78 FR 73451 - Defense Federal Acquisition Regulation Supplement: Unallowable Fringe Benefit Costs (DFARS Case...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-06

... internal controls to eliminate costs that are already unallowable. 2. Broadening the Category of Fringe... recent problems. Reasonable internal controls can significantly reduce the amount of ineligible dependent... effect of the rule is to make the DFARS consistent with current commercial practice. 8. Internal Controls...

Teaching Culture: The Challenges and Opportunities of International Public Relations.

ERIC Educational Resources Information Center

George, Amiso M.

2003-01-01

Focuses on the challenges and opportunities for international public relations practice. Looks at current United States-Arab relations issues in international crisis communication. Discusses those issues, especially the role of culture and media. Proposes strategies including a case study that teachers can use to help students become effective…

Cyberbullying among Youth: A Comprehensive Review of Current International Research and Its Implications and Application to Policy and Practice

ERIC Educational Resources Information Center

Cassidy, Wanda; Faucher, Chantal; Jackson, Margaret

2013-01-01

Cyberbullying research is rapidly expanding with many studies being published from around the world in the past five or six years. In this article we review the current international literature published in English, with particular attention to the following themes: The relationship of cyberbullying to the more traditional face-to-face bullying,…

Ethical Issues Concerning the Use of Videoconferencing To Supervise International Social Work Field Practicum Students.

ERIC Educational Resources Information Center

Panos, Patrick T.; Panos, Angelea; Cox, Shirley E.; Roby, Jini L.; Matheson, Kenneth W.

2002-01-01

Examines current ethical guidelines affecting the use of videoconferencing in the supervision of social work students nationally and internationally. Suggests protocols to address ethical and professional practice issues that are likely to arise as a result of using videoconferencing to conduct supervision across international borders. (EV)

Internal and External Focus of Attention in a Novice Form Sport

ERIC Educational Resources Information Center

Lawrence, Gavin P.; Gottwald, Vicky M.; Hardy, James; Khan, Michael A.

2011-01-01

In the current experiment, we examined optimal focus for novices during a movement sequence in which performance was measured on accurate movement form/technique. A novel gymnastics routine was practiced under either an internal skill-relevant, internal skill-irrelevant, external, or no attention focus. Retention and transfer tests were then…

International Space Agency CIO Forum Industrial Control System (ICS) and Cyber

NASA Technical Reports Server (NTRS)

Powell, Robert

2017-01-01

This briefing covers Industrial Control System (ICS) best practices for enhancing cyber protection. The briefing provides a very high-level overview of best practices currently being pursued by NASA as well as by other US government agencies such as NIST and DHS ICS-CERT. All information presented in this slide deck is publicly available and no sensitive information is provided in these slides. These slides will be used to generate discussion around best practices within the international community in the area of ICS cyber protections.

Cataloging Practices in India: Efforts for Standardization.

ERIC Educational Resources Information Center

Tikku, Upinder Kumar

1984-01-01

Surveys current cataloging practices in Indian libraries and discusses standardization in cataloging, types of catalogs, cataloging codes (Anglo-American and Ranganathan), subject headings, descriptive cataloging, and standardization efforts (international, United States, USSR, Great Britain, India). Footnotes are included. (EJS)

The practice of internal medicine in Europe: organisation, clinical conditions and procedures.

PubMed

Cranston, Mark; Semple, Colin; Duckitt, Roger; Vardi, Moshe; Lindgren, Stefan; Davidson, Christopher; Palsson, Runolfur

2013-10-01

Current information on the role of internists in the European countries is scarce. This report describes the results of a survey of the practice of internists in Europe. Two online questionnaire-based surveys were carried out by the European Board of Internal Medicine, one on the practice of internists and the other on postgraduate training in internal medicine. The national internal medicine societies of all 30 member countries of the European Federation of Internal Medicine were invited to participate. The responses were reviewed by internal medicine trainees from the respective countries and summaries of the data were sent to the national societies for approval. Descriptive analysis of the data on the practice of internists was carried out. Twenty-seven countries (90%) completed the questionnaire and approved their datasets. In 8 European countries, most internists practised internal medicine alone and in 7 countries at least half of physicians practised internal medicine together with a subspecialty. Internal medicine was considered a hospital-based specialty in most countries. The majority of selected presenting problems and diagnoses were rated as commonly encountered in all countries. More variability between countries was observed in the performance of diagnostic and therapeutic procedures. Many similarities exist in the practice of internal medicine between the European countries, while some differences are present that likely reflect the variable impact of subspecialisation. The results of the survey should prove valuable for the definition of specific competencies and development of a common curriculum for internal medicine at the European level. © 2013.

Child development in the NANDA-I and International Classification for Nursing Practices Nursing Classifications*.

PubMed

de Souza, Juliana Martins; Veríssimo, Maria De La Ó Ramallo

2013-02-01

Identify and analyze the NANDA-I diagnoses and the focus terms of the International Classification for Nursing Practices (ICNP) related to child development. Literature, reflections about clinical experience, and a model case. DATA SYNTHESE: The current diagnoses proposed by NANDA-I and the ICNP focus terms do not encompass the extent of the child development phenomenon. It is necessary studying the child development concept to improve the definition of the ICNP focus terms and the accuracy of NANDA-I diagnoses. Discussing the nursing classifications can improve their understanding and use. © 2012, The Authors. International Journal of Nursing Knowledge © 2012, NANDA International.

In the Shadow of E. H. Carr: The Evolution of International Politics

DTIC Science & Technology

2012-06-01

promote the merits of cooperation and look to institutions as a method for ensuring peace. We examine Normal Angel’s liberal theory , Robert Keohane...pages, Carr divides the field into its ideational and material sides: utopianism and realism, ethics and politics, theory and practice, intellectualism...Carr believed that the current course of international politics could lead to the ruin of humanity. He did not believe that IR theories and practices

The Global Footprint of Oral Medicine Specialists: The University of Pennsylvania Experience.

PubMed

Stoopler, Eric T; De Rossi, Scott S; Greenberg, Martin S; Sollecito, Thomas P

2016-12-01

The aim of this study was to analyze the global footprint of oral medicine specialists who graduated from the University of Pennsylvania oral medicine residency program. In 2016, a cross-sectional electronic survey was distributed to 53 graduates of that program, asking about their current geographical location and professional status. Of those 53 graduates, 23 (43%) completed the survey with 22 reporting their current location and 21 reporting their current professional status. The results showed that 17 graduates were located within the U.S., and five were located internationally. Twelve graduates were in full-time academic positions, three were in part-time academic positions/part-time private practice, three were in full-time private practice, two were in postdoctoral training programs, and one was not employed. This study found that oral medicine specialists trained at the University of Pennsylvania were located both domestically and internationally. The majority held faculty positions at academic institutions with fewer involved in private practice. This program may thus be considered a source of future dental academicians.

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

PubMed Central

Dakkuri, Adnan; Abrons, Jeanine P.; Williams, Dennis; Ombengi, David N.; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O’Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

2016-01-01

International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education. PMID:27170809

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations.

PubMed

Alsharif, Naser Z; Dakkuri, Adnan; Abrons, Jeanine P; Williams, Dennis; Ombengi, David N; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O'Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

2016-04-25

International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education.

Unification: An international aerospace information issue

NASA Technical Reports Server (NTRS)

Cotter, Gladys A.; Lahr, Thomas F.

1991-01-01

Science and technology projects are becoming more and more international and interdisciplinary. Other parts of the world, notably Europe, are increasingly powerful players in the aerospace business. This change has led to the development of various aerospace information initiatives in other countries. With scarce resources in all areas of government and industry, the NASA STI Program is reviewing its current acquisition and exchange practices and policies to factor in the changing requirements and new opportunities within the international community. Current NASA goals and activities are reviewed with a view toward developing a scenario for establishing an international aerospace data base, maintaining compatibility among national aerospace information systems, eliminating duplication of effort, and sharing resources through international cooperation wherever possible.

Unification - An international aerospace information opportunity

NASA Technical Reports Server (NTRS)

Cotter, Gladys A.; Lahr, Thomas F.

1992-01-01

Science and technology projects are becoming more and more international and interdisciplinary. Other parts of the world, notably Europe, are increasingly powerful players in the aerospace industry. This change has led to the development of various aerospace information initiatives in other countries. With scarce resources in all areas of government and industry, the NASA STI Program is reviewing its current acquisition and exchange practices and policies to factor in the changing requirements and new opportunities within the international community. Current NASA goals and activities are reviewed with a new view toward developing a scenario for establishing an international aerospace database, maintaining compatibility among national aerospace information systems, eliminating duplication of effort, and sharing resources through international cooperation wherever possible.

Unification: An international aerospace information opportunity

NASA Technical Reports Server (NTRS)

Cotter, Gladys A.; Lahr, Thomas F.; Carroll, Bonnie C.

1992-01-01

Science and technology projects are becoming more and more international and interdisciplinary. Other parts of the world, notably Europe, are increasingly powerful players in the aerospace industry. This change has led to the development of various aerospace information initiatives in other countries. With scarce resources in all areas of government and industry, the NASA STI Program is reviewing its current acquisition and exchange practices and policies to factor in the changing requirements and new opportunities within the international community. Current NASA goals and activities are reviewed with a new view toward developing a scenario for establishing an international aerospace database, maintaining compatibility among national aerospace information systems, eliminating duplication of effort, and sharing resources through international cooperation wherever possible.

Policies and Initiatives: Reforming Teacher Education in Nigeria

ERIC Educational Resources Information Center

Amadi, Martha Nkechinyere

2012-01-01

Much discussion surrounding educational policy currently is international in character. Governments, policy makers, stakeholders and many international organizations of both developed and developing countries have become concerned with how policies, practices, and outcomes in one country can be compared with those in other countries. Comparative…

Striving for best practice: standardising New Zealand nursing procedures, 1930-1960.

PubMed

Wood, Pamela J; Nelson, Katherine

2013-11-01

To identify how nurses in the past determined best practice, using the context of New Zealand, 1930-1960. In the current context of evidence-based practice, nurses strive to provide the best care, based on clinical research. We cannot assume that nurses in the past, prior to the evidence-based practice movement, did not also have a deliberate process for pursuing best practice. Discovering historical approaches to determining best practice will enrich our understanding of how nurses' current efforts are part of a continuing commitment to ensuring quality care. Historical research. The records of the Nursing Education Committee of the New Zealand Registered Nurses' Association, 1940-1959, and the 309 issues of New Zealand's nursing journal, Kai Tiaki, 1930-1960, were analysed to identify the profession's approach to ensuring best practice. This approach was then interpreted within the international context, particularly Canada and the USA. For nearly 30 years, nurse leaders collaborated in undertaking national surveys of training hospitals requesting information on different nursing practices. They subsequently distributed instructions for a range of procedures and other aspects of nursing care to standardise practice. Standardising nursing care was an effective way to ensure quality nursing at a time when hospital care was delivered mostly by nurses in training. The reasons for and timing of standardisation of nursing care in New Zealand differed from the international move towards standardisation, particularly in the USA. Historically, nurses also pursued best practice, based on standardising nursing procedures. Examining the antecedents of the present evidence-based approach to care reminds us that the process and reasons for determining best practice change through time. As knowledge and practice continually change, current confident assertions of best practice should and will continue to be challenged in future. © 2013 John Wiley & Sons Ltd.

Building SAWE Capability as an ANSI Accredited Standards Developer

NASA Technical Reports Server (NTRS)

Cerro, Jeffrey A.; Davis, Ed; Peterson, Eric; Griffiths, William T.; Brooks, Andy; Stratton, Bonnie; Attar, Jose

2014-01-01

This paper presents a 2014 status of the Society of Allied Weight Engineers' process towards becoming an Accredited Standards Developer (ASD) under certification by the United States American National Standards Institute (ANSI). Included is material from the committee's 2013 International presentation, current status, and additional general background material. The document strives to serve as a reference point to assist SAWE Recommended Practice and Standards developers in negotiating United States Standards Strategy, international standards strategy, and the association of SAWE standards and recommended practices to those efforts. Required procedures for SAWE to develop and maintain Recommended Practices and ANSI/SAWE Standards are reviewed.

eHealth and IMIA's Strategic Planning Process - IMIA conference introductory address.

PubMed

Murray, Peter; Haux, Reinhold; Lorenzi, Nancy

2008-01-01

The International Medical Informatics Association (IMIA) is the only organization in health and biomedical informatics which is fully international in scope, bridging the academic, health practice, education, and health industry worlds through conferences, working groups, special interest groups and publications. Authored by the IMIA Interim Vice President for Strategic Planning Implementation and co-authored by the current IMIA President and the IMIA Past-President, the intention of this paper is to introduce IMIA's current strategic planning process and to set this process in relation to 'eHealth: Combining Health Telematics, Telemedicine, Biomedical Engineering and Bioinformatics to the Edge', the theme of this conference. From the viewpoint of an international organization such as IMIA, an eHealth strategy needs to be considered in a comprehensive way, including broadly stimulating high-quality health and biomedical informatics research and education, as well as providing support to bridging outcomes towards a new practice of health care in a changing world.

37 CFR 1.419 - Display of currently valid control number under the Paperwork Reduction Act.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Display of currently valid... UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES International Processing Provisions General Information § 1.419 Display of currently valid control...

Quality management for the international transport of laboratory animals.

PubMed

Leary, Steven L

2008-01-01

Increased collaboration between investigators at different institutions has increased the number of laboratory animals being transported. The current system of laws and regulations governing animal shipments is inconsistent and government agencies often have areas of overlapping regulatory management. Furthermore, the lack of industry-wide shipping standards and good practices contributes to confusion among those responsible for shipment. One answer to these quality control issues would be the establishment of independent, industry-regulated 'good practices' for animal transport, similar to those used in laboratories for experimental design. These good practices could be based on the existing International Air Transport Association Live Animals Regulations, with contributions from representatives of the specialties involved. Additionally, quality control under the current system of patchwork regulations could be improved if each institution, both academic and commercial, would designate a single point of contact to follow each shipment from start to finish.

Research and Practical Trends in Geospatial Sciences

NASA Astrophysics Data System (ADS)

Karpik, A. P.; Musikhin, I. A.

2016-06-01

In recent years professional societies have been undergoing fundamental restructuring brought on by extensive technological change and rapid evolution of geospatial science. Almost all professional communities have been affected. Communities are embracing digital techniques, modern equipment, software and new technological solutions at a staggering pace. In this situation, when planning financial investments and intellectual resource management, it is crucial to have a clear understanding of those trends that will be in great demand in 3-7 years. This paper reviews current scientific and practical activities of such non-governmental international organizations as International Federation of Surveyors, International Cartographic Association, and International Society for Photogrammetry and Remote Sensing, analyzes and groups most relevant topics brought up at their scientific events, forecasts most probable research and practical trends in geospatial sciences, outlines topmost leading countries and emerging markets for further detailed analysis of their activities, types of scientific cooperation and joint implementation projects.

Transfer of Instructional Practices from Freedom Schools to the Classroom

ERIC Educational Resources Information Center

Stanford, Myah D.

2017-01-01

The instructional practices of three current classroom teachers who formerly served as Servant Leader Interns (SLIs) in the Children's Defense Fund Freedom Schools (CDFFS) Program were examined. Haskell ("Transfer of learning: cognition, instruction, and reasoning." Academic Press, San Diego, 2001) outlined eleven principles of transfer…

Quality Assurance of Non-Local Accounting Programs Conducted in Hong Kong

ERIC Educational Resources Information Center

Cheng, Mei-Ai; Leung, Noel W.

2014-01-01

This study examines the current government policy and institutional practice on quality assurance of non-local accounting programs conducted in Hong Kong. Both international guidelines, national regulations and institutional frameworks in higher education and transnational higher education, and professional practice in accounting education are…

Teachers' Journeys: A Case of Teachers of Learners Aged Five to Six

ERIC Educational Resources Information Center

Feza, Nosisi N.

2018-01-01

South Africa's esteem is low with regard to current learner achievement in mathematics. Results from international studies, such as TIMMS and SACMEQ, continuously indicate that South African learners perform below international benchmarks in mathematics. Research and evaluation studies assert that teacher practices and poor early mathematics…

The Health and Wellbeing of International Students at an Australian University

ERIC Educational Resources Information Center

Rosenthal, Doreen Anne; Russell, Jean; Thomson, Garry

2008-01-01

A representative sample of undergraduate and postgraduate international students at a large Australian university (n=979, 64% females) completed a mail-back survey of their health and wellbeing. Most students evaluated their current and previous physical and mental health positively. Health-related risk practices such as unprotected sexual…

International Handbook of Lifelong Learning. Part One [and] Part Two. Kluwer International Handbooks of Education.

ERIC Educational Resources Information Center

Aspin, David, Ed.; Chapman, Judith, Ed.; Hatton, Michael, Ed.; Sawano, Yukiko, Ed.

These volumes contain 40 papers examining the principles, policies, structure, and practice of lifelong learning worldwide. The following are among the papers included: "Towards a Philosophy of Lifelong Learning" (David Aspin, Judith Chapman); "Locating Lifelong Learning and Education in Contemporary Currents of Thought and…

Selling the Home Territory: Assignments for International MBA Students.

ERIC Educational Resources Information Center

Reep, Diana C.

2000-01-01

Describes the author's approach to a MBA writing course functioning to connect the writing and oral presentation assignments to the students' current jobs. Notes that most international students lack an understanding of American business practices. Develops the assignments around what the students do know. Notes three assignments including a…

Teacher Perceptions of Inquiry and STEM Education in Bangladesh

NASA Astrophysics Data System (ADS)

Shahidullah, Kazi K.

This dissertation reports lower secondary science teachers perceptions of current practice in Dhaka, Bangladesh concerning inquiry and STEM Education in order to establish a baseline of data for reform of science education in Bangladesh. Bangladesh has been trying to incorporate inquiry-based science curricula since the 1970s. Over time, the science curricula also aligned with different international science education movements such as Science for All, Scientific Literacy, Science, Technology, and Society. Science, Technology, Engineering, and Mathematics (STEM) is the most recent science education movement in international science education. This study explored current practices and perceptions of lower secondary science teachers in order to establish a baseline of current practice so that future reform recommendations may be pursued and recommendations made for Bangladesh to overcome the inquiry-based challenges and to incorporate new STEM-based science education trends happening in the US and throughout the world. The study explored science teachers perceptions and readiness to transform their science classrooms based on self-reported survey. The survey utilized Likert-type scale with range 1 (very strongly disagree) to 6 (very strongly agree) among four hundred lower secondary science teachers, teacher training college faculty, and university faculty. The data is presented in four different categories: curriculum, instruction, assessment, and professional development. Results indicated that the participants understand and practice a certain level of inquiry in their science classrooms, though they do not have adequate professional development. Participants also stated that they do not have sufficient instructional materials and the curriculum is not articulated enough to support inquiry. On the other hand, the participants reported that they understand and practice a certain degree of inquiry and STEM-based science education, but they also state that the current curriculum and instructional materials are not sufficient to practice inquiry nor to integrate more than one or two disciplines with science as is required in STEM integrated teaching. Finally, this study recommends a framework for science education reform for Bangladesh based upon a combination of successful international science education reformation practices.

Current debates on end-of-life sedation: an international expert elicitation study.

PubMed

Papavasiliou, Evangelia Evie; Payne, Sheila; Brearley, Sarah

2014-08-01

End-of-life sedation, though increasingly prevalent and widespread internationally, remains one of the most highly debated medical practices in the context of palliative medicine. This qualitative study aims to elicit and record the perspectives of leading international palliative care experts on current debates. Twenty-one professionals from diverse backgrounds, sharing field-specific knowledge/expertise defined by significant scholarly contribution on end-of-life sedation, were recruited. Open-ended, semi-structured interviews, following a topic-oriented structure reflecting on current debates, were conducted. Results were analysed using thematic content analysis. Three main aspects of sedation were identified and discussed as potentially problematic: (a) continuous deep sedation as an extreme facet of end-of-life sedation, (b) psycho-existential suffering as an ambivalent indication for sedation and (c) withdrawal or withholding of artificial nutrition and hydration as potentially life-shortening. On these grounds, concerns were reported over end-of-life sedation being morally equivalent to euthanasia. Considerable emphasis was placed on intentions as the distinguishing factor between end-of-life acts, and protective safeguards were introduced to distance sedation from euthanasia. This study shows that, despite the safeguards introduced, certain aspects of sedation, including the intentions associated with the practice, are still under question, parallels being drawn between end-of-life sedation and euthanasia. This reaffirms the existence of a grey area surrounding the two practices, already evidenced in countries where euthanasia is legalized. More clarity over the issues that generate this grey area, with their causes being uncovered and eliminated, is imperative to resolve current debates and effectively inform research, policy and practice of end-of-life sedation.

The Ethics of Western Rhetoric as a Basis for Teaching Foreign Students.

ERIC Educational Resources Information Center

Schliessmann, Michael R.

An increase in foreign student enrollment and subsequent questioning of traditional concepts of western rhetorical practice, particularly freedom of speech, resulted in an evaluation of current teaching practices in South Dakota State University's basic speech communication course. In a summer session course, 36 international students responded to…

The Practice of Psychotherapy in Mexico: Past and Present

ERIC Educational Resources Information Center

Stark, Marcella D.; Frels, Rebecca K.; Chavez, Rafael Reyes; Sharma, Bipin

2010-01-01

This article explores the history of psychotherapy in Mexico and describes past and current practices of psychological services, training, and supervision for Mexican international students in the United States. Sample curricula, texts, and universities in Mexico are listed. Implications for training underscore the importance of collaboration and…

Datasets collected in general practice: an international comparison using the example of obesity.

PubMed

Sturgiss, Elizabeth; van Boven, Kees

2018-06-04

International datasets from general practice enable the comparison of how conditions are managed within consultations in different primary healthcare settings. The Australian Bettering the Evaluation and Care of Health (BEACH) and TransHIS from the Netherlands collect in-consultation general practice data that have been used extensively to inform local policy and practice. Obesity is a global health issue with different countries applying varying approaches to management. The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data sources and to compare their differences. What is known about the topic? Australia had one of the longest-running consecutive datasets about general practice activity in the world, but it has recently lost government funding. The Netherlands has a longitudinal general practice dataset of information collected within consultations since 1985. What does this paper add? We discuss the benefits of general practice-collected data in two countries. Using obesity as a case example, we compare management in general practice between Australia and the Netherlands. This type of analysis should start all international collaborations of primary care management of any health condition. Having a national general practice dataset allows international comparisons of the management of conditions with primary care. Without a current, quality general practice dataset, primary care researchers will not be able to partake in these kinds of comparison studies. What are the implications for practitioners? Australian primary care researchers and clinicians will be at a disadvantage in any international collaboration if they are unable to accurately describe current general practice management. The Netherlands has developed an impressive dataset that requires within-consultation data collection. These datasets allow for person-centred, symptom-specific, longitudinal understanding of general practice management. The possibilities for the quasi-experimental questions that can be answered with such a dataset are limitless. It is only with the ability to answer clinically driven questions that are relevant to primary care that the clinical care of patients can be measured, developed and improved.

What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance.

PubMed

Le Boutillier, Clair; Leamy, Mary; Bird, Victoria J; Davidson, Larry; Williams, Julie; Slade, Mike

2011-12-01

Recovery is a multifaceted concept, and the need for operationalization in practice has been identified. Although guidance on recovery-oriented practice exists, it is from disparate sources and is difficult to apply. The aims of the study were to identify the key characteristics of recovery-oriented practice guidance on the basis of current international perspectives and to develop an overarching conceptual framework to aid the translation of recovery guidance into practice. A qualitative analysis of 30 international documents offering recovery-oriented practice guidance was conducted. Inductive, semantic-level, thematic analysis was used to identify dominant themes. Interpretive analysis was then undertaken to group the themes into practice domains. The guidance documents were diverse; from six countries-the United States, England, Scotland, Republic of Ireland, Denmark, and New Zealand-and varied in document type, categories of guidance, and level of service user involvement in guidance development. The emerging conceptual framework consists of 16 dominant themes, grouped into four practice domains: promoting citizenship, organizational commitment, supporting personally defined recovery, and working relationship. A key challenge for mental health services is the lack of clarity about what constitutes recovery-oriented practice. The conceptual framework contributes to this knowledge gap and provides a synthesis of recovery-oriented practice guidance.

[Environmental damage assessment: international regulations and revelation to China].

PubMed

Zhang, Hong-zhen; Cao, Dong; Yu, Fang; Wang, Jin-nan; Qi, Ji; Jia, Qian; Zhang, Tian-zhu; Luo, Yong-ming

2013-05-01

As the whole society gradually realizes the scarcity of nature resources and environmental value, countries all over the world have evolved and improved the system of environmental damage assessment through the practices of pollution prevention and ecological environmental protection. On one hand, in the research prospective, the practices of environmental damage assessment brought new challenges to environmental law, environmental economics, environmental science, environmental engineering, etc. On the other hand, they constantly promoted and developed relevant laws and regulations, techniques, working mechanism, and guidelines on procedure in practice. On the hasis of comparison and analysis of international practices and experiences from US, EU, and Japan, etc., this article identified relevant concepts, content, and scope of environmental damage assessment, and presented its scientific positioning and development direction. At present, both theory and practice of environmental damage assessment in China are in their infancy period. Considering current environmental situation and socioeconomic development features of China, learning international practices and experiences and raising the orientation of environmental damage assessment have great meaning in exploring the suitable environmental damage assessment system.

The Role of International Medical Graduate Psychiatrists in the United States Healthcare System

ERIC Educational Resources Information Center

Boulet, John Robin; Cassimatis, Emmanuel G.; Opalek, Amy

2012-01-01

Objective: International medical graduates (IMGs) make up a substantial proportion of the United States physician workforce, including psychiatrists in practice. The purpose of this study was to describe, based on current data, the characteristics and qualities of IMG psychiatrists who provide patient care in the US. Method: Physician data from…

Changing roles of academic societies due to globalization.

PubMed

Ehara, Shigeru; Aoki, Shigeki; Honda, Hiroshi

2016-10-01

Because of the globalization of environment around the academic society, the expected roles have changed significantly. In this short communication, we present the current situation in our international activities of the Japan Radiological Society, particularly in the academic activities and clinical practice. Establishing and reinforcing international network is one process of their promotion.

A Comparative Analysis of Internal Communication and Public Relations Audits. State of the Art.

ERIC Educational Resources Information Center

Dozier, David M.; Hellweg, Susan A.

A review of current literature regarding the state of the art in the conduct of internal communication and public relations audits by public relations practitioners reveals that these two related measurement activities are of considerable importance to the practice of public relations. Public relations audits are concerned with exploratory…

Inclusive Education in an International School: A Case Study from Hong Kong

ERIC Educational Resources Information Center

Chan, Twiggy; Yuen, Mantak

2015-01-01

This case study provides an overview of current policy, practices and problems concerning inclusion in one international secondary school in Hong Kong. A total of 13 interviews were conducted with the school management team, teachers, students and parents, supplemented by 12 classroom observations and two "student-shadowing" exercises.…

Globalization of Gerontology Education: Current Practices and Perceptions for Graduate Gerontology Education in the United States

PubMed Central

MWANGI, SAMUEL M.; YAMASHITA, TAKASHI; EWEN, HEIDI H.; MANNING, LYDIA K.; KUNKEL, SUZANNE R.

2013-01-01

The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level degree programs. The authors conducted qualitative interviews with representatives of the Association for Gerontology in Higher Education, the major national organization supporting higher education in gerontology, graduate program directors, and students. Although all respondents expressed their interest in globalizing gerontology education, actual practices are diverse. The authors discuss suggested conceptualization and strategies for globalizing gerontology education. PMID:22490075

Globalization of gerontology education: current practices and perceptions for graduate gerontology education in the United States.

PubMed

Mwangi, Samuel M; Yamashita, Takashi; Ewen, Heidi H; Manning, Lydia K; Kunkel, Suzanne R

2012-01-01

The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level degree programs. The authors conducted qualitative interviews with representatives of the Association for Gerontology in Higher Education, the major national organization supporting higher education in gerontology, graduate program directors, and students. Although all respondents expressed their interest in globalizing gerontology education, actual practices are diverse. The authors discuss suggested conceptualization and strategies for globalizing gerontology education.

Determining specific competencies for General Internal Medicine residents (PGY 4 and PGY 5). What are they and are programs currently teaching them? A survey of practicing Canadian General Internists.

PubMed

Card, Sharon E; Pausjenssen, Anne M; Ottenbreit, Rachel C

2011-11-03

General Internal Medicine (GIM) has recently been approved as a subspecialty by the Royal College of Physicians and Surgeons of Canada. As such, there is a need to define areas of knowledge that a General Internist must learn in those two years of training. There is limited literature as to what competencies are needed in a GIM practice. Draft competencies for GIM (4th and 5th year residents in internal medicine) training were developed over eight years with input from many stakeholders. Practicing General Internists were surveyed and asked their perspective as to the level of importance of each of these competencies for GIM training. They were also asked if training gaps exist in current training programs. The survey was offered widely online in both English and French to gain perspectives from as many different contexts as possible. 157 General Internists, in practice on average for 15 years, responded from all of Canada's provinces and territories. Practice profiles were diverse (large urban centers to rural centers). The majority of the competencies surveyed were perceived as important to attain at least proficiency in. Perioperative care, risk reduction, and the management of common, emergent, and complex internal medicine problems were identified as key areas to focus training programs on, with respondents perceiving these should be mastered to an expert level. Training gaps were identified, most frequently in that of the manager role (example managing practice). This is the first study we are aware of to attempt to isolate the opinions of practicing Canadian General Internists as to the major competencies that should be mastered as a General Internist. We suggest that "generalism" in the context of GIM, does not mean a bit of knowledge about everything but that defined objectives for training in this 'newest' of Royal College subspecialties can be identified. This includes mastery of core areas such as perioperative care, risk reduction, and management of common, emergent and multiple internal medicine problems. The training gaps identified need to be addressed to ensure that General Internists continue to provide excellence in health care delivery.

Utilizing a Substance Use Attitudes, Practices and Knowledge Survey for Multidisciplinary Curriculum Development

ERIC Educational Resources Information Center

Alexander, Dale; Waters, Vicki; McQueen, Katie; Basinger, Scott

2006-01-01

The authors describe the development and administration of a substance use attitudes questionnaire to social work students and clinicians, physician assistant students and practitioners, and medical interns. The general purpose for the Attitudes Survey was to collect baseline data regarding past training, current attitudes, beliefs, practices, and…

Benchmarking the Quality of Education: Discrepancies and Correspondence between Theory and Practice in 7 European Countries

ERIC Educational Resources Information Center

European Educational Research Journal, 2004

2004-01-01

This article presents the conclusion of a study that examines the discrepancies and correspondence between theory and practice in seven European countries. This article presents answers to the following research issues: (1) Discrepancies between existing quality concepts implied in the current international indicator publications and actual…

75 FR 51830 - National Cancer Institute's Best Practices for Biospecimen Resources

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-23

... current federal guidance documents and recommendations from international biospecimen organizations. DATES... be directed to senior staff of the relevant NCI Extramural and Intramural Program offices...

Templates and existing elements and models for implementation of patient exposure tracking.

PubMed

Rehani, Madan M; Berris, Theocharis

2014-01-01

There is wide interest currently in patient exposure tracking. This paper provides templates for implementation of tracking at the practice (hospital) level, multi-practice level, national level and international level. It provides suggestions for implementation in less-resourced countries. It includes elements such as patient identifier, dose quantities that should be covered and how to make sense from dose figures, availability of digital imaging and communications in medicine files with dose information or structured dose reports and capabilities of picture archiving and communication system (PACS). While tracking at several hospitals in a country connected by PACS and nationwide PACS is also a reality, tracking at the international level is currently a challenge. Guidance provided in this paper will facilitate its implementation at all levels.

Power and Control: Managing Agents for International Student Recruitment in Higher Education

ERIC Educational Resources Information Center

Huang, Iona Yuelu; Raimo, Vincenzo; Humfrey, Christine

2016-01-01

This multiple case-based study investigates the relationship between recruiting agents and the UK universities who act as their principals. The current extensive use of agents in UK higher education may be seen as an indicator of the financial impact made by international students. The study analyses the practice of agent management and explores…

Reaching Boys: An International Study of Effective Teaching Practices

ERIC Educational Resources Information Center

Reichert, Michael; Hawley, Richard

2010-01-01

Despite a continuing stream of concern on the part of researchers, demographers, and cultural pundits about a crisis in boys' social development and schooling, surprisingly little attention has been paid to what is perhaps the richest pool of data: current, observable teaching practices that clearly work with boys. In schools of all types in all…

Facing the Challenges of Educational Reform in the Arab World

ERIC Educational Resources Information Center

Karami Akkary, Rima

2014-01-01

This paper pinpoints and discusses key aspects of the current approaches to school reform in the Arab world against the backdrop of what is accepted as the best practice in the international literature on effective school reform and educational change. The main goal of the paper is to highlight deeply ingrained assumptions and practices that are…

Defining, Discussing, and Evaluating Mobile Learning: The Moving Finger Writes and Having Writ...

ERIC Educational Resources Information Center

Traxler, John

2007-01-01

Since the start of the current millennium, experience and expertise in the development and delivery of mobile learning have blossomed and a community of practice has evolved that is distinct from the established communities of "tethered" e-Learning. This community is currently visible mainly through dedicated international conference…

''Vulnerability'' in AIDS-Affected States: Rethinking Child Rights, Educational Institutions, and Development Paradigms

ERIC Educational Resources Information Center

Kendall, Nancy

2008-01-01

The article interrogates current international development constructs of childhood, rights, vulnerability, and schooling in light of the daily experiences of two Malawian children affected by HIV/AIDS. It aims to better understand how development efforts targeted at these children function in practice, and suggests that current development…

Current Evaluation of Upper Oesophageal Sphincter Opening in Dysphagia Practice: An International SLT Survey

ERIC Educational Resources Information Center

Regan, Julie; Walshe, Margaret; McMahon, Barry P.

2012-01-01

Background: The assessment of adequate upper oesophageal sphincter (UOS) opening during swallowing is an integral component of dysphagia evaluation. Aims: To ascertain speech and language therapists' (SLTs) satisfaction with current methods for assessing UOS function in people with dysphagia and to identify challenges encountered by SLTs with UOS…

Overview of Current Trends in Mental Health Problems for Australia's Youth and Adolescents

ERIC Educational Resources Information Center

Rickwood, Debra; White, Angela; Eckersley, Richard

2007-01-01

This paper provides an overview of current trends in the mental health problems of Australia's youth and adolescents. It presents information derived from the most recent and comprehensive Australian surveys of youth mental health, and provides international comparisons and views from professional practice where relevant. An update of trends for…

Ethical pharmaceutical promotion and communications worldwide: codes and regulations

PubMed Central

2014-01-01

The international pharmaceutical industry has made significant efforts towards ensuring compliant and ethical communication and interaction with physicians and patients. This article presents the current status of the worldwide governance of communication practices by pharmaceutical companies, concentrating on prescription-only medicines. It analyzes legislative, regulatory, and code-based compliance control mechanisms and highlights significant developments, including the 2006 and 2012 revisions of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) Code of Practice. Developments in international controls, largely built upon long-established rules relating to the quality of advertising material, have contributed to clarifying the scope of acceptable company interactions with healthcare professionals. This article aims to provide policy makers, particularly in developing countries, with an overview of the evolution of mechanisms governing the communication practices, such as the distribution of promotional or scientific material and interactions with healthcare stakeholders, relating to prescription-only medicines. PMID:24679064

Ethical pharmaceutical promotion and communications worldwide: codes and regulations.

PubMed

Francer, Jeffrey; Izquierdo, Jose Zamarriego; Music, Tamara; Narsai, Kirti; Nikidis, Chrisoula; Simmonds, Heather; Woods, Paul

2014-03-29

The international pharmaceutical industry has made significant efforts towards ensuring compliant and ethical communication and interaction with physicians and patients. This article presents the current status of the worldwide governance of communication practices by pharmaceutical companies, concentrating on prescription-only medicines. It analyzes legislative, regulatory, and code-based compliance control mechanisms and highlights significant developments, including the 2006 and 2012 revisions of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) Code of Practice.Developments in international controls, largely built upon long-established rules relating to the quality of advertising material, have contributed to clarifying the scope of acceptable company interactions with healthcare professionals. This article aims to provide policy makers, particularly in developing countries, with an overview of the evolution of mechanisms governing the communication practices, such as the distribution of promotional or scientific material and interactions with healthcare stakeholders, relating to prescription-only medicines.

Evaluating road delineation practices in Michigan : final report.

DOT National Transportation Integrated Search

2017-03-31

This research was conducted to assist the Michigan Department of Transportation in assessing the States : current delineation program. Opus International Consultants (Opus) and Western Michigan University : (WMU) were retained to undertake this re...

Assessment of current cybersecurity practices in the public domain : cyber indications and warnings domain.

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

Hamlet, Jason R.; Keliiaa, Curtis M.

This report assesses current public domain cyber security practices with respect to cyber indications and warnings. It describes cybersecurity industry and government activities, including cybersecurity tools, methods, practices, and international and government-wide initiatives known to be impacting current practice. Of particular note are the U.S. Government's Trusted Internet Connection (TIC) and 'Einstein' programs, which are serving to consolidate the Government's internet access points and to provide some capability to monitor and mitigate cyber attacks. Next, this report catalogs activities undertaken by various industry and government entities. In addition, it assesses the benchmarks of HPC capability and other HPC attributes thatmore » may lend themselves to assist in the solution of this problem. This report draws few conclusions, as it is intended to assess current practice in preparation for future work, however, no explicit references to HPC usage for the purpose of analyzing cyber infrastructure in near-real-time were found in the current practice. This report and a related SAND2010-4766 National Cyber Defense High Performance Computing and Analysis: Concepts, Planning and Roadmap report are intended to provoke discussion throughout a broad audience about developing a cohesive HPC centric solution to wide-area cybersecurity problems.« less

Translating Knowledge Into Practice Through an Academic-Practice Partnership for Exploring Barriers That Impact Management of Homebound Patients With Heart Failure.

PubMed

Echevarria, Mercedes

A knowledge translation project involving an academic-practice partnership and guided by action-oriented research was used for exploring barriers that impact management of homebound heart failure patients. The intervention process followed an action research model of interaction, self-reflection, response, and change in direction. External facilitators (academia) and internal facilitators (practice) worked with clinicians to identify a topic for improvement, explore barriers, locate the evidence compare current practice against evidence-based practice recommendations, introduce strategies to "close the gap" between actual practice and the desired practice, develop audit criteria, and reevaluate the impact.

A climate-compatible approach to development practice by international humanitarian NGOs.

PubMed

Clarke, Matthew; de Cruz, Ian

2015-01-01

If current climate-change predictions prove accurate, non-linear change, including potentially catastrophic change, is possible and the environments in which international humanitarian NGOs operate will change figuratively and literally. This paper proposes that a new approach to development is required that takes changing climate into account. This 'climate-compatible approach' to development is a bleak shift from some of the current orthodox positions and will be a major challenge to international humanitarian NGOs working with the most vulnerable. However, it is necessary to address the challenges and context such NGOs face, and the need to be resilient and adaptive to these changes. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Ethical review issues in collaborative research between us and low-middle income country partners: a case example.

