, faculty, facilities, and occupational hazards to be considered in…

#13ReasonsWhy Health Professionals and Educators are Tweeting: A Systematic Analysis of Uses and Perceptions of Show Content and Learning Outcomes.

PubMed

Walker, Kimberly K; Burns, Kelli

2018-04-27

This study is a content analysis of health professionals' and educators' tweets about a popular Netflix show that depicts teen suicide: 13 Reasons Why. A content analysis of 740 tweets was conducted to determine the main themes associated with professionals' and educators' tweets about the show, as well as the valence of the tweets. Additionally, a thematic analysis of linked content in tweets (n = 178) was conducted to explore additional content shared about the show and modeling outcomes. Results indicated the largest percentage of tweets was related to social learning, particularly about outcomes that could occur from viewing the show. The valence of the tweets about outcomes was more positive than negative. However, linked materials commonly circulated in tweets signified greater concern with unintended learning outcomes. Some of the linked content included media guidelines for reporting on suicide with recommendations that entertainment producers follow the guidelines. This study emphasizes the importance of including social learning objectives in future typologies of Twitter uses and demonstrates the importance of examining linked content in Twitter studies.

Potential facilitators and barriers to adopting standard treatment guidelines in clinical practice.

PubMed

Sharma, Sangeeta; Pandit, Ajay; Tabassum, Fauzia

2017-04-18

Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality/value This survey among clinicians, despite limitations, gives helpful insights. While favourable attitudes may be helpful, clinical adoption could be improved more effectively by targeting barriers.

Patient Access Study

DTIC Science & Technology

1998-03-01

guidelines. 14. SUBJECT TERMS Efficiency, health care issues, medical services, military medicine, military standards, Navy, patients , scheduling...Rev. 2-89) Prescribed by ANSI Std. 239-18 299-01 Patient Access Study Sponsor: Assistant Chief for Health Care Operations (MED 03) March 1998...Michelle Dolfini-Reed Derek Shia In today’s highly competitive health care market, patient access to care is the key ingredient to a practice’s

40 CFR 60.2665 - What if all the qualified operators are temporarily not accessible?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Operator... accessible and that you are resuming operation. Model Rule—Emission Limitations and Operating Limits ...

40 CFR 60.2665 - What if all the qualified operators are temporarily not accessible?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Operator... accessible and that you are resuming operation. Model Rule—Emission Limitations and Operating Limits ...

12 CFR Appendix F to Part 225 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2012 CFR

2012-01-01

... only to authorized individuals and controls to prevent employees from providing customer information to unauthorized individuals who may seek to obtain this information through fraudulent means. b. Access... records storage facilities to permit access only to authorized individuals; c. Encryption of electronic...

12 CFR Appendix F to Part 225 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2014 CFR

2014-01-01

... only to authorized individuals and controls to prevent employees from providing customer information to unauthorized individuals who may seek to obtain this information through fraudulent means. b. Access... records storage facilities to permit access only to authorized individuals; c. Encryption of electronic...

Standards and guidelines for biopolymers in tissue-engineered medical products: ASTM alginate and chitosan standard guides. American Society for Testing and Materials.

PubMed

Dornish, M; Kaplan, D; Skaugrud, O

2001-11-01

The American Society for Testing and Materials (ASTM) is making a concerted effort to establish standards and guidelines for the entire field of tissue-engineered medical products (TEMPS). Safety, consistency, and functionality of biomaterials used as matrices, scaffolds, and immobilizing agents in TEMPS are a concern. Therefore, the ASTM has established a number of task groups to produce standards and guidelines for such biomaterials. Alginate is a naturally occurring biomaterial used for immobilizing living cells to form an artificial organ, such as encapsulated pancreatic islets. In order to aid in successful clinical applications and to help expedite regulatory approval, the alginate used must be fully documented. The ASTM alginate guide gives information on selection of testing methodologies and safety criteria. Critical parameters such as monomer content, molecular weight, and viscosity, in addition to more general parameters, such as dry matter content, heavy metal content, bioburden, and endotoxin content are described in the ASTM document. In a like manner, the characterization parameters for chitosan, a bioadhesive polycationic polysaccharide, are described in a separate guide. For chitosan, the degree of deacetylation is of critical importance. Control of protein content and, hence, potential for hypersensitivity, endotoxin content, and total bioburden are important in chitosan preparations for TEMPS. Together these two guides represent part of the effort on behalf of the ASTM and other interested parties to ensure quality and standardization in TEMPS.

Unprofessional behaviour on social media by medical students.

PubMed

Barlow, Christopher J; Morrison, Stewart; Stephens, Hugh On; Jenkins, Emily; Bailey, Michael J; Pilcher, David

2015-12-14

To describe the social media usage patterns of medical students and to identify factors associated with their posting of unprofessional content on social media. Voluntary survey, delivered online. All students in all 20 Australian medical schools were eligible to participate (16 993 individuals). Of 1027 initial respondents during the study period (29 March - 12 August 2013), 880 completed the survey. Prevalence of unprofessional online behaviour on social media by medical students, as reported by students about their own and others' accounts. Posting of unprofessional content was self-reported by 306 students (34.7%), mainly depictions of intoxication (301 students, 34.2%) or illegal drug use (14 students, 1.6%), or posting of patient information (14 students, 1.6%). Posting of unprofessional content was associated with posting evidence of alcohol use and racist content online, MySpace use, and planning to change one's profile name after graduation. Factors associated with reduced unprofessional content included believing that videos depicting medical events with heavy alcohol use were inappropriate, and being happy with one's own social media portrayal. Exposure to guidelines on professional online conduct had no effect on posting behaviour. Social media use was nearly universal in the surveyed cohort. Posting of unprofessional content was highly prevalent despite understanding that this might be considered inappropriate, and despite awareness of professionalism guidelines. Medical educators should consider approaches to this problem that involve more than simply providing guidelines or policies, and students should be regularly prompted to evaluate and moderate their own online behaviour.

Influence of Institutional Guidelines on Oral Hygiene Practices in Intensive Care Units.

PubMed

Kiyoshi-Teo, Hiroko; Blegen, Mary

2015-07-01

Maintaining oral hygiene is a key component of preventing ventilator-associated pneumonia; however, practices are inconsistent. To explore how characteristics of institutional guidelines for oral hygiene influence nurses' oral hygiene practices and perceptions of that practice. Oral hygiene section of a larger survey study on prevention of ventilator-associated pneumonia. Critical care nurses at 8 hospitals in Northern California that had more than 1000 ventilator days in 2009 were recruited to participate in the survey. Twenty-one questions addressed oral hygiene practices and practice perceptions. Descriptive statistics, analysis of variance, and Spearman correlations were used for analyses. A total of 576 critical care nurses (45% response rate) responded to the survey. Three types of institutional oral hygiene guidelines existed: nursing policy, order set, and information bulletin. Nursing policy provided the most detail about the oral hygiene care; however, adherence, awareness, and priority level were higher with order sets (P < .05). The content and method of disseminating these guidelines varied, and nursing practices were affected by these differences. Nurses assessed the oral cavity and used oral swabs more often when those practices were included in institutional guidelines. The content and dissemination method of institutional guidelines on oral hygiene do influence the oral hygiene practices of critical care nurses. Future studies examining how institutional guidelines could best be incorporated into routine workflow are needed. ©2015 American Association of Critical-Care Nurses.

Advice for acute low back pain: a comparison of what research supports and what guidelines recommend.