PubMed

McIntosh, Scott; Sierra, Essie; Dozier, Ann; Diaz, Sergio; Quiñones, Zahira; Primack, Aron; Chadwick, Gary; Ossip-Klein, Deborah J

2008-09-01

The current ethical structure for collaborative international health research stems largely from developed countries' standards of proper ethical practices. The result is that ethical committees in developing countries are required to adhere to standards that might impose practices that conflict with local culture and unintended interpretations of ethics, treatments, and research. This paper presents a case example of a joint international research project that successfully established inclusive ethical review processes as well as other groundwork and components necessary for the conduct of human behavior research and research capacity building in the host country.

Global Harmonization of Maximum Residue Limits for Pesticides.

PubMed

Ambrus, Árpád; Yang, Yong Zhen

2016-01-13

International trade plays an important role in national economics. The Codex Alimentarius Commission develops harmonized international food standards, guidelines, and codes of practice to protect the health of consumers and to ensure fair practices in the food trade. The Codex maximum residue limits (MRLs) elaborated by the Codex Committee on Pesticide Residues are based on the recommendations of the FAO/WHO Joint Meeting on Pesticides (JMPR). The basic principles applied currently by the JMPR for the evaluation of experimental data and related information are described together with some of the areas in which further developments are needed.

Graduate Education and Professional Practice in International Peace and Conflict. Special Report 246

ERIC Educational Resources Information Center

Carstarphen, Nike; Zelizer, Craig; Harris, Robert; Smith, David J.

2010-01-01

Over the past two decades, the number of academic institutions providing education and training in international peace and conflict resolution in the United States has grown. Much of this development has been at the graduate level. In the fall of 2005, to assess the current state of the field more accurately, the United States Institute of Peace…

International Perspectives on Plagiarism and Considerations for Teaching International Trainees

PubMed Central

Heitman, Elizabeth; Litewka, Sergio

2010-01-01

In the increasingly global community of biomedical science and graduate science education, many US academic researchers work with international trainees whose views on scientific writing and plagiarism can be strikingly different from US norms. Although a growing number of countries and international professional organizations identify plagiarism as research misconduct, many international trainees come from research environments where plagiarism is ill-defined and even commonly practiced. Two research-ethics educators consider current perspectives on plagiarism around the world and contend that US research-training programs should focus on trainees’ scientific writing skills and acculturation, not simply on preventing plagiarism. PMID:21194646

Linking Theory to Practice in Learning Technology Research

ERIC Educational Resources Information Center

Gunn, Cathy; Steel, Caroline

2012-01-01

We present a case to reposition theory so that it plays a pivotal role in learning technology research and helps to build an ecology of learning. To support the case, we present a critique of current practice based on a review of articles published in two leading international journals from 2005 to 2010. Our study reveals that theory features only…

Intern pharmacists as change agents to improve the practice of nonprescription medication supply: provision of salbutamol to patients with asthma.

PubMed

Schneider, Carl R; Everett, Alan W; Geelhoed, Elizabeth; Padgett, Cale; Ripley, Scott; Murray, Kevin; Kendall, Peter A; Clifford, Rhonda M

2010-01-01

Earlier work established an evidence practice gap during provision of nonprescription salbutamol (albuterol). Pharmacist interns are hypothesized to be in a position to improve professional practice in the community pharmacy setting. To explore the potential of intern pharmacists to improve the professional practice of community pharmacy staff in the provision of nonprescription salbutamol. Intern pharmacists (n = 157) delivered an asthma intervention in 136 pharmacies consisting of an educational activity to pharmacy staff and a health promotion campaign to consumers. Post-intervention, simulated patients presented to 100 intervention and 100 control community pharmacies with a request for salbutamol. The appropriate outcome was medical referral for poor asthma control and correction of poor inhaler technique. Incidence and quantity of patient assessment and counseling provided during the visit were also assessed. Logistic regression was used to determine the predictors of medical referral. A doubling in the rate of medical referral was seen in the intervention group (19% vs 40%; p = 0.001). Assessment of reliever use frequency was the main predictor of medical referral (OR = 22.7; 95% CI 9.06 to 56.9). Correction of poor inhaler technique did not improve; however, a reduction in salbutamol supplied without patient assessment (23% vs 8%; p = 0.009) or counseling (75% vs 48%; p < 0.001) was noted. A doubling in the rate of medical referral showed a clear improvement in professional practice during the provision of nonprescription salbutamol. The improved patient outcome in the intervention group was due to increased assessment of reliever use frequency. Identification of poor inhaler technique remained near zero in both groups, which suggests that intern pharmacists were able to improve the current practice of community pharmacies yet were unable to establish a new practice behavior. This study provides evidence that intern pharmacists can act as change agents to improve pharmacy practice.

"The Falcon Cannot Hear the Falconer...". The Pedagogical Turn and the Negative Space of Irish Art Education

ERIC Educational Resources Information Center

Granville, Gary

2011-01-01

Current education policy discourse in Ireland, as elsewhere, is replete with reference to innovation, creativity and enterprise. Meanwhile, the "pedagogical turn" is a dominant motif in current discourse in art practice, curating and critique, in Ireland and internationally. This article firstly considers some of the implications of the…

Extraction of nutraceuticals from Spirulina (blue-green alga): A bioorganic chemistry practice using thin-layer chromatography.

PubMed

Herrera Bravo de Laguna, Irma; Toledo Marante, Francisco J; Luna-Freire, Kristerson R; Mioso, Roberto

2015-01-01

Spirulina is a blue-green alga (cyanobacteria) with high nutritive value. This work provides an innovative and original approach to the consideration of a bioorganic chemistry practice, using Spirulina for the separation of phytochemicals with nutraceutical characteristics via thin-layer chromatography (TLC) plates. The aim is to bring together current research, theory, and practice, and always in accordance with pedagogical ideas. © 2015 The International Union of Biochemistry and Molecular Biology.

Integrated Risk and Knowledge Management Program -- IRKM-P

NASA Technical Reports Server (NTRS)

Lengyel, David M.

2009-01-01

The NASA Exploration Systems Mission Directorate (ESMD) IRKM-P tightly couples risk management and knowledge management processes and tools to produce an effective "modern" work environment. IRKM-P objectives include: (1) to learn lessons from past and current programs (Apollo, Space Shuttle, and the International Space Station); (2) to generate and share new engineering design, operations, and management best practices through preexisting Continuous Risk Management (CRM) procedures and knowledge-management practices; and (3) to infuse those lessons and best practices into current activities. The conceptual framework of the IRKM-P is based on the assumption that risks highlight potential knowledge gaps that might be mitigated through one or more knowledge management practices or artifacts. These same risks also serve as cues for collection of knowledge particularly, knowledge of technical or programmatic challenges that might recur.

Advanced nursing practice hours as part of endorsement requirements for nurse practitioners in Australia: a definitional conundrum.

PubMed

Scanlon, Andrew; Cashin, Andrew; Watson, Ngaire; Bryce, Julianne

2012-11-01

To define what can be considered to be nursing practice, time that can be calculated as the practice of nursing as well as what is considered to be advanced nursing practice and how all this can be related to the current endorsement process for nurse practitioner (NP) in Australia. Current codes and guidelines cited by the Nurse and Midwifery Board of Australia related to nursing practice and NPs, cited competency standards from the Australian Midwifery Accreditation Council, as well as published material of peak nursing bodies from within Australia as well as internationally were used. Information was also obtained through government health and professional organization websites. All information in the literature regarding current and past status and nomenclature of advanced practice nursing was considered relevant. The definitional entanglement of what is considered to be nursing practice, the calculation of specific hours and what is advanced nursing practice interferes with endorsement of NPs in Australia, and a clear understanding of what is meant by advanced practice is required to move forward. Dependent on how practice is interpreted by the Nurse and Midwifery Board of Australia directly affects the outcome of the endorsement proceedings for individual NP candidates. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

Practicing health promotion in primary care -a reflective enquiry.

PubMed

Pati, S; Chauhan, A S; Mahapatra, S; Sinha, R; Pati, S

2017-12-01

Health promotion is an integral part of routine clinical practice. The physicians' role in improving the health status of the general population, through effective understanding and delivery of health promotion practice, is evident throughout the international literature. Data from India suggest that physicians have limited skills in delivering specific health promotion services. However, the data available on this is scarce. This study was planned to document the current health promotion knowledge, perception and practices of local primary care physicians in Odisha. An exploratory study was planned between the months of January - February 2013 in Odisha among primary care physicians working in government set up. This exploratory study was conducted, using a two-step self-administered questionnaire, thirty physicians practicing under government health system were asked to map their ideal and current health promotion practice, and potential health promotion elements to be worked upon to enhance the practice. The study recorded a significant difference between the mean of current and ideal health promotion practices. The study reported that physicians want to increase their practice on health education. We concluded that inclusion of health promotion practices in routine care is imperative for a strong healthcare system. It should be incorporated as a structured health promotion module in medical curriculum as well.

Maintaining capacity for in-practice teaching and supervision of students and general practice trainees: a cross-sectional study of early career general practitioners.

PubMed

Catzikiris, Nigel; Tapley, Amanda; Morgan, Simon; Holliday, Elizabeth G; Ball, Jean; Henderson, Kim; Elliott, Taryn; Spike, Neil; Regan, Cathy; Magin, Parker

2017-08-10

Objectives Expanding learner cohorts of medical students and general practitioner (GP) vocational trainees and the impending retirement of the 'baby boomer' GP cohort threaten the teaching and supervisory capacity of the Australian GP workforce. Engaging newly qualified GPs is essential to sustaining this workforce training capacity. The aim of the present study was to establish the prevalence and associations of in-practice clinical teaching and supervision in early career GPs. Methods The present study was a cross-sectional questionnaire-based study of recent (within 5 years) alumni of three of Australia's 17 regional general practice training programs. The outcome factor was whether the alumnus taught or supervised medical students, GP registrars or other learners in their current practice. Logistic regression analysis was used to establish associations of teaching and supervision with independent variables comprising alumnus demographics, current practice characteristics and vocational training experiences. Results In all, 230 alumni returned questionnaires (response rate 37.4%). Of currently practising alumni, 52.4% (95% confidence interval (CI) 45.6-59.0%) reported current teaching or supervisory activities. Factors significantly (P<0.05) associated with alumni currently undertaking in-practice clinical teaching and supervision were: Australian medical graduation (odds ratio (OR) for international graduates 0.36; 95% CI 0.14-0.92), working in a regional or remote area (OR 2.75; 95% CI 1.24-6.11) and currently undertaking nursing home visits, home visits or after-hours work (OR 2.01; CI 1.02-3.94). Conclusions Rural-urban and country-of-graduation differences in the engagement of early career GPs in practice-based apprenticeship-like teaching or training should inform strategies to maintain workforce training capacity. What is known about the topic? Projected changes in the demand for and supply of clinical teaching and supervision within Australian general practice will require greater uptake of teaching and supervision by recently qualified GPs to ensure sustainability of this teaching model. Although interest in and undertaking of teaching roles have been documented for GP or family medicine trainees, studies investigating the engagement in these clinical roles by GPs during their early post-training period are lacking. What does this paper add? This paper is the first to document the prevalence of teaching and supervision undertaken by early career GPs as part of their regular clinical practice. We also demonstrate associations of practice rurality, country of medical graduation and undertaking non-practice-based clinical roles with GPs' engagement in teaching and supervisory roles. What are the implications for practitioners? Establishing current teaching patterns of GPs enables appropriate targeting of new strategies to sustain an effective teaching and supervisory capacity within general practice. The findings of the present study suggest that exploring focused strategies to facilitate and support international medical graduates to engage in teaching during their vocational training, aided by focused supervisor support, may be of particular value.

Impact of Physical Abuse on Internalizing Behavior Across Generations.

PubMed

Esteves, Kyle; Gray, Sarah A O; Theall, Katherine P; Drury, Stacy S

2017-10-01

This study investigated the multigenerational impact of mothers' own exposure to physical maltreatment on internalizing symptoms in her child after accounting for her parenting practices, depression, and the child's own exposure to stressful life events. Children ( n = 101, ages 5-16), predominantly African American, were recruited into this cross sectional study using ethnographic mapping and targeted sampling for high-risk neighborhoods. Mothers reported retrospectively on their own exposure to physical maltreatment in childhood, their parenting practices, as well as current depressive symptoms. Maternal report of her child's exposure to stressful life events and child behavior was also collected. Maternal childhood exposure to physical maltreatment was significantly associated with her child's internalizing symptoms ( p = .004); this effect remained after accounting for child sex, maternal depressive symptoms, harsh parenting practices, and the child's own exposure to stressful life events. Formal tests of mediation through these pathways were non-significant. Findings suggest mothers' experience of childhood maltreatment contributes uniquely to children's internalizing symptoms, potentially through previously uncharacterized pathways. Examination of additional behavioral, psychosocial and biological pathways may help better describe the multi-generational effects of child maltreatment.

Pi Lambda Theta Summer 1988 Orient Study Tour, University of Hawaii at Manoa Campus. Course Title: International Education and East Asia. Research Report.

ERIC Educational Resources Information Center

Buzzelli, Charlotte Grace

This study compares the educational history, present educational systems, and current educational practices of Japan and Korea for the purpose of applying the study's results to improving elementary, secondary, and higher education liberal arts curricula in the United States. Framing the report is the notion of international educational exchange…

A Fresh Look at Driver Education in America

DOT National Transportation Integrated Search

2012-04-01

The objectives of this study were to: (1) identify and review current driver education and training programs in use nationally and : internationally; (2) identify best teaching practices for teenagers; (3) examine the optimal sequencing for the prese...

Efficient use of recycled concrete in transportation infrastructure

DOT National Transportation Integrated Search

2011-01-21

This study examined current national and international practices regarding the use of recycled concrete aggregates (RCA) as engineering materials by the transportation industry as well as a history of Michigan's experience with RCA. In the laboratory...

Principles to Consider in Defining New Directions in Internal Medicine Training and Certification

PubMed Central

Turner, Barbara J; Centor, Robert M; Rosenthal, Gary E

2006-01-01

SGIM endoreses seven principles related to current thinking about internal medicine training: 1) internal medicine requires a full three years of residency training before subspecialization; 2) internal medicine residency programs must dramatically increase support for training in the ambulatory setting and offer equivalent opportunities for training in both inpatient and outpatient medicine; 3) in settings where adequate support and time are devoted to ambulatory training, the third year of residency could offer an opportunity to develop further expertise or mastery in a specific type or setting of care; 4) further certification in specific specialties within internal medicine requires the completion of an approved fellowship program; 5) areas of mastery in internal medicine can be demonstrated through modified board certification and recertification examinations; 6) certification processes throughout internal medicine should focus increasingly on demonstration of clinical competence through adherence to validated standards of care within and across practice settings; and 7) regardless of the setting in which General Internists practice, we should unite to promote the critical role that this specialty serves in patient care. PMID:16637826

Deployment guidelines for diplomats: current policy and practice.

PubMed

Dunn, R; Kemp, V; Patel, D; Williams, R; Greenberg, N

2015-10-01

Diplomatic organizations routinely send staff to high-threat postings (HTPs) and consequentially have moral and legal obligations to protect their health as far as is reasonably practicable. To carry out an international survey of diplomatic organizations that send personnel to HTPs to establish how they deal practically with their obligations to protect the mental health of their staff. An online anonymous survey about their organizations' policies relating to HTPs completed by international diplomatic organizations. Fourteen of 30 organizations approached completed the questionnaire, with a response rate of 47%. Deployment length varied: no minimum (15%), a minimum of 2 years (39%) and a maximum of 2 (31%), 3 (15%) or 4 years (31%); one organization did not state any maximum. HTP and low-threat postings had the same policies in 46% of organizations. Additional care and support (66%), additional preparation (50%), enhanced leave (33%) and additional physical and mental health assessments were informally adopted to address psychosocial risks of deployment to HTPs. There was little consensus on policies and practice for HTP deployment. We suggest that formal, consistently written guidelines, based on available quality evidence, and associated training and quality assurance should be formulated to make international practice more consistent and equitable. © Crown copyright 2015.

ISS Training Best Practices and Lessons Learned

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Dempsey, Donna L.

2017-01-01

Training our crew members for long duration exploration-class missions (LDEM) will have to be qualitatively and quantitatively different from current training practices. However, there is much to be learned from the extensive experience NASA has gained in training crew members for missions on board the International Space Station (ISS). Furthermore, the operational experience on board the ISS provides valuable feedback concerning training effectiveness. Keeping in mind the vast differences between current ISS crew training and training for LDEM, the needs of future crew members, and the demands of future missions, this ongoing study seeks to document current training practices and lessons learned. The goal of the study is to provide input to the design of future crew training that takes as much advantage as possible of what has already been learned and avoids as much as possible past inefficiencies. Results from this study will be presented upon its completion. By researching established training principles, examining future needs, and by using current practices in spaceflight training as test beds, this research project is mitigating program risks and generating templates and requirements to meet future training needs.

ISS Training Best Practices and Lessons Learned

NASA Technical Reports Server (NTRS)

Dempsey, Donna L.; Barshi, Immanuel

2018-01-01

Training our crew members for long-duration Deep Space Transport (DST) missions will have to be qualitatively and quantitatively different from current training practices. However, there is much to be learned from the extensive experience NASA has gained in training crew members for missions on board the International Space Station (ISS). Furthermore, the operational experience on board the ISS provides valuable feedback concerning training effectiveness. Keeping in mind the vast differences between current ISS crew training and training for DST missions, the needs of future crew members, and the demands of future missions, this ongoing study seeks to document current training practices and lessons learned. The goal of the study is to provide input to the design of future crew training that takes as much advantage as possible of what has already been learned and avoids as much as possible past inefficiencies. Results from this study will be presented upon its completion. By researching established training principles, examining future needs, and by using current practices in spaceflight training as test beds, this research project is mitigating program risks and generating templates and requirements to meet future training needs.

Workshop on Agricultural Air Quality: State of the science

NASA Astrophysics Data System (ADS)

Aneja, Viney P.; Blunden, Jessica; Roelle, Paul A.; Schlesinger, William H.; Knighton, Raymond; Niyogi, Dev; Gilliam, Wendell; Jennings, Greg; Duke, Clifford S.

The first Workshop on Agricultural Air Quality: State of the Science was held at the Bolger Center in Potomac, Maryland from 4 to 8 June 2006. This international conference assembled approximately 350 people representing 25 nations from 5 continents, with disciplines ranging from atmospheric chemistry to soil science. The workshop was designed as an open forum in which participants could openly exchange the most current knowledge and learn about numerous international perspectives regarding agricultural air quality. Participants represented many stakeholder groups concerned with the growing need to assess agricultural impacts on the atmosphere and to develop beneficial policies to improve air quality. The workshop focused on identifying methods to improve emissions inventories and best management practices for agriculture. Workshop participants also made recommendations for technological and methodological improvements in current emissions measurement and modeling practices. The workshop commenced with a session on agricultural emissions and was followed by international perspectives from the United States, Europe, Australia, India, and South America. This paper summarizes the findings and issues of the workshop and articulates future research needs. These needs were identified in three general areas: (1) improvement of emissions measurement; (2) development of appropriate emission factors; and (3) implementation of best management practices (BMPs) to minimize negative environmental impacts. Improvements in the appropriate measurements will inform decisions regarding US farming practices. A need was demonstrated for a national/international network to monitor atmospheric emissions from agriculture and their subsequent depositions to surrounding areas. Information collected through such a program may be used to assess model performance and could be critical for evaluating any future regulatory policies or BMPs. The workshop concluded that efforts to maximize benefits and reduce detrimental effects of agricultural production need to transcend disciplinary, geographic, and political boundaries. Also, such efforts should involve natural and social scientists, economists, engineers, business leaders, and decision makers. The workshop came to the conclusion that through these collaborative efforts improvements in air quality from agricultural practices will begin to take effect.

Registration factors that limit international mobility of people holding physiotherapy qualifications: A systematic review.

PubMed

Foo, Jonathan S; Storr, Michael; Maloney, Stephen

2016-06-01

There is no enforced international standardisation of the physiotherapy profession. Thus, registration is used in many countries to maintain standards of care and to protect the public. However, registration may also limit international workforce mobility. What is known about the professional registration factors that may limit the international mobility of people holding physiotherapy qualifications? Systematic review using an electronic database search and hand searching of the World Confederation for Physical Therapy and International Network of Physiotherapy Regulatory Authorities websites. Analysis was conducted using thematic analysis. 10 articles and eight websites were included from the search strategy. Data is representative of high-income English speaking countries. Four themes emerged regarding limitations to professional mobility: practice context, qualification recognition, verification of fitness to practice, and incidental limitations arising from the registration process. Professional mobility is limited by differences in physiotherapy education programmes, resulting in varying standards of competency. Thus, it is often necessary to verify clinical competencies through assessments, as well as determining professional attributes and ability to apply competencies in a different practice context, as part of the registration process. There has been little evaluation of registration practices, and at present, there is a need to re-evaluate current registration processes to ensure they are efficient and effective, thereby enhancing workforce mobility. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Industrial Energy Efficiency Practices in Indonesia: Lesson Learned from Astra Green Energy (AGen) Award

NASA Astrophysics Data System (ADS)

Telaga, A. S.; Hartanto, I. D.

2017-03-01

Many countries have used award system to promote energy efficiency practices in industry. The award system has been found to have significant impact to increase energy conservation and sustainability adoption in companies. Astra International (AI) as a holding company of more than 200 companies also organised Astra green energy (AGen) award to all affiliated companies (AFFCO) in Astra group. The event has been used to share energy efficiency best practices among AFFCO in Astra group. AFFCOs of Astra International are among the biggest and the leader in their industrial sectors Therefore, analyses from AFFO’s energy efficiency case studies represents current practices in Indonesia industrial sectors. Analyses are divided into industry, building, and renewable energy. The results from analyses found that AFFCOs already aware of energy conservation and have implemented projects to promote energy efficiency. However, the AFFCOs do not optimally use monitoring data for energy reduction.

Ethical Review Issues in Collaborative Research between US and Low – Middle Income Country Partners: A Case Example

PubMed Central

McIntosh, Scott; Sierra, Essie; Dozier, Ann; Diaz, Sergio; Quiñones, Zahira; Primack, Aron; Chadwick, Gary; Ossip-Klein, Deborah J.

2012-01-01

The current ethical structure for collaborative international health research stems largely from developed countries’ standards of proper ethical practices. The result is that ethical committees in developing countries are required to adhere to standards that might impose practices that conflict with local culture and unintended interpretations of ethics, treatments, and research. This paper presents a case example of a joint international research project that successfully established inclusive ethical review processes as well as other groundwork and components necessary for the conduct of human behavior research and research capacity building in the host country. PMID:18554278

Current Realities and Future Possibilities: Language and Science Literacy--Empowering Research and Informing Instruction

ERIC Educational Resources Information Center

Yore, Larry D.; Treagust, David F.

2006-01-01

In this final article, we briefly review and synthesize the science and language research and practice that arose from the current literature and presentations at an international conference, referred to as the first "Island Conference". We add to the synthesis of the articles the conference deliberations and on-going discussions of the field and…

Interns reflect: the effect of formative assessment with feedback during pre-internship.

PubMed

McKenzie, Susan; Burgess, Annette; Mellis, Craig

2017-01-01

It is widely known that the opportunity for medical students to be observed and to receive feedback on their procedural skills performance is variable in the senior years. To address this problem, we provided our Pre-Intern (PrInt) students with "one-to-one" formative feedback on their ability to perform urethral catheterization (U/C) and hypothesized that their future practice of U/C as interns would benefit. This study sought to evaluate the performance and practice of interns in U/C 4-5 months after having received feedback on their performance of U/C as PrInt students. Between 2013 and 2014, two cohorts of interns, (total n=66) who had received recent formative feedback on their U/C performance as PrInt students at Central Clinical School, were invited to complete an anonymous survey. The survey contained nine closed unvalidated questions and one open-ended question, designed to allow interns to report on their current practice of U/C. Forty-one out of 66 interns (62%) completed the survey. Thirty-five out of 41 respondents (85%) reported that the assessment with feedback during their PrInt term was beneficial to their practice. Thirty of 41 (73%) reported being confident to perform U/C independently. Eleven out of 41 respondents (27%) reported that they had received additional training at intern orientation. Nine of the 11 interns (82%) reported that they had a small, but a significant, increase in confidence to perform U/C when compared with the 30 of the 41 respondents (73%) who had not ( p =0.03). Our results substantiate our hypothesis that further education by assessment with feedback in U/C during PrInt was of benefit to interns' performance. Additional educational reinforcement in U/C during intern orientation further improved intern confidence. Our results indicate that extra pre- and post-graduation procedural skills training, with feedback, should be universal.

Perceptions of the preparedness of medical graduates for internship responsibilities in district hospitals in Kenya: a qualitative study.

PubMed

Muthaura, Patricia N; Khamis, Tashmin; Ahmed, Mushtaq; Hussain, Syeda Ra'ana

2015-10-21

Aga Khan University is developing its undergraduate medical education curriculum for East Africa. In Kenya, a 1 year internship is mandatory for medical graduates' registration as practitioners. The majority of approved internship training sites are at district hospitals. The purposes of this study were to determine: (1) whether recent Kenyan medical graduates are prepared for their roles as interns in district hospitals upon graduation from medical school; (2) what working and training conditions and social support interns are likely to face in district hospital; and (3) what aspects of the undergraduate curriculum need to be addressed to overcome perceived deficiencies in interns' competencies. Focus group discussions and semi-structured interviews were conducted with current interns and clinical supervisors in seven district hospitals in Kenya. Perceptions of both interns and supervisors regarding interns' responsibilities and skills, working conditions at district hospitals, and improvements required in medical education were obtained. Findings included agreement across informants on deficiencies in interns' practical skills and experience of managing clinical challenges. Supervisors were generally critical regarding interns' competencies, whereas interns were more specific about their weaknesses. Supervisor expectations were higher in relation to surgical procedures than those of interns. There was agreement on the limited learning, clinical facilities and social support available at district hospitals including, according to interns, inadequate supervision. Supervisors felt they provided adequate supervision and that interns lacked the ability to initiate communication with them. Both groups indicated transition challenges from medical school to medical practice attributable to inadequate practical experience. They indicated the need for more direct patient care responsibilities and clinical experience at a district hospital during undergraduate training. Perception of medical graduates' unpreparedness seemed to stem from a failure to implement the apprenticeship model of learning in medical school and lack of prior exposure to district hospitals. These findings will inform curriculum development to meet stakeholder requirements, improve the quality of graduates, and increase satisfaction with transition to practice.

International perspectives on plagiarism and considerations for teaching international trainees.

PubMed

Heitman, Elizabeth; Litewka, Sergio

2011-01-01

In the increasingly global community of biomedical science and graduate science education, many US academic researchers work with international trainees whose views on scientific writing and plagiarism can be strikingly different from US norms. Although a growing number of countries and international professional organizations identify plagiarism as research misconduct, many international trainees come from research environments where plagiarism is ill-defined and even commonly practiced. Two research-ethics educators consider current perspectives on plagiarism around the world and contend that US research-training programs should focus on trainees' scientific writing skills and acculturation, not simply on preventing plagiarism. Copyright © 2011 Elsevier Inc. All rights reserved.

A 2015 Survey of Clinical Practice Patterns in the Management of Thyroid Nodules.

PubMed

Burch, Henry B; Burman, Kenneth D; Cooper, David S; Hennessey, James V; Vietor, Nicole O

2016-07-01

The management of thyroid nodules has changed dramatically over the past two decades. In the interim, technological advances including high-resolution ultrasound and molecular testing of thyroid nodules have been introduced. We sought to document current practices in the management thyroid nodules and assess the extent to which technological advances have been incorporated into current practice. We further sought to compare current practice to recommendations made in a recently updated American Thyroid Association (ATA) clinical practice guideline (CPG) and examine differences in thyroid nodule management among international members of U.S.-based endocrine societies. Members of The Endocrine Society, ATA, and American Association of Clinical Endocrinologists were invited to participate in a Web-based survey dealing with testing, treatment preference, and modulating factors in patients with thyroid nodules. A total of 897 respondents participated in the survey, including 661 members of The Endocrine Society, 454 American Association of Clinical Endocrinologists members, and 365 ATA members. Thyroid fine-needle aspiration (FNA) in 2015 is generally performed by endocrinologists (56.6%) and radiologists (31.9%), most frequently using ultrasound guidance (83.3%). Respondents in general have a lower threshold for FNA of thyroid nodules than that recommended in the updated ATA CPG. Management depends on the FNA result, with follicular lesion of undetermined significance/atypia of undetermined significance resulting in molecular testing (38.8% of respondents), repeat FNA cytology (31.5%), or immediate referral for thyroid surgery (24.4%). Nodules showing follicular neoplasm by FNA are referred for thyroid surgery by 61.2% of respondents (46.6 % lobectomy, 14.6 % total thyroidectomy) or molecular testing (29.0 %). Nodules found suspicious but not conclusive for malignancy (Bethesda category V), are referred for thyroid surgery (86.0%) and rarely undergo molecular testing (9.5%). During pregnancy, only 47.6% of respondents would perform FNA in the absence of nodular growth, with most respondents deferring FNA until after pregnancy. Endocrinologists are 64.2% less likely to perform FNA in an octogenarian than a younger patient with a comparable thyroid nodule. Striking international differences were identified in the routine measurement of calcitonin and in the use of molecular testing of thyroid nodules. In summary, our survey of clinical endocrinologists on the management of thyroid nodules documents current practice patterns and demonstrates both concordance and focal discordance with recently updated CPGs. Both international differences and a change in practice patterns during the past two decades are demonstrated.

[Diagnosis and venom specific immunotherapy (VIT) in allergic children in Poland--how much the current practice follows the international guidelines?].

PubMed

Cichocka-Jarosz, Ewa; Brzyski, Piotr; Lis, Grzegorz; Jedynak-Wasowicz, Urszula; Pietrzyk, Jacek Józef; Lange, Joanna; Małaczyńska, Teresa; Kraluk, Barbara; Swiebocka, Ewa; Breborowicz, Anna; Kycler, Zdzisława; Pietraszek-Mamcarz, Jolanta; Poszwiński, Adam; Gaszczyk, Grzegorz

2010-01-01

Insect venom allergy requires a high level approach adequate to allergy intensity. In case of severe IgE-mediated sting reactions, in children older than five years, venom immunotherapy is a treatment of choice. Identification of current practices applied to venom allergic children in Poland and their adherence to the international guidelines. Questionnaire survey concerning diagnostic and treatment rules was carried out in 8 centres of pediatric allergology, based on a similar audit conducted in the United Kingdom [Diwakar L. et al. Clin Exp Allergy 2008, 38: 1651]. In 5 centres both RAST and SPT tests were used as the first line of investigation. Subsequently 6 centres performed IDT. In three centres baseline serum tryptase levels were estimated. In case of sensitization to both bee and wasp venom in a child with the history of severe systemic reaction, but uncertain culprit insect, specific venom immunotherapy with both venoms was practised by 2 centres. In systemic reaction and not-detectable IgE in 6 centres child was followed-up in 6-12 months. Antihistamine premedication concerned all children in 7 centres. Six-week interval between booster doses was applied in half of centres. A target dose equal 100 mcg was used in 7 centres. Similarly all centres practiced 3-5 five year period of VIT. In Poland current practice with venom allergic children was conducted in congruence with most of the recommendations.

General practice registrars' intentions for future practice: implications for rural medical workforce planning.

PubMed

Harding, Catherine; Seal, Alexa; McGirr, Joe; Caton, Tim

2016-11-01

The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91)=3.528, P=0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88)=-4.280, P<0.001) and women ranked the ability to work part-time higher (t(94)=3.697, P<0.001). Fee-for-service payment alone, or in combination with capitation, was the preferred payment system. Only 22% of Australian medical graduates intend to own their own practice compared with 52% of international medical graduates (χ 2 (1)=8.498, P=0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice.

The epidemic of HIV/AIDS in developing countries; the current scenario in Pakistan.

PubMed

Yousaf, Muhammad Z; Zia, Sadia; Babar, Masroor E; Ashfaq, Usman A

2011-08-12

HIV (Human Immunodeficiency virus) causes (acquired immunodeficiency syndrome) AIDS, in which the immune system of body totally fails to develop any defense against the foreign invaders. Infection with HIV occurs by transfer of blood, semen, and breast milk. HIV/AIDS is a global problem and it results nearly 25 million deaths worldwide. Developing countries like Pakistan have issues regarding Public Health. Currently, epidemic of HIV/AIDS is established in Pakistan and there is a threat of an expanded HIV/AIDS outbreak in the country. The major reason is that population is engaging in high-risk practices, low awareness about HIV/AIDS, and treacherous blood transfusion practices. A supplementary threat to Pakistan is India because both sharing a border and India is facing a rapidly growing HIV/AIDS epidemic. Local NGOs, National and International organizations are warning that in near future Pakistan may experiences bad situation regarding HIV/AIDS.In the present article we focused current situation of surveillance of HIV/AIDS, its virology, genotype, diagnostics, high-risk groups, reasons of vulnerability in Pakistani population, and the role of different national and international organizations in this situation.

An international survey of cleaning and disinfection practices in the healthcare environment.

PubMed

Kenters, N; Gottlieb, T; Hopman, J; Mehtar, S; Schweizer, M L; Tartari, E; Huijskens, E G W; Voss, A

2018-06-18

Antimicrobial resistance has become an urgent global health priority. Basic hygiene practices and cleaning and disinfection of the hospital environment are key in preventing pathogen cross-transmission. To our knowledge no studies have assessed the worldwide differences in cleaning and disinfection practices in healthcare facilities. The electronic survey described here was developed in order to evaluate differences in healthcare facility cleaning practices around the world. The International Society of Antimicrobial Chemotherapy (ISAC, formerly ISC), Infection Prevention and Control work group developed a survey with 30 multiple-choice questions. The questions were designed to assess the current cleaning practices in healthcare settings around the world. A total of 110 healthcare professionals, representing 23 countries, participated in the online survey. In 96% of the facilities a written cleaning policy was present. Training of cleaning staff occurred in 70% of the facilities at the start of employment. Cleaning practices and monitoring of these practices varied. The survey enabled assessment and recognition of widely differing global practices in approaches to environmental cleaning and disinfection. Development of guideline recommendations for cleaning and disinfection could improve practices and set minimum standards worldwide. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine.

PubMed

Stucki, Gerold; Zampolini, Mauro; Juocevicius, Alvydas; Negrini, Stefano; Christodoulou, Nicolas

2017-04-01

Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.

Interns reflect: the effect of formative assessment with feedback during pre-internship

PubMed Central

McKenzie, Susan; Burgess, Annette; Mellis, Craig

2017-01-01

Background It is widely known that the opportunity for medical students to be observed and to receive feedback on their procedural skills performance is variable in the senior years. To address this problem, we provided our Pre-Intern (PrInt) students with “one-to-one” formative feedback on their ability to perform urethral catheterization (U/C) and hypothesized that their future practice of U/C as interns would benefit. This study sought to evaluate the performance and practice of interns in U/C 4–5 months after having received feedback on their performance of U/C as PrInt students. Methods Between 2013 and 2014, two cohorts of interns, (total n=66) who had received recent formative feedback on their U/C performance as PrInt students at Central Clinical School, were invited to complete an anonymous survey. The survey contained nine closed unvalidated questions and one open-ended question, designed to allow interns to report on their current practice of U/C. Results Forty-one out of 66 interns (62%) completed the survey. Thirty-five out of 41 respondents (85%) reported that the assessment with feedback during their PrInt term was beneficial to their practice. Thirty of 41 (73%) reported being confident to perform U/C independently. Eleven out of 41 respondents (27%) reported that they had received additional training at intern orientation. Nine of the 11 interns (82%) reported that they had a small, but a significant, increase in confidence to perform U/C when compared with the 30 of the 41 respondents (73%) who had not (p=0.03). Conclusion Our results substantiate our hypothesis that further education by assessment with feedback in U/C during PrInt was of benefit to interns’ performance. Additional educational reinforcement in U/C during intern orientation further improved intern confidence. Our results indicate that extra pre- and post-graduation procedural skills training, with feedback, should be universal. PMID:28138270

Critical evaluation of international health programs: Reframing global health and evaluation.

PubMed

Chi, Chunhuei; Tuepker, Anaïs; Schoon, Rebecca; Núñez Mondaca, Alicia

2018-04-01

Striking changes in the funding and implementation of international health programs in recent decades have stimulated debate about the role of communities in deciding which health programs to implement. An important yet neglected piece of that discussion is the need to change norms in program evaluation so that analysis of community ownership, beyond various degrees of "participation," is seen as central to strong evaluation practices. This article challenges mainstream evaluation practices and proposes a framework of Critical Evaluation with 3 levels: upstream evaluation assessing the "who" and "how" of programming decisions; midstream evaluation focusing on the "who" and "how" of selecting program objectives; and downstream evaluation, the focus of current mainstream evaluation, which assesses whether the program achieved its stated objectives. A vital tenet of our framework is that a community possesses the right to determine the path of its health development. A prerequisite of success, regardless of technical outcomes, is that programs must address communities' high priority concerns. Current participatory methods still seldom practice community ownership of program selection because they are vulnerable to funding agencies' predetermined priorities. In addition to critiquing evaluation practices and proposing an alternative framework, we acknowledge likely challenges and propose directions for future research. Copyright © 2018 John Wiley & Sons, Ltd.

Theory versus practice in Strategic Environmental Assessment (SEA)

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

Lobos, Víctor, E-mail: vlobosg@gmail.com; Centro de Estudios del Desarrollo, San Crescente 551, Las Condes, Santiago; Partidario, Maria

Could the theory of Strategic Environmental Assessment (SEA) be ahead of its time and decoupled from its practice? This paper evolved in search for this leading research question. Over the years the discourse on SEA experienced a gradual shift from the technocratic and rationalist thinking that supported its origin to more strategic approaches and integrated concepts, suggested since the mid 1990's. In this paper we share the results of our analysis of international thinking and practical experience with SEA. Results reveal that SEA practice changes very slowly when compared to advanced thinking supporting the noted shift. Current SEA practice showsmore » to be still predominantly rooted in the logic of projects' environmental impact assessment (EIA). It is strongly bound to legal and regulatory requirements, and the motivation for its application persists being the delivery of environmental (or final) reports to meet legal obligations. Even though advanced SEA theoretical thinking claim its potential to help decisions to look forward, change mind-sets and the rationale of decision-making to meet sustainability challenges and enhance societal values, we note a weak relationship between the theoretical development of SEA and its practice. Why is this happening? Which factors explain this apparent inertia, resistance to change, in the SEA practice? Results appear to demonstrate the influence of assumptions, understandings, concepts, and beliefs in the use of SEA, which in turn suggest the political sensitivity of the instrument. - Highlights: • Theoretical thinking in SEA is ahead of its time. • SEA international practice reveals inertia to move out of project’ EIA comfort zone. • World current SEA practice show similar understandings of 30 years ago. • 100 world reports and survey of practitioners supported world review. • SEA great challenge is to change paradigms into new scientific complexity theories.« less

Observations on the NHS internal market: will the dodo get the last laugh?

PubMed Central

Royce, R. G.