PubMed

Stevens, Matthew L; Lin, Chung-Wei C; de Carvalho, Flavia A; Phan, Kevin; Koes, Bart; Maher, Chris G

2017-10-01

Advice is widely considered an effective treatment for acute low back pain (LBP); however, details on what and how to deliver this intervention is less clear. We assessed and compared clinical trials that test advice for acute LBP with practice guidelines for their completeness of reporting and concordance on the content, method of delivery, and treatment regimen of advice interventions. Systematic review. Advice randomized controlled trials were identified through a systematic search. Guidelines were taken from recent overviews of guidelines for LBP. Completeness of reporting was assessed using the Template for Intervention Description and Replication checklist. Thematic analysis was used to characterize advice interventions into topics across the aspects of content, method of delivery, and regimen. Concordance between clinical trials and guidelines was assessed by comparing the number of trials that found a statistically significant treatment effect for an intervention that included a specific advice topic with the number of guidelines recommending that topic. The median (interquartile range) completeness of reporting for clinical trials and guidelines was 8 (7-9) and 3 (2-4) out of nine items on the Template for Intervention Description and Replication checklist, respectively. Guideline recommendations were discordant with clinical trials for 50% of the advice topics identified. Completeness of reporting was less than ideal for randomized controlled trials and extremely poor for guidelines. The recommendations made in guidelines of advice for acute LBP were often not concordant with the results of clinical trials. Taken together, these findings mean that the potential clinical value of advice interventions for patients with acute LBP is probably not being realized. Copyright © 2017 Elsevier Inc. All rights reserved.

An Adaptive Channel Access Method for Dynamic Super Dense Wireless Sensor Networks.

PubMed

Lei, Chunyang; Bie, Hongxia; Fang, Gengfa; Zhang, Xuekun

2015-12-03

Super dense and distributed wireless sensor networks have become very popular with the development of small cell technology, Internet of Things (IoT), Machine-to-Machine (M2M) communications, Vehicular-to-Vehicular (V2V) communications and public safety networks. While densely deployed wireless networks provide one of the most important and sustainable solutions to improve the accuracy of sensing and spectral efficiency, a new channel access scheme needs to be designed to solve the channel congestion problem introduced by the high dynamics of competing nodes accessing the channel simultaneously. In this paper, we firstly analyzed the channel contention problem using a novel normalized channel contention analysis model which provides information on how to tune the contention window according to the state of channel contention. We then proposed an adaptive channel contention window tuning algorithm in which the contention window tuning rate is set dynamically based on the estimated channel contention level. Simulation results show that our proposed adaptive channel access algorithm based on fast contention window tuning can achieve more than 95 % of the theoretical optimal throughput and 0 . 97 of fairness index especially in dynamic and dense networks.

Impact of implementing electronic clinical practice guidelines for the diagnosis, control and treatment of cardiovascular risk factors: A pre-post controlled study.

PubMed

Comin, Eva; Catalan-Ramos, Arantxa; Iglesias-Rodal, Manuel; Grau, Maria; Del Val, Jose Luis; Consola, Alicia; Amado, Ester; Pons, Angels; Mata-Cases, Manel; Franzi, Alicia; Ciurana, Ramon; Frigola, Eva; Cos, Xavier; Davins, Josep; Verdu-Rotellar, Jose M

To evaluate the impact of computerized clinical practice guidelines on the management, diagnosis, treatment, control, and follow-up of the main cardiovascular risk factors: hypertension, hypercholesterolaemia, and type 2 diabetes mellitus. Pre-post controlled study. Catalonia, autonomous community located in north-eastern Spain. Individuals aged 35-74 years assigned to general practitioners of the Catalan Health Institute. The intervention group consisted of individuals whose general practitioners had accessed the computerized clinical practice guidelines at least twice a day, while the control group consisted of individuals whose general practitioner had never accessed the computerized clinical practice guidelines platform. The Chi-squared test was used to detect significant differences in the follow-up, control, and treatment variables for all three disorders (hypertension, hypercholesterolaemia, and type 2 diabetes mellitus) between individuals assigned to users and non-users of the computerized clinical practice guidelines, respectively. A total of 189,067 patients were included in this study, with a mean age of 56 years (standard deviation 12), and 55.5% of whom were women. Significant differences were observed in hypertension management, treatment and control; type 2 diabetes mellitus management, treatment and diagnoses, and the management and control of hypercholesterolaemia in both sexes. Computerized clinical practice guidelines are an effective tool for the control and follow-up of patients diagnosed with hypertension, type 2 diabetes mellitus, and hypercholesterolaemia. The usefulness of computerized clinical practice guidelines to diagnose and adequately treat individuals with these disorders remains unclear. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

21st Century Senior Leader Education: Ubiquitous Open Access Learning Environment

DTIC Science & Technology

2011-02-22

Failures: It‘s the content, stupid ‖22 because agencies focus on systems rather than substance and access to the content is critical. The access to Army...Resource Capabilities. 18 As an example to demonstrate how a civilian capability provides learning value to the PLE, the ― Google Alerts‖ ® web...technology pushed content to the author for review in the development of this paper. The technology consists of a user creating a Google account, logging

28 CFR 92.11 - Content of the recruitment and retention programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Content of the recruitment and retention programs. 92.11 Section 92.11 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) OFFICE OF COMMUNITY ORIENTED POLICING SERVICES (COPS) Police Recruitment Program Guidelines § 92.11 Content of the recruitment...

28 CFR 92.11 - Content of the recruitment and retention programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Content of the recruitment and retention programs. 92.11 Section 92.11 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) OFFICE OF COMMUNITY ORIENTED POLICING SERVICES (COPS) Police Recruitment Program Guidelines § 92.11 Content of the recruitment...

28 CFR 92.11 - Content of the recruitment and retention programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Content of the recruitment and retention programs. 92.11 Section 92.11 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) OFFICE OF COMMUNITY ORIENTED POLICING SERVICES (COPS) Police Recruitment Program Guidelines § 92.11 Content of the recruitment...

28 CFR 92.11 - Content of the recruitment and retention programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Content of the recruitment and retention programs. 92.11 Section 92.11 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) OFFICE OF COMMUNITY ORIENTED POLICING SERVICES (COPS) Police Recruitment Program Guidelines § 92.11 Content of the recruitment...

28 CFR 92.11 - Content of the recruitment and retention programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Content of the recruitment and retention... ORIENTED POLICING SERVICES (COPS) Police Recruitment Program Guidelines § 92.11 Content of the recruitment... program and applicant needs throughout the recruitment process. The process should be based on an...

Use of clinical guidelines in remote Australia: A realist evaluation.

PubMed

Reddy, Sandeep; Orpin, Victoria; Herring, Sally; Mackie-Schneider, Stephanie; Struber, Janet

2018-02-01

The aim of this evaluation was to assess the acceptability, accessibility, and compliance with the 2014 editions of the Remote Primary Health Care Manuals (RPHCM) in health care centres across remote areas of Northern and Central Australia. To undertake a comprehensive evaluation that considered context, the evaluation used a realist evaluation framework. The evaluation used a variety of methods including interviews and survey to develop and test a programme theory. Many remote health practitioners have adopted standardized, evidence-based practice because of the use of the RPHCM. The mechanisms that led to the use of the manuals include acceptance of the worth of the protocols to their clinical practice, reliance on manual content to guide their practice, the perception of credibility, the applicability of RPHCM content to the context, and a fear of the consequences of not using the RPHCMs. Some remote health practitioners are less inclined to use the RPHCM regularly because of a perception that the content is less suited to their needs and daily practice or it is hard to navigate or understand. The evaluation concluded that there is work to be done to widen the RPHCM user base, and organizations need to increase support for their staff to use the RPHCM protocols better. These measures are expected to enable standardized clinical practice in the remote context. © 2017 John Wiley & Sons, Ltd.

The clinical content of preconception care: nutrition and dietary supplements.

PubMed

Gardiner, Paula M; Nelson, Lauren; Shellhaas, Cynthia S; Dunlop, Anne L; Long, Richard; Andrist, Sara; Jack, Brian W

2008-12-01

Women of child-bearing age should achieve and maintain good nutritional status prior to conception to help minimize health risks to both mothers and infants. Many women may not be aware of the importance of preconception nutrition and supplementation or have access to nutrition information. Health care providers should be knowledgeable about preconception/pregnancy-related nutrition and take the initiative to discuss this information during preconception counseling. Women of reproductive age should be counseled to consume a well-balanced diet including fruits and vegetables, iron and calcium-rich foods, and protein-containing foods as well as 400 microg of folic acid daily. More research is critically needed on the efficacy and safety of dietary supplements and the role of obesity in birth outcomes. Preconception counseling is the perfect opportunity for the health care provider to discuss a healthy eating guideline, dietary supplement intake, and maintaining a healthy weight status.

Where to find nutritional science journals on the World Wide Web.

PubMed

Brown, C M

1997-08-01

The World Wide Web (WWW) is a burgeoning information resource that can be utilized for current awareness and assistance in manuscript preparation and submission. The ever changing and expanding nature of the WWW allows it to provide up to the minute information, but this inherent changeability often makes information access difficult. To assist nutrition scientists in locating useful information about nutritional science journals on the WWW, this article critically reviews and describes the WWW sites for seventeen highly ranked nutrition and dietetics journals. Included in each annotation are the site's title, web address or Universal Resource Locator (URL), journal ranking and site authorship. Also listed is whether or not the site makes available the guidelines for authors, tables of contents, abstracts, online ordering, as well as information about the editorial board. This critical survey illustrates that the information on the web, regardless of its authority, is not of equal quality.

A critical review on iodine presence in drinking water access at the Saharawi refugee camps (Tindouf, Algeria).

PubMed

Pichel, N; Vivar, M

2017-07-01

Iodine content in drinking water at the Saharawi refugee camps was analysed to assess the controversy in the origin of the prevalence of goitre among this population. A review on the iodine presence in drinking water reported in the literature was conducted, along with international standards and guidelines for iodine intake and iodine concentration in drinking water were also consulted. Chinese legislation was taken as the reference standard to evaluate the iodine concentration in water as adequate (10-150μg/L) or not (high iodine >150μg/L and iodine excess goitre >300μg/L). Water sampling was conducted in 2015 and 2016 at the Saharawi camps (El Aiun, Awserd, Smara, Boujador and Dakhla) and at the institutional capital of Rabouni. The water supply in the camps is organized in three zones: El Aiun and Awserd where each 'wilaya' receives treated water 20days and raw water another 20days; Smara, Rabouni and Boujador receiving treated water continuously and Dakhla receiving raw water continuously. Results show that Smara, Rabouni and Boujador have access to drinking water with adequate iodine levels, as it occurs in Dakhla where raw water meets the Chinese standard, however in El Aiun and Awserd all population should have access to treated water given the current quality of the raw water supply. External supplies of water and animal milk could be also contributing to the high iodine intake. In conclusion, the contribution of drinking water as the main source of iodine to the urinary iodine concentration (UIC) and goitre prevalence among the Saharawi refugee population is not clear. Further studies should be conducted to assess the iodine content among all the nutritional sources of the population with a detailed study on the daily intake of these foods and drinks, including UIC and goitre prevalence studies. Copyright © 2017 Elsevier GmbH. All rights reserved.

Veterinary students' usage and perception of video teaching resources

PubMed Central

2011-01-01

Background The purpose of our study was to use a student-centred approach to develop an online video learning resource (called 'Moo Tube') at the School of Veterinary Medicine and Science, University of Nottingham, UK and also to provide guidance for other academics in the School wishing to develop a similar resource in the future. Methods A focus group in the format of the nominal group technique was used to garner the opinions of 12 undergraduate students (3 from year-1, 4 from year-2 and 5 from year-3). Students generated lists of items in response to key questions, these responses were thematically analysed to generate key themes which were compared between the different year groups. The number of visits to 'Moo Tube' before and after an objective structured practical examination (OSPE) was also analysed to provide data on video usage. Results Students highlighted a number of strengths of video resources which can be grouped into four overarching themes: (1) teaching enhancement, (2) accessibility, (3) technical quality and (4) video content. Of these themes, students rated teaching enhancement and accessibility most highly. Video usage was seen to significantly increase (P < 0.05) prior to an examination and significantly decrease (P < 0.05) following the examination. Conclusions The students had a positive perception of video usage in higher education. Video usage increases prior to practical examinations. Image quality was a greater concern with year-3 students than with either year-1 or 2 students but all groups highlighted the following as important issues: i) good sound quality, ii) accessibility, including location of videos within electronic libraries, and iii) video content. Based on the findings from this study, guidelines are suggested for those developing undergraduate veterinary videos. We believe that many aspects of our list will have resonance in other areas of medicine education and higher education. PMID:21219639

An Exposition of Current Mobile Learning Design Guidelines and Frameworks

ERIC Educational Resources Information Center

Teall, Ed; Wang, Minjuan; Callaghan, Vic; Ng, Jason W. P.

2014-01-01

As mobile devices with wireless access become more readily available, learning delivered via mobile devices of all types must be designed to ensure successful learning. This paper first examines three questions related to the design of mobile learning: 1) what mobile learning (m-learning) guidelines can be identified in the current literature, 2)…

A Consortium for Teacher Preparation: Model Guidelines for Small Colleges.

ERIC Educational Resources Information Center

Fouts, Jeffrey T.

Guidelines have been developed for a consortium approach to teacher preparation in a small college that may need some expertise and access to teaching materials which can be provided by local school districts and other agencies. This approach to the design, management, and evaluation of the program offers the opportunity to involve the schools…

A Model Policy Statement and Guidelines for Implementation: Equal Treatment of Students.

ERIC Educational Resources Information Center

Education Commission of the States, Denver, CO.

This booklet offers a model policy statement that schools shall provide equal educational opportunities to all students regardless of sex. It includes stipulations and guidelines to achieve equal access in all areas of education. The following areas are considered: (1) Course offerings: every course shall be open to all students and schools should…

Evidence-Based Practice Guidelines and School Nursing

ERIC Educational Resources Information Center

Adams, Susan; McCarthy, Ann Marie

2007-01-01

The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…

Policy content and stakeholder network analysis for infant and young child feeding in India.

PubMed

Puri, Seema; Fernandez, Sylvia; Puranik, Amrita; Anand, Deepika; Gaidhane, Abhay; Quazi Syed, Zahiruddin; Patel, Archana; Uddin, Shahadat; Thow, Anne Marie

2017-06-13

Over the last decade, infant and young child feeding (IYCF) indicators in India have improved. However, poor IYCF practices are still apparent, associated with pervasive high rates of child under-nutrition. Interventions to improve IYCF need augmentation by appropriate policy support to consolidate gains. The aim of this study was to identify opportunities to strengthen and support IYCF policies through a policy content and stakeholder network analysis. IYCF policies and guidelines were systematically mapped and coded using predetermined themes. Six 'net-map' group interviews were conducted for stakeholder analysis with data analyzed using ORA (organizational risk analyzer, copyright Carley, Carnegie Mellon University) software. The study was carried out at a national level and in the states of Maharashtra and unified Andhra Pradesh. Thirty relevant policy documents were identified. Support for IYCF was clearly apparent and was actioned within sectoral policies and strategic plans. We identified support for provision of information to mothers and caregivers in both sectoral and high-level/strategic policy documents. At a sectoral level, there was support for training health care workers and for enabling mothers to access IYCF. Opportunities to strengthen policy included expanding coverage and translating policy goals into implementation level documents. At the national level, Ministry of Women and Child Development [MoWCD], Ministry of Health and Family Welfare [MoHFW] and the Prime Minister's Nutrition Council [PMNC] were the most influential actors in providing technical support while MoHFW, MoWCD, and Bill Melinda Gates Foundation were the most influential actors in providing funding and were therefore influential stakeholders in shaping IYCF policies and programs. We identified a wide range of strengths in the IYCF policy environment in India and also opportunities for improvement. One key strength is the integration of IYCF policies into a range of agendas and guidelines related to health and child development service delivery at the national and state level. However, the lack of a specific national policy on IYCF means that there is no formal mechanism for review and monitoring implementation across sectors and jurisdictions. Another opportunity identified is the development of IYCF policy guidelines in emergencies and for tribal populations.

Guidelines for the Practice of Adaptive Diabetes Education for Visually Impaired Persons.

ERIC Educational Resources Information Center

Berkowitz, Kathy

1993-01-01

This article presents guidelines developed by the American Association of Diabetes Educators concerning adaptive diabetes education for visually impaired persons (ADEVIP). The article discusses definitions, values, and assumptions; recommended professional educational background; role delineation; and process and content of ADEVIP. (DB)

Curricular Guidelines for Dental Hygiene Care for the Handicapped.