1995-01-01

Distinguishing between the theory and practice of the internal market has been obscured by the considerable controversy generated by the reforms themselves. In such an environment both the advocates and the opponents of a market based solution have tended to promote their respective claims by reference to underlying political philosophies and economic theories rather than practical experience. Royce gives his observations of the actual operation of the internal market with particular reference to the commissioning function in Wales. He highlights inadequacies and inequities in the current system and proposes some remedial actions. Central to these are the importance of ensuring equitable funding for all purchasers, acknowledging the necessity of rationing, and promoting efficient and effective health care, sometimes at the expense of patient choice and guaranteed local service provision. Images p432-a PMID:7640593

Alternate approaches to future electron-positron linear colliders

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

Loew, G.A.

1998-07-01

The purpose of this article is two-fold: to review the current international status of various design approaches to the next generation of e{sup +}e{sup {minus}} linear colliders, and on the occasion of his 80th birthday, to celebrate Richard B. Neal`s many contributions to the field of linear accelerators. As it turns out, combining these two tasks is a rather natural enterprise because of Neal`s long professional involvement and insight into many of the problems and options which the international e{sup +}e{sup {minus}} linear collider community is currently studying to achieve a practical design for a future machine.

Practising Cultures of Learning in Internationalising Universities

ERIC Educational Resources Information Center

Jin, Lixian; Cortazzi, Martin

2017-01-01

Internationalising higher education (HE) shows tensions between recruiting international students as a means of securing income and meeting their particular educational needs towards practices of caring for their social, psychological, intercultural and educational well-being. This paper briefly outlines the extent of current HE…

Supporting Beginning Teacher Planning and Enactment of Investigation-based Science Discussions: The Design and Use of Tools within Practice-based Teacher Education

NASA Astrophysics Data System (ADS)

Kademian, Sylvie M.

Current reform efforts prioritize science instruction that provides opportunities for students to engage in productive talk about scientific phenomena. Given the challenges teachers face enacting instruction that integrates science practices and science content, beginning teachers need support to develop the knowledge and teaching practices required to teach reform-oriented science lessons. Practice-based teacher education shows potential for supporting beginning teachers while they are learning to teach in this way. However, little is known about how beginning elementary teachers draw upon the types of support and tools associated with practice-based teacher education to learn to successfully enact this type of instruction. This dissertation addresses this gap by investigating how a practice-based science methods course using a suite of teacher educator-provided tools can support beginning teachers' planning and enactment of investigation-based science lessons. Using qualitative case study methodologies, this study drew on video-records, lesson plans, class assignments, and surveys from one cohort of 22 pre-service teachers (called interns in this study) enrolled in a year-long elementary education master of the arts and teaching certification program. Six focal interns were also interviewed at multiple time-points during the methods course. Similarities existed across the types of tools and teaching practices interns used most frequently to plan and enact investigation-based discussions. For the focal interns, use of four synergistic teaching practices throughout the lesson enactments (including consideration of students' initial ideas; use of open-ended questions to elicit, extend, and challenge ideas; connecting across students' ideas and the disciplinary core ideas; and use of a representation to organize and highlight students' ideas) appeared to lead to increased opportunities for students to share their ideas and engage in data analysis, argumentation and explanation construction. Student opportunities to engage in practices that prioritize scientific discourse also occurred when interns were using dialogic voice and the tools designed to foster development of teacher knowledge for facilitating investigation-based science discussions. However, several intern characteristics likely moderated or mediated intern use of tools, dialogic voice, and productive teaching practices to capitalize on student contributions. These characteristics included intern knowledge of the science content and practices and initial beliefs about science teaching. Missed opportunities to use a combination of several teaching practices and tools designed to foster the development of knowledge for science teaching resulted in fewer opportunities for students to engage in data analysis, argumentation based on evidence, and construction of scientific explanations. These findings highlight the potential of teacher-educator provided tools for supporting beginning teachers in learning to facilitate investigation-based discussions that capitalize on student contributions. These findings also help the field conceptualize how beginning teachers use tools and teaching practices to plan and enact investigation-based science lessons, and how intern characteristics relate to tool use and planned and enacted lessons. By analyzing the investigation-based science lessons holistically, this study begins to unpack the complexities of facilitating investigation-based discussions including the interplay between intern characteristics and tool use, and the ways intern engagement in synergistic teaching practices provide opportunities for students to engage in data analysis, explanation construction, and argumentation. This study also describes methodological implications for this type of whole-lesson analysis and comments on the need for further research investigating beginning teachers' use of tools over time. Finally, I propose the need for iterative design of scaffolds to further support beginning teacher facilitation of investigation-based science lessons.

Product-based Safety Certification for Medical Devices Embedded Software.

PubMed

Neto, José Augusto; Figueiredo Damásio, Jemerson; Monthaler, Paul; Morais, Misael

2015-01-01

Worldwide medical device embedded software certification practices are currently focused on manufacturing best practices. In Brazil, the national regulatory agency does not hold a local certification process for software-intensive medical devices and admits international certification (e.g. FDA and CE) from local and international industry to operate in the Brazilian health care market. We present here a product-based certification process as a candidate process to support the Brazilian regulatory agency ANVISA in medical device software regulation. Center of Strategic Technology for Healthcare (NUTES) medical device embedded software certification is based on a solid safety quality model and has been tested with reasonable success against the Class I risk device Generic Infusion Pump (GIP).

International surgery: definition, principles and Canadian practice.

PubMed

Lett, Ronald

2003-10-01

This article is dedicated to the Canadian international surgeon, Norman Bethune (1890-1939). International surgery is defined as a humanitarian branch of medicine concerned with the treatment of bodily injuries or disorders by incision or manipulations, emphasizing cooperation and understanding among nations and involving education, research, development and advocacy. In this article I review the colonial past, the dark ages following the Declaration of Alma-Ata, the progress made and the present challenges in international surgery. I present a definition of international surgery that recognizes the current era of surgical humanitarianism, validates a global understanding of surgical issues and promotes cooperation among nations. Included are the principles of international surgery: education, research, infrastructure development and advocacy. International surgical projects are classified according to type (clinical, relief, developmental) and integration strategy (vertical or horizontal). Also reviewed are the Canadian practice of international surgery by nongovernmental, professional and academic organizations and the requirements of international and Canadian funding agencies, the development concepts basic to all projects, including results-based management and the cross-cutting themes of gender equity, environmental protection and human safety. I recommend formalizing international surgery into a discipline as a means of promoting surgical care in low-income countries. If international surgery is to be sustained in Canada, infrastructure and support from Canadian surgeons is particularly important. An understanding of the history, definition and classification of international surgery should promote surgical care in low-income countries.

International surgery: definition, principles and Canadian practice

PubMed Central

Lett, Ronald

2003-01-01

This article is dedicated to the Canadian international surgeon, Norman Bethune (1890–1939). International surgery is defined as a humanitarian branch of medicine concerned with the treatment of bodily injuries or disorders by incision or manipulations, emphasizing cooperation and understanding among nations and involving education, research, development and advocacy. In this article I review the colonial past, the dark ages following the Declaration of Alma-Ata, the progress made and the present challenges in international surgery. I present a definition of international surgery that recognizes the current era of surgical humanitarianism, validates a global understanding of surgical issues and promotes cooperation among nations. Included are the principles of international surgery: education, research, infrastructure development and advocacy. International surgical projects are classified according to type (clinical, relief, developmental) and integration strategy (vertical or horizontal). Also reviewed are the Canadian practice of international surgery by nongovernmental, professional and academic organizations and the requirements of international and Canadian funding agencies, the development concepts basic to all projects, including results-based management and the cross-cutting themes of gender equity, environmental protection and human safety. I recommend formalizing international surgery into a discipline as a means of promoting surgical care in low-income countries. If international surgery is to be sustained in Canada, infrastructure and support from Canadian surgeons is particularly important. An understanding of the history, definition and classification of international surgery should promote surgical care in low-income countries. PMID:14577711

The Potential Value of the U.N. Convention on the Rights of the Child in Pediatric Bioethics Settings.

PubMed

Silva, Michael Da; Lew, Cheryl D; Lundy, Laura; Lang, Kellie R; Melamed, Irene; Shaul, Randi Zlotnik

2016-01-01

This article provides support for the use of a particular international human rights law document, the U.N. Convention on the Rights of the Child (CRC), in contemporary pediatric bioethics practice without relying on the legally binding force of the document. It first demonstrates that the CRC's core commitments and values substantially overlap with the core commitments and values of mainstream bioethics and with the laws of many domestic jurisdictions where mainstream bioethics are currently practiced. It then explores some implications of this overlap. For instance, the substantial international human rights law scholarship on how to understand these commitments and values can be helpful in suggesting ways to operationalize them in domestic bioethics practice and can offer insightful, internationally generated ethical perspectives that may not have been considered. The article also argues that the CRC can help health-care organizations develop policies consistent with the best interests of children and that the CRC can serve as a common language of values for transnational health-care collaborations. However, as a final case discussion demonstrates, whatever the merits of the CRC, one may face practical difficulties in trying to use it.

[International bibliographic databases--Current Contents on disk and in FTP format (Internet): presentation and guide].

PubMed

Bloch-Mouillet, E

1999-01-01

This paper aims to provide technical and practical advice about finding references using Current Contents on disk (Macintosh or PC) or via the Internet (FTP). Seven editions are published each week. They are all organized in the same way and have the same search engine. The Life Sciences edition, extensively used in medical research, is presented here in detail, as an example. This methodological note explains, in French, how to use this reference database. It is designed to be a practical guide for browsing and searching the database, and particularly for creating search profiles adapted to the needs of researchers.

International Polar Research and Space Weather

NASA Astrophysics Data System (ADS)

Lanzerotti, Louis J.

2009-02-01

The fiftieth anniversary of the International Geophysical Year (IGY), currently celebrated in the 2007-2009 International Polar Year (IPY), highlights space weather's heritage from polar research. The polar regions were still very much "terra incognito" 50 years ago. At the same time, communications technologies had significantly advanced since the time of the second IPY, in 1932-1933. Yet even before the second IPY, several directors of international meteorological services stated in a 1928 resolution that "increased knowledge [of the polar regions] will be of practical application to problems connected with terrestrial magnetism, marine and aerial navigation, wireless telegraphy and weather forecasting" (see http://scaa.usask.ca/gallery/northern/currie/en_polaryear.shtml).

The lamaze certified childbirth educator: standards of practice.

PubMed

Lothian, Judith A

2007-01-01

A student in a Lamaze Childbirth Educator Program expresses concern that some Lamaze Certified Childbirth Educators (LCCE educators) do not teach classes that reflect Lamaze standards. In this column, the ethical and professional standards of the LCCE educator and the challenges the childbirth educator experiences while practicing in the current maternity-care environment are presented and discussed. Lamaze International's Code of Ethics for Lamaze Certified Childbirth Educators provides guidance when dealing with these challenges.

Recommendations From the International Consortium on Professional Nursing Practice in Long-Term Care Homes.

PubMed

McGilton, Katherine S; Bowers, Barbara J; Heath, Hazel; Shannon, Kay; Dellefield, Mary Ellen; Prentice, Dawn; Siegel, Elena O; Meyer, Julienne; Chu, Charlene H; Ploeg, Jenny; Boscart, Veronique M; Corazzini, Kirsten N; Anderson, Ruth A; Mueller, Christine A

2016-02-01

In response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the Consortium) was formed to develop nursing leadership capacity and address the concerns regarding the current state of professional nursing practice in LTCHs. At its invitational, 2-day inaugural meeting, the Consortium brought together international nurse experts to explore the potential of registered nurses (RNs) who work as supervisors or charge nurses within the LTCHs and the value of their contribution in nursing homes, consider what RN competencies might be needed, discuss effective educational (curriculum and practice) experiences, health care policy, and human resources planning requirements, and to identify what sustainable nurse leadership strategies and models might enhance the effectiveness of RNs in improving resident, family, and staff outcomes. The Consortium made recommendations about the following priority issues for action: (1) define the competencies of RNs required to care for older adults in LTCHs; (2) create an LTCH environment in which the RN role is differentiated from other team members and RNs can practice to their full scope; and (3) prepare RN leaders to operate effectively in person-centered care LTCH environments. In addition to clear recommendations for practice, the Consortium identified several areas in which further research is needed. The Consortium advocated for a research agenda that emphasizes an international coordination of research efforts to explore similar issues, the pursuit of examining the impact of nursing and organizational models, and the showcasing of excellence in nursing practice in care homes, so that others might learn from what works. Several studies already under way are also described. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

A "good practice" approach to the quality and consistency of morphological examination of the internal head structures of the term rabbit fetus.

PubMed

French, Julian M

2014-07-01

Variation in the interpretation of the regulatory guidelines has resulted in a diversity of techniques employed to examine the internal structures of the foetal rabbit head. Examination of the foetal rabbit brain, using a single transverse section as the sole technique, is considered not to be sufficiently thorough to be regarded as an adequate examination method. It is not compliant with published EPA and OECD guidelines covering required examination of the internal head structures, nor is it considered to conform to the spirit of the safety assessment required by the ICH guideline. Fixation of approximately half of the heads in each litter to allow the examination of multiple transverse sections enables the major structures within the head to be assessed effectively. This method is compliant with current guidelines, represents "good practice" and should be consistently adopted for the examination of the internal head structures of the term rabbit foetus. Copyright © 2014 Elsevier Inc. All rights reserved.

Board on Research Data and Information

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

Sztein, A. Ester; Boright, John

2015-08-14

The Board on Research Data and Information (BRDI) has planned and undertaken numerous activities regarding data citation, attribution, management, policy, publishing, centers, access, curation, sharing, and infrastructure; and international collaboration and cooperation. Some of these activities resulted in National Research Council reports (For Attribution: Developing Data Attribution and Citation Practices and Standards (2012), The Case for International Scientific Data Sharing: A Focus on Developing Countries (2012), and The Future of Scientific Knowledge Discovery in Open Networked Environments (2012); and a peer-reviewed paper (Out of Cite, Out of Mind: The Current State of Practice, Policy, and Technology for the Citation ofmore » Data, 2013). BRDI held symposia, workshops and sessions in the U.S. and abroad on diverse topics such as global scientific data infrastructures, discovery of data online, privacy in a big data world, and data citation principles, among other timely data-related subjects. In addition, BRDI effects the representation of the United States before the International Council for Science’s International Committee on Data for Science and Technology (CODATA).« less

Development of an international comorbidity education framework.

PubMed

Lawson, C; Pati, S; Green, J; Messina, G; Strömberg, A; Nante, N; Golinelli, D; Verzuri, A; White, S; Jaarsma, T; Walsh, P; Lonsdale, P; Kadam, U T

2017-08-01

The increasing number of people living with multiple chronic conditions in addition to an index condition has become an international healthcare priority. Health education curricula have been developed alongside single condition frameworks in health service policy and practice and need redesigning to incorporate optimal management of multiple conditions. Our aims were to evaluate current teaching and learning about comorbidity care amongst the global population of healthcare students from different disciplines and to develop an International Comorbidity Education Framework (ICEF) for incorporating comorbidity concepts into health education. We surveyed nursing, medical and pharmacy students from England, India, Italy and Sweden to evaluate their understanding of comorbidity care. A list of core comorbidity content was constructed by an international group of higher education academics and clinicians from the same disciplines, by searching current curricula and analysing clinical frameworks and the student survey data. This list was used to develop the International Comorbidity Education Framework. The survey sample consisted of 917 students from England (42%), India (48%), Italy (8%) and Sweden (2%). The majority of students across all disciplines said that they lacked knowledge, training and confidence in comorbidity care and were unable to identify specific teaching on comorbidities. All student groups wanted further comorbidity training. The health education institution representatives found no specific references to comorbidity in current health education curricula. Current clinical frameworks were used to develop an agreed list of core comorbidity content and hence an International Comorbidity Education Framework. Based on consultation with academics and clinicians and on student feedback we developed an International Comorbidity Education Framework to promote the integration of comorbidity concepts into current healthcare curricula. Copyright © 2017 Elsevier Ltd. All rights reserved.

Current knowledge related to intelligence and thinking with implications for the development and use of case studies.

PubMed

Lunney, Margaret

2008-01-01

This paper reviews current knowledge regarding intelligence and thinking, and relates this knowledge to learning to diagnose human responses and to select health outcomes and nursing interventions. Knowledge from relevant literature sources was summarized. The provision of high-quality nursing care requires use of critical thinking with three elements of nursing care: nursing diagnosis, health outcomes, and nursing interventions. Metacognition (thinking about thinking) should be used with knowledge of the subject matter and repeated practice in using the knowledge. Because there are limited clinical opportunities to practice using metacognition and knowledge of these nursing care elements, case studies can be used to foster nurses' expertise. Simulations of clinical cases are needed that illustrate application of the nursing knowledge represented in NANDA International, Nursing Outcomes Classification, and Nursing Interventions Classification. The International Journal of Nursing Terminologies and Classifications will promote the dispersion of case studies as a means of facilitating the implementation and use of nursing languages and classifications.

The Status and Outlook of Distributed Generation Public Policy in Mexico

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

Zinaman, Owen; Aznar, Alexandra Y.; Flores-Espino, Francisco

Mexico is a regional leader in setting goals for reducing greenhouse gas emissions (GHG) and distributed generation (DG) development is a key priority for the country's policymakers. Current DG policies have fostered growth but need to be modernized to serve current needs and accommodate higher penetration levels. In this report, NREL summarizes international DG policy experiences and best practices and identifies the potential opportunities for policy reform.

The sustainable management and protection of forests: analysis of the current position globally.

PubMed

Freer-Smith, Peter; Carnus, Jean-Michel

2008-06-01

The loss of forest area globally due to change of land use, the importance of forests in the conservation of biodiversity and in carbon and other biogeochemical cycles, together with the threat to forests from pollution and from the impacts of climate change, place forestry policy and practice at the center of global environmental and sustainability strategy. Forests provide important economic, environmental, social, and cultural benefits, so that in forestry, as in other areas of environmental policy and management, there are tensions between economic development and environmental protection. In this article we review the current information on global forest cover and condition, examine the international processes that relate to forest protection and to sustainable forest management, and look at the main forest certification schemes. We consider the link between the international processes and certification schemes and also their combined effectiveness. We conclude that in some regions of the world neither mechanism is achieving forest protection, while in others local or regional implementation is occurring and is having a significant impact. Choice of certification scheme and implementation of management standards are often influenced by a consideration of the associated costs, and there are some major issues over the monitoring of agreed actions and of the criteria and indicators of sustainability. There are currently a number of initiatives seeking to improve the operation of the international forestry framework (e.g., The Montreal Process, the Ministerial Convention of the Protection of Forests in Europe and European Union actions in Europe, the African Timber Organisation and International Tropical Timber Organisation initiative for African tropical forest, and the development of a worldwide voluntary agreement on forestry in the United Nations Forum on Forests). We suggest that there is a need to improve the connections between scientific understanding, policy development, and forestry practice, and also the cooperation between the various international initiatives and processes, so that the international framework is more effective and its influence is extended geographically.

Global perspectives on ensuring the safety of pharmaceutical products in the distribution process
.

PubMed

Jeong, Sohyun; Ji, Eunhee

2018-01-01

The distribution of counterfeit or falsified drugs is increasing worldwide. This can contribute to the high burden of disease and cost to society and is of global concern with the worldwide circulation of pharmaceuticals. The preparation and implementation of good distribution practice should be one of the most important aspects of ensuring safe drug circulation and administration. This research aimed to compare and analyze good distribution practice guidelines from advanced countries and international organizations, and to evaluate the status of the current good distribution practice guidelines in the world. Advanced pharmaceutical countries and international organizations, such as the World Health Organization, European Union, Pharmaceutical Inspection Co-operation Scheme, United States of America, Canada, and Australia, which have stable good distribution practice guidelines and public confidence, were included in the analysis. The World Health Organization and European Union guidelines are models for standardized good distribution practice for nations worldwide. The United States of America has a combination of four different series of distribution practices which have a unique structure and detailed content compared to those of other countries. The Canadian guidelines focus on temperature control during storage and transportation. The Australian guidelines apply to both classes of medicinal products and medical devices and need separate standardization. Transparent information about the Internet chain, international cooperation regarding counterfeiting, a high-standard qualification of sellers and customers, and technology to track and trace the whole life cycle of drugs should be the main focus of future good distribution practice guidelines worldwide.
.

Factors Associated With Full Implementation of Scope of Practice.

PubMed

Ganz, Freda DeKeyser; Toren, Orly; Fadlon, Yafit

2016-05-01

To describe whether nurses fully implement their scope of practice; nurses' perceptions of future practice implementation; and the association between scope of practice implementation with professional autonomy and self-efficacy. A descriptive correlational study was conducted using a convenience sample of 145 registered nurses with post-basic certification from two Israeli university hospitals, from May 2012 to September 2013. Five questionnaires were distributed: (a) Demographic and Work Characteristics, (b) Implementation of Scope of Practice, (c) Attitudes Towards Future Practice, (d) Practice Behavior Scale, and (e) Practice Self-Efficacy. Descriptive statistics for all demographic and questionnaire data were analyzed. Two regression models were developed, where current and future implementations were the criterion variables and demographic and work characteristics, professional autonomy, and self-efficacy were the predictors. High levels of professional autonomy, self-efficacy, and attitudes towards future practice were found in contrast to low or moderate levels of current implementation of the full extent of scope of practice. Primary reasons associated with low implementation were lack of relevance to practice and permission to perform the practice. Significant associations were found between professional autonomy, self-efficacy, and attitudes towards future practice, but not with current implementation. Nurses wanted to practice to the full extent of their scope of practice and felt able to do so but were hindered by administrative and not personal barriers. Even though staff nurses with post-basic certification had high levels of professional autonomy and self-efficacy, many were not implementing the full extent of their scope of practice. Similar to findings from around the world, external factors, such as administrative and policy barriers, were found to thwart the full implementation of nurses' full scope of practice. Therefore, practicing nurses should be aware of these barriers and work towards reducing them. © 2016 Sigma Theta Tau International.

After a Cesarean…What's a Birth Professional to Do?

PubMed Central

Andrews, Desirre; Humphries, Gretchen

2010-01-01

The discrepancy between the evidence supporting vaginal birth after cesarean and actual medical practice illuminates the larger issues of evidence-based care versus current obstetrical practice. Although the reasons for the disconnect between what we know to be healthy birth practices and what women actually experience are multiple and complex, a commitment to providing accurate education, truly client-centered support, and active patient advocacy will give women the ability to insist on best practice care for themselves and their babies. The International Cesarean Awareness Network believes that all childbirth professionals and advocates share a responsibility to promote change and must work together to be effective. PMID:21358830

The influence of globalization on medical regulation: a descriptive analysis of international medical graduates registered through alternative licensure routes in Ontario.

PubMed

Yen, Wendy; Hodwitz, Kathryn; Thakkar, Niels; Martimianakis, Maria Athina Tina; Faulkner, Dan

2016-12-01

The increasing globalization of the medical profession has influenced health policy, health human resource planning, and medical regulation in Canada. Since the early 2000s, numerous policy initiatives have been created to facilitate the entry of international medical graduates (IMGs) into the Canadian workforce. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) developed alternative licensure routes to increase the ability of qualified IMGs to obtain licenses to practice. The current study provides demographic and descriptive information about the IMGs registered through the CPSO's alternative licensure routes between 2000 and 2012. An analysis of the characteristics and career trajectories of all IMGs practicing in the province sheds light on broader globalization trends and raises questions about the future of health human resource planning in Canada. As the medical profession becomes increasingly globalized, health policy and regulation will continue to be influenced by trends in international migration, concerns about global health equity, and the shifting demographics of the Canadian physician workforce. Implications for future policy development in the complex landscape of medical education and practice are discussed.

Re-defining nursing expertise in the United kingdom.

PubMed

Hardy, Sally; Titchen, Angie; Manley, Kim; McCormack, Brendan

2006-07-01

There is now international recognition of the importance of practice expertise in modern and effective health services. The Expertise in Practice Project in the United Kingdom began in May 1998 and continued to 2004. It included nurses working in all four countries of the United Kingdom, and it covered clinical specialists from pediatrics to palliative care. The project added to the current understanding of what nursing practice expertise is, through the identification and verification of attributes and factors which enable expert practice. The proposed framework offers a language for sharing what constitutes practice expertise and offers insight into what occurs between the expert practitioner and the people that experience their care. The Expertise in Practice Project demonstrates that nurses affect change and facilitate performance and organizational development.

The Civil Aviation Sector in Lebanon. Part 1; Institutional Reforms

NASA Technical Reports Server (NTRS)

Baaj, M. Hadi

2002-01-01

Civil aviation is one of the key contributors to a successful economic system. This has been recognized within Lebanon, which is undertaking developing a new civil aviation strategy encompassing a program of organizational reform, coordinated internationally, to meet the challenges of the new century. Such strategy is vital, as it will provide a coherent vision for the sector, compliment the extensive investments deployed by Lebanon in its aviation infrastructure, and guide future planning and investments. The proposed Civil Aviation Strategy for Lebanon has two major components: (1) institutional reform aiming at creating effective overall legal and regulatory frameworks in-line with current international best practice; and (2) implementation of liberalization measures and open skies policy. This paper aims to: (1) present Lebanon's current institutional arrangements; (2) review the institutional arrangements in key select countries (in order to define current trends in best institutional practice); (3) discuss the proposed institutional reform (which are at the basis of Lebanon's Draft Civil Aviation Reform Law) while showing that they conform with the identified best institutional trends; and (4) outline an implementation plan. The Draft Law has been approved by the Council of Ministers and now awaits Parliamentary endorsement.

77 FR 26768 - Food and Drug Administration/International Society for Pharmaceutical Engineering Cosponsorship...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... year, FDA speakers provide updates on current efforts affecting the development of global regulatory strategies, while industry professionals from some of today's leading pharmaceutical companies present case... hear directly from FDA experts and representatives of global regulatory authorities on best practices...

Innovative Research Strategies for Business Education

ERIC Educational Resources Information Center

O'Connor, Bridget N.

2007-01-01

An internal, ongoing debate that all professional areas of study have is how to understand the impact of shifting economies, demographics, technologies, and globalization. Much business education research focuses on describing current practices. To this end, issues are often addressed by using surveys that are analyzed using descriptive analysis…

Reframing Accountability Policy Research with Postpositivism, Pluralism, Democracy and Subsidiarity.

ERIC Educational Resources Information Center

Macpherson, R. J. S.

A 1994 review of international policy research on accountability in education indicates that there is widespread concern over policy content, processes, and consequences. Current purposes tend to be polarized by a simplistic dualism--hyperindividualism versus communitarianism. Policies and practices often exhibit neocentralist assumptions. This…

Publication Opportunities for Early Childhood Academics.

ERIC Educational Resources Information Center

Sumsion, Jennifer

Recognizing the increasing pressure for publication for early childhood academics and the lack of current information about journals' publication practices, this study surveyed editors of Australian and international journals. The journals were selected through a survey of 43 academic staff of an institute of early childhood education and through…

Venezuelan Counseling: Advancement and Current Challenges

ERIC Educational Resources Information Center

Vera, George Davy

2011-01-01

In the worldwide community it is not well known that counseling and guidance professional practices have a long tradition in Venezuela. Therefore, this contribution's main purpose is to inform the international audience about past and contemporary counseling in Venezuela. Geographic, demographic, and cultural facts about Venezuela are provided.…

Educational Resource Management: An International Perspective

ERIC Educational Resources Information Center

Glover, Derek; Levacic, Rosalind

2007-01-01

This book offers practical guidance on management of financial and real resources in schools and college, and critically evaluates current tensions involved in the area of educational resource management. It is essential reading for educational leaders who wish to improve the effectiveness, efficiency and equity of their resource utilisation…

Temperature metrology

NASA Astrophysics Data System (ADS)

Fischer, J.; Fellmuth, B.

2005-05-01

The majority of the processes used by the manufacturing industry depend upon the accurate measurement and control of temperature. Thermal metrology is also a key factor affecting the efficiency and environmental impact of many high-energy industrial processes, the development of innovative products and the health and safety of the general population. Applications range from the processing, storage and shipment of perishable foodstuffs and biological materials to the development of more efficient and less environmentally polluting combustion processes for steel-making. Accurate measurement and control of temperature is, for instance, also important in areas such as the characterization of new materials used in the automotive, aerospace and semiconductor industries. This paper reviews the current status of temperature metrology. It starts with the determination of thermodynamic temperatures required on principle because temperature is an intensive quantity. Methods to determine thermodynamic temperatures are reviewed in detail to introduce the underlying physical basis. As these methods cannot usually be applied for practical measurements the need for a practical temperature scale for day-to-day work is motivated. The International Temperature Scale of 1990 and the Provisional Low Temperature Scale PLTS-2000 are described as important parts of the International System of Units to support science and technology. Its main importance becomes obvious in connection with industrial development and international markets. Every country is strongly interested in unique measures, in order to guarantee quality, reproducibility and functionability of products. The eventual realization of an international system, however, is only possible within the well-functioning organization of metrological laboratories. In developed countries the government established scientific institutes have certain metrological duties, as, for instance, the maintenance and dissemination of national units. For the base unit kelvin, this procedure is described in the sections on practical temperature scales, practical thermometry and reference standards. Testing experimentally the fundamental laws of physics means in practice the precise determination of the fundamental constants appearing in the laws. The essence of current activities is that prototypes, which may vary uncontrollably with time and location, are replaced by abstract experimental prescriptions that relate the units to the constants. This approach is shown for the definition of the kelvin and the Boltzmann constant. Dedicated to the occasion of the 60th birthday of Wolfgang Buck.

Applications of three-dimensional printing technology in urological practice.

PubMed

Youssef, Ramy F; Spradling, Kyle; Yoon, Renai; Dolan, Benjamin; Chamberlin, Joshua; Okhunov, Zhamshid; Clayman, Ralph; Landman, Jaime

2015-11-01

A rapid expansion in the medical applications of three-dimensional (3D)-printing technology has been seen in recent years. This technology is capable of manufacturing low-cost and customisable surgical devices, 3D models for use in preoperative planning and surgical education, and fabricated biomaterials. While several studies have suggested 3D printers may be a useful and cost-effective tool in urological practice, few studies are available that clearly demonstrate the clinical benefit of 3D-printed materials. Nevertheless, 3D-printing technology continues to advance rapidly and promises to play an increasingly larger role in the field of urology. Herein, we review the current urological applications of 3D printing and discuss the potential impact of 3D-printing technology on the future of urological practice. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

WHO Expert Committee on Specifications for Pharmaceutical Preparations.

PubMed

2009-01-01

The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new standards and guidelines were adopted and recommended for use: the current list of available International Chemical Reference Substances and International Infrared Reference Spectra; guidelines on stability testing of active pharmaceutical ingredients and finished pharmaceutical products; procedure for prequalification of pharmaceutical products; and the procedure for assessing the acceptability, in principle, of active pharmaceutical ingredients for use in pharmaceutical products.

National continuous surveys on internal quality control for HbA1c in 306 clinical laboratories of China from 2012 to 2016: Continual improvement.

PubMed

Li, Tingting; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2017-09-01

This study aimed to evaluate whether the quality performance of clinical laboratories in China has been greatly improved and whether Internal Quality Control (IQC) practice of HbA1c has also been changed since National Center for Clinical Laboratories (NCCL) of China organized laboratories to report IQC data for HbA1c in 2012. Internal Quality Control information of 306 External Quality Assessment (EQA) participant laboratories which kept reporting IQC data in February from 2012 to 2016 were collected by Web-based EQA system. Then percentages of laboratories meeting four different imprecision specifications for current coefficient of variations (CVs) of HbA1c measurements were calculated. Finally, we comprehensively analyzed analytical systems and IQC practice of HbA1c measurements. The current CVs of HbA1c tests have decreased significantly from 2012 to 2016. And percentages of laboratories meeting four imprecision specifications for CVs all showed the increasing tendency year by year. As for analytical system, 52.1% (159/306) laboratories changed their systems with the change in principle of assay. And many laboratories began to use cation exchange high-performance liquid chromatography (CE-HPLC) instead of Immunoturbidimetry, because CE-HPLC owed a lower intra-laboratory CVs. The data of IQC practice, such as IQC rules and frequency, also showed significant variability among years with overall tendency of meeting requirements. The imprecision performance of HbA1c tests has been improved in these 5 years with the change in IQC practice, but it is still disappointing in China. Therefore, laboratories should actively find existing problems and take action to promote performance of HbA1c measurements. © 2016 Wiley Periodicals, Inc.

Integrated fundamental research on current collection

NASA Astrophysics Data System (ADS)

Kuhlmann-Wilsdorf, Doris

1992-10-01

The aim of our research has been to add to basic understanding in the area of current collection with particular emphasis on topics likely to benefit practical objectives. Under sponsorship of this contract twenty three papers were published in the international literature as listed in the last section. Additionally, thirteen invited lectures and eleven contributed lectures on various aspects of this research were delivered at Universities, Research Laboratories and International Conferences by the Principal Investigator and co-workers. Last not least, development of a novel metal fiber material for sliding electrical contacts has been continued with much success. This is expected to become very useful for making metal fiber brushes for homopolar motors/generators as well as for EML armatures.

The Lamaze Certified Childbirth Educator: Standards of Practice

PubMed Central

Lothian, Judith A.

2007-01-01

A student in a Lamaze Childbirth Educator Program expresses concern that some Lamaze Certified Childbirth Educators (LCCE educators) do not teach classes that reflect Lamaze standards. In this column, the ethical and professional standards of the LCCE educator and the challenges the childbirth educator experiences while practicing in the current maternity-care environment are presented and discussed. Lamaze International's Code of Ethics for Lamaze Certified Childbirth Educators provides guidance when dealing with these challenges. PMID:18408808

A case study of the introduction of the International Classification for Nursing Practice(®) in Poland.

PubMed

Kilańska, D; Gaworska-Krzemińska, A; Grabowska, H; Gorzkowicz, B

2016-09-01

The development of a nursing practice, improvements in nurses' autonomy, and increased professional and personal responsibility for the medical services provided all require professional documentation with records of health status assessments, decisions undertaken, actions and their outcomes for each patient. The International Classification for Nursing Practice is a tool that meets all of these needs, and although it requires continuous evaluation, it offers professional documentation and communication in the practitioner and researcher community. The aim of this paper is to present a theoretical critique of an issue related to policy and experience of the current situation in Polish nursing - especially of the efforts to standardize nursing practices through the introduction and development of the Classification in Poland. Despite extensive promotion and training by International Council of Nurses members worldwide, there are still many countries where the Classification has not been implemented as a standard tool in healthcare facilities. Recently, a number of initiatives were undertaken in cooperation with the local and state authorities to disseminate the Classification in healthcare facilities. Thanks to intense efforts by the Polish Nurses Association and the International Council of Nurses Accredited Center for ICNP(®) Research & Development at the Medical University of Łódź, the Classification is known in Poland and has been tested at several centres. Nevertheless, an actual implementation that would allow for national and international interoperability requires strategic governmental decisions and close cooperation with information technology companies operating in the country. Discussing the barriers to the implementation of the Classification can improve understanding of it and its use. At a policy level, decision makers need to understand that use Classification in eHealth services and tools it is necessary to achieve interoperability. © 2016 International Council of Nurses.

Biosafety and biosecurity as essential pillars of international health security and cross-cutting elements of biological nonproliferation

PubMed Central

2010-01-01

The critical aspects of biosafety, biosecurity, and biocontainment have been in the spotlight in recent years. There have also been increased international efforts to improve awareness of modern practices and concerns with regard to the safe pursuit of life sciences research, and to optimize current oversight frameworks, thereby resulting in decreased risk of terrorist/malevolent acquisition of deadly pathogens or accidental release of a biological agent, and increased safety of laboratory workers. Our purpose is to highlight how the World Health Organization’s (WHO) revised International Health Regulations (IHR[2005]), the Biological Weapons Convention (BWC), and the United Nations Security Council Resolution (UNSCR) 1540 overlap in their requirements with regard to biosafety and biosecurity in order to improve the understanding of practitioners and policymakers and maximize the use of national resources employed to comply with internationally-mandated requirements. The broad range of goals of these international instruments, which are linked by the common thread of biosafety and biosecurity, highlight their significance as essential pillars of international health security and cross-cutting elements of biological nonproliferation. The current efforts of the Republic of Georgia to enhance biosafety and biosecurity in accordance with these international instruments are summarized. PMID:21143822

Globalization of healthcare: case management in a 21st-century world.

PubMed

Craig, Kathy; Beichl, Lisa

2009-01-01

This article explains the current state of the global healthcare market with respect to international medical travel (medical tourism) and worldwide provider sourcing. Emphasis is placed on the traditional twin pillars of oversight: program accreditation and branding affiliation. These are discussed for their main strength, which is their ability to operate at a system-strata level. This strength also represents a primary weakness from the international patient's perspective, which is the functional gap between systemic oversight and bedside surveillance. International case management (ICM) is identified as the right conduit of patient-level service delivery that fills the gap between system and bedside. The ICM professional is introduced and defined as the provider of patient-centered quality and safety improvements, who coordinates and collaborates using international network connections and culture-sensitive in-country communication skills. The article's information is useful for healthcare practitioners who want to learn about the global medical marketplace. Practitioners who are preparing to or who already have business enterprises associated with the global healthcare market will also find the information helpful. Explanations and content are useful to case management generalists, specialists, and business developers. The content is intended for uptake by interested parties within and outside the healthcare practice arena. All research and syntheses were executed by the authors. Sources included business correspondences, medical tourism literature, corporate Internet profiles, news releases, and healthcare industry investigative and monitoring agencies. Clinical competencies stem from the international practice experiences of one author (K. Craig). International health insurance, economics, and financing expertise stems from other author (L. Beichl). This article launches the platform for development of checklists, tools, and guidelines for international case management practice. The article focuses on (1) the examination of traditional quality safeguards of accreditation and branding and (2) the introduction of patient-centered ICM practices. The article aims to identify sources of risk for individual medical consumers who travel across national borders to seek medical care and methods of risk mitigation, especially international case management.

Joint Official Positions of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX(®). Executive Summary of the 2010 Position Development Conference on Interpretation and use of FRAX® in clinical practice.

PubMed

Hans, Didier B; Kanis, John A; Baim, Sanford; Bilezikian, John P; Binkley, Neil; Cauley, Jane A; Compston, Juliet E; Cooper, Cyrus; Dawson-Hughes, Bess; El-Hajj Fuleihan, Ghada; Leslie, William D; Lewiecki, E Michael; Luckey, Marjorie M; McCloskey, Eugene V; Papapoulos, Socrates E; Poiana, Catalina; Rizzoli, René

2011-01-01

The International Society for Clinical Densitometry (ISCD) and the International Osteoporosis Foundation (IOF) convened the FRAX(®) Position Development Conference (PDC) in Bucharest, Romania, on November 14, 2010, following a two-day joint meeting of the ISCD and IOF on the "Interpretation and Use of FRAX(®) in Clinical Practice." These three days of critical discussion and debate, led by a panel of international experts from the ISCD, IOF and dedicated task forces, have clarified a number of important issues pertaining to the interpretation and implementation of FRAX(®) in clinical practice. The Official Positions resulting from the PDC are intended to enhance the quality and clinical utility of fracture risk assessment worldwide. Since the field of skeletal assessment is still evolving rapidly, some clinically important issues addressed at the PDCs are not associated with robust medical evidence. Accordingly, some Official Positions are based largely on expert opinion. Despite limitations inherent in such a process, the ISCD and IOF believe it is important to provide clinicians and technologists with the best distillation of current knowledge in the discipline of bone densitometry and provide an important focus for the scientific community to consider. This report describes the methodology and results of the ISCD-IOF PDC dedicated to FRAX(®). Copyright © 2011 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

The Second Joint NASA/FAA/DOD Conference on Aging Aircraft. Pt. 1

NASA Technical Reports Server (NTRS)

Harris, Charles E. (Editor)

1999-01-01

The purpose of the Conference was to bring together world leaders in aviation safety research, aircraft design and manufacturing, fleet operation and aviation maintenance to disseminate information on current practices and advanced technologies that will assure the continued airworthiness of the aging aircraft in the military and commercial fleets. The Conference included reviews of current industry practices, assessments of future technology requirements, and status of aviation safety research. The Conference provided an opportunity for interactions among the key personnel in the research and technology development community, the original equipment manufacturers, commercial airline operators, military fleet operators, aviation maintenance, and aircraft certification and regulatory authorities. Conference participation was unrestricted and open to the international aviation community.