ERIC Educational Resources Information Center

Journal of Dental Education, 1984

1984-01-01

The American Association of Dental Schools' guidelines for dental hygiene curriculum cover the scope and definitions of care for the handicapped, interrelationships between disciplines and courses, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives, sequencing, faculty, and…

Curriculum Guidelines for Operative Dentistry.

ERIC Educational Resources Information Center

Journal of Dental Education, 1984

1984-01-01

The American Association of Dental Schools' guidelines for operative dentistry curricula include an overview of the scope and objectives of operative dentistry, notes on the interrelationship of the discipline and the total curriculum, and an outline of primary educational goals, core content, specific behavioral objectives, sequencing, faculty,…

Foot and Ankle Fellowship Websites: An Assessment of Accessibility and Quality.

PubMed

Hinds, Richard M; Danna, Natalie R; Capo, John T; Mroczek, Kenneth J

2017-08-01

The Internet has been reported to be the first informational resource for many fellowship applicants. The objective of this study was to assess the accessibility of orthopaedic foot and ankle fellowship websites and to evaluate the quality of information provided via program websites. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Fellowship and Residency Electronic Interactive Database (FREIDA) fellowship databases were accessed to generate a comprehensive list of orthopaedic foot and ankle fellowship programs. The databases were reviewed for links to fellowship program websites and compared with program websites accessed from a Google search. Accessible fellowship websites were then analyzed for the quality of recruitment and educational content pertinent to fellowship applicants. Forty-seven orthopaedic foot and ankle fellowship programs were identified. The AOFAS database featured direct links to 7 (15%) fellowship websites with the independent Google search yielding direct links to 29 (62%) websites. No direct website links were provided in the FREIDA database. Thirty-six accessible websites were analyzed for content. Program websites featured a mean 44% (range = 5% to 75%) of the total assessed content. The most commonly presented recruitment and educational content was a program description (94%) and description of fellow operative experience (83%), respectively. There is substantial variability in the accessibility and quality of orthopaedic foot and ankle fellowship websites. Recognition of deficits in accessibility and content quality may assist foot and ankle fellowships in improving program information online. Level IV.

75 FR 56163 - Nondiscrimination on the Basis of Disability in State and Local Government Services

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... and maintain accessibility guidelines for facilities designed, constructed, altered, or leased with... Design for purposes of subchapters II and III of this chapter * * * to ensure that buildings, facilities, rail passenger cars, and vehicles are accessible, in terms of architecture and design, transportation...

Interviews as Historical Evidence: A Discussion of New Standards of Documentation and Access.

ERIC Educational Resources Information Center

Ritchie, Donald A.; And Others

1991-01-01

Presents a discussion of the documentation of and access to interviews for historical research purposes. Examines problems of documentation, transcription, permission, and storage. Presents questions of property, professional ethics, and witnesses. Argues for interview guidelines, training of researchers for interviewing, and taping of interviews.…

Manual for Accessibility: [Conference, Meeting, and Lodging Facilities]. Revised.

ERIC Educational Resources Information Center

National Rehabilitation Association, Alexandria, VA.

This illustrated manual and survey forms are designed to be used by organizations, hotel and restaurant associations, interested individuals and others as a guide for selecting accessible conference, meeting, and lodging facilities. The guidelines can also be used with existing facilities to identify specific modifications and accommodations. The…

Guidelines for the retrofit installation of accessible pedestrian signals by the Virginia Department of Transportation : Phase II report.

DOT National Transportation Integrated Search

2005-01-01

In late 2000, the Northern Virginia District of the Virginia Department of Transportation (VDOT) received a request from a visually impaired citizen to install accessible pedestrian signals (APS) at an intersection in Falls Church. Since there were n...

The Accessible School: Universal Design for Educational Settings.

ERIC Educational Resources Information Center

Bar, Laurel; Galluzzo, Judith

This book provides practical reasons for the Americans with Disabilities Act requirements for accessibility of school sites, buildings, and educational rooms as well as clear illustrations to aid in the explanation of the guidelines. It addresses practical matters such as safety and cost-effectiveness while increasing sensitivity to different…

Guidelines for the retrofit installation of accessible pedestrian signals by the Virginia Department of Transportation : Phase I report.

DOT National Transportation Integrated Search

2003-01-01

In late 2000, the Northern Virginia District of the Virginia Department of Transportation (VDOT) received a request from a visually impaired citizen to install accessible pedestrian signals (APS) at an intersection in Falls Church. Since there were n...

Web OPAC Interfaces: An Overview.

ERIC Educational Resources Information Center

Babu, B. Ramesh; O'Brien, Ann

2000-01-01

Discussion of Web-based online public access catalogs (OPACs) focuses on a review of six Web OPAC interfaces in use in academic libraries in the United Kingdom. Presents a checklist and guidelines of important features and functions that are currently available, including search strategies, access points, display, links, and layout. (Author/LRW)

A Working Model for Complying with Accessibility Guidelines for Online Learning

ERIC Educational Resources Information Center

Cifuentes, Lauren; Janney, Alexandra; Guerra, Lauran; Weir, Jennifer

2016-01-01

We describe our activities that emerged in the context of an Office of Distance Education and Learning Technologies' efforts to systematically and systemically address accessibility for online learning in order to comply with ethical principles, best practices, and laws. The activities include three overarching continuous tasks: strategically…

32 CFR 56.8 - Guidelines for determining discriminatory practices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... accessible to deaf and hearing-impaired persons by means such as training museum staff, such as docents, in... for compliance with paragraph (c)(4) of this section. (5) Military museums. (i) In the case of military museums, program accessibility shall mean that exhibits, displays, tours, lectures, circulating or...

32 CFR 56.8 - Guidelines for determining discriminatory practices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... accessible to deaf and hearing-impaired persons by means such as training museum staff, such as docents, in... for compliance with paragraph (c)(4) of this section. (5) Military museums. (i) In the case of military museums, program accessibility shall mean that exhibits, displays, tours, lectures, circulating or...

32 CFR 56.8 - Guidelines for determining discriminatory practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... accessible to deaf and hearing-impaired persons by means such as training museum staff, such as docents, in... for compliance with paragraph (c)(4) of this section. (5) Military museums. (i) In the case of military museums, program accessibility shall mean that exhibits, displays, tours, lectures, circulating or...

32 CFR 56.8 - Guidelines for determining discriminatory practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... accessible to deaf and hearing-impaired persons by means such as training museum staff, such as docents, in... for compliance with paragraph (c)(4) of this section. (5) Military museums. (i) In the case of military museums, program accessibility shall mean that exhibits, displays, tours, lectures, circulating or...

Epigenome data release: a participant-centered approach to privacy protection.

PubMed

Dyke, Stephanie O M; Cheung, Warren A; Joly, Yann; Ammerpohl, Ole; Lutsik, Pavlo; Rothstein, Mark A; Caron, Maxime; Busche, Stephan; Bourque, Guillaume; Rönnblom, Lars; Flicek, Paul; Beck, Stephan; Hirst, Martin; Stunnenberg, Henk; Siebert, Reiner; Walter, Jörn; Pastinen, Tomi

2015-07-17

Large-scale epigenome mapping by the NIH Roadmap Epigenomics Project, the ENCODE Consortium and the International Human Epigenome Consortium (IHEC) produces genome-wide DNA methylation data at one base-pair resolution. We examine how such data can be made open-access while balancing appropriate interpretation and genomic privacy. We propose guidelines for data release that both reduce ambiguity in the interpretation of open-access data and limit immediate access to genetic variation data that are made available through controlled access.

Clinical practice guidelines in hypertension: a review.

PubMed

Álvarez-Vargas, Mayita Lizbeth; Galvez-Olortegui, José Kelvin; Galvez-Olortegui, Tomas Vladimir; Sosa-Rosado, José Manuel; Camacho-Saavedra, Luis Arturo

2015-10-23

The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in hypertension. This is the first in a series of review articles, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Of all clinical practice guidelines, three were selected and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used to assess each guide. The guidelines obtained the lowest score in the domain of applicability (mean 43.8%); while the highest score was for clarity of presentation (mean 81.5%). The lowest percentage was found in the applicability domain (European guideline) and the highest of all scores was found in two domains: scope and purpose, and clarity of presentation (Canadian guideline). Assessing the quality of the clinical practice guidelines analyzed, the Canadian is one with the best scores obtained by applying the AGREE II instrument, and it is advised to be used without modifications.