Reliance on internal autopsies in coronial investigations: a review of the issues.

PubMed

Barnes, Michael; Carpenter, Belinda

2011-09-01

Internal autopsies are invasive and result in the mutilation of the deceased person's body. They are expensive and pose occupational health and safety risks. Accordingly, they should only be done for good cause. However, until recently, "full" internal autopsies have usually been undertaken in most coroners' cases. There is a growing trend against this practice but it is meeting resistance from some pathologists who argue that any decision as to the extent of the autopsy should rest with them. This article examines the origins of the coronial system to place in context the current approach to a death investigation and to review the debate about the role of an internal autopsy in the coronial system.

Sexual Health and Canadian Youth: How Do We Measure Up?

ERIC Educational Resources Information Center

Maticka-Tyndale, Eleanor

2001-01-01

Assesses the current sexual health status of Canadian youth in relation to sexually transmitted diseases, pregnancy rates, and sexual practices, discussing the social and historical context of adolescence and adolescent sexuality in Canada. The paper draws insights from international comparisons of adolescent sexual health indicators and discusses…

Understanding Deaf Bilingual Education from the inside: A SWOT Analysis

ERIC Educational Resources Information Center

Munoz-Baell, Irma M.; Alvarez-Dardet, Carlos; Ruiz-Cantero, M.; Ferreiro-Lago, Emilio; Aroca-Fernandez, Eva

2011-01-01

This article reports on a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis using a nominal group process undertaken to identify and tackle significant factors, both internal and external, affecting those current Deaf bilingual practices in Spain which promote or prevent the processes through which more inclusive (barrier-free)…

Language and Higher Education: Two Current Challenges

ERIC Educational Resources Information Center

Brumfit, Christopher

2004-01-01

For higher education, two recent changes in world language practices are crucial: the emergence of English as the default language of international communication, and the technology of the Internet. The first appears to have contributed to problems of motivation for English-speaking learners of foreign languages. Information is provided about…

Defining a Tri-Dimensional Role for Leadership in Further Education Colleges

ERIC Educational Resources Information Center

Lambert, Steve

2013-01-01

This article presents a review of current leadership practices of principals in further education colleges and suggests that principalship is more than a two-dimensional functional model comprising internal or externally focused activities. During the past 20 years further education leadership has become more demanding, with greater accountability…

76 FR 77477 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... borrowers, as all businesses, need accounting systems for their own internal use as well as external use. Such records are maintained as part of normal business practices. Without systems, no records would... information unless it displays a currently valid OMB control number. Rural Utilities Service Title: Accounting...

Assessing Complexity. Group Composing for a Secondary School Qualifcation

ERIC Educational Resources Information Center

Thorpe, Vicki

2017-01-01

This article examines a unique music curriculum and assessment environment through the fndings of a practical action research project carried out in secondary schools. I address two current international educational issues: the relationship between formal and informal learning in music, and how individuals' contributions in collaborative groups…

Rethinking Postgraduate Education in Geography: International Perspectives on Improving Practice

ERIC Educational Resources Information Center

Monk, Janice; Foote, Kenneth; Solem, Michael

2012-01-01

This symposium brings together multi-national assessments of the current state of and challenges facing postgraduate education in geography. Contributors from Europe, Australia, South Africa and the USA identify ways in which restructuring of educational systems and wider political contexts affect programmes within the field. While highlighting…

Uniformity and Diversity in Language Policy: Global Perspectives

ERIC Educational Resources Information Center

Norrby, Catrin; Hajek, John

2011-01-01

This book brings together current research by leading international scholars on the often contentious nature of language policies and their practical outcomes in North America, Australia and Europe. It presents a range of perspectives from which to engage with a variety of pressing issues raised by multilingualism, multiculturalism, immigration,…

"Why Bother so Incredibly Much?": Student Perspectives on PISA Science Assignments

ERIC Educational Resources Information Center

Serder, Margareta; Jakobsson, Anders

2015-01-01

Large-scale assessment, such as the Programme for International Assessment (PISA), plays an increasingly important role in current educational practice and politics. However, many scholars have questioned the validity and reliability of the tests and the extent to which they actually constitute trustworthy representations of students' knowledge.…

Three In-Course Assessment Reforms to Improve Higher Education Learning Outcomes

ERIC Educational Resources Information Center

Sadler, D. Royce

2016-01-01

A current international concern is that, for too large a proportion of graduates, their higher order cognitive and practical capabilities are below acceptable levels. The constituent courses of academic programmes are the most logical sites for developing these capabilities. Contributing to patchy attainment are deficiencies in three particular…

Standardization of haematology critical results management in adults: an International Council for Standardization in Haematology, ICSH, survey and recommendations.

PubMed

Keng, T B; De La Salle, B; Bourner, G; Merino, A; Han, J-Y; Kawai, Y; Peng, M T; McCafferty, R

2016-10-01

These recommendations are intended to develop a consensus in the previously published papers as to which parameters and what values should be considered critical. A practical guide on the standardization of critical results management in haematology laboratories would be beneficial as part of good laboratory and clinical practice and for use by laboratory-accrediting agencies. A working group with members from Europe, America, Australasia and Asia was formed by International Council for Standardization in Haematology. A pattern of practice survey of 21 questions was distributed in 2014, and the data were collected electronically by Survey Monkey. The mode, or most commonly occurring value, was selected as the threshold for the upper and lower alert limits for critical results reporting. A total of 666 laboratories submitted data to this study and, of these, 499 submitted complete responses. Full blood count critical results alert thresholds, morphology findings that trigger critical result notification, critical results alert list, notification process and maintenance of critical results management protocol are described. This international survey provided a snapshot of the current practice worldwide and has identified the existence of considerable heterogeneity of critical results management. The recommendations in this study represent a consensus of good laboratory practice. They are intended to encourage the implementation of a standardized critical results management protocol in the laboratory. © 2016 John Wiley & Sons Ltd.

Healthy Birth Practice #5: Avoid Giving Birth on Your Back and Follow Your Body's Urge to Push.

PubMed

DiFranco, Joyce T; Curl, Marilyn

2014-01-01

Women in the United States are still giving birth in the supine position and are restricted in how long they can push and encouraged to push forcefully by their caregivers. Research does not support these activities. There is discussion about current research and suggestions on how to improve the quality of the birth experience. This article is an updated evidence-based review of the "Lamaze International Care Practices That Promote Normal Birth, Care Practice #5: Spontaneous Pushing in Upright or Gravity-Neutral Positions," published in The Journal of Perinatal Education, 16(3), 2007.

Body composition for health and performance: a survey of body composition assessment practice carried out by the Ad Hoc Research Working Group on Body Composition, Health and Performance under the auspices of the IOC Medical Commission.

PubMed

Meyer, Nanna L; Sundgot-Borgen, Jorunn; Lohman, Timothy G; Ackland, Timothy R; Stewart, Arthur D; Maughan, Ronald J; Smith, Suzanne; Müller, Wolfram

2013-11-01

Successful performers in weight-sensitive sports are characterised by low body mass (BM) and fat content. This often requires chronic energy restriction and acute weight loss practices. To evaluate current use of body composition (BC) assessment methods and identify problems and solutions with current BC approaches. A 40-item survey was developed, including demographic and content questions related to BC assessment. The survey was electronically distributed among international sporting organisations. Frequencies and χ(2) analyses were computed. 216 responses were received, from 33 countries, representing various institutions, sports and competitive levels. Of the sample, 86% of respondents currently assess BC, most frequently using skinfolds (International Society for the Advancement of Kinanthropometry (ISAK): 50%; non-ISAK, conventional: 40%; both: 28%), dual energy X-ray absorptiometry (38%), bioelectrical impedance (29%), air displacement plethysmography (17%) and hydrostatic weighing (10%). Of those using skinfolds, more at the international level used ISAK, whereas conventional approaches were more reported at regional/national level (p=0.006). The sport dietitian/nutritionist (57%) and physiologist/sports scientist (54%) were most frequently the professionals assessing BC, followed by MDs and athletic trainers, with some reporting coaches (5%). 36% of 116 respondents assessed hydration status and more (64%) did so at international than regional/national level (36%, p=0.028). Of 125 participants answering the question of whether they thought that BC assessment raised problems, 69% said 'yes', with most providing ideas for solutions. Results show high use of BC assessment but also a lack of standardisation and widespread perception of problems related to BM and BC in sport. Future work should emphasise standardisation with appropriate training opportunities and more research on BC and performance.

The Future of General Internal Medicine

PubMed Central

Larson, Eric B; Fihn, Stephan D; Kirk, Lynne M; Levin, Wendy; Loge, Ronald V; Reynolds, Eileen; Sandy, Lewis; Schroeder, Steven; Wenger, Neil; Williams, Mark

2004-01-01

The Society of General Internal Medicine asked a task force to redefine the domain of general internal medicine. The task force believes that the chaos and dysfunction that characterize today's medical care, and the challenges facing general internal medicine, should spur innovation. These are our recommendations: while remaining true to its core values and competencies, general internal medicine should stay both broad and deep—ranging from uncomplicated primary care to continuous care of patients with multiple, complex, chronic diseases. Postgraduate and continuing education should develop mastery. Wherever they practice, general internists should be able to lead teams and be responsible for the care their teams give, embrace changes in information systems, and aim to provide most of the care their patients require. Current financing of physician services, especially fee-for-service, must be changed to recognize the value of services performed outside the traditional face-to-face visit and give practitioners incentives to improve quality and efficiency, and provide comprehensive, ongoing care. General internal medicine residency training should be reformed to provide both broad and deep medical knowledge, as well as mastery of informatics, management, and team leadership. General internal medicine residents should have options to tailor their final 1 to 2 years to fit their practice goals, often earning a certificate of added qualification (CAQ) in special generalist fields. Research will expand to include practice and operations management, developing more effective shared decision making and transparent medical records, and promoting the close personal connection that both doctors and patients want. We believe these changes constitute a paradigm shift that can benefit patients and the public and reenergize general internal medicine. PMID:14748863

Sociological and ethical issues in transplant commercialism.

PubMed

Epstein, Miran

2009-04-01

'Global transplant commercialism' (practices and policies involving international trade in organs from living vendors, e.g., 'transplant tourism') is currently subjected to unprecedented criticism. In parallel, the debate around 'local transplant commercialism' (practices and policies that confine trade in organs from living vendors to national markets or economic unions) is heating up. In an attempt to assess the potential outcomes of these trends, this article reviews and discusses some sociological and ethical issues, ending with a proposal for a reinvigorated anticommercialist strategy. The current international campaign against global transplant commercialism is conducted by an ad hoc alliance between strange bedfellows, proponents of local transplant commercialism on the one hand and opponents of any transplant commercialism on the other. Disparities in the rigor of the respective ethical discourses, the expanding list of precedents of legitimized commerce in the human body, and the political economy of transplantation, all suggest that the former have the upper hand. Recent achievements in the struggle against international organ trafficking may not herald the abolition of transplant commercialism but rather presage its reconfiguration in deglobalized forms. In light of such a prospect, those who wish to prevent the pervasive commodification of the human body from entering the gates of transplant medicine should consider devising a new, perhaps more radical, strategy.

International veterinary epilepsy task force consensus report on epilepsy definition, classification and terminology in companion animals.

PubMed

Berendt, Mette; Farquhar, Robyn G; Mandigers, Paul J J; Pakozdy, Akos; Bhatti, Sofie F M; De Risio, Luisa; Fischer, Andrea; Long, Sam; Matiasek, Kaspar; Muñana, Karen; Patterson, Edward E; Penderis, Jacques; Platt, Simon; Podell, Michael; Potschka, Heidrun; Pumarola, Martí Batlle; Rusbridge, Clare; Stein, Veronika M; Tipold, Andrea; Volk, Holger A

2015-08-28

Dogs with epilepsy are among the commonest neurological patients in veterinary practice and therefore have historically attracted much attention with regard to definitions, clinical approach and management. A number of classification proposals for canine epilepsy have been published during the years reflecting always in parts the current proposals coming from the human epilepsy organisation the International League Against Epilepsy (ILAE). It has however not been possible to gain agreed consensus, "a common language", for the classification and terminology used between veterinary and human neurologists and neuroscientists, practitioners, neuropharmacologists and neuropathologists. This has led to an unfortunate situation where different veterinary publications and textbook chapters on epilepsy merely reflect individual author preferences with respect to terminology, which can be confusing to the readers and influence the definition and diagnosis of epilepsy in first line practice and research studies.In this document the International Veterinary Epilepsy Task Force (IVETF) discusses current understanding of canine epilepsy and presents our 2015 proposal for terminology and classification of epilepsy and epileptic seizures. We propose a classification system which reflects new thoughts from the human ILAE but also roots in former well accepted terminology. We think that this classification system can be used by all stakeholders.

Management of dredge material in the Republic of Ireland - A review.

PubMed

Sheehan, C; Harrington, J

2012-05-01

As an island nation the Republic of Ireland's ports and harbours are key to the economic wellbeing of the country as they are the primary transport link to the United Kingdom, mainland Europe and beyond. This paper examines the main aspects of the Irish dredging industry with comparison to international practice and standards, including the source of the dredge material and volumes generated annually, the dredging plant employed and the management processes currently practised. Relevant European and Irish legislation governing dredging, disposal at sea and waste licensing are presented. The potential impacts of disposal at sea are discussed with the implications for the Irish dredging industry of recently introduced European Directives assessed. Beneficial use rates for dredge material and the techniques implemented in Ireland are examined and compared with international practice. Recent notable beneficial use projects for dredge material and proposed innovative dredge material management techniques for specific dredging projects in Ireland are presented. Proposals to encourage greater beneficial use of dredge material and minimise disposal at sea for Ireland are presented including the introduction of environmental credits, tax breaks and a grant system for pilot schemes. An alternative disposal at sea charge fee structure is also recommended to encourage alternative dredge material management practices. Ireland's management of contaminated sediment is also presented with recent projects described highlighting the current practice of primarily exporting contaminated sediment to mainland Europe. Alternative methods of treatment of contaminated sediment are assessed in an Irish context. Future issues and challenges facing the Irish dredging industry are assessed and a critical analysis of the current approaches to dredge material management is presented. Copyright © 2011 Elsevier Ltd. All rights reserved.

[The quality of epidemiological research on pediatric refractive error and amblyopia in China needs to be improved].

PubMed

He, M G

2017-01-11

Over the past decade, great progress has been made in the clinical and epidemiological studies on refractive error and amblyopia in children with research findings published in international peer reviewed journals. This article reviews some of the essential publications so that the research findings could be learnt extensively, understood critically and objectively, and applied effectively to clinical practice. We aim to address the current limitations and shed light on clinical practice. (Chin J Ophthalmol, 2017, 53: 3-6) .

"Best practice" in inflammatory bowel disease: an international survey and audit.

PubMed

Van Der Eijk, Ingrid; Verheggen, Frank W.; Russel, Maurice G.; Buckley, Martin; Katsanos, Kostas; Munkholm, Pia; Engdahl, Ingemar; Politi, Patrizia; Odes, Selwyn; Fossen, Jan; Stockbrügger, Reinhold W.

2004-04-01

Background: An observational study was conducted at eight university and four district hospitals in eight countries collaborating in clinical and epidemiological research in inflammatory bowel disease (IBD) to compare European health care facilities and to define current "best practice" with regard to IBD. Methods: The approach used in this multi-national survey was unique. Existing quality norms, developed for total hospital care by a specialized organization, were restricted to IBD-specific care and adapted to the frame of reference of the study group. In each center, these norms were surveyed by means of questionnaires and professional audits in all participating centers. The collected data were reported to the center, compared to data from other hospitals, and used to benchmark. Group consensus was reached with regard to defining current "best practice". Results: The observations in each center involved patient-oriented processes, technical and patient safety, and quality of the medical standard. Several findings could be directly implemented to improve IBD care in another hospital (benchmarks). These included a confidential relationship between health care worker(s) and patients, and availability of patient data. Conclusions: The observed benchmarks, in combination with other subjectively chosen "positive" procedures, have been defined as current "best practice in IBD", representing practical guidelines towards better quality of care in IBD.

Developing standardised treatment for adults with myositis and different phenotypes: an international survey of current prescribing preferences.

PubMed

Tansley, Sarah; Shaddick, Gavin; Christopher-Stine, Lisa; Sharp, Charlotte; Dourmishev, Lyubomir; Maurer, Britta; Chinoy, Hector; McHugh, Neil

2016-01-01

The evidence base for treatment of the idiopathic inflammatory myopathies is extremely limited. The rarity and heterogeneity of these diseases has hampered the development of good quality clinical trials and while a range of immunomodulatory treatments are commonly used in clinical practice, as yet there are no clear guidelines directing their use. We aimed to establish current prescribing regimens used to treat adults with myositis internationally. An electronic survey based on different clinical scenarios was distributed internationally to clinicians involved in the treatment of patients with myositis. Participants were asked to select their first-line treatment preferences in each situation. A multinomial regression analysis was used to assess the influence of clinical scenario, respondent expertise and country of origin on first-line treatment choice. 107 survey responses were received. 57% of respondents considered themselves an expert in myositis and the majority of respondents were rheumatologists although responses from other specialities were also received. Pharmacological treatment with steroids and additional immunotherapy was the preference in most scenarios. First-line immunosuppressant choice was significantly influenced by the clinical scenario, the expertise of the treating physician and country of practice. Azathioprine, methotrexate and mycophenolate mofetil were the most commonly chosen agents. In the absence of available evidence, clinical experience and expert consensus often forms the basis of treatment guidelines. These results suggest that an international consensus approach would be possible in myositis and would overcome an urgent, yet unmet need for patients suffering with this difficult disease.

Integrated fundamental research on current collection

NASA Astrophysics Data System (ADS)

Kuhlmann-Wilsdorf, Doris; Tran, Leo

1993-06-01

The aim of our research was to add to the basic understanding in the area of current collection with particular emphasis on topics likely to benefit practical objectives. Under sponsorship of this contract, 23 papers were published in the international literature. Additionally, 13 invited lectures and 11 contributed lectures on various aspects of this research were delivered at universities, research laboratories, and international conferences by the principal investigator and co-workers. The development of a novel metal fiber material for sliding electrical contacts was continued with much success. This is expected to become very useful for making metal fiber brushed for homopolar motors/generators, as well as for EML armatures. Included in this report are title pages (and abstracts) for the 23 published papers.

The current practice of mentoring across Accreditation Council of Graduate Medical Education – International accredited programs in Qatar from faculty and trainees perspectives

PubMed Central

Suliman, Shireen; Al-Mohammed, Ahmed; Al Mohanadi, Dabia; Allen, Margaret; Bylund, Carma L

2018-01-01

Purpose Mentoring plays a vital role in academic productivity, personal development, and career guidance for students, residents, fellows, and junior faculty. A culture of mentoring is spreading across residency and fellowship training programs in Hamad Medical Corporation, the main teaching tertiary care facility in Qatar. However, there is insufficient knowledge about the current practice of mentoring in these programs. Methods We conducted a cross-sectional study by surveying all faculty and trainees in all residency and fellowship training programs in Qatar. Each completed a web-based questionnaire that asked about the current experience, self-efficacy and measures of improvement of the current practice of mentoring across training programs. Results A total of 393/650 faculty members (61%), 187/250 fellows (74%), and 405/650 residents (62%) responded to the two surveys. Most (74% of faculty members) reported being current mentors, while 67% of residents and fellows reported that they currently have mentors. Faculty who received training in mentoring and those who had an established formal mentoring program in their departments were more likely to enroll in mentoring than others (86%, P<0.01; 71%, P<0.05%, respectively). Trainees suggested that the two main areas to improve the current mentoring initiative in their departments were to develop a structured mentoring program and to train the mentors. Content analysis revealed participants’ confusion differentiating between the terms mentoring and supervision. Conclusion Based on the current study, many existing mentoring relationships have an evident confusion between supervision and mentoring roles. Developing structured mentoring program and training both faculty and trainees in mentoring is recommended to improve the current practice of mentoring within the training programs. PMID:29416385

Expanding Cancer Prevention Education to National and International Audiences: The National Cancer Institute’s Principles and Practice of Cancer Prevention and Control Annual Summer Course

PubMed Central

Faupel-Badger, Jessica M.; van Bemmel, Dana M.; Wiest, Jonathan S.; Nelson, David E.

2012-01-01

The Summer Curriculum in Cancer Prevention has been sponsored by the National Cancer Institute’s Cancer Prevention Fellowship Program for over two decades. This curriculum includes a four-week course entitled “Principles and Practice of Cancer Prevention and Control.” The ultimate goal of this course is to present the most current cancer prevention research to a diverse workforce of researchers and practitioners eager to address the current challenges in this field. The course covers the current status of cancer prevention research and practice, ranging from epidemiology and clinical practice, and from basic to behavioral science research. It is comprised of lectures grouped into nine modules representing broad and specific topics relevant to cancer prevention. Course participants come from a broad cross-section of career stages, professions, and research interests, and are from across the United States and other countries. Over time and in response to feedback from participants, the course has developed to meet the needs and expectations of this diverse audience, and may serve as a model for those interested in cancer prevention education and training in other countries. PMID:21785976

Mentoring Matters: Finding the Golden Mean--Mentors and Student Teachers Working for Success

ERIC Educational Resources Information Center

Spangler, Susan

2012-01-01

The cooperating teachers who make the greatest positive impact on interns allow student teachers to make mistakes and learn from them, offer constructive feedback, invest in their student teachers' success, practice current pedagogy in their own classrooms, and remain positive throughout the experience. In this article, the author suggests that…

Professional Characteristics of Canadian Counsellors: Results of a National Survey

ERIC Educational Resources Information Center

Gazzola, Nicola; Smith, J. David; Kearney, M. Kate; King-Andrews, Heather L.

2010-01-01

With statutory regulation of mental health professions clearly at the forefront in many Canadian jurisdictions, counselling appears to be experiencing internal tensions regarding its vision and direction. The goal of this study was to collect data directly from Canadian counsellors to more clearly define the current practices of counselling in…

"English for the Global": Discourses in/of English-Language Voluntourism

ERIC Educational Resources Information Center

Jakubiak, Cori

2012-01-01

Drawing upon the notion of hyperglobalism and critical perspectives on English as an international language, this study examines the ways in which English language teaching via volunteer tourism (i.e. English-language voluntourism) is represented and legitimated as an altruistic practice among organizational sponsors and in the talk of current and…

International Handbook on the Continuing Professional Development of Teachers

ERIC Educational Resources Information Center

Day, Christopher; Sachs, Judyth

2005-01-01

This Handbook brings together theoretical and empirical research on purposes, policies and practices of teachers' continuing professional development (CPD) over the last twenty years. It provides a unique collection of regional writing from key professionals in different regions of the world, featuring: (1) A review of current CPD literature; (2)…

EcoWellness & Guiding Principles for the Ethical Integration of Nature into Counseling

ERIC Educational Resources Information Center

Reese, Ryan F.

2016-01-01

Connection with nature impacts human wellness, yet few resources currently exist in the international literature to help guide clinicians in the ethical integration of EcoWellness into therapeutic processes. Ethical principles for EcoWellness practice are introduced and linked to applicable portions of the American Counseling Association's (2014)…

A Place for Development Education in the Current Spanish and English Curricula: Finding Possibilities for Practice

ERIC Educational Resources Information Center

Regueiro, Patricia Digón; García, Rosa María Méndez; DePalma, Renée; Matos, Silvana Longueira

2017-01-01

Development education has a long and well-established trajectory in terms of initiatives promoted by international organizations, national governments and civil associations, accompanied by a growing awareness of the significance of global issues. Nevertheless, an analysis of the education policy reflected in the official Spanish and English…

A Functional Neuroimaging Study of the Clinical Reasoning of Medical Students

ERIC Educational Resources Information Center

Chang, Hyung-Joo; Kang, June; Ham, Byung-Joo; Lee, Young-Mee

2016-01-01

As clinical reasoning is a fundamental competence of physicians for good clinical practices, medical academics have endeavored to teach reasoning skills to undergraduate students. However, our current understanding of student-level clinical reasoning is limited, mainly because of the lack of evaluation tools for this internal cognitive process.…

Eating and Scraping Away at Practice with Two-Year-Olds

ERIC Educational Resources Information Center

Barron, Ian; Taylor, Lisa

2017-01-01

This paper examines how early childhood policy initiatives in the United Kingdom and internationally currently reflect neoliberal concerns with school readiness in the development of human capital and what diverse theoretical perspectives might offer. The focus is a project involving a group of early childhood academics from one university and a…

Assessing Competition on the Russian University Market Using a Modified Panzar-Rosse Model

ERIC Educational Resources Information Center

Sergeeva, Vladlena Vladimirovna

2016-01-01

This paper reviews some government policy measures aimed at strengthening competition in the Russian university market and looks at the best international practices in this area. It analyzes the competitive behavior of universities under the current government policy on higher education and research and development and suggests an approach to…

Parental Ethnotheories, Social Practice and the Culture-Specific Development of Social Smiling in Infants

ERIC Educational Resources Information Center

Kartner, Joscha; Holodynski, Manfred; Wormann, Viktoriya

2013-01-01

In this article we argue that current theories on socioemotional development during infancy need to be reconceptualized in order to account for cross-cultural variation in caregiver-infant interaction. In line with the cultural-historical internalization theory of emotional development (Holodynski & Friedlmeier, 2006) and the ecocultural model of…

Preparing Medical Graduates for an Interconnected World: Current Practices and Future Possibilities for Internationalizing the Medical Curriculum in Different Contexts

ERIC Educational Resources Information Center

Stütz, Alexander; Green, Wendy; McAllister, Lindy; Eley, Diann

2015-01-01

Preparing medical graduates who are competent to work in a global environment requires broad integration of international and intercultural perspectives throughout the medical curriculum. Employing Leask and Bridge's "conceptual framework of internationalisation of the curriculum," this article first highlights the emphasis placed on…

Preparing Young Adolescents for a Bright Future--Right Now!

ERIC Educational Resources Information Center

Deering, Paul D.; Martin, Kathryn L.; Buelow, Stephanie M.; Hoffman, Jennifer T.; Cameli, Sandy; Martin, Matt; Walker, Robert E.; O'Neill, Tara B.

2016-01-01

We must prepare young adolescents for a bright future by examining all of our educational practices in terms of their current and future relevance. The education we provide our students must prepare them to address enormously complex issues involving demographics and international relations, environmental and human health, and the development and…

Reading Comprehension Instruction in Irish Primary Classrooms: Key Insights into Teachers' Perspectives on Classroom Practices

ERIC Educational Resources Information Center

Concannon-Gibney, Tara; Murphy, Brian

2012-01-01

Despite a wealth of international research indicating the importance but also the dearth of explicit reading comprehension instruction in classrooms, current classroom reading pedagogy does not appear to have acknowledged and addressed this shortcoming to any significant degree. This is cause for some considerable concern, as today's students…

Flower Power: The Armoured Expert in the CanMEDS Competency Framework?

ERIC Educational Resources Information Center

Whitehead, Cynthia R.; Austin, Zubin; Hodges, Brian D.

2011-01-01

Competency frameworks based on roles definitions are currently being used extensively in health professions education internationally. One of the most successful and widely used models is the CanMEDS Roles Framework. The medical literature has raised questions about both the theoretical underpinnings and the practical application of outcomes-based…

Networking for Digital Preservation: Current Practice in 15 National Libraries. IFLA Publications 119

ERIC Educational Resources Information Center

Verheul, Ingeborg

2006-01-01

In 2004-2005, The National Library of the Netherlands (Koninklijke Bibliotheek) conducted a survey for the IFLA-CDNL Alliance for Bibliographic Standards (ICABS)--an alliance founded jointly by the International Federation of Library Associations (IFLA), the Conference of Directors of National Libraries (CDNL) and the national libraries of…

Deaf Education in China: History, Current Issues, and Emerging Deaf Voices

ERIC Educational Resources Information Center

Lytle, R. R.; Johnson, K. E.; Hui, Y. J.

2005-01-01

An overview is provided of (a) deaf education in China, (b) views of deaf Chinese, and (c) recent empowering international collaborations. China's national policy focuses on oral/aural education and hearing rehabilitation. However, everyday practice in schools for deaf children includes various forms of Chinese Sign Language. Early childhood…

Conceptualising professionalism in occupational therapy through a Western lens.

PubMed

Hordichuk, Chelsea J; Robinson, Allison J; Sullivan, Theresa M

2015-06-01

The term professionalism is embedded within curriculum and occupational therapy documents, yet, explicit discussion of the concept is lacking in the literature. This paper strives for a greater understanding of how professionalism is currently conceptualised within Western occupational therapy literature. A broad literature search was conducted and included international peer-reviewed and grey literature from Western cultures including Australia, Canada, New Zealand, the United Kingdom and the United States. To enrich understanding, some documents from medicine were also included. Professionalism is widely upheld as a core construct of occupational therapy. However, an evidence-based consensus of the specific elements of professionalism guiding occupational therapy practice is lacking. Currently, understanding of professionalism is largely based on multiple, isolated concepts presented in Western professional association documents. Acknowledging the multifaceted and multicultural nature of professionalism is essential to begin systematically delineating and conceptualising elements of professionalism specific to occupational therapy. This review has been conducted from a solely Western cultural lens. Additional work to highlight differences specific to international contexts, cultures, and societal influences is needed to enrich the understanding of professionalism in occupational therapy practice. © 2015 Occupational Therapy Australia.

Marketing alcohol to young people: implications for industry regulation and research policy.

PubMed

Jackson, M C; Hastings, G; Wheeler, C; Eadie, D; Mackintosh, A M

2000-12-01

This paper focuses on the marketing of alcohol to young people in the United Kingdom, but the lessons that emerge have international significance. Alcohol is a global enterprise and recent consolidation means that it is controlled by a decreasing number of expanding multi-nationals. Alcohol companies are able to allocate significant resources to researching consumer preferences, developing new products and promoting them on an international level. Recent years have seen a growth in the value that youth culture attaches to brand labels and symbols and a move away from the healthy-living ethos. The alcohol industry's response to these trends has been to design alcoholic beverages that appeal to young people, using well-informed and precisely targeted marketing strategies. This has led to growing concerns about the implications for public health and a demand for tighter controls to regulate alcohol marketing practices. In the United Kingdom, controls on alcohol are piecemeal and reactive and the current system of voluntary regulation appears ineffective. This paper argues for more research to establish current industry practice and inform the development of a comprehensive regulatory structure and system of monitoring.

[Application of the balanced scorecard in nursing practice].

PubMed

Huang, Tsai-Yu; Chwo, Miao-Ju

2004-02-01

Kaplan and Norton's balanced scorecard (BSC) was developed in 1992. It was designed to be both a performance framework and a management methodology. The BSC enables an organization to convert its mission and vision into specific strategic objectives across four perspectives: (1) the financial perspective, (2) the customer perspective, (3) the internal business process perspective, and (4) the learning and growth perspective. Emphasis is focused on the balance of internal and external, outcome and future, and subjective and objective measures. Currently, some health care organizations have implemented the concept of the BSC as a performance measurement tool and are convinced that the BSC can be of great value to an organization. This paper provides development of the BSC and its application in the health care system and nursing practice.

International Conference on Advances in Radiation Oncology (ICARO): outcomes of an IAEA meeting.

PubMed

Salminen, Eeva K; Kiel, Krystyna; Ibbott, Geoffrey S; Joiner, Michael C; Rosenblatt, Eduardo; Zubizarreta, Eduardo; Wondergem, Jan; Meghzifene, Ahmed

2011-02-04

The IAEA held the International Conference on Advances in Radiation Oncology (ICARO) in Vienna on 27-29 April 2009. The Conference dealt with the issues and requirements posed by the transition from conventional radiotherapy to advanced modern technologies, including staffing, training, treatment planning and delivery, quality assurance (QA) and the optimal use of available resources. The current role of advanced technologies (defined as 3-dimensional and/or image guided treatment with photons or particles) in current clinical practice and future scenarios were discussed.ICARO was organized by the IAEA at the request of the Member States and co-sponsored and supported by other international organizations to assess advances in technologies in radiation oncology in the face of economic challenges that most countries confront. Participants submitted research contributions, which were reviewed by a scientific committee and presented via 46 lectures and 103 posters. There were 327 participants from 70 Member States as well as participants from industry and government. The ICARO meeting provided an independent forum for the interaction of participants from developed and developing countries on current and developing issues related to radiation oncology.

Assessment of interns and postgraduate dental student's knowledge regarding equipment ergonomics.

PubMed

Rajeswari, S Raja; Gowda, Triveni M; Kumar, Tarun Ab; Arya, Kanchan; Mehta, Dhoom Singh

2016-01-01

The substantial knowledge concerning ergonomics and its practical application is vital for forestalling musculoskeletal disorders. The role of equipment ergonomics (EE) in preventing these work-related ailments is significantly noteworthy. The aim of the study was to assess the prevailing perception of postgraduates (PGs) and interns regarding EE and preparing the Indian dental workforce for the challenges of India's growing economy and population. Authors conducted a cross-sectional survey between December 2013 and February 2014 amidst the interns and PG dental students of Davangere city, Karnataka, India. The data were collected using 21-item custom designed proforma, comprising of questions evaluating student's basic knowledge about EE. Statistical analysis was done using Chi-square test in each group (PGs and interns) and Mann-Whitney test was implemented for comparison between both groups. Of 358 subjects surveyed, 48% PGs and 52% interns affirmed that they came across EE only through this survey. In addition, 91.18% of PGs and 90.59% interns believed that the accentuation on EE is less in the current dental curriculum. Comprehensive understanding and practical application of EE among the participants was found to be lacking. The importance of microbreaks and chair side exercises should be emphasized and training should be initiated at an early stage before improper postural habits develop.

The influence of globalization on medical regulation: a descriptive analysis of international medical graduates registered through alternative licensure routes in Ontario

PubMed Central

Yen, Wendy; Hodwitz, Kathryn; Thakkar, Niels; Martimianakis, Maria Athina (Tina); Faulkner, Dan

2016-01-01

The increasing globalization of the medical profession has influenced health policy, health human resource planning, and medical regulation in Canada. Since the early 2000s, numerous policy initiatives have been created to facilitate the entry of international medical graduates (IMGs) into the Canadian workforce. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) developed alternative licensure routes to increase the ability of qualified IMGs to obtain licenses to practice. The current study provides demographic and descriptive information about the IMGs registered through the CPSO’s alternative licensure routes between 2000 and 2012. An analysis of the characteristics and career trajectories of all IMGs practicing in the province sheds light on broader globalization trends and raises questions about the future of health human resource planning in Canada. As the medical profession becomes increasingly globalized, health policy and regulation will continue to be influenced by trends in international migration, concerns about global health equity, and the shifting demographics of the Canadian physician workforce. Implications for future policy development in the complex landscape of medical education and practice are discussed. PMID:28344705

Review article: practical current issues in perioperative patient safety.

PubMed

Eichhorn, John H

2013-02-01

This brief review provides an overview and, importantly, a context perspective of relevant current practical issues in perioperative patient safety. The dramatic improvement in anesthesia patient safety over the last 30 years was not initiated by electronic monitors but, rather, largely by a set of behaviours known as "safety monitoring" that were then made decidedly more effective by extending the human senses through electronic monitoring, for example, capnography and pulse oximetry. In the highly developed world, this current success is threatened by complacency and production pressure. In some areas of the developing/underdeveloped world, the challenge is implementing the components of anesthesia practice that will bring safety improvements to parallel the overall current success, for instance, applying the World Federation of Societies of Anaesthesiologists (WFSA) "International Standards for A Safe Practice of Anaesthesia". Generally, expanding the current success in safety involves many practical issues. System issues involve research, effective reporting mechanisms and analysis/broadcasting of results, perioperative communication (including "speaking up to power"), and checklists. Monitoring issues involve enforcing existing published monitoring standards and also recognizing the risk of danger to the patient from hypoventilation during procedural sedation and from postoperative intravenous pain medications. Issues of clinical care include medication errors in the operating room, cerebral hypoperfusion (especially in the head-up position), dangers of airway management, postoperative residual weakness from muscle relaxants, operating room fires, and risks specific in obstetric anesthesia. Recognition of the issues outlined here and empowerment of all anesthesia professionals, from the most senior professors and administrators to the newest practitioners, should help maintain, solidify, and expand the improvements in anesthesia and perioperative patient safety.

COMMERCIAL SURROGACY: WHAT ROLE FOR LAW IN AUSTRALIA?

PubMed

Sifris, Ronli; Ludlow, Karinne; Sifris, Adiva

2015-12-01

This editorial begins by illuminating current conversations regarding the regulation of commercial surrogacy in Australia. It defines "commercial surrogacy" and explains the interaction between changes in social attitudes and changes to the law before setting out the current Australian law and practice in this area. An examination of current domestic law and practice reveals that surrogacy legislation in Australia is mired in inconsistencies and a lack of uniformity but that the one key common element is the prohibition of commercial surrogacy. The inability of couples to access commercial surrogacy within Australia has led to offshore reproductive tourism and unpredictable, contradictory decision-making as the Family Court attempts to apply legislation which was never intended to apply in this context. The editorial then turns to consider the international arena, discussing the approach of the Hague Conference on Private International Law before delving into a human rights analysis of commercial surrogacy arrangements. The adoption of a rights-based approach requires an analysis of this vexed issue from the perspective of the child, surrogate and intending parents. While questions surrounding the human rights implications of legalising commercial surrogacy continue to be the subject of passionate debate, the authors believe that the human rights of all parties are best protected through appropriate regulation rather than absolute prohibition.

Clinical practice guidelines for fertility preservation in young women undergoing gonadotoxic treatment: an overview and critical appraisal of methodological quality and content.

PubMed

Baysal, Özlem; Hamilton, Jozefien A M; Hamilton, Carl J C M; Braat, Didi D M; Beerendonk, Catharina C M; Nelen, Willianne L D M

2018-04-13

What is the methodological quality and content of internationally available clinical practice guidelines (CPGs) on fertility preservation (FP) care in adult women? Internationally available CPGs on FP care in adult women were identified after conducting an extensive literature search and consulting (inter)national key experts. The methodological quality of the CPGs was appraised by an (inter)national panel of experts using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. The content of the best CPGs, scoring ≥60% for the domain 'Rigour of development' of the AGREE II instrument, was extracted and categorized according to their topic. Thirty of the 1808 documents found were included. After consulting (inter)national key experts, 30 CPGs were included, six of which scored ≥60% for their 'Rigour of development'. The number of FP-related topics discussed by these six CPGs ranged from 4 to 12. The number of recommendations provided by the CPGs on these topics varied. The number of topics to which ≥5 recommendations were dedicated ranged from 0 to 4 between CPGs. CPGs on the subject of FP care are available, but there is room for improvement in quality and content. Although written for use in daily practice, the CPGs can also be used to develop quality indicators to monitor the quality of current FP care or to evaluate future improvement initiatives. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Prospective systematic review registration: perspective from the Guidelines International Network (G-I-N).