Ministry of Health Clinical Practice Guidelines: Prevention, Diagnosis and Management of Tuberculosis

PubMed Central

Wang, Yee Tang Sonny; Chee, Cynthia Bin Eng; Hsu, Li Yang; Jagadesan, Raghuram; Kaw, Gregory Jon Leng; Kong, Po Marn; Lew, Yii Jen; Lim, Choon Seng; Lim, Ting Ting Jayne; Lu, Kuo Fan Mark; Ooi, Peng Lim; Sng, Li-Hwei; Thoon, Koh Cheng

2016-01-01

The Ministry of Health (MOH) has developed the clinical practice guidelines on Prevention, Diagnosis and Management of Tuberculosis to provide doctors and patients in Singapore with evidence-based treatment for tuberculosis. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Prevention, Diagnosis and Management of Tuberculosis, for the information of SMJ readers. The chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines. PMID:26996216

An assessment of antenatal care among Syrian refugees in Lebanon.

PubMed

Benage, Matthew; Greenough, P Gregg; Vinck, Patrick; Omeira, Nada; Pham, Phuong

2015-01-01

After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon. A field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices. In total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1-2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon. Standards of antenatal care are not being met for pregnant Syrian refugee women in Lebanon. This descriptive analysis of relative frequencies suggests reproductive health providers should focus attention on increasing antenatal care visits, particularly to third trimester and late gestational age patients and to those in less secure sheltering arrangements. With this approach they can improve care content by providing early testing and interventions per accepted guidelines designed to improve pregnancy outcomes.

Nursing Care for Patients with Synthetic Arteriovenous Grafts.

PubMed

Gilliland, Michelle; Brown, Jami S; Pryor, Lillian

2017-01-01

Dealing with a growing older adult patient population, keeping pace with current guidelines, and adhering to new recommendations is a perpetual endeavor for healthcare professionals. Because determining the best access for individual patients is not always obvious, vascular access is a challenging aspect of patient care. This article presents information on the ever-evolving and improving world of vascular access, specifically synthetic grafts. Copyright© by the American Nephrology Nurses Association.

ERMes: Open Source Simplicity for Your E-Resource Management

ERIC Educational Resources Information Center

Doering, William; Chilton, Galadriel

2009-01-01

ERMes, the latest version of electronic resource management system (ERM), is a relational database; content in different tables connects to, and works with, content in other tables. ERMes requires Access 2007 (Windows) or Access 2008 (Mac) to operate as the database utilizes functionality not available in previous versions of Microsoft Access. The…

Assessment of Web Content Accessibility Levels in Spanish Official Online Education Environments

ERIC Educational Resources Information Center

Roig-Vila, Rosabel; Ferrández, Sergio; Ferri-Miralles, Imma

2014-01-01

Diversity-based designing, or the goal of ensuring that web-based information is accessible to as many diverse users as possible, has received growing international acceptance in recent years, with many countries introducing legislation to enforce it. This paper analyses web content accessibility levels in Spanish education portals according to…

Training Guidelines for Healthy School Meals for Food Service Professionals.

ERIC Educational Resources Information Center

Food and Consumer Service (USDA), Washington, DC.

These guidelines offer recommended topic areas and content for training local-level food service personnel. The recommended topic areas for training school food service directors/supervisors and food service managers are nutrition requirements, menu planning for school meals, procurement, financial management, marketing, food production, program…

12 CFR Appendix B to Part 364 - Interagency Guidelines Establishing Information Security Standards

Code of Federal Regulations, 2011 CFR

2011-01-01

... Part 364—Interagency Guidelines Establishing Information Security Standards Table of Contents I... Customer Information A. Information Security Program B. Objectives III. Development and Implementation of Customer Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and...

Curriculum Guidelines for Aspects of Oral Pathology for Dental Assisting Education.

ERIC Educational Resources Information Center

Journal of Dental Education, 1987

1987-01-01

Guidelines for structuring an oral pathology curriculum for dental assistants include: a definition of oral pathology; the scope of instruction and relationships with other fields; recommendations for prerequisites; core content in various subfields; specific behavioral objectives; and suggestions for sequencing, faculty, and facilities. (MSE)

Curriculum Guidelines for Periodontics for Dental Hygiene Programs.

ERIC Educational Resources Information Center

Journal of Dental Education, 1986

1986-01-01

American Association of Dental Schools guidelines consist of an introduction to the field and its interrelationships with other fields of dental hygiene; an overview of the curriculum; outlines of primary educational goals, prerequisites, and specific content-related and clinical behavioral objectives; and recommendations concerning sequencing,…

Academic Learning Thrives in a Caring, Sharing Educational Community.

ERIC Educational Resources Information Center

Bencivenga, Anthony S.; Elias, Maurice J.

2003-01-01

Describes the educational program at Benjamin Franklin Middle School in Ridgewood, New Jersey, as an example of the potential for synergy between content instruction and character development. Highlights how the school follows guidelines from the publication "Promoting Social and Emotional Learning, Guidelines for Educators." (EV)

Mind the gap: An empirical study of post-trial access in HIV biomedical prevention trials.

PubMed

Haire, Bridget; Jordens, Christopher

2015-08-01

The principle of providing post-trial access for research participants to successful products of that research is widely accepted and has been enshrined in various declarations and guidelines. While recent ethical guidelines recognise that the responsibility to provide post-trial access extends to sponsors, regulators and government bodies as well as to researchers, it is the researchers who have the direct duty of care to participants. Researchers may thus need to act as advocates for trial participants, especially where government bodies, sponsors, and regulatory bodies have complex interests vested in decisions about whether or not new interventions are made available, how, and to whom. This paper provides an empirical account of post-trial access in the context of HIV prevention research. It describes both access to the successful products of research and the provision antiretroviral drugs for trial participants who acquire HIV. First, we provide evidence that, in the current system, there is considerable variation in the duration and timeliness of access. We then argue that by analysing the difficulties faced by researchers to this point, and their efforts to meet this obligation, much can be learned about how to secure post-trial access in HIV biomedical preventions trials. While researchers alone have a limited obligation, their advocacy on behalf of trial participants may be necessary to call the other parties to account. © 2013 John Wiley & Sons Ltd.

Evidence-based guidelines for wise use of electronic games by children.

PubMed

Straker, Leon; Abbott, Rebecca; Collins, Rachel; Campbell, Amity

2014-01-01

Electronic games (e-games) are widely used by children, often for substantial durations, yet to date there are no evidence-based guidelines regarding their use. The aim of this paper is to present guidelines for the wise use of e-games by children based on a narrative review of the research. This paper proposes a model of factors that influence child-e-games interaction. It summarises the evidence on positive and negative effects of use of e-games on physical activity and sedentary behaviour, cardio-metabolic health, musculoskeletal health, motor coordination, vision, cognitive development and psychosocial health. Available guidelines and the role of guidelines are discussed. Finally, this information is compiled into a clear set of evidence-based guidelines, about wise use of e-games by children, targeting children, parents, professionals and the e-game industry. These guidelines provide an accessible synthesis of available knowledge and pragmatic guidelines based on e-game specific evidence and related research.

[Evidence-based clinical oral healthcare guidelines 4. Adherence requires an implementation strategy].