PubMed

Van der Wees, Philip; Qaseem, Amir; Kaila, Minna; Ollenschlaeger, Guenter; Rosenfeld, Richard

2012-02-09

Clinical practice and public health guidelines are important tools for translating research findings into practice with the aim of assisting health practitioners as well as patients and consumers in health behavior and healthcare decision-making. Numerous programs for guideline development exist around the world, with growing international collaboration to improve their quality. One of the key features in developing trustworthy guidelines is that recommendations should be based on high-quality systematic reviews of the best available evidence. The review process used by guideline developers to identify and grade relevant evidence for developing recommendations should be systematic, transparent and unbiased. In this paper, we provide an overview of current international developments in the field of practice guidelines and methods to develop guidelines, with a specific focus on the role of systematic reviews. The Guidelines International Network (G-I-N) aims to stimulate collaboration between guideline developers and systematic reviewers to optimize the use of available evidence in guideline development and to increase efficiency in the guideline development process. Considering the significant benefit of systematic reviews for the guideline community, the G-I-N Board of Trustees supports the international prospective register of systematic reviews (PROSPERO) initiative. G-I-N also recently launched a Data Extraction Resource (GINDER) to present and share data extracted from individual studies in a standardized template. PROSPERO and GINDER are complementary tools to enhance collaboration between guideline developers and systematic reviewers to allow for alignment of activities and a reduction in duplication of effort.

Preparing for practice: Nursing intern and faculty perceptions on clinical experiences.

PubMed

AlThiga, Hanan; Mohidin, Sharifah; Park, Yoon Soo; Tekian, Ara

2017-04-01

Clinical experience and exposure to real patients are required elements of nursing education. Trainees in nursing are expected to be prepared adequately for the hard-working environment, increasing patient complexity, and higher-level competencies. This study investigates differences between nursing interns and clinical faculty on actual and perceived importance of educational preparation and development of clinical competencies, focusing on the nursing curriculum and transition to practice. A convenient sampling technique with a mixed-methods design was used to collect quantitative and qualitative data, by surveying and interviewing nursing interns and faculty members from King Abdul-Aziz University in Saudi Arabia; data collection occurred in December 2015. The survey (23 items) and focused interviews measured perceptions of clinical instruction and experience. Descriptive statistics and t-tests were used to analyze differences in mean ratings between actual and perceived importance. Themes collected from narrative interview data were summarized. Significant differences were found between nursing interns (n = 46) and faculty (n = 29) perceptions of actual clinical teaching and experiences and its importance including the clinical teaching and the development of clinical competence, p < .01. Moreover, nursing interns rated actual experiences of knowledge base and skills significantly lower than faculty perceptions, p = .001. Narrative data provided in-depth information on factors contributing and hindering the learning and teaching environment. Findings from this study call for clinical instruction and experiences to take a step further to meet current practice standards and to improve patient safety in the health professions education of nurses.

Year-End Clinic Handoffs: A National Survey of Academic Internal Medicine Programs.

PubMed

Phillips, Erica; Harris, Christina; Lee, Wei Wei; Pincavage, Amber T; Ouchida, Karin; Miller, Rachel K; Chaudhry, Saima; Arora, Vineet M

2017-06-01

While there has been increasing emphasis and innovation nationwide in training residents in inpatient handoffs, very little is known about the practice and preparation for year-end clinic handoffs of residency outpatient continuity practices. Thus, the latter remains an identified, yet nationally unaddressed, patient safety concern. The 2014 annual Association of Program Directors in Internal Medicine (APDIM) survey included seven items for assessing the current year-end clinic handoff practices of internal medicine residency programs throughout the country. Nationwide survey. All internal medicine program directors registered with APDIM. Descriptive statistics of programs and tools used to formulate a year-end handoff in the ambulatory setting, methods for evaluating the process, patient safety and quality measures incorporated within the process, and barriers to conducting year-end handoffs. Of the 361 APDIM member programs, 214 (59%) completed the Transitions of Care Year-End Clinic Handoffs section of the survey. Only 34% of respondent programs reported having a year-end ambulatory handoff system, and 4% reported assessing residents for competency in this area. The top three barriers to developing a year-end handoff system were insufficient overlap between graduating and incoming residents, inability to schedule patients with new residents in advance, and time constraints for residents, attendings, and support staff. Most internal medicine programs do not have a year-end clinic handoff system in place. Greater attention to clinic handoffs and resident assessment of this care transition is needed.

Students entering internship show readiness in the nutrition care process.

PubMed

Baker, S D; Cotugna, N

2013-10-01

The British Dietetic Association and the International Confederation of Dietetic Associations are developing an international model for dietetics practice as an aid in providing evidence-based practice. In the USA, undergraduate programmes are mandated by the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) to incorporate the nutrition care process (NCP) into the curriculum so that students can use the process during their dietetic internship and later practice. The present study aimed to assess interns' readiness in the NCP prior to beginning a dietetic internship. Before starting the internship, the 40 interns in the 2009-2010 class of a university-based internship were sent an e-mail requesting they complete an online survey. Questions inquired about their NCP background with respect to: academic preparation, work or volunteer experiences, knowledge and confidence in ability to apply the NCP. Survey results were analysed with SPSS statistical software (SPSS Inc., Chicago, IL, USA). The 39 interns completing the survey indicated they had prior exposure to the NCP. All but one reported that their academic coursework covered the NCP. Approximately half of the interns worked or volunteered in settings that used the NCP. Overall, students correctly answered most of the questions assessing their basic knowledge in the NCP. Thirty-seven of the 39 interns had some confidence or felt confident in their ability to apply the NCP during internship rotations. This distance internship attracts students from all over the USA, and so the findings of the present study shed light on current undergraduate preparation in the NCP. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

A qualitative review of existing national and international occupational safety and health policies relating to occupational sedentary behaviour.

PubMed

Coenen, Pieter; Gilson, Nicholas; Healy, Genevieve N; Dunstan, David W; Straker, Leon M

2017-04-01

Prolonged sedentary time is now recognised as an emergent ergonomics issue. We aimed to review current occupational safety and health policies relevant to occupational sedentary behaviour. An electronic search for documents was conducted on websites of ergonomics and occupational safety and health organisations from 10 countries and six international/pan-European agencies. Additionally, 43 informants (nine countries) were contacted and an international conference workshop held. 119 documents (e.g. legislation, guidelines, codes of practice) were identified. Using a qualitative synthesis, it was observed that many jurisdictions had legal frameworks establishing a duty of care for employers, designers/manufacturers/suppliers and employees. While no occupational authority policies focusing specifically on sedentary behaviour were found, relevant aspects of existing policies were identified. We highlight implications for ergonomics research and practice and recommend the development of policy to specifically address occupational sedentary behaviour and support workplace initiatives to assess and control the risks of this emergent hazard. Copyright © 2016 Elsevier Ltd. All rights reserved.

Contributions of international cooperation projects to the HIV/AIDS response in China.

PubMed

Sun, Jiangping; Liu, Hui; Li, Hui; Wang, Liqiu; Guo, Haoyan; Shan, Duo; Bulterys, Marc; Korhonen, Christine; Hao, Yang; Ren, Minghui

2010-12-01

For 20 years, China has participated in 267 international cooperation projects against the HIV/AIDS epidemic and received ∼526 million USD from over 40 international organizations. These projects have played an important role by complementing national efforts in the fight against HIV/AIDS in China. The diverse characteristics of these projects followed three phases over 20 years. Initially, stand-alone projects provided technical support in surveillance, training or advocacy for public awareness. As the epidemic spread across China, projects became a part of the comprehensive and integrated national response. Currently, international best practices encourage the inclusion of civil society and non-governmental organizations in an expanded response to the epidemic. Funding from international projects has accounted for one-third of the resources provided for the HIV/AIDS response in China. Beyond this strong financial support, these programmes have introduced best practices, accelerated the introduction of AIDS policies, strengthened capacity, improved the development of grassroots social organizations and established a platform for communication and experience sharing with the international community. However, there are still challenges ahead, including integrating existing resources and exploring new programme models. The National Centre for AIDS/STD Control and Prevention (NCAIDS) in China is consolidating all international projects into national HIV prevention, treatment and care activities. International cooperation projects have been an invaluable component of China's response to HIV/AIDS, and China has now been able to take this information and share its experiences with other countries with the help of these same international programmes.

Transfusion practice in anemic, non-bleeding patients: Cross-sectional survey of physicians working in general internal medicine teaching hospitals in Switzerland.

PubMed

von Babo, Michelle; Chmiel, Corinne; Müggler, Simon Andreas; Rakusa, Julia; Schuppli, Caroline; Meier, Philipp; Fischler, Manuel; Urner, Martin

2018-01-01

Transfusion practice might significantly influence patient morbidity and mortality. Between European countries, transfusion practice of red blood cells (RBC) greatly differs. Only sparse data are available on transfusion practice of general internal medicine physicians in Switzerland. In this cross-sectional survey, physicians working in general medicine teaching hospitals in Switzerland were investigated regarding their self-reported transfusion practice in anemic patients without acute bleeding. The definition of anemia, transfusion triggers, knowledge on RBC transfusion, and implementation of guidelines were assessed. 560 physicians of 71 hospitals (64%) responded to the survey. Anemia was defined at very diverging hemoglobin values (by 38% at a hemoglobin <130 g/L for men and by 57% at <120 g/L in non-pregnant women). 62% and 43% respectively, did not define anemia in men and in women according to the World Health Organization. Fifty percent reported not to transfuse RBC according to international guidelines. Following factors were indicated to influence the decision to transfuse: educational background of the physicians, geographical region of employment, severity of anemia, and presence of known coronary artery disease. 60% indicated that their knowledge on Transfusion-related Acute Lung Injury (TRALI) did not influence transfusion practice. 50% of physicians stated that no local transfusion guidelines exist and 84% supported the development of national recommendations on transfusion in non-acutely bleeding, anemic patients. This study highlights the lack of adherence to current transfusion guidelines in Switzerland. Identifying and subsequently correcting this deficit in knowledge translation may have a significant impact on patient care.

Global trends in critical values practices and their harmonization.

PubMed

Kost, Gerald J; Hale, Kristin N

2011-02-01

The objectives of this article were 1) to identify current trends in critical values practices in North America, Europe, and other regions; 2) to describe progress toward harmonization of critical limits; and 3) to synthesize strategies that will encourage global consensus. Critical limits are described in national surveys. Critical value practices are guided by federal statutes, The Joint Commission regulations, and accreditation requirements in the US; by provincial healthcare agencies in Canada; by thought leaders and ISO EN 15189:2007 in Europe; and in SE Asia, mostly by ad hoc policies lacking statutory grip. Review of databases, literature, websites, federal statutes, litigation, official policies, current affairs, and accreditation agency requirements. Practical strategies will accelerate harmonization of critical values practices, as follows: a) continue national and international survey comparisons; b) clarify age, ethnic, and subject dependencies; c) standardize qualitative and quantitative decision levels for urgent clinician notification; d) monitor compliance and timeliness for safety; and e) alert high frequencies of critical values related to adverse events. New expectations and communication technologies present opportunities for enhanced performance using wireless closed-loop reporting with recipient acknowledgment to reduce phone calls and improve efficiency. Hospitals worldwide can benefit from developing consensus for critical values practices.

Contemporary training practices in elite British powerlifters: survey results from an international competition.

PubMed

Swinton, Paul A; Lloyd, Ray; Agouris, Ioannis; Stewart, Arthur

2009-03-01

The primary objective of this study was to investigate current powerlifting training methods in light of anecdotal evidence purporting increased similarity with the explosive training practices of weightlifters. The study also assessed the prevalence of contemporary training practices frequently recommended for powerlifters in the popular literature. A 20-item survey was distributed to 32 elite British powerlifters at an International competition. The subject group included multiple national, international, and commonwealth champions and record holders. Based on 2007 competition results, the average Wilks score of the group was 450.26 +/- 34.7. The response rate for the surveys was 88% (28 of 32). The survey was sectioned into 6 areas of inquiry: a) repetition speed, b) explosive training load, c) resistance materials used, d) adjunct power training methods, e) exercise selection, and f) training organization. The results demonstrate that the majority of powerlifters train with the intention to explosively lift maximal and submaximal loads (79 and 82%, respectively). Results revealed that 39% of the lifters regularly used elastic bands and that 57% incorporated chains in their training. Evidence for convergence of training practices between powerlifters and weightlifters was found when 69% of the subjects reported using the Olympic lifts or their derivatives as part of their powerlifting training. Collectively, the results demonstrate that previous notions of how powerlifters train are outdated. Contemporary powerlifters incorporate a variety of training practices that are focused on developing both explosive and maximal strength.

Education of Pharmacists in Canada

PubMed Central

Ensom, Mary H.H.

2008-01-01

In Canada, the education of pharmacists is built upon a foundation of strong, research-intensive publicly funded universities and a universal health-care system that balances government and private financing for prescription medications. The evolution of pharmacy education and practice in Canada has laid the foundation for a variety of emerging trends related to expanded roles for pharmacists, increasing interprofessional collaboration for patient-centered care, and emergence of pharmacy technicians as a soon-to-be regulated professional group in parts of the country. Current challenges include the need to better integrate internationally educated pharmacists within the domestic workforce and tools to ensure continuous professional development and maintenance of competency of practitioners. Academic pharmacy is currently debating how best to manage the need to enhance the pharmacy curriculum to meet current and future skills needs, and whether a doctor of pharmacy (PharmD) degree ought to become the standard entry-to-practice qualification for pharmacists in Canada. PMID:19325948

The Association of Parent Mindfulness with Parenting and Youth Psychopathology Across Three Developmental Stages.

PubMed

Parent, Justin; McKee, Laura G; N Rough, Jennifer; Forehand, Rex

2016-01-01

The primary purpose of the current study was to test a model examining the process by which parent dispositional mindfulness relates to youth psychopathology through mindful parenting and parenting practices. The universality of the model across youth at three developmental stages was examined: young childhood (3-7 years; n = 210), middle childhood (8-12 years; n = 200), and adolescence (13-17 years; n = 205). Overall, participants were 615 parents (55% female) and one of their 3-to-17 year old children (45% female). Parents reported on their dispositional mindfulness, mindful parenting, positive and negative parenting practices and their child's or adolescent's internalizing and externalizing problems. Consistent findings across all three developmental stages indicated that higher levels of parent dispositional mindfulness were indirectly related to lower levels of youth internalizing and externalizing problems through higher levels of mindful parenting and lower levels of negative parenting practices. Replication of these findings across families with children at different developmental stages lends support to the generalizability of the model.

Business Process Flow Diagrams in Tissue Bank Informatics System Design, and Identification and Communication of Best Practices: The Pharmaceutical Industry Experience.

PubMed

McDonald, Sandra A; Velasco, Elizabeth; Ilasi, Nicholas T

2010-12-01

Pfizer, Inc.'s Tissue Bank, in conjunction with Pfizer's BioBank (biofluid repository), endeavored to create an overarching internal software package to cover all general functions of both research facilities, including sample receipt, reconciliation, processing, storage, and ordering. Business process flow diagrams were developed by the Tissue Bank and Informatics teams as a way of characterizing best practices both within the Bank and in its interactions with key internal and external stakeholders. Besides serving as a first step for the software development, such formalized process maps greatly assisted the identification and communication of best practices and the optimization of current procedures. The diagrams shared here could assist other biospecimen research repositories (both pharmaceutical and other settings) for comparative purposes or as a guide to successful informatics design. Therefore, it is recommended that biorepositories consider establishing formalized business process flow diagrams for their laboratories, to address these objectives of communication and strategy.

International short-term medical missions: a systematic review of recommended practices.

PubMed

Roche, Stephanie D; Ketheeswaran, Pavinarmatha; Wirtz, Veronika J

2017-01-01

To identify practices for conducting international short-term medical missions (STMMs) recommended in the literature and examine how these link STMMs to recipient countries' existing health systems. Systematic review of PubMed-indexed articles on STMMs and their bibliographies using preferred reporting items for systematic reviews and meta-analyses guidelines. Recommendations were organized using the World Health Organization Health Systems Framework. In 92 publications, 67 % offered at least one recommendation that would link STMMs to the recipient country's health system. Among these recommendations, most focused on service delivery and few on health financing and governance. There is a lack of consensus around a proper standard of care, patient selection, and trip duration. Comprehensive global standards are needed for STMM work to ensure that services are beneficial both to patients and to the broader healthcare systems of recipient countries. By providing an overview of the current recommendations and important gaps where practice recommendations are needed, this study can provide relevant input into the development of global standards for STMMs.

Astrophysics and Cosmology: International Partnerships

NASA Astrophysics Data System (ADS)

Blandford, Roger

2016-03-01

Most large projects in astrophysics and cosmology are international. This raises many challenges including: --Aligning the sequence of: proposal, planning, selection, funding, construction, deployment, operation, data mining in different countries --Managing to minimize cost growth through reconciling different practices --Communicating at all levels to ensure a successful outcome --Stabilizing long term career opportunities. There has been considerable progress in confronting these challenges. Lessons learned from past collaborations are influencing current facilities but much remains to be done if we are to optimize the scientific and public return on the expenditure of financial and human resources.

State of Global Pediatric Neurosurgery Outreach: Survey by the International Education Subcommittee

PubMed Central

Davis, Matthew C.; Rocque, Brandon G.; Singhal, Ash; Ridder, Tom; Pattisapu, Jogi V.; Johnston, James M.

2017-01-01

Object Neurosurgical services are increasingly recognized as essential components of surgical care worldwide. Degree of interest among neurosurgeons regarding international work, and barriers to involvement in global neurosurgical outreach, are largely unexplored. We distributed a survey to members of the AANS/CNS Joint Section on Pediatric Neurosurgery to assess the state of global outreach among its members and identify barriers to involvement. Methods An internet-based questionnaire was developed by the International Education Subcommittee of the AANS/CNS Joint Section on Pediatric Neurosurgery, and distributed to pediatric neurosurgeons via the AANS/CNS Joint Section email contact list. Participants were surveyed on involvement in global neurosurgical outreach, geographic location, nature of participation, and barriers to further involvement. Results A 35.3% response rate was obtained, with 116 respondents completed the survey. 61% performed or taught neurosurgery in a developing country, 49% traveling at least annually. Africa was the most common region (54%), followed by South America (30%), through 29 separate organizing entities. Hydrocephalus was the most commonly treated condition (88%), followed by spinal dysraphism (74%) and tumor (68%). Most respondents obtained follow-up through communication from local surgeons (77%). 71% believed the international experience improved their practice, and 74% were very or extremely interested in working elsewhere. Interference with current practice (61%), cost (44%), and difficulty identifying international partners (43%) were the most commonly cited barriers to participation. Conclusion Any coordinated effort to expand global neurosurgical capacity begins with appreciation for the current state of outreach efforts. Increasing participation in global outreach will require addressing both real and perceived barriers to involvement. Creation and curation of a centralized online database of ongoing projects to facilitate coordination and involvement may be beneficial. PMID:28524788

Documentation: Records and Reports.

PubMed

Akers, Michael J

2017-01-01

This article deals with documentation to include the beginning of documentation, the requirements of Good Manufacturing Practice reports and records, and the steps that can be taken to minimize Good Manufacturing Practice documentation problems. It is important to remember that documentation for 503a compounding involves the Formulation Record, Compounding Record, Standard Operating Procedures, Safety Data Sheets, etc. For 503b outsourcing facilities, compliance with Current Good Manufacturing Practices is required, so this article is applicable to them. For 503a pharmacies, one can see the development and modification of Good Manufacturing Practice and even observe changes as they are occurring in 503a documentation requirements and anticipate that changes will probably continue to occur. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

The practice of skin-bleaching for a cosmetic purpose in immigrant communities.

PubMed

Mahé, Antoine

2014-01-01

Using skin-lightening compounds for a cosmetic purpose that are normally restricted to medical use or forbidden has become a world-wide practice. Complications are numerous. Immigrant communities often import their practice from their original country. A review of the literature on the subject of complications of cosmetic skin-bleaching, with special focus on data concerning immigrants originating from highly endemic countries, was conducted. Complications of cosmetic skin-bleaching are common, involving mainly the skin although some general complications are also reported with a growing incidence. The high frequency of this practice, added to the frequency of various complications, suggests it might be considered as a genuine public health problem currently. © 2014 International Society of Travel Medicine.

Appraisal of antimicrobial prescribing practices of governmental and non-governmental dentists for hospitals in the western region of Saudi Arabia.

PubMed

Al-Harthi, Sameer E; Khan, Lateef M; Abed, Hassan H; Alkreathy, Huda M; Ali, Ahmed S

2013-12-01

To scrutinize the knowledge, attitude, and antimicrobial practices in Saudi Arabian Dentistry. In this cross-sectional survey of dentists, a self-administered questionnaire comprising of 61 questions was dispersed to the participants randomly, which included their professional profile, awareness of the current scope of antimicrobial resistance, prescribing practice, frequency of antimicrobial prescription, and sources of continuing education of antimicrobials. The study took place in the Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between February and April 2013. Knowledge and awareness concerning specific antimicrobials, with specific oral cavity lesion was 78% for the students and interns, 80% for residents, and 95.3% for specialists. Approximately 89% of the students, interns and residents, and 98.4% of the specialists endorsed indiscriminate use of antibiotics. In addition, 93.4% of students, 90% of interns and residents, and 90.6% of specialists agreed that lack of health education is one of the contributors to overuse of antimicrobials. Moreover, 91.9% of the interns, 80% of residents, and 75.5% of specialists preferred amoxicillin + clavulanate as their first choice; however, a wide variation in the dosage frequency, and duration was observed. Participants are well aware of the significance of antimicrobial resistance, and considered that judicious use of antimicrobials is highly imperative to restrain this fiery predicament. Divergence was demonstrated between specialists and residents in prescribing practices. Institutional antimicrobial guideline was not interesting to all the respondents. This highlights the need for incessant instructive intervention in order to accomplish the prime objective of retreating antimicrobial resistance.

Standardising Responsibility? The Significance of Interstitial Spaces.

PubMed

Wickson, Fern; Forsberg, Ellen-Marie

2015-10-01

Modern society is characterised by rapid technological development that is often socially controversial and plagued by extensive scientific uncertainty concerning its socio-ecological impacts. Within this context, the concept of 'responsible research and innovation' (RRI) is currently rising to prominence in international discourse concerning science and technology governance. As this emerging concept of RRI begins to be enacted through instruments, approaches, and initiatives, it is valuable to explore what it is coming to mean for and in practice. In this paper we draw attention to a realm that is often backgrounded in the current discussions of RRI but which has a highly significant impact on scientific research, innovation and policy-namely, the interstitial space of international standardization. Drawing on the case of nanoscale sciences and technologies to make our argument, we present examples of how international standards are already entangled in the development of RRI and yet, how the process of international standardization itself largely fails to embody the norms proposed as characterizing RRI. We suggest that although current models for RRI provide a promising attempt to make research and innovation more responsive to societal needs, ethical values and environmental challenges, such approaches will need to encompass and address a greater diversity of innovation system agents and spaces if they are to prove successful in their aims.

Training doctors for primary care in China: Transformation of general practice education.

PubMed

Li, Donald

2016-01-01

China is known for developing a cadre of "Barefoot Doctors" to address her rural healthcare needs in past. The tradition of barefoot doctors has inspired similar developments in several other countries across world. Recently China has embarked upon an ambitious new mission to create a primary care workforce consisting of trained general practitioners having international standard skillsets. This editorial provides an insight into the current status of policy deliberations with regards to training of primary care doctors and a new surge in general practice education in China.

Belonging and Learning to Belong in School: The Implications of the Hidden Curriculum for Indigenous Students

ERIC Educational Resources Information Center

Rahman, Kiara

2013-01-01

This paper engages with current educational literature in Australia and internationally, in exploring the implications of the hidden curriculum for Indigenous students. It argues that in schools, most of the learning rules or guidelines reflect the "white" dominant culture values and practices, and that it is generally those who don't…

Towards Evidence-Based Initial Teacher Education in Singapore: A Review of Current Literature

ERIC Educational Resources Information Center

Low, Ee-Ling; Hui, Chenri; Taylor, Peter G.; Ng, Pak Tee

2012-01-01

Initial teacher education (ITE) in Singapore is shifting towards evidence-based practice. Despite a clear policy orientation, ITE in Singapore has not yet produced the evidence base that it is anticipating. This paper presents an analytical review of previous research into ITE in Singapore and makes comparisons to the larger international context.…

International Trends in the Implementation of Assessment for Learning: Implications for Policy and Practice

ERIC Educational Resources Information Center

Birenbaum, Menucha; DeLuca, Christopher; Earl, Lorna; Heritage, Margaret; Klenowski, Val; Looney, Anne; Smith, Kari; Timperley, Helen; Volante, Louis; Wyatt-Smith, Claire

2015-01-01

This paper discusses the emergence of assessment for learning (AfL) across the globe with particular attention given to Western educational jurisdictions. Authors from Australia, Canada, Ireland, Israel, New Zealand, Norway, and the USA explain the genesis of AfL, its evolution and impact on school systems, and discuss current trends in policy…

Supporting International Applicants and Promoting an Ethical Model of Global College Admission

ERIC Educational Resources Information Center

Redding, Alexis Brooke

2013-01-01

This article examines the challenges facing the pool of global applicants to US colleges and evaluates the practices of the internationaI IECs who currently fill the void that exists between applicants and admission officers. The author, is a doctoral student at the Harvard Graduate School of Education, where she researches ethical issues in…

Twinning "Practices of Change" with "Theory of Change": Room for Emergence in Advocacy Evaluation

ERIC Educational Resources Information Center

Arensman, Bodille; van Waegeningh, Cornelie; van Wessel, Margit

2018-01-01

Theory of change (ToC) is currently "the" approach for the evaluation and planning of international development programs. This approach is considered especially suitable for complex interventions. We question this assumption and argue that ToC's focus on cause-effect logic and intended outcomes does not do justice to the recursive nature…

Thinking about the Brain to Balance Classroom Literacy Programs

ERIC Educational Resources Information Center

Nathanson, Steven A.; Nathanson, Marsha L.

2004-01-01

In this paper, we discuss the link between effective literacy practices recommended by the International Reading Association and current research on how the brain learns derived from MRI and PET scan studies begun in the 1990's. Five key areas of brain-based research discussed include time and attention, emotion, the nature of memory, the learning…

Thinking and Caring about Indigenous Peoples' Human Rights: Swedish Students Writing History beyond Scholarly Debate

ERIC Educational Resources Information Center

Nygren, Thomas

2016-01-01

According to national and international guidelines, schools should promote historical thinking and foster moral values. Scholars have debated, but not analysed in depth in practice, whether history education can and should hold a normative dimension. This study analyses current human rights education in two Swedish senior high school groups, in…

Right to Inclusive Education for Students with Disabilities in Kenya

ERIC Educational Resources Information Center

Elder, Brent C.

2015-01-01

This article explores the current inclusive education system in Kenya, and how those practices relate to Article 24 of the United Nations' Convention on the Rights of Persons with Disabilities (CRPD). Local laws and international instruments are presented to shed light on the extent to which students with disabilities have a right to inclusive…

Training Patterns of German Companies in India, China, Japan and the USA: What Really Works?

ERIC Educational Resources Information Center

Pilz, Matthias

2016-01-01

The transfer of vocational education and training (VET) systems is currently the subject of lively international debate, but there has so far been very little documentation of the process or analysis of how such transfers are achieved in practical terms. This paper therefore considers the potential for transferring Germany's "dual"…

Professional Development through Community Partnership: How a Class Project Led to Graduate Student Teaching Practices

ERIC Educational Resources Information Center

Laidemitt, Heidi; DeMola, Sarah; Martin, Jaymee; Kelley, Caroline

2012-01-01

This article is written from the perspective of 4 current MA TESOL graduate students at the Monterey Institute of International Studies (MIIS). These students have written about their experiences by incorporating their theoretical and pedagogical English language-teaching knowledge into the growth and maintenance of a community-based ESL program…

Teaching Comparative Law in the 21st Century: Beyond the Civil/Common Law Dichotomy.

ERIC Educational Resources Information Center

Waxman, Michael P.

2001-01-01

Asserts that the inexorable shift to transnational and global legal practice demands a comparable shift in methods of teaching comparative law to move it beyond its current American common law/European civil law myopia. Proposes an introductory course, Law in Comparative Cultures, which exposes students to a panoply of international legal systems.…

From Aspirations to Practice: Curriculum Challenges for a New "Twenty-First-Century" Secondary School

ERIC Educational Resources Information Center

McPhail, Graham J.

2016-01-01

This paper reports on the initial stages of an empirical study of a new secondary school in New Zealand. The school vision and organisation reflect current international twenty-first-century learning discourse by confronting long-established beliefs concerning the nature of education and knowledge and the roles of teachers and students. The…

Excellence, Reform and Equity in Education: An International Perspective. Occasional Papers Series, Number 13.

ERIC Educational Resources Information Center

Deem, Rosemary; And Others

The five papers presented in this monograph deal with the implications of the criticisms of education and the calls for excellence now evident in a number of industrialized nations. While the issues discussed vary, there is a common concern to understand how current changes in educational policy may affect educational practice. "Women, Educational…

Edging into the future: education in microbiology and beyond.

PubMed

Fahnert, Beatrix

2016-04-01

State-of-the-art papers from around the globe addressing current topics in education were published in the FEMS Microbiology Letters virtual Thematic Issue 'Education' in November 2015 (http://femsle.oxfordjournals.org/content/thematic-issue-education), which was innovative and well received by microbiologists and other educators. Its unique content is reviewed here to facilitate broader access and further discussions in the professional community. Best practice in supporting school teaching and exposing students to concepts from other disciplines is presented in context of inspiring the next generations, where also historical microbiology can be drawn upon. Technology-enhanced education is discussed including its applications (e.g. lecture podcasts for flipped learning, learning from experts via videoconference). Authentic learning is covered with examples of research-led teaching, water and showerhead biofilm analyses and participation in the International Genetically Engineered Machines competition. Enhancing employability is focussed on, including supporting personal development and work-readiness in general and for the changing nature of the microbiology profession. International mobility develops international awareness but challenges teachers. Teaching training, teaching excellence and dissemination of best practice are reviewed. Times of challenge and change in the Higher Education landscape motivate us to improve educational approaches and frameworks, so that we are prepared for new topics to emerge as current topics in education. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Practice variation on use of antibiotics: An international survey among pediatric urologists.

PubMed

Kim, Jin K; Chua, Michael E; Ming, Jessica M; Braga, Luis H; Smith, Grahame H H; Driver, Christopher; Koyle, Martin A

2018-05-19

Although there is abundance in literature focusing on the use of prophylactic antibiotics for adult urological procedures, the evidence for using antibiotics following common pediatric urological procedures is limited with no specific guidelines for use. Consequently, current practices on antibiotic usage for common interventions may be variable among practicing pediatric urologists, lacking evidence-based support. The aim was to evaluate the current practice pattern on antibiotic usage for common interventions amongst pediatric urologists (PU) practicing in four English-speaking sectors of the world. An anonymous survey of five scenarios with multiple choice options was disseminated to all active practicing members of the Pediatric Urologist of Canada (PUC) and Society of Pediatric Urology of Australia and New Zealand (SPUNZA), as well as all those attending the 2016 British Association of Pediatric Urology (BAPU) and 2017 American Association of Pediatric Urology (AAPU) meetings. The response for each scenario was summarized for overall practice pattern variation and the pattern for each sector was compared using the Fisher exact test. A total of 126 respondents completed the survey (68.5% response rate) with at least a 65% response rate for each of the four sectors. The majority of respondents do not use antibiotics for indwelling urethral (46.8%) and suprapubic catheters (53.4%); however, they do give antibiotics for J-J stent placement (65.1%) and hypospadias surgery (84.9%), and use antibiotics after hypospadias surgery where catheters or stents are left indwelling (80.9%, 84.2%, respectively). Among those surveyed, the PUC members and AAPU PU demonstrated similar practice patterns which often significantly differed from that of SPUNZA members and BAPU attendees. Specifically, a significantly larger proportion of the North American pediatric urologists do not use antibiotics for common procedures compared with Australia, New Zealand, and the UK (Table). In the absence of prospective studies in antibiotic use for pediatric patients to guide clinicians, there is a clear variability among sectors in the use of antibiotics for most clinical scenarios investigated. With increasing resistance patterns and possible adverse effects of antibiotics, it is important that the international pediatric urology community engage in discussions and collaborations to address this issue. Practice patterns in antibiotic usage amongst PU varies widely, some of which may be associated with their local "culture." There is a need to understand these differences and begin to standardize treatment in the hopes of increasing appropriate use of antibiotics internationally. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Global survey of hospital pharmacy practice.

PubMed

Doloresco, Fred; Vermeulen, Lee C

2009-03-01

The current state of hospital pharmacy practice around the globe and key issues facing international hospital pharmacy practice were studied. This survey assessed multiple aspects of hospital pharmacy practice within each of the Member States recognized by the United Nations. An official respondent from each nation was identified by a structured nomination process. The survey instrument was developed; pilot tested; translated into English, French, and Spanish; and distributed in July 2007. The nature, scope, and breadth of hospital pharmacy practices in medication procurement, prescribing, preparation and distribution, administration, outcomes monitoring, and human resources and training were evaluated. Descriptive statistics were used to characterize the responses. Eighty-five countries (44% of the 192 Member States) responded to the survey. The respondent sample of countries was representative of all nations in terms of population, geographic region, World Health Organization region, and level of economic development. In addition to qualifying the nature of hospital pharmacy practice, the survey highlighted numerous challenges facing the profession of pharmacy in the hospital setting around the globe, including access to medicines and adequately trained pharmacists. While the practice of hospital pharmacy differs from country to country, many nations face similar challenges, regardless of their population, location, or wealth. These survey results provide a basis for identifying opportunities for growth and development, as well as for international collaboration, to advance the profession of pharmacy and ensure that patients worldwide receive the care that they deserve.

A Novel Approach to Improving Utilization of Laboratory Testing.

PubMed

Zhou, Yaolin; Procop, Gary W; Riley, Jacquelyn D

2018-02-01

- The incorporation of best practice guidelines into one's institution is a challenging goal of utilization management, and the successful adoption of such guidelines depends on institutional context. Laboratorians who have access to key clinical data are well positioned to understand existing local practices and promote more appropriate laboratory testing. - To apply a novel approach to utilization management by reviewing international clinical guidelines and current institutional practices to create a reliable mechanism to improve detection and reduce unnecessary tests in our patient population. - We targeted a frequently ordered genetic test for HFE-related hereditary hemochromatosis, a disorder of low penetrance. After reviewing international practice guidelines, we evaluated 918 HFE tests and found that all patients with new diagnoses had transferrin saturation levels that were significantly higher than those of patients with nonrisk genotypes (72% versus 42%; P < .001). - Our "one-button" order that restricts HFE genetic tests to patients with transferrin saturation greater than 45% is consistent with published practice guidelines and detected 100% of new patients with HFE-related hereditary hemochromatosis. - Our proposed algorithm differs from previously published approaches in that it incorporates both clinical practice guidelines and local physician practices, yet requires no additional hands-on effort from pathologists or clinicians. This novel approach to utilization management embraces the role of pathologists as leaders in promoting high-quality patient care in local health care systems.

International "best practices" in health care: the roles of context and innovation.

PubMed

Goes, Jim; Savage, Grant T; Friedman, Leonard H

2015-01-01

Explores recent approaches to international best practices and how they relate to context and innovation in health services. Critical review of existing research on best practices and how they created, diffused, and translate in the international setting. Best practices are widely used and discussed, but processes by which they are developed and diffused across international settings are not well understood. Further research is needed on innovation and dissemination of best practices internationally. This commentary points out directions for future research on innovation and diffusion of best practices, particularly in the international setting.

A 2011 survey of clinical practice patterns in the management of Graves' disease.

PubMed

Burch, Henry B; Burman, Kenneth D; Cooper, David S

2012-12-01

More than two decades have passed since members from the American Thyroid Association (ATA), European Thyroid Association, and Japan Thyroid Association were surveyed on management practices for patients with hyperthyroidism due to Graves' disease (GD). We sought to document current practices in the management of GD and compare these results both to those documented in earlier surveys and to practice recommendations made in the 2011 ATA/American Association of Clinical Endocrinologists (AACE) hyperthyroidism practice guidelines. Lastly, we sought to examine differences in GD management among international members of U.S.-based endocrine societies. Members of The Endocrine Society (TES), ATA, and AACE were invited to participate in a web-based survey dealing with testing, treatment preference, and modulating factors in patients with GD. A total of 730 respondents participated in the survey, 696 of whom completed all sections. Respondents included 641 TES members, 330 AACE members, and 157 ATA members. The preferred mode of therapy in uncomplicated GD was antithyroid drugs (ATDs) by 53.9% of respondents, radioactive iodine (RAI) therapy by 45.0%, and thyroid surgery in 0.7%. Compared with 1991, fewer U.S. (59.7 vs. 69%) and European (13.3% vs. 25%) respondents would use RAI therapy. Methimazole and carbimazole were the preferred ATDs, with only 2.7% of respondents selecting propylthiouracil. Patients with Graves' ophthalmopathy were treated with ATDs (62.9%) or surgery (18.5%) and less frequently with RAI plus corticosteroids (16.9%) or RAI alone (1.9%). Striking changes have occurred in the management of GD over the past two decades, with a shift away from RAI and toward ATDs in patients with uncomplicated GD. Apparent international differences persist but should be interpreted with caution. Current practices diverge in some areas from recently published guidelines; these differences should be assessed serially to determine the impact of the guidelines on future clinical practice.

Barriers to breastfeeding in Lebanon: A policy analysis.

PubMed

Akik, Chaza; Ghattas, Hala; Filteau, Suzanne; Knai, Cecile

2017-08-01

Although the issue of breastfeeding in Lebanon has risen on the political agenda, the country does not meet international recommendations for early breastfeeding practices. This study analysed barriers to dissemination, implementation, and enforcement of key policies to improve early breastfeeding practices. We conducted interviews with stakeholders in breastfeeding policy in Lebanon and used a framework approach for analysing data. We found a disconnect between policy endorsement and translation on the ground, weak engagement of professional associations and governmental institutions, undue influence by the breast milk substitute industry, and competing priorities-most notably the current refugee crisis. This study highlights the potential policy opportunities to counter these barriers and points to the role of international organisations and grassroots advocacy in pushing, monitoring, and implementing policies that protect breastfeeding, where government capacity is limited, and the private sector is strong.

Genetic screening for the predisposition to venous thromboembolism: a cost-utility analysis of clinical practice in the Italian health care system.