PubMed

Braspenning, J C C; Mettes, T G P H; van der Sanden, W J M; Wensing, M J P

2015-03-01

Adherence to clinical guidelines requires support in practice. However, systematic implementation of evidence-based guidelines is not common practice in oral healthcare. The Knowledge Institute Oral Care (KiMo) offers the opportunity to take into account potential barriers and facilitators during the development of evidence-based clinical practice guidelines. These factors which are relevant to the guideline and the oral healthcare practice provide the ingredients for a tailor-made programme of implementation that has a scientific basis. Elements of any implementation programme are the quality indicators derived from the oral healthcare guidelines. These indicators should fit, on the one hand, the specific goals of the guidelines (patient safety, effectiveness, efficiency, patient-centred, timeliness, accessibility) and, onthe other hand, the various perspectives of the different stakeholders, such as patients, caregivers, health insurers and inspectorate. These quality indicators provide information on adherence to the guidelines, the results of a certain treatment and the success of the implementation strategy, all with the aim to improve the quality of oral healthcare.

The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives

PubMed Central

2014-01-01

Background The potential of clinical practice guidelines has not been realized due to inconsistent adoption in clinical practice. Optimising intrinsic characteristics of guidelines (e.g., its wording and format) that are associated with uptake (as perceived by their end users) may have potential. Using findings from a realist review on guideline uptake and consultation with experts in guideline development, we designed a conceptual version of a future tool called Guideline Implementability Tool (GUIDE-IT). The tool will aim to involve family physicians in the guideline development process by providing a process to assess draft guideline recommendations. This feedback will then be given back to developers to consider when finalizing the recommendations. As guideline characteristics are best assessed by end-users, the objectives of the current study were to explore how family physicians perceive guideline implementability, and to determine what components should comprise the final GUIDE-IT prototype. Methods We conducted a qualitative study with family physicians inToronto, Ontario. Two experienced investigators conducted one-hour interviews with family physicians using a semi-structured interview guide to 1) elicit feedback on perceptions on guideline implementability; 2) to generate a discussion in response to three draft recommendations; and 3) to provide feedback on the conceptual GUIDE-IT. Sessions were audio taped and transcribed verbatim. Data collection and analysis were guided by content analyses. Results 20 family physicians participated. They perceived guideline uptake according to facilitators and barriers across 6 categories of guideline implementability (format, content, language, usability, development, and the practice environment). Participants’ feedback on 3 draft guideline recommendations were grouped according to guideline perception, cognition, and agreement. When asked to comment on GUIDE-IT, most respondents believed that the tool would be useful, but urged to involve “regular” or community family physicians in the process, and suggested that an online system would be the most efficient way to deliver it. Conclusions Our study identified facilitators and barriers of guideline implementability from the perspective of community and academic family physicians that will be used to build our GUIDE-IT prototype. Our findings build on current knowledge by showing that family physicians perceive guideline uptake mostly according to factors that are in the control of guideline developers. PMID:24476491

Breast Cancer Screening and Social Media: a Content Analysis of Evidence Use and Guideline Opinions on Twitter.

PubMed

Nastasi, Anthony; Bryant, Tyler; Canner, Joseph K; Dredze, Mark; Camp, Melissa S; Nagarajan, Neeraja

2018-06-01

There is ongoing debate regarding the best mammography screening practices. Twitter has become a powerful tool for disseminating medical news and fostering healthcare conversations; however, little work has been done examining these conversations in the context of how users are sharing evidence and discussing current guidelines for breast cancer screening. To characterize the Twitter conversation on mammography and assess the quality of evidence used as well as opinions regarding current screening guidelines, individual tweets using mammography-related hashtags were prospectively pulled from Twitter from 5 November 2015 to 11 December 2015. Content analysis was performed on the tweets by abstracting data related to user demographics, content, evidence use, and guideline opinions. Standard descriptive statistics were used to summarize the results. Comparisons were made by demographics, tweet type (testable claim, advice, personal experience, etc.), and user type (non-healthcare, physician, cancer specialist, etc.). The primary outcomes were how users are tweeting about breast cancer screening, the quality of evidence they are using, and their opinions regarding guidelines. The most frequent user type of the 1345 tweets was "non-healthcare" with 323 tweets (32.5%). Physicians had 1.87 times higher odds (95% CI, 0.69-5.07) of providing explicit support with a reference and 11.70 times higher odds (95% CI, 3.41-40.13) of posting a tweet likely to be supported by the scientific community compared to non-healthcare users. Only 2.9% of guideline tweets approved of the guidelines while 14.6% claimed to be confused by them. Non-healthcare users comprise a significant proportion of participants in mammography conversations, with tweets often containing claims that are false, not explicitly backed by scientific evidence, and in favor of alternative "natural" breast cancer prevention and treatment. Furthermore, users appear to have low approval and confusion regarding screening guidelines. These findings suggest that more efforts are needed to educate and disseminate accurate information to the general public regarding breast cancer prevention modalities, emphasizing the safety of mammography and the harms of replacing conventional prevention and treatment modalities with unsubstantiated alternatives.

Optimizing the Design of Preprinted Orders for Ambulatory Chemotherapy: Combining Oncology, Human Factors, and Graphic Design

PubMed Central

Jeon, Jennifer; White, Rachel E.; Hunt, Richard G.; Cassano-Piché, Andrea L.; Easty, Anthony C.

2012-01-01

Purpose: To establish a set of guidelines for developing ambulatory chemotherapy preprinted orders. Methods: Multiple methods were used to develop the preprinted order guidelines. These included (A) a comprehensive literature review and an environmental scan; (B) analyses of field study observations and incident reports; (C) critical review of evidence from the literature and the field study observation analyses; (D) review of the draft guidelines by a clinical advisory group; and (E) collaboration with graphic designers to develop sample preprinted orders, refine the design guidelines, and format the resulting content. Results: The Guidelines for Developing Ambulatory Chemotherapy Preprinted Orders, which consist of guidance on the design process, content, and graphic design elements of ambulatory chemotherapy preprinted orders, have been established. Conclusion: Health care is a safety critical, dynamic, and complex sociotechnical system. Identifying safety risks in such a system and effectively addressing them often require the expertise of multiple disciplines. This study illustrates how human factors professionals, clinicians, and designers can leverage each other's expertise to uncover commonly overlooked patient safety hazards and to provide health care professionals with innovative, practical, and user-centered tools to minimize those hazards. PMID:23077436

Optimizing the design of preprinted orders for ambulatory chemotherapy: combining oncology, human factors, and graphic design.

PubMed

Jeon, Jennifer; White, Rachel E; Hunt, Richard G; Cassano-Piché, Andrea L; Easty, Anthony C

2012-03-01

To establish a set of guidelines for developing ambulatory chemotherapy preprinted orders. Multiple methods were used to develop the preprinted order guidelines. These included (A) a comprehensive literature review and an environmental scan; (B) analyses of field study observations and incident reports; (C) critical review of evidence from the literature and the field study observation analyses; (D) review of the draft guidelines by a clinical advisory group; and (E) collaboration with graphic designers to develop sample preprinted orders, refine the design guidelines, and format the resulting content. The Guidelines for Developing Ambulatory Chemotherapy Preprinted Orders, which consist of guidance on the design process, content, and graphic design elements of ambulatory chemotherapy preprinted orders, have been established. Health care is a safety critical, dynamic, and complex sociotechnical system. Identifying safety risks in such a system and effectively addressing them often require the expertise of multiple disciplines. This study illustrates how human factors professionals, clinicians, and designers can leverage each other's expertise to uncover commonly overlooked patient safety hazards and to provide health care professionals with innovative, practical, and user-centered tools to minimize those hazards.

Integration of complementary and alternative medicine information and advice in chronic disease management guidelines.

PubMed

Team, Victoria; Canaway, Rachel; Manderson, Lenore

2011-01-01

The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions - cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) - to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor-client discussion about CAM.

Incentive Mechanism for P2P Content Sharing over Heterogenous Access Networks

NASA Astrophysics Data System (ADS)

Sato, Kenichiro; Hashimoto, Ryo; Yoshino, Makoto; Shinkuma, Ryoichi; Takahashi, Tatsuro

In peer-to-peer (P2P) content sharing, users can share their content by contributing their own resources to one another. However, since there is no incentive for contributing contents or resources to others, users may attempt to obtain content without any contribution. To motivate users to contribute their resources to the service, incentive-rewarding mechanisms have been proposed. On the other hand, emerging wireless technologies, such as IEEE 802.11 wireless local area networks, beyond third generation (B3G) cellular networks and mobile WiMAX, provide high-speed Internet access for wireless users. Using these high-speed wireless access, wireless users can use P2P services and share their content with other wireless users and with fixed users. However, this diversification of access networks makes it difficult to appropriately assign rewards to each user according to their contributions. This is because the cost necessary for contribution is different in different access networks. In this paper, we propose a novel incentive-rewarding mechanism called EMOTIVER that can assign rewards to users appropriately. The proposed mechanism uses an external evaluator and interactive learning agents. We also investigate a way of appropriately controlling rewards based on the system service's quality and managing policy.

Physician preferences for accredited online continuing medical education.

PubMed

Young, Kevin J; Kim, Julie J; Yeung, George; Sit, Christina; Tobe, Sheldon W

2011-01-01

The need for up-to-date and high-quality continuing medical education (CME) is growing while the financial investment in CME is shrinking. Despite online technology's potential to efficiently deliver electronic CME (eCME) to large numbers of users, it has not yet displaced traditional CME. The purpose of this study was to explore what health care providers want in eCME and how they want to use it. This was a qualitative study. Two 3-hour focus groups were held with physicians in both academic and community practices as well as trainees knowledgeable in the hypertension clinical practice guidelines with a willingness to discuss eCME. Content/thematic analysis was used to examine the data. Three main themes emerged: credibility, content/context, and control. Credibility was the most consistent and dominant theme. Affiliations with medical organizations and accreditation were suggested as methods by which eCME can gain credibility. The content and need for discussion of the content emerged as a key pivot point between eCME and traditional CME: a greater need for discussion was linked to a preference for traditional face-to-face CME. Control over the content and how it was accessed was an emergent theme, giving learners the ability to control the depth of learning and the time spent. They valued the ability to quickly find information that was in a format (podcast, video, mobile device) that best suited their learning needs or preferences at the time. This study provides insight into physician preferences for eCME and hypotheses that can be used to guide further research. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Speciation of arsenic in bulk and rhizosphere soils from artisanal cooperative mines in Bolivia.

PubMed

Acosta, Jose A; Arocena, Joselito M; Faz, Angel

2015-11-01

Soils near artisanal and small-scale gold mines (ASGM) have high arsenic (As) contents due to the presence of arsenopyrite in gold ores and accelerated accumulations due to mine wastes disposal practices and other mining activities. We determined the content and speciation to understand the fate and environmental risks of As accumulations in 24 bulk and 12 rhizosphere soil samples collected in the Virgen Del Rosario and the Rayo Rojo cooperative mines in the highlands of Bolivia. Mean total As contents in bulk and rhizosphere soils ranged from 13 to 64 mg kg(-1) and exceeded the soil environmental quality guidelines of Canada. Rhizosphere soils always contained at least twice the As contents in the bulk soil. Elemental mapping using 4×5 μm synchrotron-generated X-ray micro-beam revealed As accumulations in areas enriched with Fe. Results of As-X-ray Absorption Near Edge Spectroscopy (As-XANES) showed that only As(V) species was detectable in all samples regardless of As contents, size fractions and types of vegetation. Although the toxicity of As(V) is less than As(III), we suggest that As uptake of commonly-grazed vegetation by alpaca and llama must be determined to fully understand the environmental risks of high As in soils near ASGM in Bolivia. In addition, knowledge on the speciation of the As bio-accessible fraction will provide another useful information to better understand the fate and transfer of As from soils into the food chain in environments associated with the ASGM in Bolivia and other parts of the world. Copyright © 2014 Elsevier Ltd. All rights reserved.

Section 508 Standards

EPA Pesticide Factsheets

Guidelines, design tips, and tools for ensuring that all Information and Communications Technology; including websites, software, hardware, multimedia, and telecommunication; is accessible to disabled users.

32 CFR 767.9 - Content of permit holder's final report.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Content of permit holder's final report. 767.9 Section 767.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS... JURISDICATION OF THE DEPARTMENT OF THE NAVY Permit Guidelines § 767.9 Content of permit holder's final report...

32 CFR 767.9 - Content of permit holder's final report.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Content of permit holder's final report. 767.9 Section 767.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS... JURISDICATION OF THE DEPARTMENT OF THE NAVY Permit Guidelines § 767.9 Content of permit holder's final report...

Earth Science Content Guidelines Grades K-12.

ERIC Educational Resources Information Center

American Geological Inst., Alexandria, VA.

Teams of teachers, other science educators, and scientists selected from a national search for project writers have proposed using the following set of questions to guide the inclusion of earth science content into the kindergarten through grade 12 curriculum. The Essential Questions are organized in a K-12 sequence by six content areas: (1) Solid…

Quality Assessment of Clinical Practice Guidelines Developed by Professional Societies in Turkey

PubMed Central

Yaşar, Ilknur; Kahveci, Rabia; Baydar Artantaş, Aylin; Ayhan Başer, Duygu; Gökşin Cihan, Fatma; Şencan, Irfan; Koç, Esra Meltem; Özkara, Adem

2016-01-01

Background Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. There is a limited number of studies on guidelines in Turkey. The quality of Ministry of Health guidelines have formerly been assessed whereas there is no information on the other guidelines developed in the country. Aim This study aims to assess the quality of CPGs that are developed by professional societies that work for the health sector in Turkey, and compare the findings with international guidelines. Methodology Professional societies that work for the health sector were determined by using the data obtained from the Ministry of Internal Affairs. Inclusion and exclusion criteria were defined for selecting the CPGs. Guidelines containing recommendations about disease management to the doctors, accessible online, developed within the past 5 years, citing references for recommendations, about the diseases over 1% prevalence according to the “Statistical Yearbook of Turkey 2012” were included in the study. The quality of CPGs were assessed with the AGREE II instrument, which is an internationally recognized tool for this purpose. Four independent reviewers, who did not participate in the development of the selected guidelines and were trained in CPG appraisal, used the AGREE instrument for assessment of the selected guidelines. Findings 47 professional societies were defined which provided access to CPGs in their websites; 3 of them were only open to members so these could not be reached. 8 CPGs from 7 societies were selected from a total of 401 CPGs from 44 societies. The mean scores of the domains of the guidelines which were assessed by the AGREE II tool were; Scope and purpose: 64%, stakeholder involvement: 37.9%, rigour of development: 35.3%, clarity and presentation: 77.9%, applicability: 49.0% and editorial independence: 46.0%. Conclusion This is the first study in Turkey regarding quality appraisal of guidelines developed by the local professional societies. It adds to the limited amount of information in the literature that comes from Turkey as well as other developing countries. PMID:27295303

Patient reported outcomes (PROs) in clinical trials: is 'in-trial' guidance lacking? a systematic review.

PubMed

Kyte, Derek G; Draper, Heather; Ives, Jonathan; Liles, Clive; Gheorghe, Adrian; Calvert, Melanie

2013-01-01

Patient reported outcomes (PROs) are increasingly assessed in clinical trials, and guidelines are available to inform the design and reporting of such trials. However, researchers involved in PRO data collection report that specific guidance on 'in-trial' activity (recruitment, data collection and data inputting) and the management of 'concerning' PRO data (i.e., data which raises concern for the well-being of the trial participant) appears to be lacking. The purpose of this review was to determine the extent and nature of published guidelines addressing these areas. Systematic review of 1,362 articles identified 18 eligible papers containing 'in-trial' guidelines. Two independent authors undertook a qualitative content analysis of the selected papers. Guidelines presented in each of the articles were coded according to an a priori defined coding frame, which demonstrated reliability (pooled Kappa 0.86-0.97), and validity (<2% residual category coding). The majority of guidelines present were concerned with 'pre-trial' activities (72%), for example, outcome measure selection and study design issues, or 'post-trial' activities (16%) such as data analysis, reporting and interpretation. 'In-trial' guidelines represented 9.2% of all guidance across the papers reviewed, with content primarily focused on compliance, quality control, proxy assessment and reporting of data collection. There were no guidelines surrounding the management of concerning PRO data. The findings highlight there are minimal in-trial guidelines in publication regarding PRO data collection and management in clinical trials. No guidance appears to exist for researchers involved with the handling of concerning PRO data. Guidelines are needed, which support researchers to manage all PRO data appropriately and which facilitate unbiased data collection.