PubMed

Compagni, Amelia; Melegaro, Alessia; Tarricone, Rosanna

2013-01-01

In the Italian health care system, genetic tests for factor V Leiden and factor II are routinely prescribed to assess the predisposition to venous thromboembolism (VTE) of women who request oral contraception. With specific reference to two subpopulations of women already at risk (i.e., familial history or previous event of VTE), the study aimed to assess whether current screening practices in Italy are cost-effective. Two decisional models accrued costs and quality-adjusted life-years (QALY) annually from the perspective of the National Health Service. The two models were derived from a decision analysis exercise concerning testing practices and consequent prescribing behavior for oral contraception conducted with 250 Italian gynecologists. Health care costs were compiled on the basis of 10-year hospital discharge records and the activities of a thrombosis center. Whenever possible, input data were based on the Italian context; otherwise, the data were taken from the international literature. Current testing practices on women with a familial history of VTE generate an incremental cost-effectiveness ratio of €72,412/QALY, which is well above the acceptable threshold of cost-effectiveness of €40,000 to €50,000/QALY. In the case of women with a previous event of VTE, the most frequently used testing strategy is cost-ineffective and leads to an overall loss of QALY. This study represents the first attempt to conduct a cost-utility analysis of genetic screening practices for the predisposition to VTE in the Italian setting. The results indicate that there is an urgent need to better monitor the indications for which tests for factor V Leiden and factor II are prescribed. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

Management of Pediatric Delirium in Pediatric Cardiac Intensive Care Patients: An International Survey of Current Practices.

PubMed

Staveski, Sandra L; Pickler, Rita H; Lin, Li; Shaw, Richard J; Meinzen-Derr, Jareen; Redington, Andrew; Curley, Martha A Q

2018-06-01

The purpose of this study was to describe how pediatric cardiac intensive care clinicians assess and manage delirium in patients following cardiac surgery. Descriptive self-report survey. A web-based survey of pediatric cardiac intensive care clinicians who are members of the Pediatric Cardiac Intensive Care Society. Pediatric cardiac intensive care clinicians (physicians and nurses). None. One-hundred seventy-three clinicians practicing in 71 different institutions located in 13 countries completed the survey. Respondents described their clinical impression of the occurrence of delirium to be approximately 25%. Most respondents (75%) reported that their ICU does not routinely screen for delirium. Over half of the respondents (61%) have never attended a lecture on delirium. The majority of respondents (86%) were not satisfied with current delirium screening, diagnosis, and management practices. Promotion of day/night cycle, exposure to natural light, deintensification of care, sleep hygiene, and reorientation to prevent or manage delirium were among nonpharmacologic interventions reported along with the use of anxiolytic, antipsychotic, and medications for insomnia. Clinicians responding to the survey reported a range of delirium assessment and management practices in postoperative pediatric cardiac surgery patients. Study results highlight the need for improvement in delirium education for pediatric cardiac intensive care clinicians as well as the need for systematic evaluation of current delirium assessment and management practices.

Tailoring International Pressure Ulcer Prevention Guidelines for Nigeria: A Knowledge Translation Study Protocol.

PubMed

Ilesanmi, Rose Ekama; Gillespie, Brigid M; Adejumo, Prisca Olabisi; Chaboyer, Wendy

2015-07-28

The 2014 International Pressure Ulcer Prevention (PUP) Clinical Practice Guidelines (CPG) provides the most current evidence based strategies to prevent Pressure Ulcer (PU). The evidence upon which these guidelines have been developed has predominantly been generated from research conducted in developed countries. Some of these guidelines may not be feasible in developing countries due to structural and resource issues; therefore there is a need to adapt these guidelines to the context thus making it culturally acceptable. To present a protocol detailing the tailoring of international PUPCPG into a care bundle for the Nigerian context. Guided by the Knowledge to Action (KTA) framework, a two phased study will be undertaken. In Phase 1, the Delphi technique with stakeholder leaders will be used to review the current PUPCPG, identifying core strategies that are feasible to be adopted in Nigeria. These core strategies will become components of a PUP care bundle. In Phase 2, key stakeholder interviews will be used to identify the barriers, facilitators and potential implementation strategies to promote uptake of the PUP care bundle. A PUP care bundle, with three to eight components is expected to be developed from Phase 1. Implementation strategies to promote adoption of the PUP care bundle into clinical practice in selected Nigerian hospitals, is expected to result from Phase 2. Engagement of key stakeholders and consumers in the project should promote successful implementation and translate into better patient care. Using KTA, a knowledge translation framework, to guide the implementation of PUPCPG will enhance the likelihood of successful adoption in clinical practice. In implementing a PUP care bundle, developing countries face a number of challenges such as the feasibility of its components and the required resources.

Microsurgery Training for the Twenty-First Century

PubMed Central

Myers, Simon Richard; Froschauer, Stefan; Akelina, Yelena; Tos, Pierluigi; Kim, Jeong Tae

2013-01-01

Current educational interventions and training courses in microsurgery are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess current training tools in microsurgery education and devise alternative methods that would enhance training. Simulation is an increasingly important tool for educators because, whilst facilitating improved technical proficiency, it provides a way to reduce risks to both trainees and patients. The International Microsurgery Simulation Society has been founded in 2012 in order to consolidate the global effort in promoting excellence in microsurgical training. The society's aim to achieve standarisation of microsurgical training worldwide could be realised through the development of evidence based educational interventions and sharing best practices. PMID:23898422

The Second Joint NASA/FAA/DoD Conference on Aging Aircraft. Part 2

NASA Technical Reports Server (NTRS)

Harris, Charles E. (Editor)

1999-01-01

The purpose of the Conference was to bring together world leaders in aviation safety research, aircraft design and manufacturing, fleet operation and aviation maintenance to disseminate information on current practices and advanced technologies that will assure the continued airworthiness of the aging aircraft in the military and commercial fleets. The Conference included reviews of current industry practices, assessments of future technology requirements, and status of aviation safety research. The Conference provided an opportunity for interactions among the key personnel in the research and technology development community, the original equipment manufacturers, commercial airline operators, military fleet operators, aviation maintenance, and aircraft certification and regulatory authorities. Conference participation was unrestricted and open to the international aviation community. Appendix B contains the name and addresses of the 623 participants in the Conference.

The international seismological observing period in Africa

USGS Publications Warehouse

Engdahl, E.R.; Bergman, Eric A.

1992-01-01

The International Seismological Observing Period (ISOP) is a specific time interval designated for enhanced international cooperation in the collection and dissemination of observatory measurements from the global seismographic network. The primary purpose of the ISOP is to strengthen the international infrastructure that supports current seismological practice and increase the cooperation among nations that operate seismological observatories. Measurements, reported by the existing global network and compiled by agencies such as the International Seismological Centre (ISC), are providing new information about earthquakes and the structure of the Earth of fundamental importance to the Earth sciences. However, these data represent but a small fraction of the information contained in the seismograms. One of the goals of the ISOP is to collect improved sets of data. In particular, the measurement and reporting of later-arriving phases, during a fixed ISOP period, from earthquakes selected for detailed observation by the cooperating stations will be encouraged. The use of advanced, digital instrumentation provides an unprecedented opportunity for enhancing the methods of seismogram interpretation and seismic parameter extraction, by the implementation of digital processing methods at seismic observatories worldwide. It must be ensured that this new information will be available to the entire seismological community. It is believed that this purpose is best served with an ISOP that promotes increased on-site processing at digital stations in Africa and elsewhere. Improvements in seismology require truly international cooperation and the educational aspects of seismological practice form one of the goals of the ISOP. Thus, workshops will be needed in Africa to train analysts in ISOP procedures and to introduce them to modern techniques and applications of the data. Participants will, thus, benefit from theoretical results and practical experience that are of direct relevance to their own work. ?? 1992.

Role of Imaging in the Staging and Response Assessment of Lymphoma: Consensus of the International Conference on Malignant Lymphomas Imaging Working Group

PubMed Central

Barrington, Sally F.; Mikhaeel, N. George; Kostakoglu, Lale; Meignan, Michel; Hutchings, Martin; Müeller, Stefan P.; Schwartz, Lawrence H.; Zucca, Emanuele; Fisher, Richard I.; Trotman, Judith; Hoekstra, Otto S.; Hicks, Rodney J.; O'Doherty, Michael J.; Hustinx, Roland; Biggi, Alberto; Cheson, Bruce D.

2014-01-01

Purpose Recent advances in imaging, use of prognostic indices, and molecular profiling techniques have the potential to improve disease characterization and outcomes in lymphoma. International trials are under way to test image-based response–adapted treatment guided by early interim positron emission tomography (PET) –computed tomography (CT). Progress in imaging is influencing trial design and affecting clinical practice. In particular, a five-point scale to grade response using PET-CT, which can be adapted to suit requirements for early- and late-response assessment with good interobserver agreement, is becoming widely used both in practice- and response-adapted trials. A workshop held at the 11th International Conference on Malignant Lymphomas (ICML) in 2011 concluded that revision to current staging and response criteria was timely. Methods An imaging working group composed of representatives from major international cooperative groups was asked to review the literature, share knowledge about research in progress, and identify key areas for research pertaining to imaging and lymphoma. Results A working paper was circulated for comment and presented at the Fourth International Workshop on PET in Lymphoma in Menton, France, and the 12th ICML in Lugano, Switzerland, to update the International Harmonisation Project guidance regarding PET. Recommendations were made to optimize the use of PET-CT in staging and response assessment of lymphoma, including qualitative and quantitative methods. Conclusion This article comprises the consensus reached to update guidance on the use of PET-CT for staging and response assessment for [18F]fluorodeoxyglucose-avid lymphomas in clinical practice and late-phase trials. PMID:25113771

Exploring international clinical education in US-based programs: identifying common practices and modifying an existing conceptual model of international service-learning.

PubMed

Pechak, Celia M; Black, Jill D

2014-02-01

Increasingly physical therapist students complete part of their clinical training outside of their home country. This trend is understudied. The purposes of this study were to: (1) explore, in depth, various international clinical education (ICE) programs; and (2) determine whether the Conceptual Model of Optimal International Service-Learning (ISL) could be applied or adapted to represent ICE. Qualitative content analysis was used to analyze ICE programs and consider modification of an existing ISL conceptual model for ICE. Fifteen faculty in the United States currently involved in ICE were interviewed. The interview transcriptions were systematically analyzed by two researchers. Three models of ICE practices emerged: (1) a traditional clinical education model where local clinical instructors (CIs) focus on the development of clinical skills; (2) a global health model where US-based CIs provide the supervision in the international setting, and learning outcomes emphasized global health and cultural competency; and (3) an ICE/ISL hybrid where US-based CIs supervise the students, and the foci includes community service. Additionally the data supported revising the ISL model's essential core conditions, components and consequence for ICE. The ICE conceptual model may provide a useful framework for future ICE program development and research.

Internationalization of the animal science undergraduate curriculum: a survey of its current status, barriers to its implementation and its value.

PubMed

Forsberg, N E; Taur, J S; Xiao, Y; Chesbrough, H

2003-04-01

The goal of this project was to identify the current level at which internationalization has been adopted as a theme in the North American animal science curriculum and to identify its value and the barriers to its implementation. We surveyed animal, dairy, and poultry science departments across Canada and the United States. One hundred twenty-four surveys were mailed and 60% were returned. Associations between aspects of internationalization and student outcomes (admission to veterinary and graduate schools and starting salaries) were examined. Although administrators strongly believed internationalization had value, implementation was limited. The most common practices included international content in core animal science classes, advising, international internships, and participation of faculty in international scholarly activities. Few departments have incorporated internationalization into their mission statements or developed a specific international-themed class, scholarships devoted to international activities, or roles for international students. Few departments reported participation of students in international programs. Barriers included finances and limited commitment from higher administration. Student outcomes were positively associated with faculty size, percentage of international faculty, the ratio of international students to the total student population, international content in core animal science classes, a specific international-themed class, availability of international internships, and exchange of class material internationally via the Internet. Departments that did not offer international opportunities had a negative association (r = -0.79) with starting salary, but these relationships may not be causal. Alternatively, progressive departments may attract and retain exceptional students. The analysis indicated an awareness of the value of international programs, positive impacts in student outcomes, and financial barriers to implementation.

The hierarchy of environmental health and safety practices in the U.S. nanotechnology workplace.

PubMed

Engeman, Cassandra D; Baumgartner, Lynn; Carr, Benjamin M; Fish, Allison M; Meyerhofer, John D; Satterfield, Terre A; Holden, Patricia A; Harthorn, Barbara Herr

2013-01-01

Manufacturing of nanoscale materials (nanomaterials) is a major outcome of nanotechnology. However, the potential adverse human health effects of manufactured nanomaterial exposure are not yet fully understood, and exposures in humans are mostly uncharacterized. Appropriate exposure control strategies to protect workers are still being developed and evaluated, and regulatory approaches rely largely on industry self-regulation and self-reporting. In this context of soft regulation, the authors sought to: 1) assess current company-reported environmental health and safety practices in the United States throughout the product life cycle, 2) consider their implications for the manufactured nanomaterial workforce, and 3) identify the needs of manufactured nanomaterial companies in developing nano-protective environmental health and safety practices. Analysis was based on the responses of 45 U.S.-based company participants in a 2009-2010 international survey of private companies that use and/or produce nanomaterials. Companies reported practices that span all aspects of the current government-recommended hierarchical approach to manufactured nanomaterials' exposure controls. However, practices that were tailored to current manufactured nanomaterials' hazard and exposure knowledge, whether within or outside the hierarchical approach, were reported less frequently than general chemical hygiene practices. Product stewardship and waste management practices-the influences of which are substantially downstream-were reported less frequently than most other environmental health and safety practices. Larger companies had more workers handling nanomaterials, but smaller companies had proportionally more employees handling nanomaterials and more frequently identified impediments to implementing nano-protective practices. Company-reported environmental health and safety practices suggest more attention to environmental health and safety is necessary, especially with regard to practices that can cause external effects. Given reported impediments, smaller companies may especially benefit from more attention. However, the manufactured nanomaterial workforce within smaller companies is particularly difficult to identify and hence locate, posing challenges to developing and enforcing appropriate workplace environmental health and safety. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a file containing Survey of Current Health and Safety Practices in the Nanomaterial Industry and a file containing figures.].

Validation of a global scale to assess the quality of interprofessional teamwork in mental health settings.

PubMed

Tomizawa, Ryoko; Yamano, Mayumi; Osako, Mitue; Hirabayashi, Naotugu; Oshima, Nobuo; Sigeta, Masahiro; Reeves, Scott

2017-12-01

Few scales currently exist to assess the quality of interprofessional teamwork through team members' perceptions of working together in mental health settings. The purpose of this study was to revise and validate an interprofessional scale to assess the quality of teamwork in inpatient psychiatric units and to use it multi-nationally. A literature review was undertaken to identify evaluative teamwork tools and develop an additional 12 items to ensure a broad global focus. Focus group discussions considered adaptation to different care systems using subjective judgements from 11 participants in a pre-test of items. Data quality, construct validity, reproducibility, and internal consistency were investigated in the survey using an international comparative design. Exploratory factor analysis yielded five factors with 21 items: 'patient/community centred care', 'collaborative communication', 'interprofessional conflict', 'role clarification', and 'environment'. High overall internal consistency, reproducibility, adequate face validity, and reasonable construct validity were shown in the USA and Japan. The revised Collaborative Practice Assessment Tool (CPAT) is a valid measure to assess the quality of interprofessional teamwork in psychiatry and identifies the best strategies to improve team performance. Furthermore, the revised scale will generate more rigorous evidence for collaborative practice in psychiatry internationally.

Cerebrospinal fluid protein and glucose examinations and tuberculosis:
Will laboratory safety regulations force a change of practice?

PubMed

Tormey, William P; O'Hagan, Christopher

2015-01-01

Cerebrospinal fluid (CSF) protein and glucose examinations are usually performed in chemical pathology departments on autoanalysers. Tuberculosis (TB) is a group 3 biological agent under Directive 2000/54/EC of the European Parliament but in the biochemistry laboratory, no extra precautions are taken in its analysis in possible TB cases. The issue of laboratory practice and safety in the biochemical analyses of CSF specimens, when tuberculosis infection is in question is addressed in the context of ambiguity in the implementation of current national and international health and safety regulations. Additional protective measures for laboratory staff during the analysis of CSF TB samples should force a change in current laboratory practice and become a regulatory issue under ISO 15189. Annual Mantoux skin test or an interferon-γ release assay for TB should be mandatory for relevant staff. This manuscript addresses the issue of biochemistry laboratory practice and safety in the biochemical analyses of CSF specimens when tuberculosis infection is in question in the context of the ambiguity of statutory health and safety regulations.

Contributions of international cooperation projects to the HIV/AIDS response in China

PubMed Central

Sun, Jiangping; Liu, Hui; Li, Hui; Wang, Liqiu; Guo, Haoyan; Shan, Duo; Bulterys, Marc; Korhonen, Christine; Hao, Yang; Ren, Minghui

2010-01-01

Background For 20 years, China has participated in 267 international cooperation projects against the HIV/AIDS epidemic and received ∼526 million USD from over 40 international organizations. These projects have played an important role by complementing national efforts in the fight against HIV/AIDS in China. Methods The diverse characteristics of these projects followed three phases over 20 years. Initially, stand-alone projects provided technical support in surveillance, training or advocacy for public awareness. As the epidemic spread across China, projects became a part of the comprehensive and integrated national response. Currently, international best practices encourage the inclusion of civil society and non-governmental organizations in an expanded response to the epidemic. Results Funding from international projects has accounted for one-third of the resources provided for the HIV/AIDS response in China. Beyond this strong financial support, these programmes have introduced best practices, accelerated the introduction of AIDS policies, strengthened capacity, improved the development of grassroots social organizations and established a platform for communication and experience sharing with the international community. However, there are still challenges ahead, including integrating existing resources and exploring new programme models. The National Centre for AIDS/STD Control and Prevention (NCAIDS) in China is consolidating all international projects into national HIV prevention, treatment and care activities. Conclusion International cooperation projects have been an invaluable component of China’s response to HIV/AIDS, and China has now been able to take this information and share its experiences with other countries with the help of these same international programmes. PMID:21113032

Exploring the scope of expanding advanced nursing practice in nurse-led clinics: a multiple-case study.

PubMed

Shiu, Ann T Y; Lee, Diana T F; Chau, Janita P C

2012-08-01

This article is a report on a study to explore the development of expanding advanced nursing practice in nurse-led clinics in Hong Kong. Nurse-led clinics serviced by advanced practice nurses, a common international practice, have been adopted in Hong Kong since 1990s. Evaluations consistently show that this practice has good clinical outcomes and contributes to containing healthcare cost. However, similar to the international literature, it remains unclear as to what the elements of good advanced nursing practice are, and which directions Hong Kong should adopt for further development of such practice. A multiple-case study design was adopted with six nurse-led clinics representing three specialties as six case studies, and including two clinics each from continence, diabetes and wound care. Each case had four embedded units of analysis. They included non-participant observation of nursing activities (9 days), nurse interviews (N = 6), doctor interviews (N = 6) and client interviews (N = 12). The data were collected in 2009. Within- and cross-case analyses were conducted. The cross-case analysis demonstrated six elements of good advanced nursing practice in nurse-led clinics, and showed a great potential to expand the practice by reshaping four categories of current boundaries, including community-hospital, wellness-illness, public-private and professional-practice boundaries. From these findings, we suggest a model to advance the scope of advanced nursing practice in nurse-led clinics. The six elements may be applied as audit criteria for evaluation of advanced nursing practice in nurse-led clinics, and the proposed model provides directions for expanding such practice in Hong Kong and beyond. © 2011 Blackwell Publishing Ltd.

Professional Experiences of International Medical Graduates Practicing Primary Care in the United States

PubMed Central

Nunez-Smith, Marcella; Bernheim, Susannah May; Berg, David; Gozu, Aysegul; Curry, Leslie Ann

2010-01-01

Background International medical graduates (IMGs) comprise approximately 25% of the US physician workforce, with significant representation in primary care and care of vulnerable populations. Despite the central role of IMGs in the US healthcare system, understanding of their professional experiences is limited. Objective To characterize the professional experiences of non-US born IMGs from limited-resource nations practicing primary care in the US. Design Qualitative study based on in-depth in-person interviews. Participants Purposeful sample of IMGs (n = 25) diverse in country of origin, length of practice in the US, specialty (internal medicine, family medicine and pediatrics), age and gender. Participants were currently practicing primary care physicians in New York, New Jersey or Connecticut. Approach A standardized interview guide was used to explore professional experiences of IMGs. Key Results Four recurrent and unifying themes characterize these experiences: 1) IMGs experience both overt and subtle forms of workplace bias and discrimination; 2) IMGs recognize professional limitations as part of “the deal”; 3) IMGs describe challenges in the transition to the culture and practice of medicine in the US; 4) IMGs bring unique skills and advantages to the workplace. Conclusions Our data reveal that IMGs face workplace challenges throughout their careers. Despite diversity in professional background and demographic characteristics, IMGs in our study reported common experiences in the transition to and practice of medicine in the US. Findings suggest that both workforce and workplace interventions are needed to enable IMG physicians to sustain their essential and growing role in the US healthcare system. Finally, commonalities with experiences of other minority groups within the US healthcare system suggest that optimizing IMGs’ experiences may also improve the experiences of an increasingly diverse healthcare workforce. PMID:20502974

Professional experiences of international medical graduates practicing primary care in the United States.

PubMed

Chen, Peggy Guey-Chi; Nunez-Smith, Marcella; Bernheim, Susannah May; Berg, David; Gozu, Aysegul; Curry, Leslie Ann

2010-09-01

International medical graduates (IMGs) comprise approximately 25% of the US physician workforce, with significant representation in primary care and care of vulnerable populations. Despite the central role of IMGs in the US healthcare system, understanding of their professional experiences is limited. To characterize the professional experiences of non-US born IMGs from limited-resource nations practicing primary care in the US. Qualitative study based on in-depth in-person interviews. Purposeful sample of IMGs (n = 25) diverse in country of origin, length of practice in the US, specialty (internal medicine, family medicine and pediatrics), age and gender. Participants were currently practicing primary care physicians in New York, New Jersey or Connecticut. A standardized interview guide was used to explore professional experiences of IMGs. Four recurrent and unifying themes characterize these experiences: 1) IMGs experience both overt and subtle forms of workplace bias and discrimination; 2) IMGs recognize professional limitations as part of "the deal"; 3) IMGs describe challenges in the transition to the culture and practice of medicine in the US; 4) IMGs bring unique skills and advantages to the workplace. Our data reveal that IMGs face workplace challenges throughout their careers. Despite diversity in professional background and demographic characteristics, IMGs in our study reported common experiences in the transition to and practice of medicine in the US. Findings suggest that both workforce and workplace interventions are needed to enable IMG physicians to sustain their essential and growing role in the US healthcare system. Finally, commonalities with experiences of other minority groups within the US healthcare system suggest that optimizing IMGs' experiences may also improve the experiences of an increasingly diverse healthcare workforce.

The reliability and validity of multiple mini interviews (MMIs) in values based recruitment to nursing, midwifery and paramedic practice programmes: Findings from an evaluation study.

PubMed

Callwood, Alison; Cooke, Debbie; Bolger, Sarah; Lemanska, Agnieszka; Allan, Helen

2018-01-01

Universities in the United Kingdom (UK) are required to incorporate values based recruitment (VBR) into their healthcare student selection processes. This reflects an international drive to strengthen the quality of healthcare service provision. This paper presents novel findings in relation to the reliability and predictive validity of multiple mini interviews (MMIs); one approach to VBR widely being employed by universities. To examine the reliability (internal consistency) and predictive validity of MMIs using end of Year One practice outcomes of under-graduate pre-registration adult, child, mental health nursing, midwifery and paramedic practice students. Cross-discipline evaluation study. One university in the United Kingdom. Data were collected in two streams: applicants to A) The September 2014 and 2015 Midwifery Studies programmes; B) September 2015 adult; Child and Mental Health Nursing and Paramedic Practice programmes. Fifty-seven midwifery students commenced their programme in 2014 and 69 in 2015; 47 and 54 agreed to participate and completed Year One respectively. 333 healthcare students commenced their programmes in September 2015. Of these, 281 agreed to participate and completed their first year (180 adult, 33 child and 34 mental health nursing and 34 paramedic practice students). Stream A featured a seven station four-minute model with one interviewer at each station and in Stream B a six station model was employed. Cronbach's alpha was used to assess MMI station internal consistency and Pearson's moment correlation co-efficient to explore associations between participants' admission MMI score and end of Year one clinical practice outcomes (OSCE and mentor grading). Stream A: Significant correlations are reported between midwifery applicant's MMI scores and end of Year One practice outcomes. A multivariate linear regression model demonstrated that MMI score significantly predicted end of Year One practice outcomes controlling for age and academic entry level: coefficients 0.195 (p=0.002) and 0.116 (p=0.002) for OSCE and mentor grading respectively. In Stream B no significant correlations were found between MMI score and practice outcomes measured by mentor grading. Internal consistency for each MMI station was 'excellent' with values ranging from 0.966-0.974 across Streams A and B. This novel, cross-discipline study shows that MMIs are reliable VBR tools which have predictive validity when a seven station model is used. These data are important given the current international use of different MMI models in healthcare student selection processes. Copyright © 2017. Published by Elsevier Ltd.

The Importance of Play in Early Childhood Education: A Critical Perspective on Current Policies and Practices in Germany and Hong Kong

ERIC Educational Resources Information Center

Faas, Stefan; Wu, Shu-chen; Geiger, Steffen

2017-01-01

In order to reflect international reform movements in a system- and culture-comparative perspective, the following article investigates the early childhood education systems in Germany and in Hong Kong, with reference to the respective social and educational roots, pedagogical development lines, and basic educational approaches. In addition,…

Short Sighted: How America's Lack of Attention to International Education Studies Impedes Improvement. Policy Brief

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

To future generations, Americans' current educational myopia is likely to appear, at best, a negligent failure to anticipate and meet the needs of the nation and its citizens. And for the sake of those future generations, this brief suggests that the short-sighted practices and parochial policies that have delayed significant improvement in the…

The Effects of Commercial Cool Water Washing of Shell Eggs on Haugh Unit, Vitelline Membrane Strength, Aerobic Microorganisms and Fungi

USDA-ARS?s Scientific Manuscript database

Current egg washing practices utilize wash water temperatures averaging 49°C, and have been found to increase internal egg temperature by 6.7 to 7.8°C. These high temperatures create a more optimal environment for bacterial growth, including Salmonella Enteritidis (SE), if it is present. SE is the...

Brief Report: Can Metrics of Reporting Bias Enhance Early Autism Screening Measures?

ERIC Educational Resources Information Center

Taylor, Cora M.; Vehorn, Alison; Noble, Hylan; Weitlauf, Amy S.; Warren, Zachary E.

2014-01-01

The goal of the current study was to develop and pilot the utility of two simple internal response bias metrics, over-reporting and under-reporting, in terms of additive clinical value within common screening practices for early detection of autism spectrum disorder risk. Participants were caregivers and children under 36 months of age (n = 145)…

An Examination of the Relationship between Supervision and Self-Efficacy in Early Career School Psychologists, School Psychology Interns, and Practicum Students

ERIC Educational Resources Information Center

Kaas, Felicia M.

2017-01-01

The purpose of this study is to explore the relationship between self-efficacy and supervision in early career school psychologists and school psychology graduate students who are currently completing either their practicum or internship experiences. The sample consisted of practicing early career school psychologists (ECPs) and school psychology…

Qualitative Educational Research in Developing Countries: Current Perspectives. Reference Books in International Education, Volume 35. Garland Reference Library of Social Science, Volume 927.

ERIC Educational Resources Information Center

Crossley, Michael, Ed.; Vulliamy, Graham, Ed.

This book contains 11 essays that offer in-depth accounts of qualitative research in developing countries. Each chapter focuses upon a specific method and considers related theoretical and practical issues with reference to recent experiences in selected developing countries. Key issues addressed include: (1) the identification of appropriate…

The International Infrastructure of Area Studies Centers: Lessons for Current Practice from a Prior Wave of Internationalization

ERIC Educational Resources Information Center

Friedman, Jonathan Z.; Miller-Idriss, Cynthia

2015-01-01

Existing studies of the internationalization of higher education have detailed the broad contours of change in the new "global" era, but they have told us much less about the individuals and processes underpinning these transformations. Moreover, they tend to treat internationalization as a recent or new phenomenon. There have been prior…

Content Analysis of "School Psychology International", 1990-2011: An Analysis of Trends and Compatibility with the NASP Practice Model

ERIC Educational Resources Information Center

Little, Steven G.; Akin-Little, Angeleque; Lloyd, Keryn

2011-01-01

Formal analysis of research publications serves as one indicator of the current status of a profession or a journal. Content analyses provide both practitioners and academicians with information on the status of research in the profession. These types of analyses can also provide information on the concordance between published research and what…

The Role of Research in the Policy and Practice of Quality Teacher Education: An International Review

ERIC Educational Resources Information Center

Tatto, Maria Teresa

2015-01-01

The stated goal of current education reform is the redesign of education systems in pursuit of quality. Systems that consistently "come out on top" have excited much interest in uncovering the features that have contributed to their success; notably among these is the preparation of future teachers. Research on teacher education quality…

Writing as a Learning Tool: Integrating Theory and Practice. Studies in Writing, Volume 7.

ERIC Educational Resources Information Center

Tynjala, Paivi, Ed.; Mason, Lucia, Ed.; Lonka, Kirsti, Ed.

This book, the seventh volume in the Studies in Writing International Series on the Research of Learning and Instruction of Writing, is an account of the current state of using writing as a tool for learning. The book presents psychological and educational foundations of the writing across the curriculum movement and describes writing-to-learn…

Children of Trauma: Stressful Life Events and Their Effects on Children and Adolescents. International Universities Press Stress and Health Series. Monograph 8.

ERIC Educational Resources Information Center

Miller, Thomas W., Ed.

Clinical theory and practice models are provided along with current concepts in diagnosis and treatment. Theoretical formulations, hypotheses, issues, and implications related to life stress measurement are addressed and applied to medical and mental health concerns. Contributions include: (1) "Stress Response and Adaptation in Children:…

After Action Report: Cursor On Target International User Group Meeting (2nd). Held on 1-2 April 2014

DTIC Science & Technology

2014-04-01

is ready access to the cafeteria and Starbucks coffee bar in an area where all can travel without escort. Use of the ACME facilities adjacent to... price ” they were willing to “pay” in terms of potential modifications to current CoT practices and implementations. Future discussions should focus

Administrative needs of academic partnerships at one Ethiopian university: a pilot study.

PubMed

White, Mary T; Worku, Netsanet

2013-07-01

International university partnerships are important contributors to international collaboration, research, and capacity strengthening worldwide. In Ethiopia, such partnerships have been initiated at many universities for many years. Partnership effectiveness is known to be dependent in part on effective administrative practices and infrastructure. This study examines the administrative services and resources considered most valuable for sustainable partnerships at one Ethiopian university. A survey questionnaire was distributed to 67 Ethiopian and international colleagues currently or recently involved in partnerships at the University of Gondar, of which 10 were completed and returned by personnel at the University of Gondar and 8 were returned from international colleagues. Both Ethiopian and international respondents agreed on the value of partnerships, the dominant challenges, and administrative solutions. However, the study also revealed striking differences in perceptions of equity and benefit. While the study is small, it raises some important questions for further study.

Internal displacement in Colombia: Fifteen distinguishing features.

PubMed

Shultz, James M; Ceballos, Ángela Milena Gómez; Espinel, Zelde; Oliveros, Sofia Rios; Fonseca, Maria Fernanda; Florez, Luis Jorge Hernandez

2014-01-01

This commentary aims to delineate the distinguishing features of conflict-induced internal displacement in the nation of Colombia, South America. Even as Colombia is currently implementing a spectrum of legal, social, economic, and health programs for "victims of armed conflict," with particular focus on internally displaced persons (IDPs), the dynamics of forced migration on a mass scale within this country are little known beyond national borders.   The authors of this commentary are embarking on a global mental health research program in Bogota, Colombia to define best practices for reaching the displaced population and implementing sustainable, evidence-based screening and intervention for common mental disorders. Presenting the defining characteristics of internal displacement in Colombia provides the context for our work and, more importantly, conveys the compelling and complex nature of this humanitarian crisis. We attempt to demonstrate Colombia's unique position within the global patterning of internal displacement.

Internal displacement in Colombia

PubMed Central

Shultz, James M; Ceballos, Ángela Milena Gómez; Espinel, Zelde; Oliveros, Sofia Rios; Fonseca, Maria Fernanda; Florez, Luis Jorge Hernandez

2014-01-01

This commentary aims to delineate the distinguishing features of conflict-induced internal displacement in the nation of Colombia, South America. Even as Colombia is currently implementing a spectrum of legal, social, economic, and health programs for “victims of armed conflict,” with particular focus on internally displaced persons (IDPs), the dynamics of forced migration on a mass scale within this country are little known beyond national borders.   The authors of this commentary are embarking on a global mental health research program in Bogota, Colombia to define best practices for reaching the displaced population and implementing sustainable, evidence-based screening and intervention for common mental disorders. Presenting the defining characteristics of internal displacement in Colombia provides the context for our work and, more importantly, conveys the compelling and complex nature of this humanitarian crisis. We attempt to demonstrate Colombia’s unique position within the global patterning of internal displacement. PMID:28228997

A conceptual framework for international service-learning course planning: promoting a foundation for ethical practice in the physical therapy and occupational therapy professions.

PubMed

Lattanzi, Jill Black; Pechak, Celia

2011-01-01

As physical therapy (PT) and occupational therapy (OT) educational programs endeavor to foster core values of social responsibility, justice, and altruism in an increasingly global community, the incorporation of local and international service-learning (ISL) into the curriculum is growing. Much of the research has focused on the measurement of student learning, with little written about the impact on the host community. Proponents of global health initiatives are calling for consideration of all stakeholders to ensure ethical practice. This paper explores the current literature related to PT and OT ISL and builds a conceptual framework for ISL course planning. The essential phases in the framework include: 1) pre-experience planning/preparation stage, 2) field immersion experience stage, and 3) postexperience stage. The essential elements are: 1) cultural competency training, 2) communication and coordination with community, 3) comprehensive assessment, and 4) strategic planning. The authors suggest this framework as a practical tool to structure ISL courses with an explicit emphasis on ethical concerns. Additionally, they seek to foster more dialogue and action related to the promotion of ethical practices in ISL in PT and OT education programs.

Responding to the global economic crisis: inclusive social work practice.

PubMed

Strier, Ron

2013-10-01

The present global economic crisis raises new concerns for social workers. One of its most visible results is the further socioeconomic decline and marginalization of excluded populations. This article suggests that the current circumstances require a much more engaged, egalitarian, and reflexive practice-a practice, based on social rights, that matches the magnitude of the crisis and its negative impact on traditional social work constituencies. Consequently, the article suggests the concept of inclusive social work practice (ISWP), a conceptual framework whose main principles respond to four processes of social exclusion closely related to the present global crisis: extreme social isolation, growing dependency, multiple deprivation, and internalized oppression. The author describes the impact of the global crisis on patterns of social exclusion and presents the methodological foundations of the ISWP framework.

Fast-mode duplex qPCR for BCR-ABL1 molecular monitoring: innovation, automation, and harmonization.

PubMed

Gerrard, Gareth; Mudge, Katherine; Foskett, Pierre; Stevens, David; Alikian, Mary; White, Helen E; Cross, Nicholas C P; Apperley, Jane; Foroni, Letizia

2012-07-01

Reverse transcription quantitative polymerase chain reaction (RTqPCR)is currently the most sensitive tool available for the routine monitoring of disease level in patients undergoing treatment for BCRABL1 associated malignancies. Considerable effort has been invested at both the local and international levels to standardise the methodology and reporting criteria used to assess this critical metric. In an effort to accommodate the demands of increasing sample throughput and greater standardization, we adapted the current best-practice guidelines to encompass automation platforms and improved multiplex RT-qPCR technology.

"Once when i was on call...," theory versus reality in training for professionalism.

PubMed

Eggly, Susan; Brennan, Simone; Wiese-Rometsch, Wilhelmine

2005-04-01

To identify the degree to which interns' reported experiences with professional and unprofessional behavior converge and/or diverge with ideal professional behavior proposed by the physician community. Interns at Wayne State University's residency programs in internal medicine, family medicine, and transitional medicine responded to essay questions about their experience with professional and unprofessional behavior as part of a curriculum on professionalism. Responses were coded for whether they reflected each of the principles and responsibilities outlined in a major publication on physician professionalism. Content analysis included the frequencies with which the interns' essays reflected each principle or responsibility. Additionally, a thematic analysis revealed themes of professional behavior that emerged from the essays. Interns' experiences with professional and unprofessional behavior most frequently converged with ideal behavior proposed by the physician community in categories involving interpersonal interactions with patients. Interns infrequently reported experiences involving behavior related to systems or sociopolitical issues. Interns' essays reflect their concern with interpersonal interactions with patients, but they are either less exposed to or less interested in describing behavior regarding systems or sociopolitical issues. This may be due to their stage of training or to the emphasis placed on interpersonal rather than systems or sociopolitical issues during training. The authors recommend future proposals of ideal professional behavior be revised periodically to reflect current experiences of practicing physicians, trainees, other health care providers and patients. Greater educational emphasis should be placed on the systems and sociopolitical environment in which trainees practice.

Quality specification and status of internal quality control of cardiac biomarkers in China from 2011 to 2016.

PubMed

Li, Tingting; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2017-09-07

This study aimed to investigate the status of internal quality control (IQC) for cardiac biomarkers from 2011 to 2016 so that we can have overall knowledge of the precision level of measurements in China and set appropriate precision specifications. Internal quality control data of cardiac biomarkers, including creatinine kinase MB (CK-MB) (μg/L), CK-MB(U/L), myoglobin (Mb), cardiac troponin I (cTnI), cardiac troponin T (cTnT), and homocysteines (HCY), were collected by a web-based external quality assessment (EQA) system. Percentages of laboratories meeting five precision quality specifications for current coefficient of variations (CVs) were calculated. Then, appropriate precision specifications were chosen for these six analytes. Finally, the CVs and IQC practice were further analyzed with different grouping methods. The current CVs remained nearly constant for 6 years. cTnT had the highest pass rates every year against five specifications, whereas HCY had the lowest pass rates. Overall, most analytes had a satisfactory performance (pass rates >80%), except for HCY, if one-third TEa or the minimum specification were employed. When the optimal specification was applied, the performance of most analytes was frustrating (pass rates < 60%) except for cTnT. The appropriate precision specifications of Mb, cTnI, cTnT and HCY were set as current CVs less than 9.20%, 9.90%, 7.50%, 10.54%, 7.63%, and 6.67%, respectively. The data of IQC practices indicated wide variation and substantial progress. The precision performance of cTnT was already satisfying, while the other five analytes, especially HCY, were still frustrating; thus, ongoing investigation and continuous improvement for IQC are still needed. © 2017 Wiley Periodicals, Inc.

Radiation dose management in thoracic CT: an international survey.

PubMed

Molinari, Francesco; Tack, Denis M; Boiselle, Philip; Ngo, Long; Mueller-Mang, Christina; Litmanovich, Diana; Bankier, Alexander A

2013-01-01

We aimed to examine current practice patterns of international thoracic radiologists regarding radiation dose management in adult thoracic computed tomography (CT) examinations. An electronic questionnaire was sent to 800 members of five thoracic radiology societies in North America, Europe, Asia, and Latin America addressing radiation dose training and education, standard kVp and mAs settings for thoracic CT, dose reduction practices, clinical scenarios, and demographics. Of the 800 radiologists, 146 responded to our survey. Nearly half (66/146, 45% [95% confidence interval, 37%-53%]) had no formal training in dose reduction, with "self-study of the literature" being the most common form of training (54/146, 37% [29%-45%]). One hundred and seventeen (80% [74%-87%]) had automatic exposure control, and 76 (65% [56%-74%]) used it in all patients. Notably, most respondents (89% [84%-94%]) used a 120 to 125 kVp standard setting, whereas none used 140 kVp. The most common average dose-length-product (DLP) value was 150 to 249 mGy.cm (75/146, 51% [43%-59%]), and 59% (51%-67%) delivered less than 250 mGy.cm in a 70 kg patient. There was a tendency towards higher DLP values with multidetector-row CT. Age, gender, and pregnancy were associated more with dose reduction than weight and clinical indication. Efforts for reducing patient radiation dose are highly prevalent among thoracic radiologists. Areas for improvement include reduction of default tube current settings, reduction of anatomical scan coverage, greater use of automatic exposure control, and eventually, reduction of current reference dose values. Our study emphasizes the need for international guidelines to foster greater conformity in dose reduction by thoracic radiologists.

A Review of Player Monitoring Approaches in Basketball: Current Trends and Future Directions.

PubMed

Fox, Jordan L; Scanlan, Aaron T; Stanton, Robert

2017-07-01

Fox, JL, Scanlan, AT, and Stanton, R. A review of player monitoring approaches in basketball: current trends and future directions. J Strength Cond Res 31(7): 2021-2029, 2017-Effective monitoring of players in team sports such as basketball requires an understanding of the external demands and internal responses, as they relate to training phases and competition. Monitoring of external demands and internal responses allows coaching staff to determine the dose-response associated with the imposed training load (TL), and subsequently, if players are adequately prepared for competition. This review discusses measures reported in the literature for monitoring the external demands and internal responses of basketball players during training and competition. The external demands of training and competition were primarily monitored using time-motion analysis, with limited use of microtechnology being reported. Internal responses during training were typically measured using hematological markers, heart rate, various TL models, and perceptual responses such as rating of perceived exertion (RPE). Heart rate was the most commonly reported indicator of internal responses during competition with limited reporting of hematological markers or RPE. These findings show a large discrepancy between the reporting of external and internal measures and training and competition demands. Microsensors, however, may be a practical and convenient method of player monitoring in basketball to overcome the limitations associated with current approaches while allowing for external demands and internal responses to be recorded simultaneously. The triaxial accelerometers of microsensors seem well suited for basketball and warrant validation to definitively determine their place in the monitoring of basketball players. Coaching staff should make use of this technology by tracking individual player responses across the annual plan and using real-time monitoring to minimize factors such as fatigue and injury risk.

The orthopaedic research scene and strategies to improve it.

PubMed

Rankin, K S; Sprowson, A P; McNamara, I; Akiyama, T; Buchbinder, R; Costa, M L; Rasmussen, S; Nathan, S S; Kumta, S; Rangan, A

2014-12-01

Trauma and orthopaedics is the largest of the surgical specialties and yet attracts a disproportionately small fraction of available national and international funding for health research. With the burden of musculoskeletal disease increasing, high-quality research is required to improve the evidence base for orthopaedic practice. Using the current research landscape in the United Kingdom as an example, but also addressing the international perspective, we highlight the issues surrounding poor levels of research funding in trauma and orthopaedics and indicate avenues for improving the impact and success of surgical musculoskeletal research. ©2014 The British Editorial Society of Bone & Joint Surgery.

The emergence and pitfalls of international tissue banking.

PubMed

Phillips, Glyn O

2018-05-23

The rapid growth of tissue banking and associated international organisations following the fall of the Berlin wall in 1991 is described. This surge in collaboration led to a world-wide constructive movement to use and to produce human tissues. As the years progressed industrialisation, led by the USA, improved the quality of tissue allografts but led higher costs and consolidation within the developing industry. The growth of litigation more than kept pace with the industrial progress. One landmark case is described, the outcome of which could revolutionise the current practices now applied to eliminate possible viral contamination of implanted tissue grafts.

International seismological data center: Preparation of an experimental data base

NASA Astrophysics Data System (ADS)

Israelson, H.; Jeppsson, I.; Barkeby, G.

1980-11-01

An experimental data base compiled for a temporary international seismological data center is presented. Data include recording and measurements at 60 globally distributed seismological stations for a one week period. Data for definition, location and magnitude estimation of seismic events are examined. Original digital records from 11 seismological research observatories around the world are also analyzed to provide additional identification data. It is shown that the routine measurement and reporting of data at seismological stations as proposed by the Seismic Experts Group at the UN Committee of Disarmament, is an onerous task that goes far beyond current seismological practices.

International online survey to assess current practice in equine anaesthesia.

PubMed

Wohlfender, F D; Doherr, M G; Driessen, B; Hartnack, S; Johnston, G M; Bettschart-Wolfensberger, R

2015-01-01

Multicentre Confidential Enquiries into Perioperative Equine Fatalities (CEPEF) have not been conducted since the initial CEPEF Phases 1-3, 20 years ago. To collect data on current practice in equine anaesthesia and to recruit participants for CEPEF-4. Online questionnaire survey. An online questionnaire was prepared and the link distributed internationally to veterinarians possibly performing equine anaesthesia, using emails, posters, flyers and an editorial. The questionnaire included 52 closed, semiclosed and open questions divided into 8 subgroups: demographic data, anaesthetist, anaesthesia management (preoperative, technical equipment, monitoring, drugs, recovery), areas of improvements and risks and motivation for participation in CEPEF-4. Descriptive statistics and Chi-squared tests for comparison of categorical variables were performed. A total of 199 questionnaires were completed by veterinarians from 14 different countries. Of the respondents, 43% worked in private hospitals, 36% in private practices and 21% in university teaching hospitals. In 40 institutions (23%) there was at least one diplomate of the European or American colleges of veterinary anaesthesia and analgesia on staff. Individual respondents reported routinely employ the following anaesthesia monitoring modalities: electrocardiography (80%), invasive arterial blood pressures (70%), pulse oximetry (60%), capnography (55%), arterial blood gases (47%), composition of inspired and expired gases (45%) and body temperature (35%). Drugs administered frequently or routinely as part of a standard protocol were: acepromazine (44%), xylazine (68%), butorphanol (59%), ketamine (96%), diazepam (83%), isoflurane (76%), dobutamine (46%), and, as a nonsteroidal anti-inflammatory drug, phenylbutazone (73%) or flunixin meglumine (66%). Recovery was routinely assisted by 40%. The main factors perceived by the respondents to affect outcome of equine anaesthesia were the preoperative health status of the animal and training of the anaesthetist. Current practice in equine anaesthesia varies widely, and the study has highlighted important topics relevant for designing a future prospective multicentre cohort study (CEPEF-4). The Summary is available in Chinese - see Supporting information. © 2014 EVJ Ltd.

An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice.

PubMed

Thornley, P; de Sa, D; Evaniew, N; Farrokhyar, F; Bhandari, M; Ghert, M

2016-04-01

Evidence -based medicine (EBM) is designed to inform clinical decision-making within all medical specialties, including orthopaedic surgery. We recently published a pilot survey of the Canadian Orthopaedic Association (COA) membership and demonstrated that the adoption of EBM principles is variable among Canadian orthopaedic surgeons. The objective of this study was to conduct a broader international survey of orthopaedic surgeons to identify characteristics of research studies perceived as being most influential in informing clinical decision-making. A 29-question electronic survey was distributed to the readership of an established orthopaedic journal with international readership. The survey aimed to analyse the influence of both extrinsic (journal quality, investigator profiles, etc.) and intrinsic characteristics (study design, sample size, etc.) of research studies in relation to their influence on practice patterns. A total of 353 surgeons completed the survey. Surgeons achieved consensus on the 'importance' of three key designs on their practices: randomised controlled trials (94%), meta-analyses (75%) and systematic reviews (66%). The vast majority of respondents support the use of current evidence over historical clinical training; however subjective factors such as journal reputation (72%) and investigator profile (68%) continue to influence clinical decision-making strongly. Although intrinsic factors such as study design and sample size have some influence on clinical decision-making, surgeon respondents are equally influenced by extrinsic factors such as investigator reputation and perceived journal quality.Cite this article: Dr M. Ghert. An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice. Bone Joint Res 2016;5:130-136. DOI: 10.1302/2046-3758.54.2000578. © 2016 Ghert et al.

Current trends in medical English education and the Japan College of Rheumatology International School.

PubMed

Jego, Eric Hajime; Amengual, Olga

2017-11-01

In light of the present revolution happening in medical education in Japan as medical schools implement new curricula to conform to global standards, there is a growing demand for more internationalization and higher quality practical medical English education. In response, many institutions including governmental organizations, universities and academic associations are moving ahead with new initiatives to adapt to these changing demands. This paper reviews the current trends and innovations in medical English education in Japan. This paper also describes one initiative by the Japan College of Rheumatology (JCR) known as the JCR International School held yearly in Karuizawa. By examining recent trends and innovations in medical English education in Japan, the most relevant and applicable can be elucidated to illuminate a path forward for improved medical English education within the JCR.

Recommendations for Planning and Managing International Short-term Pharmacy Service Trips

PubMed Central

Alsharif, Naser Z.; Rovers, John; Connor, Sharon; White, Nicole D.; Hogue, Michael D.

2017-01-01

International pharmacy service trips by schools and colleges of pharmacy allow students to provide health care to medically underserved areas. A literature review (2000-2016) in databases and Internet searches with specific keywords or terms was performed to assess current practices to establish and maintain successful pharmacy service trips. Educational documents such as syllabi were obtained from pharmacy programs and examined. A preliminary draft was developed and authors worked on sections of interest and expertise. Considerations and current recommendations are provided for the key aspects of the home institution and the host country requirements for pharmacy service trips based on findings from a literature search and the authors’ collective, extensive experience. Evaluation of the trip and ethical considerations are also discussed. This article serves as a resource for schools and colleges of pharmacy that are interested in the development of new pharmacy service trips and provides key considerations for continuous quality improvement of current or future activities. PMID:28381883

Recommendations for Planning and Managing International Short-term Pharmacy Service Trips.

PubMed

Johnson, Kalin L; Alsharif, Naser Z; Rovers, John; Connor, Sharon; White, Nicole D; Hogue, Michael D

2017-03-25

International pharmacy service trips by schools and colleges of pharmacy allow students to provide health care to medically underserved areas. A literature review (2000-2016) in databases and Internet searches with specific keywords or terms was performed to assess current practices to establish and maintain successful pharmacy service trips. Educational documents such as syllabi were obtained from pharmacy programs and examined. A preliminary draft was developed and authors worked on sections of interest and expertise. Considerations and current recommendations are provided for the key aspects of the home institution and the host country requirements for pharmacy service trips based on findings from a literature search and the authors' collective, extensive experience. Evaluation of the trip and ethical considerations are also discussed. This article serves as a resource for schools and colleges of pharmacy that are interested in the development of new pharmacy service trips and provides key considerations for continuous quality improvement of current or future activities.

Management of the bladder in traumatic injuries of the spinal cord during the First World War and its implications for the current practice of urology.

PubMed

Silver, John R

2011-08-01

What's known on the subject? and What does the study add? Prior to the First World War, traumatic injuries to the spinal cord rapidly led to death from severe infections of the bladder. During the Second World War, Ludwig Guttmann resurrected the use of intermittent catheterisation at Stoke Mandeville Hospital, by meticulous attention to detail and was so successful, that this method was introduced into general urological practice. Historical review of the management of the bladder in patients with spinal injuries. Spinal injury patients--literature review--personal experience at Stoke Mandeville Hospital. Review of the different methods of catheterisation from the 19th century to today. Methods learned from the management of the bladder of spinal injuries patients were adopted into mainstream urology. © 2011 THE AUTHOR; BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

Tracking and Reporting Outcomes Of Procedural Sedation (TROOPS): Standardized Quality Improvement and Research Tools from the International Committee for the Advancement of Procedural Sedation.

PubMed

Roback, M G; Green, S M; Andolfatto, G; Leroy, P L; Mason, K P

2018-01-01

Many hospitals, and medical and dental clinics and offices, routinely monitor their procedural-sedation practices-tracking adverse events, outcomes, and efficacy in order to optimize the sedation delivery and practice. Currently, there exist substantial differences between settings in the content, collection, definition, and interpretation of such sedation outcomes, with resulting widespread reporting variation. With the objective of reducing such disparities, the International Committee for the Advancement of Procedural Sedation has herein developed a multidisciplinary, consensus-based, standardized tool intended to be applicable for all types of sedation providers in all locations worldwide. This tool is amenable for inclusion in either a paper or an electronic medical record. An additional, parallel research tool is presented to promote consistency and standardized data collection for procedural-sedation investigations. Copyright © 2017. Published by Elsevier Ltd.

Nurses' perceptions of health beliefs and impact on teaching and practice: a Q-sort study.

PubMed

Cao, R; Stone, T E; Petrini, M A; Turale, S

2018-03-01

To understand Chinese nurses' perceptions of health beliefs, their content, origin and the influence of sociocultural factors, as a basis of their evidence-based practice. This study contributes to a larger study to establish the health beliefs of Japanese, Australian, Chinese, South Korean and Thai nurses. Registered nurses teach patients and students about maintaining or attaining health are subject to the same range of influences and their health beliefs may be antithetical to current health evidence. Q-method design using q-sort and interview was used to explore the perspectives on a range of health beliefs of 60 nurses in four cities in China. Three factors arose from the perceptions of the participants about health and accounted for 50.2% of the total variance: (1) social impact, (2) 'the importance of evidence', and (3) beliefs rooted in culture. Influence on nurses' health beliefs was explored in terms of the internalized and frequently unconscious beliefs, values and norms tying them to their communities, reflecting the need for nurses to be aware of their health beliefs and behaviours. Education for nurses in practice needs to acknowledge that individual practitioners' beliefs strongly influence health teaching for patients and families. In order to implement evidenced-based practice and teach in line with current evidence nurses need to critically examine and reflect on the impact of culture, society and the media on their own health beliefs. Education policy needs to consider that culture and societal pressures affect nurses' health beliefs and practice. Critical thinking, reflective and evidence-based practice need to be emphasized in clinical training and nurse education. China also needs to develop policies to allow nurses to be able to assess the reliability of health information on the Internet and to make quality health research more available. © 2017 International Council of Nurses.

Training activities at FSUE 'RADON' and Lomonosov's Moscow state university under practical arrangements with IAEA

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

Batyukhnova, O.G.; Karlina, O.K.; Neveykin, P.P.

The International Education Training Centre (IETC) at Moscow Federal State Unitary Enterprise (FSUE) 'Radon', in co-operation with the International Atomic Energy Agency (IAEA), has developed expertise and provided training to waste management personnel for the last 15 years. Since 1997, the educational system of the enterprise with the support of the IAEA has acquired an international character: more than 470 experts from 35 countries - IAEA Member States completed the professional development. Training is conducted at various thematic courses or fellowships for individual programs and seminars on IAEA technical projects. In June 2008 a direct agreement (Practical Arrangements) has beenmore » signed between FSUE 'Radon' and the IAEA on cooperation in the field of development of new technologies, expert's advice to IAEA Member States, and, in particular, the training of personnel in the field of radioactive waste management (RWM), which opens up new perspectives for fruitful cooperation of industry professionals. A similar agreement - Practical Arrangements - has been signed between Lomonosov's MSU and the IAEA in 2012. In October 2012 a new IAEA two-weeks training course started at Lomonosov's MSU and FSUE 'Radon' in the framework of the Practical Agreements signed. Pre-disposal management of waste was the main topic of the courses. The paper summarizes the current experience of the FSUE 'Radon' in the organization and implementation of the IAEA sponsored training and others events and outlines some of strategic educational elements, which IETC will continue to pursue in the coming years. (authors)« less

International clinical placements for Australian undergraduate nursing students: A systematic thematic synthesis of the literature.

PubMed

Browne, Caroline A; Fetherston, Catherine M; Medigovich, Kristina

2015-10-01

International clinical placements provide undergraduate nursing students with the opportunity to experience or practice nursing care in diverse countries, settings, and cultures. This systematic review aims to ascertain the current knowledge on international clinical placements offered by undergraduate nursing programs in Australia. It seeks to explore three questions: (1) How have previous experiences of nursing students' international clinical placements been described? (2) How have participants and stakeholders determined if the placement has been successful? And (3) What benefits or challenges have been identified by stakeholders as a result of participating in international clinical placements? A systematic thematic synthesis was undertaken. A search of electronic databases including CINAHL, Proquest Central, Scopus, PubMed, and Health Collection was undertaken between September and October 2014. Key terms including 'international clinical placement', 'study abroad', 'international exchange', 'nursing', and 'Australia' were used to identify articles that appeared in peer-reviewed English language journals and that explored international clinical placements offered to undergraduate nursing students by Australian universities. Eight studies were identified that meet the inclusion criteria, and through thematic analysis, five key themes were identified including developing cultural awareness and competence, providing a global perspective on health care, translation of theory to practice, growing personally through reflection, and overcoming apprehension to successfully meet the challenge. A comparison search of literature from Canada and the United Kingdom revealed that similar themes occurred internationally. Although personal successes were identified by students undertaking international clinical placement, further research is required to identify all stakeholder experiences including those of the educators, the educational institutions, and travel providers supporting these placements and the communities where the placements take place. Copyright © 2015 Elsevier Ltd. All rights reserved.

Aircraft disinsection.

PubMed

Rayman, Russell B

2006-07-01

Aircraft disinsection has been an international practice since the 1920s, the purpose of which is to protect public health, the environment, agriculture, and livestock by the eradication of disease vectors. Although most nations of the world have discontinued this practice, about 20 continue with this requirement. Aircraft disinsection is sanctioned by international law with the World Health Organization (WHO) publishing general procedural guidelines in the International Health Regulations (IHR). There are currently four acceptable procedures: blocks away, top of descent, on arrival, and residual. A 2% pyrethrum solution, a naturally occurring substance found in the chrysanthemum flower, or several synthetic pyrethroids, are the recommended agents because they are extremely effective insecticides which pose minimal health risks. Although the use of insecticides for aircraft disinsection is controversial, national policies compelling this requirement must be respected. This paper will explore the background of aircraft disinsection, the procedures, the types of agents, and the toxicity. If aircraft disinsection is regulatory policy, it should be done in accordance with WHO procedures. Residual application is probably the most efficacious method. The use of air curtains or plastic strips should be explored as an alternative to the use of chemicals.

[Telecardiology: Tasks and duties of telemedicine].

PubMed

Borbás, János; Forczek, Erzsébet; Sepp, Róbert; Bari, Ferenc

2017-11-01

Telemedicine is a young science that integrates innovations of information-technology and telecommunications into medical science. A successful telemedicine procedure should guarantee reduced workload of the healthcare system with well secured and cost-effective processes. Our goal was to collect the development phases of telemedicine projects through existing telecardiology solutions. Subsequent to reviewing international publications we analyzed the past and present situation of blood pressure monitoring, remote diagnostics of electrocardiography, implantable cardioverter defibrillator monitoring and pocket ultrasound devices. In case of new solutions (a) several internationally accepted, confidently reproducible "good practices" are needed for creating (b) guidelines and recommendations of international medical associations. They have to ensure (c) cost-effective work, with well-designed sustainability and (d) patient confidentiality. Improving (e) education for professionals and patients is essential. We recommend to telemedicine developers to use our standards in order to introduce their products more effectively into clinical practice. It is encouraging that current possibilities of telecardiology partly or fully meet the aforementioned criteria. Further development of the topic can contribute to financial sustainability of our healthcare and might be able to resolve limitations of human resources. Orv Hetil. 2017; 158(44): 1741-1746.

76 FR 77237 - U.S. National Authority for the WHO Global Code of Practice on the International Recruitment of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-12

... Authority for the WHO Global Code of Practice on the International Recruitment of Health Personnel; Notice... Global Code of Practice on the International Recruitment of Health Personnel, notice is hereby given of... Global Code of Practice on International Recruitment of Health Personnel is ``to establish and promote...

The role of ethics in data governance of large neuro-ICT projects.

PubMed

Stahl, Bernd Carsten; Rainey, Stephen; Harris, Emma; Fothergill, B Tyr

2018-05-14

We describe current practices of ethics-related data governance in large neuro-ICT projects, identify gaps in current practice, and put forward recommendations on how to collaborate ethically in complex regulatory and normative contexts. We undertake a survey of published principles of data governance of large neuro-ICT projects. This grounds an approach to a normative analysis of current data governance approaches. Several ethical issues are well covered in the data governance policies of neuro-ICT projects, notably data protection and attribution of work. Projects use a set of similar policies to ensure users behave appropriately. However, many ethical issues are not covered at all. Implementation and enforcement of policies remain vague. The data governance policies we investigated indicate that the neuro-ICT research community is currently close-knit and that shared assumptions are reflected in infrastructural aspects. This explains why many ethical issues are not explicitly included in data governance policies at present. With neuro-ICT research growing in scale, scope, and international involvement, these shared assumptions should be made explicit and reflected in data governance.

The Association of Parent Mindfulness with Parenting and Youth Psychopathology across Three Developmental Stages

PubMed Central

Parent, Justin; McKee, Laura G.; Mahon, Jennifer; Foreh, Rex

2015-01-01

The primary purpose of the current study was to test a model examining the process by which parent dispositional mindfulness relates to youth psychopathology through mindful parenting and parenting practices. The universality of the model across youth at three developmental stages was examined: young childhood (3 – 7 yrs.; n = 210), middle childhood (8 – 12 yrs.; n = 200), and adolescence (13 – 17 yrs.; n = 205). Overall, participants were 615 parents (55 % female) and one of their 3-to-17 year old children (45 % female). Parents reported on their dispositional mindfulness, mindful parenting, positive and negative parenting practices and their child's or adolescent's internalizing and externalizing problems. Consistent findings across all three developmental stages indicated that higher levels of parent dispositional mindfulness were indirectly related to lower levels of youth internalizing and externalizing problems through higher levels of mindful parenting and lower levels of negative parenting practices. Replication of these findings across families with children at different developmental stages lends support to the generalizability of the model. PMID:25633828

Evaluating an online pharmaceutical education system for pharmacy interns in critical care settings.

PubMed

Yeh, Yu-Ting; Chen, Hsiang-Yin; Cheng, Kuei-Ju; Hou, Ssu-An; Yen, Yu-Hsuan; Liu, Chien-Tsai

2014-02-01

Incorporating electronic learning (eLearning) system into professional experimental programs such as pharmacy internships is a challenge. However, none of the current systems can fully support the unique needs of clinical pharmacy internship. In this study we enhanced a commercial eLearning system for clinical pharmacy internship (The Clinical Pharmacy Internship eLearning System, CPIES). The KAP questionnaire was used to evaluate the performance of group A with the traditional teaching model and group B with the CPIES teaching model. The CPIES teaching model showed significant improvement in interns' knowledge and practice (p = 0.002 and 0.031, respectively). The traditional teaching model only demonstrated significant improvement in practice (p = 0.011). Moreover, professionalism, such as attitudes on cooperating with other health professionals, is developed by learning from a good mentor. The on-line teaching and traditional teaching methods should undoubtedly be blended in a complete teaching model in order to improve learners' professional knowledge, facilitate correct attitude, and influence good practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations.

PubMed

Dornblaser, Emily K; Ratka, Anna; Gleason, Shaun E; Ombengi, David N; Tofade, Toyin; Wigle, Patricia R; Zapantis, Antonia; Ryan, Melody; Connor, Sharon; Jonkman, Lauren J; Ochs, Leslie; Jungnickel, Paul W; Abrons, Jeanine P; Alsharif, Naser Z

2016-04-25

The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students.

Compilation of a casebook on bioethics and the Holocaust as a platform for bioethics education.

PubMed

Chelouche, Tessa

2013-03-01

The Holocaust arose, in part, because of a profound and pervasive breakdown of medical professional ethics. This history is complex and powerfully instructive. The value judgments and moral actions of the Nazi doctors can inform current debate and practices and also prevent the use of inaccurate analogies in current bioethical debates. Under the auspices of the International Center for Health, Law and Ethics at Haifa University, we are in the process of publishing a casebook on bioethical topics, using personal cases from the Third Reich and the Holocaust. The casebook will provide a platform for deep reflection and discourse on historical ethical issues and their relevance for today. This teaching tool can also inspire healthcare professionals and students to practice with greater compassion, knowledge, tolerance, respect and justice on behalf of their patients.

Differing forms, differing purposes: A typology of health impact assessment

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

Harris-Roxas, Ben, E-mail: b.harris-roxas@unsw.edu.au; Harris, Elizabeth, E-mail: e.harris@unsw.edu.a

2011-07-15

There is currently considerable diversity in health impact assessment (HIA) practice internationally. Historically this diversity has been described as simple dichotomies, for example the differences between HIAs of projects and policies. However these distinctions have failed to adequately describe the differences that can be observed between different forms of HIAs. This paper describes the three historical and disciplinary fields from which HIA has emerged - environmental health, a social view of health, and health equity. It also puts forward a typology of four different forms of HIA that can be observed in current HIA practice: mandated, decision-support, advocacy, and community-ledmore » HIAs. This paper argues that these different forms of HIA serve different purposes and are not necessarily in competition; rather they allow HIA to be responsive to a range of population health concerns and purposes.« less

Impact of medical tourism on cosmetic surgery in the United States.

PubMed

Franzblau, Lauren E; Chung, Kevin C

2013-10-01

Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States.

Logistics Lessons Learned in NASA Space Flight

NASA Technical Reports Server (NTRS)

Evans, William A.; DeWeck, Olivier; Laufer, Deanna; Shull, Sarah

2006-01-01

The Vision for Space Exploration sets out a number of goals, involving both strategic and tactical objectives. These include returning the Space Shuttle to flight, completing the International Space Station, and conducting human expeditions to the Moon by 2020. Each of these goals has profound logistics implications. In the consideration of these objectives,a need for a study on NASA logistics lessons learned was recognized. The study endeavors to identify both needs for space exploration and challenges in the development of past logistics architectures, as well as in the design of space systems. This study may also be appropriately applied as guidance in the development of an integrated logistics architecture for future human missions to the Moon and Mars. This report first summarizes current logistics practices for the Space Shuttle Program (SSP) and the International Space Station (ISS) and examines the practices of manifesting, stowage, inventory tracking, waste disposal, and return logistics. The key findings of this examination are that while the current practices do have many positive aspects, there are also several shortcomings. These shortcomings include a high-level of excess complexity, redundancy of information/lack of a common database, and a large human-in-the-loop component. Later sections of this report describe the methodology and results of our work to systematically gather logistics lessons learned from past and current human spaceflight programs as well as validating these lessons through a survey of the opinions of current space logisticians. To consider the perspectives on logistics lessons, we searched several sources within NASA, including organizations with direct and indirect connections with the system flow in mission planning. We utilized crew debriefs, the John Commonsense lessons repository for the JSC Mission Operations Directorate, and the Skylab Lessons Learned. Additionally, we searched the public version of the Lessons Learned Information System (LLIS) and verified that we received the same result using the internal version of LLIS for our logistics lesson searches. In conducting the research, information from multiple databases was consolidated into a single spreadsheet of 300 lessons learned. Keywords were applied for the purpose of sorting and evaluation. Once the lessons had been compiled, an analysis of the resulting data was performed, first sorting it by keyword, then finding duplication and root cause, and finally sorting by root cause. The data was then distilled into the top 7 lessons learned across programs, centers, and activities.

On the Temporal Variability of Low-Mode Internal Tides in the Deep Ocean

NASA Technical Reports Server (NTRS)

Ray, Richard D.; Zaron, E. D.

2010-01-01

In situ measurements of internal tides are typically characterized by high temporal variability, with strong dependence on stratification, mesoscale eddies, and background currents commonly observed. Thus, it is surprising to find phase-locked internal tides detectable by satellite altimetry. An important question is how much tidal variability is missed by altimetry. We address this question in several ways. We subset the altimetry by season and find only very small changes -- an important exception being internal tides in the South China Sea where we observe strong seasonal dependence. A wavenumber-domain analysis confirms that throughout most of the global ocean there is little temporal variability in altimetric internal-tide signals, at least in the first baroclinic mode, which is the mode that dominates surface elevation. The analysis shows higher order modes to be significantly more variable. The results of this study have important practical implications for the anticipated SWOT wide-swath altimeter mission, for which removal of internal tide signals is critical for observing non-tidal submesoscale phenomena.

Global Floods and Droughts Simulation to Support International Flood Initiative and International Drought Initiative of the UNESCO International Hydrological Program

NASA Astrophysics Data System (ADS)

Gusyev, M.; Takeuchi, K.; Magome, J.; Masood, M.

2015-12-01

One of the main achievements of the IHD/IHP programs is the promotion and enhancement of hydrological data exchange within the global water community. World Catalogue of Very Large Floods, World Water Balance and Water Resources of the Earth are the great examples of some initial collaborative efforts and the FRIEND and Catalogue of Rivers for Southeast Asia and the Pacific are the more recent outcomes. Along with similar efforts by WMO, FAO, IGBP, CEOS and many other national and international institutes, the global hydrological monitoring and nowcast have made a considerable progress last decade and are about to put into practice. Such efforts include global streamflow alert system of U Maryland and GFAS-streamflow of ICHARM and U Yamanshi. Especially the recent achievements of GFAS-streamflow support the current efforts of IHP International Flood Initiative (IFI) and International Drought Initiatives (IDI) by global nowcasts and easily visible indicators in 20-km resolution.

First on-line survey of an international multidisciplinary working group (MightyMedic) on current practice in diagnosis, therapy and follow-up of dyslipidemias.

PubMed

Stefanutti, C; D'Alessandri, G; Petta, A; Harada-Shiba, M; Julius, U; Soran, H; Moriarty, P M; Romeo, S; Drogari, E; Jaeger, B R

2015-05-01

The MightyMedic (Multidisciplinary International Group for Hemapheresis TherapY and MEtabolic DIsturbances Contrast) Working Group has been founded in 2013. The leading idea was to establish an international network of interdisciplinary nature aimed at working to cross national borders research projects, clinical trials, educational initiatives (meetings, workshops, summer schools) in the field of metabolic diseases, namely hyperlipidemias, and diabetes, preventive cardiology, and atherosclerosis. Therapeutic apheresis, its indications and techniques, is a parallel field of investigation. The first on-line survey of the Group has been completed in the first half of 2014. The survey included # 24 Centers in Italy, Germany, Greece, UK, Sweden, Japan and USA. Relevant data have been collected on current practice in diagnosis, therapy and follow-up of dyslipidemias. 240 subjects with hyperlipidemia and treated with lipoprotein apheresis have been reported in the survey, but a large percentage of patients (35%) who could benefit from this therapeutic option are still treated by conventional drug approach. Genetic molecular diagnosis is performed in only 33% of patients while Lipoprotein(a) (Lp(a)) is included in cardiovascular disease risk assessment in 71% of participating Centers. New detailed investigations and prospective multicenter studies are needed to evaluate changes induced by the impact of updated indications and strategies, as well as new treatment options, targeting standardization of therapeutic and diagnostic approaches. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Tuberous sclerosis complex surveillance and management: recommendations of the 2012 International Tuberous Sclerosis Complex Consensus Conference.

PubMed

Krueger, Darcy A; Northrup, Hope

2013-10-01

Tuberous sclerosis complex is a genetic disorder affecting every organ system, but disease manifestations vary significantly among affected individuals. The diverse and varied presentations and progression can be life-threatening with significant impact on cost and quality of life. Current surveillance and management practices are highly variable among region and country, reflective of the fact that last consensus recommendations occurred in 1998 and an updated, comprehensive standard is lacking that incorporates the latest scientific evidence and current best clinical practices. The 2012 International Tuberous Sclerosis Complex Consensus Group, comprising 79 specialists from 14 countries, was organized into 12 separate subcommittees, each led by a clinician with advanced expertise in tuberous sclerosis complex and the relevant medical subspecialty. Each subcommittee focused on a specific disease area with important clinical management implications and was charged with formulating key clinical questions to address within its focus area, reviewing relevant literature, evaluating the strength of data, and providing a recommendation accordingly. The updated consensus recommendations for clinical surveillance and management in tuberous sclerosis complex are summarized here. The recommendations are relevant to the entire lifespan of the patient, from infancy to adulthood, including both individuals where the diagnosis is newly made as well as individuals where the diagnosis already is established. The 2012 International Tuberous Sclerosis Complex Consensus Recommendations provide an evidence-based, standardized approach for optimal clinical care provided for individuals with tuberous sclerosis complex. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

The emergence of international food safety standards and guidelines: understanding the current landscape through a historical approach.

PubMed

Ramsingh, Brigit

2014-07-01

Following the Second World War, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) teamed up to construct an International Codex Alimentarius (or 'food code') which emerged in 1963. The Codex Committee on Food Hygiene (CCFH) was charged with the task of developing microbial hygiene standards, although it found itself embroiled in debate with the WHO over the nature these standards should take. The WHO was increasingly relying upon the input of biometricians and especially the International Commission on Microbial Specifications for Foods (ICMSF) which had developed statistical sampling plans for determining the microbial counts in the final end products. The CCFH, however, was initially more focused on a qualitative approach which looked at the entire food production system and developed codes of practice as well as more descriptive end-product specifications which the WHO argued were 'not scientifically correct'. Drawing upon historical archival material (correspondence and reports) from the WHO and FAO, this article examines this debate over microbial hygiene standards and suggests that there are many lessons from history which could shed light upon current debates and efforts in international food safety management systems and approaches.

Sponsorship in non-commercial clinical trials: definitions, challenges and the role of Good Clinical Practices guidelines.

PubMed

Ravinetto, Raffaella; De Nys, Katelijne; Boelaert, Marleen; Diro, Ermias; Meintjes, Graeme; Adoke, Yeka; Tagbor, Harry; Casteels, Minne

2015-12-30

Non-commercial clinical research plays an increasingly essential role for global health. Multiple partners join in international consortia that operate under the limited timeframe of a specific funding period. One organisation (the sponsor) designs and carries out the trial in collaboration with research partners, and is ultimately responsible for the trial's scientific, ethical, regulatory and legal aspects, while another organization, generally in the North (the funder), provides the external funding and sets funding conditions. Even if external funding mechanisms are key for most non-commercial research, the dependence on an external funder's policies may heavily influence the choices of a sponsor. In addition, the competition for accessing the available external funds is great, and non-commercial sponsors may not be in a position to discuss or refuse standard conditions set by a funder. To see whether the current definitions adequately address the intricacies of sponsorship in externally-funded trials, we looked at how a "sponsor" of clinical trials is defined in selected international guidelines, with particular focus on international Good Clinical Practices codes, and in selected European and African regulations/legislations. Our limited analysis suggests that the sponsors definition from the 1995 WHO Good Clinical Practices code has been integrated as such into many legislations, guidelines and regulations, and that it is not adequate to cover today's reality of funding arrangements in global health, where the legal responsibility and the funding source are de facto split. In agreement with other groups, we suggest that the international Good Clinical Practices codes should be updated to reflect the reality of non-commercial clinical research. In particular, they should explicitly include the distinction between commercial and non-commercial sponsors, and provide guidance to non-commercial sponsors for negotiating with external funding agencies and other research counterparts. Non-commercial sponsors of clinical trials should surely invest in the development of adequate legal, administrative and management skills. By acknowledging their role and specificities, and by providing them with adapted guidance, the international Good Clinical Practices codes would provide valuable guidance and support to non-commercial clinical research, whose relevance for global health is increasingly evident.

International fieldwork placements in low-income countries: Exploring community perspectives.

PubMed

Shields, Megan; Quilty, Jenny; Dharamsi, Shafik; Drynan, Donna

2016-10-01

There has been a significant increase in the number of occupational and physical therapy students going on international fieldwork placements in low-income countries. Yet, there has been a lack of research describing this experience from the agencies that host students. The research question was 'how do members of an agency within a low-income country perceive, interpret and give meaning to international fieldwork placements where students from a Canadian university provide occupational and physical therapy services?' Purposive sampling was used to recruit participants from five affiliated international fieldwork sites. Six semi-structured interviews exploring the perspectives of individuals from agency sites in low-income countries facilitated the data collection. Interviews were audiotaped and transcribed verbatim for thematic analysis. Four themes provided insight into the participants' experience of hosting student therapists. Participants emphasised: (i) there was a reciprocity of learning between agency members and students; (ii) they felt responsible for the health and safety of the students, as well as providing an enriching experience; (iii) participants questioned the preparation phase; and (iv) recommendations were made by participants to strengthen partnerships while contemplating sustainable practices. This study highlighted that effective preparation, enhanced communication, reflection and reciprocity is necessary to achieve what hosting agencies view as sustainable international placements. These results provide a platform for stakeholders to question their current processes for fieldwork placement engagement and potential suggestions for improving current international fieldwork partnerships. © 2016 Occupational Therapy Australia.

Current situation of oil refinery in Bulgaria

NASA Astrophysics Data System (ADS)

Vershkova, Elena; Petkova, Petinka; Grinkevich, Anastasia

2016-09-01

This article deals with the classification approach for oil refineries in international practices. Criteria of refinery estimation group, including its financial status estimation, have been investigated. The analysis object is “Lukoil Neftochim Bourgas” AD (LNCHB) activity. This company is a leading enterprise in Bulgaria. The analysis of LNCHB operating: energy intensity index; index of operating costs and return on investment index have been performed.

1-1 in Education: Current Practice, International Comparative Research Evidence and Policy Implications. OECD Education Working Papers, No. 44,

ERIC Educational Resources Information Center

Valiente, Oscar

2010-01-01

Over the last decade, more and more public and private stakeholders, in developed and developing countries, have been supporting 1:1 initiatives in education (i.e. every child receives her/his own personal computing device). These 1:1 initiatives represent a qualitative move forward from previous educational experiences with ICT, inasmuch as every…

31 CFR 10.33 - Best practices for tax advisors.

Code of Federal Regulations, 2010 CFR

2010-07-01

... THE INTERNAL REVENUE SERVICE Duties and Restrictions Relating to Practice Before the Internal Revenue... Internal Revenue Service. (b) Procedures to ensure best practices for tax advisors. Tax advisors with... or assisting in the preparation of submissions to the Internal Revenue Service should take reasonable...

Current challenges in optimizing systemic therapy for patients with pancreatic cancer: expert perspectives from the Australasian Gastrointestinal Trials Group (AGITG) with invited international faculty.

PubMed

Segelov, Eva; Lordick, Florian; Goldstein, David; Chantrill, Lorraine A; Croagh, Daniel; Lawrence, Ben; Arnold, Dirk; Chau, Ian; Obermannova, Radka; Price, Timothy Jay

2017-10-01

Despite recent progress, the outlook for most patients with pancreatic cancer remains poor. There is variation in how patients are managed globally due to differing interpretations of the evidence, partly because studies in this disease are challenging to undertake. This article collates the evidence upon which current best practice is based and offers an expert opinion from an international faculty on how latest developments should influence current treatment paradigms. Areas covered: Optimal chemotherapy for first and subsequent lines of therapy; optimal management of locally advanced, non-metastatic cancer including the role of neoadjuvant chemo(radio)therapy, current evidence for adjuvant chemotherapy, major advances in pancreatic cancer genomics and challenges in supportive care particularly relevant to patients with pancreatic cancer. For each section, literature was reviewed by comprehensive search techniques, including clinical trial websites and abstracts from international cancer meetings. Expert commentary: For each section, a commentary is provided. Overall the challenges identified were: difficulties in diagnosing pancreatic cancer early, challenges for performing randomised clinical trials in all stages of the disease, some progress in systemic therapy with new agents and in identifying molecular subtypes that may be clinically relevant and move towards personalized therapy, but still, pancreatic cancer remains a very poor prognosis cancer with significant palliative care needs.