Patient Reported Outcomes (PROs) in Clinical Trials: Is ‘In-Trial’ Guidance Lacking? A Systematic Review

PubMed Central

Kyte, Derek G.; Draper, Heather; Ives, Jonathan; Liles, Clive; Gheorghe, Adrian; Calvert, Melanie

2013-01-01

Background Patient reported outcomes (PROs) are increasingly assessed in clinical trials, and guidelines are available to inform the design and reporting of such trials. However, researchers involved in PRO data collection report that specific guidance on ‘in-trial’ activity (recruitment, data collection and data inputting) and the management of ‘concerning’ PRO data (i.e., data which raises concern for the well-being of the trial participant) appears to be lacking. The purpose of this review was to determine the extent and nature of published guidelines addressing these areas. Methods and Findings Systematic review of 1,362 articles identified 18 eligible papers containing ‘in-trial’ guidelines. Two independent authors undertook a qualitative content analysis of the selected papers. Guidelines presented in each of the articles were coded according to an a priori defined coding frame, which demonstrated reliability (pooled Kappa 0.86–0.97), and validity (<2% residual category coding). The majority of guidelines present were concerned with ‘pre-trial’ activities (72%), for example, outcome measure selection and study design issues, or ‘post-trial’ activities (16%) such as data analysis, reporting and interpretation. ‘In-trial’ guidelines represented 9.2% of all guidance across the papers reviewed, with content primarily focused on compliance, quality control, proxy assessment and reporting of data collection. There were no guidelines surrounding the management of concerning PRO data. Conclusions The findings highlight there are minimal in-trial guidelines in publication regarding PRO data collection and management in clinical trials. No guidance appears to exist for researchers involved with the handling of concerning PRO data. Guidelines are needed, which support researchers to manage all PRO data appropriately and which facilitate unbiased data collection. PMID:23560103

Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline.

PubMed

Lyman, Gary H; Greenlee, Heather; Bohlke, Kari; Bao, Ting; DeMichele, Angela M; Deng, Gary E; Fouladbakhsh, Judith M; Gil, Brigitte; Hershman, Dawn L; Mansfield, Sami; Mussallem, Dawn M; Mustian, Karen M; Price, Erin; Rafte, Susan; Cohen, Lorenzo

2018-06-11

Purpose The Society for Integrative Oncology (SIO) produced an evidence-based guideline on use of integrative therapies during and after breast cancer treatment that was determined to be relevant to the American Society of Clinical Oncology (ASCO) membership. ASCO considered the guideline for endorsement. Methods The SIO guideline addressed the use of integrative therapies for the management of symptoms and adverse effects, such as anxiety and stress, mood disorders, fatigue, quality of life, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Interventions of interest included mind and body practices, natural products, and lifestyle modifications. SIO systematic reviews focused on randomized controlled trials that were published from 1990 through 2015. The SIO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO Expert Panel was convened to review the guideline contents and recommendations. Results The ASCO Expert Panel determined that the recommendations in the SIO guideline-published in 2017-are clear, thorough, and based on the most relevant scientific evidence. ASCO endorsed the guideline with a few added discussion points. Recommendations Key recommendations include the following: Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-l-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy because of a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related adverse effects. Additional information is available at: www.asco.org/supportive-care-guidelines .

Reactions on Twitter to updated alcohol guidelines in the UK: a content analysis.

PubMed

Stautz, Kaidy; Bignardi, Giacomo; Hollands, Gareth J; Marteau, Theresa M

2017-02-28

In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter. Tweets containing the hashtag #alcoholguidelines made during 1 week following the announcement of the updated guidelines were retrieved using the Twitter Archiver tool. The source, sentiment and themes of the tweets were categorised using manual content analysis. A total of 3061 tweets was retrieved. 6 sources were identified, the most prominent being members of the public. Of 821 tweets expressing sentiment specifically towards the guidelines, 80% expressed a negative sentiment. 11 themes were identified, 3 of which were broadly supportive of the guidelines, 7 broadly unsupportive and 1 neutral. Overall, more tweets were unsupportive (49%) than supportive (44%). While the most common theme overall was sharing information, the most common in tweets from members of the public encouraged alcohol consumption (15%) or expressed disagreement with the guidelines (14%), reflecting reactance, resistance and misunderstanding. This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media. 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/.

Economic comparisons of haul road construction versus forwarding versus longer skid distances

Treesearch

Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

1992-01-01

There currently exists no set of basic guidelines for Appalachian loggers to use in the decision making process for selecting the best way to harvest a tract of timber. Specifically, guidelines are needed for deciding between the alternatives of constructing truck haul roads to access an area or other alternatives such as skidding or forwarding timber longer distances...

A game-theoretical approach to multimedia social networks security.

PubMed

Liu, Enqiang; Liu, Zengliang; Shao, Fei; Zhang, Zhiyong

2014-01-01

The contents access and sharing in multimedia social networks (MSNs) mainly rely on access control models and mechanisms. Simple adoptions of security policies in the traditional access control model cannot effectively establish a trust relationship among parties. This paper proposed a novel two-party trust architecture (TPTA) to apply in a generic MSN scenario. According to the architecture, security policies are adopted through game-theoretic analyses and decisions. Based on formalized utilities of security policies and security rules, the choice of security policies in content access is described as a game between the content provider and the content requester. By the game method for the combination of security policies utility and its influences on each party's benefits, the Nash equilibrium is achieved, that is, an optimal and stable combination of security policies, to establish and enhance trust among stakeholders.

A Game-Theoretical Approach to Multimedia Social Networks Security

PubMed Central

Liu, Enqiang; Liu, Zengliang; Shao, Fei; Zhang, Zhiyong

2014-01-01

The contents access and sharing in multimedia social networks (MSNs) mainly rely on access control models and mechanisms. Simple adoptions of security policies in the traditional access control model cannot effectively establish a trust relationship among parties. This paper proposed a novel two-party trust architecture (TPTA) to apply in a generic MSN scenario. According to the architecture, security policies are adopted through game-theoretic analyses and decisions. Based on formalized utilities of security policies and security rules, the choice of security policies in content access is described as a game between the content provider and the content requester. By the game method for the combination of security policies utility and its influences on each party's benefits, the Nash equilibrium is achieved, that is, an optimal and stable combination of security policies, to establish and enhance trust among stakeholders. PMID:24977226

Total phenolic, anthocyanin contents and antioxidant capacity of selected elderberry (Sambucus canadensis L.) accessions

PubMed Central

Özgen, Mustafa; Scheerens, Joseph C.; Reese, R. Neil; Miller, Raymond A.

2010-01-01

Fourteen purple-black American elderberry accessions (Sambucus canadensis L.) obtained from various sites in midwestern USA and then grown at a single Ohio production site in USA were analyzed for their total phenolic (TP) and total monomeric anthocyanin (TMA) contents and for their antioxidant capacity by the ferric reducing antioxidant power (FRAP) and DPPH radical scavenging assays. Total phenolic and anthocyanin contents were measured using the Folin-Ciocalteu reagent and the pH differential methods, respectively. Overall, the phytonutrient contents and antioxidant capacity of our elderberry accessions were similar to those typically reported for black raspberries, blackberries and other dark-fleshed small fruits. Variability among accessions was greatest for TMA content (CV 37.5%); individuals ranged nearly threefold from 1308 to 4004 μg cy3-GE/g on a fresh weight basis. Variation among accessions was also evident for TP, FRAP and DPPH values (CV 14.4, 21.7 and 26.8%, respectively). TP and TMA values were very highly correlated (r = 0.93), although individuals differed in the estimated proportion of total phenolics attributable to anthocyanins. Both TP and TMA also highly correlated to antioxidant capacity values (r = 0.70–0.85). Within this limited study of 14 accessions, variability for phytonutrient content and antioxidant capacity suggested the employment of wild germplasm within an elderberry improvement program to incorporate an array of superior horticultural, post-harvest or processing traits into new or existing cultivars with superior phytonutrient profiles. PMID:20931079