Enhancing the learning of sport skills through external-focus feedback.

PubMed

Wulf, Gabriele; McConnel, Nathan; Gärtner, Matthias; Schwarz, Andreas

2002-06-01

The authors examined how the effectiveness of feedback for the learning of complex motor skills is affected by the focus of attention it induces. The feedback referred specifically either to body movements (internal focus) or to movement effects (external focus). In Experiment 1, groups of novices and advanced volleyball players (N = 48) practiced "tennis" serves under internal-focus or external-focus feedback conditions in a 2 (expertise) x 2 (feedback type) design. Type of feedback did not differentially affect movement quality, but external-focus feedback resulted in greater accuracy of the serves than internal-focus feedback during both practice and retention, independent of the level of expertise. In Experiment 2, the effects of relative feedback frequency as a function of attentional focus were examined. A 2 (feedback frequency: 100% vs. 33%) x 2 (feedback type) design was used. Experienced soccer players (N = 52) were required to shoot lofted passes at a target. External-focus feedback resulted in greater accuracy than internal-focus feedback did. In addition, reduced feedback frequency was beneficial under internal-focus feedback conditions, whereas 100% and 33% feedback were equally effective under external-focus conditions. The results demonstrate the effectiveness of effect-related, as opposed to movement-related, feedback and also suggest that there is a need to revise current views regarding the role of feedback for motor learning.

An exploration of the roles of nurse managers in evidence-based practice implementation.

PubMed

Wilkinson, Joyce E; Nutley, Sandra M; Davies, Huw T O

2011-12-01

Internationally, nurses face ongoing difficulties in making a reality of evidence-based practice. Existing studies suggest that nurse managers (NMs) should play a key role in leading and facilitating evidence-based practice, but the nature of this role has not yet been fully explored or articulated. This is one of the first studies to investigate the roles of NMs in evidence-based practice implementation. METHODOLOGY AND METHODS: Using a case study approach the study explores five propositions in relation to the NMs' potential evidence-based practice role and the extent to which their attitudes, knowledge, and skills support such a role. In doing so, it draws on interviews (n= 51), documentary analysis and observational data. Data analysis reveals that the role of NMs in facilitating evidence-based practice is under-articulated, largely passive and currently limited by competing demands. Progress in implementing evidence-based practice in the case study sites is largely explained by factors other than the role played by NMs. As such, the findings expose significant discrepancies between NMs' actual roles and those espoused in the literature as being necessary. Contextual factors are important and it is clear that the role of the contemporary NM places considerable emphasis on management and administration to the detriment of clinical practice concerns. The study reveals that NMs are only involved in evidence-based practice implementation in a passive role, not the full engagement described in the literature as being necessary. This study adds previously lacking detail of the roles of NMs. It elucidates why exhortations to NMs to become more involved in evidence-based practice implementation are ineffective without action to address the problems identified. Copyright ©2011 Sigma Theta Tau International.

Barriers to and enablers of implementing antimicrobial stewardship programs in veterinary practices.

PubMed

Hardefeldt, Laura Y; Gilkerson, J R; Billman-Jacobe, H; Stevenson, M A; Thursky, K; Bailey, K E; Browning, G F

2018-03-23

Antimicrobial stewardship (AMS) programs are yet to be widely implemented in veterinary practice and medical programs are unlikely to be directly applicable to veterinary settings. To gain an in-depth understanding of the factors that influence effective AMS in veterinary practices in Australia. A concurrent explanatory mixed methods design was used. The quantitative phase of the study consisted of an online questionnaire to assess veterinarians' attitudes to antimicrobial resistance (AMR) and antimicrobial use in animals, and the extent to which AMS currently is implemented (knowingly or unknowingly). The qualitative phase used semi-structured interviews to gain an understanding of the barriers to and enablers of AMS in veterinary practices. Data were collected and entered into NVivo v.11, openly coded and analyzed according to mixed methods data analysis principles. Companion animal, equine, and bovine veterinarians participated in the study. Veterinary practices rarely had antimicrobial prescribing policies. The key barriers were a lack of AMS governance structures, client expectations and competition between practices, cost of microbiological testing, and lack of access to education, training and AMS resources. The enablers were concern for the role of veterinary antimicrobial use in development of AMR in humans, a sense of pride in the service provided, and preparedness to change prescribing practices. Our study can guide development and establishment of AMS programs in veterinary practices by defining the major issues that influence the prescribing behavior of veterinarians. © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

NonTuberculous Mycobacteria infection and lung transplantation in cystic fibrosis: a worldwide survey of clinical practice.

PubMed

Tissot, Adrien; Thomas, Matthew F; Corris, Paul A; Brodlie, Malcolm

2018-05-22

In people with cystic fibrosis infection with NonTuberculous Mycobacteria is of increasing prevalence. Mycobacterium abscessus complex is of particular concern and has been associated with adverse clinical outcomes. Optimal treatment usually requires multiple antibiotics for over 12 months. When considering lung transplantation for patients with NonTuberculous Mycobacteria potential benefits must be balanced against the risks of uncontrolled infection post-transplant and significant side-effects associated with treatment. In this survey we assessed current international practice with regard to assessing and listing patients for lung transplantation. We designed a questionnaire enquiring about local practice regarding screening for NonTuberculous Mycobacteria infection, specific contra-indications to transplantation, management and segregation of patients pre- and post-transplant. The survey was sent via e-mail to 37 paediatric and adult lung transplant centres across Europe, North America and Australia. We gathered complete questionnaires from 21 centres (57% response rate). Few centres (29%) have a clear written policy regarding NonTuberculous Mycobacteria. Sixteen (76%) centres require molecular identification of NonTuberculous Mycobacteria species. Only four centres would consider infection with M. abscessus complex in itself a contra-indication for listing, however 76% regard it as a relative contra-indication. Eighty-six percent require treatment pre-transplantation. Finally, only 61% of centres had a clear policy regarding segration of patients pre-transplant and 48% post-transplant. The issue of NonTuberculous Mycobacteria infection in people with cystic fibrosis requiring lung transplantation is well-recognized however current international recommendations are not detailed and there is variation in practice between centres. There is an urgent requirement for high quality clinical data to inform decision-making.

Primary Care Physicians' Beliefs and Practices Regarding E-Cigarette Use by Patients Who Smoke: A Qualitative Assessment.

PubMed

El-Shahawy, Omar; Brown, Richard; Elston Lafata, Jennifer

2016-04-26

We explored primary care physicians' (PCPs') beliefs and practices about e-cigarettes. Cross-sectional, semi-structured interviews with PCPs in 2014 were conducted and audio-recorded. Participants were 15 general internal and family medicine physicians practicing in two settings in Virginia, USA. Interview recordings were transcribed, and the content analyzed using the Constant Comparative Method to identify key themes regarding PCPs' reported current practices and beliefs. Five themes were identified: (1) existing clinic processes do not include mechanisms to screen for noncombustible tobacco products (such as e-cigarettes); (2) e-cigarette discussions are becoming commonplace with patients initiating the discussions and seeking physician guidance regarding e-cigarette use; (3) a lack of knowledge regarding the potential harms and benefits of e-cigarettes, yet a willingness to support their patients' desire to use e-cigarettes (4) believing e-cigarettes are a safer alternative to smoking combustible tobacco products; and (5) abandoning concerns regarding the potential harms of e-cigarettes in the context of highly addicted patients and those with extensive comorbidities. Despite acknowledging limited knowledge regarding e-cigarettes, findings suggest that some PCPs are currently recommending e-cigarettes to their patients for smoking cessation and relative harm reduction, often personalizing recommendations based on the patient's perceived addiction level and current health status. Physicians need to be informed about the evolving evidence regarding the risks and benefits of e-cigarettes.

Wind power forecasting: IEA Wind Task 36 & future research issues

NASA Astrophysics Data System (ADS)

Giebel, G.; Cline, J.; Frank, H.; Shaw, W.; Pinson, P.; Hodge, B.-M.; Kariniotakis, G.; Madsen, J.; Möhrlen, C.

2016-09-01

This paper presents the new International Energy Agency Wind Task 36 on Forecasting, and invites to collaborate within the group. Wind power forecasts have been used operatively for over 20 years. Despite this fact, there are still several possibilities to improve the forecasts, both from the weather prediction side and from the usage of the forecasts. The new International Energy Agency (IEA) Task on Forecasting for Wind Energy tries to organise international collaboration, among national meteorological centres with an interest and/or large projects on wind forecast improvements (NOAA, DWD, MetOffice, met.no, DMI,...), operational forecaster and forecast users. The Task is divided in three work packages: Firstly, a collaboration on the improvement of the scientific basis for the wind predictions themselves. This includes numerical weather prediction model physics, but also widely distributed information on accessible datasets. Secondly, we will be aiming at an international pre-standard (an IEA Recommended Practice) on benchmarking and comparing wind power forecasts, including probabilistic forecasts. This WP will also organise benchmarks, in cooperation with the IEA Task WakeBench. Thirdly, we will be engaging end users aiming at dissemination of the best practice in the usage of wind power predictions. As first results, an overview of current issues for research in short-term forecasting of wind power is presented.

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

Giebel, G.; Cline, J.; Frank, H.

Here, this paper presents the new International Energy Agency Wind Task 36 on Forecasting, and invites to collaborate within the group. Wind power forecasts have been used operatively for over 20 years. Despite this fact, there are still several possibilities to improve the forecasts, both from the weather prediction side and from the usage of the forecasts. The new International Energy Agency (IEA) Task on Forecasting for Wind Energy tries to organise international collaboration, among national meteorological centres with an interest and/or large projects on wind forecast improvements (NOAA, DWD, MetOffice, met.no, DMI,...), operational forecaster and forecast users. The Taskmore » is divided in three work packages: Firstly, a collaboration on the improvement of the scientific basis for the wind predictions themselves. This includes numerical weather prediction model physics, but also widely distributed information on accessible datasets. Secondly, we will be aiming at an international pre-standard (an IEA Recommended Practice) on benchmarking and comparing wind power forecasts, including probabilistic forecasts. This WP will also organise benchmarks, in cooperation with the IEA Task WakeBench. Thirdly, we will be engaging end users aiming at dissemination of the best practice in the usage of wind power predictions. As first results, an overview of current issues for research in short-term forecasting of wind power is presented.« less

Transplant tourism or international transplant medicine? A case for making the distinction.

PubMed

Chin, J J L; Campbell, A V

2012-07-01

Transplant tourism is routinely denounced by influential voices such as the World Health Organization, the Declaration of Istanbul and the Madrid Resolution as an unethical solution to worldwide organ shortages. Instead, it is suggested that national deceased donor schemes and multinational organ-sharing programs are the only acceptable avenues for addressing the organ shortage crisis. The present demand for self-sufficiency in organ supply responds to risks such as poor clinical outcomes, and exploitation of the poor through the various commercial practices of transplant tourism. However, opponents of transplant tourism say little about what governments should do to ensure that their citizens have real and comprehensive access to all forms of transplantation. To address this complex question, we describe a current practice of international transplant medicine in Singapore. It addresses salient concerns with transplant tourism and supports the principle of national self-sufficiency in organ supply, even as its health care system thrives and expands comprehensive transplant services to its citizens by catering to international patients. We offer a critical appraisal of the Singaporean system, and some suggestions to minimize the risk of abuse by international patients or operatives of illegal organ markets. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

Staffing Practices: A Discussion of Strategies That Work.

ERIC Educational Resources Information Center

Gilmore, Vance; Frankel, Nancy; Derber, Anne; Schneider, Mike

2001-01-01

Four camp directors discuss staff recruiting practices, their three top sources of quality staff, the value of international staff, special approaches for hiring international staff, training practices for international staff, how they help international staff adjust to their camps, staff rates of return, and off-season activities that motivate…

Knowledge translation and interprofessional collaboration: Where the rubber of evidence-based care hits the road of teamwork.

PubMed

Zwarenstein, Merrick; Reeves, Scott

2006-01-01

Knowledge-translation interventions and interprofessional education and collaboration interventions all aim at improving health care processes and outcomes. Knowledge-translation interventions attempt to increase evidence-based practice by a single professional group and thus may fail to take into account barriers from difficulties in interprofessional relations. Interprofessional education and collaboration interventions aim to improve interprofessional relations, which may in turn facilitate the work of knowledge translation and thus evidence-based practice. We summarize systematic review work on the effects of interventions for interprofessional education and collaboration. The current evidence base contains mainly descriptive studies of these interventions. Knowledge is limited regarding the impact on care and outcomes and the extent to which the interventions increase the practice of evidence-based care. Rigorous multimethod research studies are needed to develop and strengthen the current evidence base in this field. We describe a Health Canada-funded randomized trial in which quantitative and qualitative data will be gathered in 20 general internal medicine units located at 5 Toronto, Ontario, teaching hospitals. The project examines the impact of interprofessional education and collaboration interventions on interprofessional relationships, health care processes (including evidence-based practice), and patient outcomes. Routes are suggested by which interprofessional education and collaboration interventions might affect knowledge translation and evidence-based practice.

State of global pediatric neurosurgery outreach: survey by the International Education Subcommittee.

PubMed

Davis, Matthew C; Rocque, Brandon G; Singhal, Ash; Ridder, Thomas; Pattisapu, Jogi V; Johnston, James M

2017-08-01

OBJECTIVE Neurosurgical services are increasingly recognized as essential components of surgical care worldwide. The degree of interest among neurosurgeons regarding international work, and the barriers to involvement in global neurosurgical outreach, are largely unexplored. The authors distributed a survey to members of the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Joint Section on Pediatric Neurosurgery to assess the state of global outreach among its members and to identify barriers to involvement. METHODS An internet-based questionnaire was developed by the International Education Subcommittee of the AANS/CNS Joint Section on Pediatric Neurosurgery and distributed to pediatric neurosurgeons via the AANS/CNS Joint Section email contact list. Participants were surveyed on their involvement in global neurosurgical outreach, geographic location, nature of the participation, and barriers to further involvement. RESULTS A 35.3% response rate was obtained, with 116 respondents completing the survey. Sixty-one percent have performed or taught neurosurgery in a developing country, and 49% travel at least annually. Africa was the most common region (54%), followed by South America (30%), through 29 separate organizing entities. Hydrocephalus was the most commonly treated condition (88%), followed by spinal dysraphism (74%), and tumor (68%). Most respondents obtained follow-up through communications from local surgeons (77%). Seventy-one percent believed the international experience improved their practice, and 74% were very or extremely interested in working elsewhere. Interference with current practice (61%), cost (44%), and difficulty identifying international partners (43%) were the most commonly cited barriers to participation. CONCLUSIONS Any coordinated effort to expand global neurosurgical capacity begins with appreciation for the current state of outreach efforts. Increasing participation in global outreach will require addressing both real and perceived barriers to involvement. Creation and curation of a centralized online database of ongoing projects to facilitate coordination and involvement may be beneficial.

Breast cancer risk from different mammography screening practices.

PubMed

Bijwaard, Harmen; Brenner, Alina; Dekkers, Fieke; van Dillen, Teun; Land, Charles E; Boice, John D

2010-09-01

Mammography screening is an accepted procedure for early detection of breast tumors among asymptomatic women. Since this procedure involves the use of X rays, it is itself potentially carcinogenic. Although there is general consensus about the benefit of screening for older women, screening practices differ between countries. In this paper radiation risks for these different practices are estimated using a new approach. We model breast cancer induction by ionizing radiation in a cohort of patients exposed to frequent X-ray examinations. The biologically based, mechanistic model provides a better foundation for the extrapolation of risks to different mammography screening practices than empirical models do. The model predicts that the excess relative risk (ERR) doubles when screening starts at age 40 instead of 50 and that a continuation of screening at ages 75 and higher carries little extra risk. The number of induced fatal breast cancers is estimated to be considerably lower than derived from epidemiological studies and from internationally accepted radiation protection risks. The present findings, if used in a risk-benefit analysis for mammography screening, would be more favorable to screening than estimates currently recommended for radiation protection. This has implications for the screening ages that are currently being reconsidered in several countries.

Internal Quality Control Practices in Coagulation Laboratories: recommendations based on a patterns-of-practice survey.

PubMed

McFarlane, A; Aslan, B; Raby, A; Moffat, K A; Selby, R; Padmore, R

2015-12-01

Internal quality control (IQC) procedures are crucial for ensuring accurate patient test results. The IQMH Centre for Proficiency Testing conducted a web-based survey to gather information on the current IQC practices in coagulation testing. A questionnaire was distributed to 174 Ontario laboratories licensed to perform prothrombin time (PT) and activated partial thromboplastin time (APTT). All laboratories reported using two levels of commercial QC (CQC); 12% incorporate pooled patient plasma into their IQC program; >68% run CQC at the beginning of each shift; 56% following maintenance, with reagent changes, during a shift, or with every repeat sample; 6% only run CQC at the beginning of the day and 25% when the instruments have been idle for a defined period of time. IQC run frequency was determined by manufacturer recommendations (71%) but also influenced by the stability of test (27%), clinical impact of an incorrect test result (25%), and sample's batch number (10%). IQC was monitored using preset limits based on standard deviation (66%), precision goals (46%), or allowable performance limits (36%). 95% use multirules. Failure actions include repeating the IQC (90%) and reporting patient results; if repeat passes, 42% perform repeat analysis of all patient samples from last acceptable IQC. Variability exists in coagulation IQC practices among Ontario clinical laboratories. The recommendations presented here would be useful in encouraging standardized IQC practices. © 2015 John Wiley & Sons Ltd.

Multifilamentary niobium tin magnet conductors

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

Larbalestier, D.C.; Madsen, P.E.; Lee, J.A.

1975-03-01

Practical magnet conductors of multifilamentary Nb$sub 3$Sn have been produced. Evaluation of these bronze route conductors is described. Conductors studied range from a 1369 filament all-bronze matrix conductor to 5143 and approximately 42,000 filament conductors, containing internal high purity copper protected by diffusion barriers. Filament sizes vary from approximately 3 to 8 $mu$m diameter. The effect of heat treatment conditions on critical current and transition temperature is presented and it is shown that overall critical current densities greater than those available in niobium titanium can now be produced in multifilamentary Nb$sub 3$Sn magnet conductor.

Dosing antiretroviral medication when crossing time zones: a review

PubMed Central

Lewis, Joseph M.; Volny-Anne, Alain; Waitt, Catriona; Boffito, Marta; Khoo, Saye

2016-01-01

International tourism continues to increase worldwide, and people living with HIV and their clinicians are increasingly confronted with the problem of how to dose antiretroviral therapy during transmeridian air travel across time zones. No guidance on this topic currently exists. This review is a response to requests from patient groups for clear, practical and evidence-based guidance for travelling on antiretroviral therapy; we present currently available data on the pharmacokinetic forgiveness and toxicity of various antiretroviral regimens, and synthesize this data to provide guidelines on how to safely dose antiretrovirals when travelling across time zones. PMID:26684823

A comprehensive model for diagnosing the causes of individual medical performance problems: skills, knowledge, internal, past and external factors (SKIPE).

PubMed

Norfolk, Tim; Siriwardena, A Niroshan

2013-01-01

This discussion paper describes a new and comprehensive model for diagnosing the causes of individual medical performance problems: SKIPE (skills, knowledge, internal, past and external factors). This builds on a previous paper describing a unifying theory of clinical practice, the RDM-p model, which captures the primary skill sets required for effective medical performance (relationship, diagnostics and management), and the professionalism that needs to underpin them. The SKIPE model is currently being used, in conjunction with the RDM-p model, for the in-depth assessment and management of doctors whose performance is a cause for concern.

International Standards and Reference Materials for Quantitative Molecular Infectious Disease Testing

PubMed Central

Madej, Roberta M.; Davis, Jack; Holden, Marcia J.; Kwang, Stan; Labourier, Emmanuel; Schneider, George J.

2010-01-01

The utility of quantitative molecular diagnostics for patient management depends on the ability to relate patient results to prior results or to absolute values in clinical practice guidelines. To do this, those results need to be comparable across time and methods, either by producing the same value across methods and test versions or by using reliable and stable conversions. Universally available standards and reference materials specific to quantitative molecular technologies are critical to this process but are few in number. This review describes recent history in the establishment of international standards for nucleic acid test development, organizations involved in current efforts, and future issues and initiatives. PMID:20075208

Using human rights to improve maternal and neonatal health: history, connections and a proposed practical approach.

PubMed

Gruskin, Sofia; Cottingham, Jane; Hilber, Adriane Martin; Kismodi, Eszter; Lincetto, Ornella; Roseman, Mindy Jane

2008-08-01

We describe the historical development of how maternal and neonatal mortality in the developing world came to be seen as a public-health concern, a human rights concern, and ultimately as both, leading to the development of approaches using human rights concepts and methods to advance maternal and neonatal health. We describe the different contributions of the international community, women's health advocates and human rights activists. We briefly present a recent effort, developed by WHO with the Harvard Program on International Health and Human Rights, that applies a human rights framework to reinforce current efforts to reduce maternal and neonatal mortality.

Developmental dysplasia of the hip: addressing evidence gaps with a multicentre prospective international study.

PubMed

Schaeffer, Emily K; Study Group, Ihdi; Mulpuri, Kishore

2018-05-07

There is a lack of high quality evidence available to guide clinical practice in the treatment and management of developmental dysplasia of the hip (DDH). Evidence has been limited by persistent confusion on diagnostic and classification terminology, variability in surgeon decision making and a reliance on single centre, retrospective studies with small patient numbers. To address gaps in knowledge regarding screening, diagnosis and management of DDH, the International Hip Dysplasia Institute began a multicentre, international prospective study on infants with hips dislocated at rest. This review discusses the current state of screening, diagnostic and management practices in DDH and addresses important unanswered questions that will be critical in identifying best practices and optimising patient outcomes. There is insufficient evidence to support universal ultrasound screening; instead, selective screening should be performed by 6-8 weeks of age on infants with risk factors of breech presentation, family history, or history of clinical hip instability. Follow-up of infants with risk factors and normal initial screening should be considered to at least 6 months of age. Brace treatment is a sensible first-line treatment for management of dislocated hips at rest in infants < 6 months of age. Early operative reduction may be considered as there is insufficient evidence to support a protective role for the ossific nucleus in the development of avascular necrosis.

Editor's Choice-The role of the emergency department in the management of acute heart failure: An international perspective on education and research.

PubMed

Pang, Peter S; Collins, Sean P; Miró, Òscar; Bueno, Hector; Diercks, Deborah B; Di Somma, Salvatore; Gray, Alasdair; Harjola, Veli-Pekka; Hollander, Judd E; Lambrinou, Ekaterini; Levy, Phillip D; Papa, AnnMarie; Möckel, Martin

2017-08-01

Emergency departments are a major entry point for the initial management of acute heart failure (AHF) patients throughout the world. The initial diagnosis, management and disposition - the decision to admit or discharge - of AHF patients in the emergency department has significant downstream implications. Misdiagnosis, under or overtreatment, or inappropriate admission may place patients at increased risk for adverse events, and add costs to the healthcare system. Despite the critical importance of initial management, data are sparse regarding the impact of early AHF treatment delivered in the emergency department compared to inpatient or chronic heart failure management. Unfortunately, outcomes remain poor, with nearly a third of patients dying or re-hospitalised within 3 months post-discharge. In the absence of robust research evidence, consensus is an important source of guidance for AHF care. Thus, we convened an international group of practising emergency physicians, cardiologists and advanced practice nurses with the following goals to improve outcomes for AHF patients who present to the emergency department or other acute care setting through: (a) a better understanding of the pathophysiology, presentation and management of the initial phase of AHF care; (b) improving initial management by addressing knowledge gaps between best practices and current practice through education and research; and (c) to establish a framework for future emergency department-based international education and research.

Solar Cell Calibration and Measurement Techniques

NASA Technical Reports Server (NTRS)

Bailey, Sheila; Brinker, Dave; Curtis, Henry; Jenkins, Phillip; Scheiman, Dave

1997-01-01

The increasing complexity of space solar cells and the increasing international markets for both cells and arrays has resulted in workshops jointly sponsored by NASDA, ESA and NASA. These workshops are designed to obtain international agreement on standardized values for the AMO spectrum and constant, recommend laboratory measurement practices and establish a set of protocols for international comparison of laboratory measurements. A working draft of an ISO standard, WDI 5387, 'Requirements for Measurement and Calibration Procedures for Space Solar Cells' was discussed with a focus on the scope of the document, a definition of primary standard cell, and required error analysis for all measurement techniques. Working groups addressed the issues of Air Mass Zero (AMO) solar constant and spectrum, laboratory measurement techniques, and the international round robin methodology. A summary is presented of the current state of each area and the formulation of the ISO document.

Solar Cell Calibration and Measurement Techniques

NASA Technical Reports Server (NTRS)

Bailey, Sheila; Brinker, Dave; Curtis, Henry; Jenkins, Phillip; Scheiman, Dave

2004-01-01

The increasing complexity of space solar cells and the increasing international markets for both cells and arrays has resulted in workshops jointly sponsored by NASDA, ESA and NASA. These workshops are designed to obtain international agreement on standardized values for the AMO spectrum and constant, recommend laboratory measurement practices and establish a set of protocols for international comparison of laboratory measurements. A working draft of an ISO standard, WD15387, "Requirements for Measurement and Calibration Procedures for Space Solar Cells" was discussed with a focus on the scope of the document, a definition of primary standard cell, and required error analysis for all measurement techniques. Working groups addressed the issues of Air Mass Zero (AMO) solar constant and spectrum, laboratory measurement techniques, and te international round robin methodology. A summary is presented of the current state of each area and the formulation of the ISO document.

[Human capital vs. manpower: fostering a greater global perspective within the nursing profession in Taiwan].

PubMed

Chen, Li-Yen; Chou, Shieu-Ming

2014-04-01

Nursing today is an occupation greatly influenced and shaped by global standards and internationally recognized standard practices and requirements. Therefore, cultivating nursing capital and ensuring nursing manpower requires an international perspective. Nursing migration is currently a popular approach used by many developed countries to address domestic shortfalls in nursing manpower. These international medical services have had a great impact on nursing education. Being able to communicate in English and to adapt transculturally have thus become increasingly important. Ability to communicate well in English is one effective way both to minimize nurse-patient misunderstandings and to increase the quality of care available to foreign patients. In addition, transcultural communication underscores the value of respecting cultural diversity. Fostering and enhancing these abilities will enhance and expand the role of Taiwanese nurses in the professional global movement and increase their contributions to the internal medical community.

International terrorism and mental health: recent research and future directions.

PubMed

Fischer, Peter; Ai, Amy L

2008-03-01

International terrorism has become a major global concern. Several studies conducted in North America and Europe in the aftermath of terrorist attacks reveal that international terrorism represents a significant short-term and long-term threat to mental health. In the present article, the authors clarify the concept and categories of terrorism and then present central findings from studies conducted in the United States and Europe, which mainly focus on negative impacts on mental health, such as emotional stress and PTSD. Furthermore, the authors outline experiments that focus on social interaction processes thought to be triggered by international terrorism and which are assumed to be related indirectly to mental health processes. Next, they highlight the potential positive outcomes on the resilience side, in line with the current theory on posttraumatic growth in adversity. Finally, theoretical and practical implications as well as limitations and future directions are discussed.

Issues and controversies of hepatocellular carcinoma-targeted therapy clinical trials in Asia: experts' opinion.

PubMed

Chen, Pei-Jer; Furuse, Junji; Han, Kwang-Hyub; Hsu, Chiun; Lim, Ho-Yeong; Moon, Hanlim; Qin, Shukui; Ye, Sheng-Long; Yeoh, Ee-Min; Yeo, Winnie

2010-11-01

Asia has a disproportionate share of the world's burden of hepatocellular carcinoma (HCC). However, the highly regarded clinical practice guidelines and recommendations for the design and conduct of clinical trials for HCC largely reflect Western practice. In order to design mutually beneficial international clinical trials of promising targeted therapies, it is imperative to understand how the aetiology, staging and treatment of HCC differ between Asian and Western countries. Our group, comprising experts in oncology and hepatology from countries that constitute the Eastern Asian region, convened to compare and contrast our current practices, evaluate potential compliance with the clinical trial recommendations, and offer suggestions for modifications that would enhance international collaboration. Here, we describe the results of our discussions, including recommendations for appropriate patient stratification based on potentially important differences in HCC aetiology, identification of practices that may confound interpretation of clinical trial outcomes (traditional Chinese medicine; antivirals that target hepatitis B virus; heterogeneous embolization procedures), suggestions for utilizing a common staging system in study protocols, recognition that sorafenib usage is limited by financial constraints and potentially increased toxicity in Asian patients, and expansion of patient populations that should be eligible for initial clinical trials with new agents. © 2010 John Wiley & Sons A/S.

Transfusion practice in Helsinki University Central Hospital: an analysis of diagnosis-related groups (DRG).

PubMed

Syrjälä, M T; Kytöniemi, I; Mikkolainen, K; Ranimo, J; Lauharanta, J

2001-12-01

Transfusion data combined with data automatically recorded in hospital databases provides an outstanding tool for blood utilization reporting. When the reporting is performed with an online analytical processing (OLAP) tool, real time reporting can be provided to blood subscribers. When this data is combined with a common patient classification system, Diagnosis-Related Groups (DRG), it is possible to produce statistical results, that are similar in different institutions and may provide a means for international transfusion bench-marking and cost comparison. We use a DRG classification to describe the transfusion practice in Helsinki University Central Hospital. The key indicators include the percentage of transfused patients, the number of transfused units and costs in different DRG groups, as well as transfusion rates per DRG weighted treatment episodes. Ninety-three per cent of all transfusions could be classified into different DRGs. The largest blood-using DRG group was acute adult leukaemia (DRG 473), which accounted for 10.4% of all transfusion costs. The 13 largest blood consuming DRGs accounted for half the total costs in 1998. Currently, there is a lack of an internationally accepted standardized way to report institutional or national transfusion practices. DRG-based transfusion reporting might serve as a means for transfusion benchmarking and thus aid studies of variations in transfusion practice.

Implementing the Code of Practice on International Recruitment in Romania - exploring the current state of implementation and what Romania is doing to retain its domestic health workforce.

PubMed

Paina, Ligia; Ungureanu, Marius; Olsavszky, Victor

2016-06-30

The Romanian health system is struggling to retain its health workers, who are currently facing strong incentives for migration to Western European health systems. Retention issues, coupled with high levels of migration, complicate Romania's efforts in providing basic health services for rural, underserved, and marginalized populations, as well as in achieving equitable health access for all. The WHO Global Code of Practice on International Recruitment of Health Personnel (the Code) aims to promote ethical international recruitment and health systems strengthening. We explore Romania's implementation of the Code's principles and recommendations. We analysed peer-reviewed and grey literature, in English and Romanian, and sought secondary data from the websites of Romania's largest medical universities. The analysis was guided by the following themes and recommendations in the Code: health personnel development and health systems sustainability, international cooperation, data gathering, information exchange, and implementation and monitoring of the Code. Romania's implementation of the Code was observed to be limited. Gaps were identified with regards to several aspects of the Romanian health system, including the lack of support to health personnel training, recruitment, and retention in order to increase the appeal for health providers to practice in Romania and in underserved areas. In terms of international cooperation, the Code recommends various policy instruments to guide recruitment, including bilateral agreements. However, we could not determine which of these instruments were used as a result of the Code and whether or not they were effective. We identified little evidence of initiatives for health workers' professional and personal support. Insufficient data and few information exchange platforms exist on health workforce issues, hindering active sharing of data on migration with European Union and WHO audiences. We could not identify any evidence of monitoring of the Code's implementation to date. In the absence of major system reforms, health workers will continue to migrate to urban areas and abroad. Romanian policymakers should address more of the Code's recommendations by developing a national policy for human resources for health, a central database to aid health workforce planning and management, stronger platforms for information exchange and civil society engagement, and updated and transparent bilateral agreements.

Intensive comprehensive aphasia programs: an international survey of practice.

PubMed

Rose, Miranda L; Cherney, Leora R; Worrall, Linda E

2013-01-01

In response to the need to simultaneously address multiple domains of the International Classification of Functioning, Disability and Health (ICF) in aphasia therapy and to incorporate intensive treatment doses consistent with principles of neuroplasticity, a potentially potent treatment option termed intensive comprehensive aphasia programs (ICAPs) has been developed. To conduct an international survey of ICAPs to determine the extent of their use and to explore current ICAP practices. A 32-item online survey was distributed internationally through Survey Monkey between May and August 2012. The survey addressed ICAP staffing, philosophy, values, funding, admission criteria, activities, family involvement, outcome measures, and factors considered important to success. Twelve ICAPs responded: 8 from the United States, 2 from Canada, and 1 each from Australia and the United Kingdom. The majority of ICAPs are affiliated with university programs and are funded through participant self-pay. ICAPs emphasize individualized treatment goals and evidence-based practices, with a focus on applying the principles of neuroplasticity related to repetition and intensity of treatment. On average, 6 people with aphasia attend each ICAP, for 4 days per week for 4 weeks, receiving about 100 hours of individual, group, and computer-based treatment. Speech-language pathologists, students, and volunteers staff the majority of ICAPs. ICAPs are increasing in number but remain a rare service delivery option. They address the needs of individuals who want access to intensive treatment and are interested in making significant changes to their communication skills and psychosocial well-being in a short period of time. Their efficacy and cost-effectiveness require future investigation.

The Application of Simulated Experimental Teaching in International Trade Course

ERIC Educational Resources Information Center

Ma, Tao; Chen, Wen

2009-01-01

International Trade Practice is a professional basic course for specialty of International Economy and Trade. As the core of International Trade Practice, it is extremely related to foreign affairs and needs much practical experience. This paper puts forward some suggestions on how to improve the performance of teaching in order to educate the…

"It Doesn't Really Matter Which University You Attend or Which Subject You Study While Abroad." The Massification of Student Mobility Programmes and Its Implications for Equality in Higher Education

ERIC Educational Resources Information Center

Courtois, Aline

2018-01-01

Based on documentary analysis and interviews, the article examines the current practices of Irish universities in their efforts to increase their students' participation in international exchange programmes. It argues that increased participation, while a positive outcome, obscures a growing differentiation in the types of exchange programmes and…

Total Body Irradiation: Guidelines from the International Lymphoma Radiation Oncology Group (ILROG).

PubMed

Wong, Jeffrey Y C; Filippi, Andrea Riccardo; Dabaja, Bouthaina Shbib; Yahalom, Joachim; Specht, Lena

2018-07-01

Total body irradiation (TBI) remains an effective myeloablative treatment in regimens used for preparation and conditioning before allogeneic stem cell transplantation for leukemia. The regimens used vary across institutions in terms of dose, dose rate, fractionation, and technique. The objective of this document is to provide comprehensive guidelines for the current practice of delivering total body irradiation. Copyright © 2018 Elsevier Inc. All rights reserved.

Cutaneous T-cell lymphoma (CTCL): Current practices in blood assessment and the utility of T-cell receptor (TCR)-Vβ chain restriction.

PubMed

Gibson, Juliet F; Huang, Jing; Liu, Kristina J; Carlson, Kacie R; Foss, Francine; Choi, Jaehyuk; Edelson, Richard; Hussong, Jerry W; Mohl, Ramsey; Hill, Sally; Girardi, Michael

2016-05-01

Accurate quantification of malignant cells in the peripheral blood of patients with cutaneous T-cell lymphoma is important for early detection, prognosis, and monitoring disease burden. We sought to determine the spectrum of current clinical practices; critically evaluate elements of current International Society for Cutaneous Lymphomas (ISCL) B1 and B2 staging criteria; and assess the potential role of T-cell receptor-Vβ analysis by flow cytometry. We assessed current clinical practices by survey, and performed a retrospective analysis of 161 patients evaluated at Yale (2011-2014) to compare the sensitivity, specificity, positive predictive value, and negative predictive value of parameters for ISCL B2 staging. There was heterogeneity in clinical practices among institutions. ISCL B1 criteria did not capture 5 Yale cohort cases with immunophenotypic abnormalities that later progressed. T-cell receptor-Vβ testing was more specific than polymerase chain reaction and aided diagnosis in detecting clonality, but was of limited benefit in quantification of tumor burden. Because of limited follow-up involving a single center, further investigation will be necessary to conclude whether our proposed diagnostic algorithm is of general clinical benefit. We propose further study of modified B1 criteria: CD4/CD8 ratio 5 or greater, %CD4(+) CD26(-) 20% or greater, or %CD4(+) CD7(-) 20% or greater, with evidence of clonality. T-cell receptor-Vβ testing should be considered in future diagnostic and staging algorithms. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Adaptation of international guidelines for metastatic colorectal cancer: an asian consensus.

PubMed

Cheng, Ann-Lii; Li, Jin; Vaid, Ashok K; Ma, Brigette Buig Yue; Teh, Catherine; Ahn, Joong B; Bello, Maximino; Charoentum, Chaiyut; Chen, Li-Tzong; de Lima Lopes, Gilberto; Ho, Gwo F; Kong, Hwai L; Lam, Ka O; Liu, Tian S; Park, Young S; Sriuranpong, Virote; Sudoyo, Aru W; Wang, Jaw-Yuan; Zhang, Jun; Zhang, Su Z; Ciardiello, Fortunato; Köhne, Clause-Henning; Shaw, Michael; Kim, Tae Won

2014-09-01

Colorectal cancer (CRC) is among the most common cancers worldwide, but marked epidemiological differences exist between Asian and non-Asian populations. Hence, a consensus meeting was held in Hong Kong in December 2012 to develop Asia-specific guidelines for the management of metastatic CRC (mCRC). A multidisciplinary expert panel, consisting of 23 participants from 10 Asian and 2 European countries, discussed current guidelines for colon or rectal cancer and developed recommendations for adapting these guidelines to Asian clinical practice. Participants agreed that mCRC management in Asia largely follows international guidelines, but they proposed a number of recommendations based on regional 'real-world' experience. In general, participants agreed that 5-fluorouracil (5-FU) infusion regimens in doublets can be substituted with UFT (capecitabine, tegafur-uracil) and S1 (tegafur, 5-chloro-2,4-dihydroxypyridine and oxonic acid), and that the monoclonal antibodies cetuximab and panitumumab are recommended for KRAS wild type tumors. For KRAS mutant tumors, bevacizumab is the preferred biological therapy. FOLFOX (folinic acid, 5-FU, and oxaliplatin) is preferred for initial therapy in Asian patients. The management of mCRC is evolving, and it must be emphasized that the recommendations presented here reflect current treatment practices and thus might change as more data become available. Copyright © 2014 Elsevier Inc. All rights reserved.

Internationalizing forensic assessments of criminal responsibility.

PubMed

Meynen, Gerben; Oei, Karel

2011-12-01

One of the important characteristics of current medicine is that it is an international endeavor. The fact that medicine is a global undertaking might even be one of its core strengths. However, the universal nature of medicine can be compromised when local issues become significant factors in medical practice. In this paper we identify criminal law as a relevant factor complicating the process of internationalizing a particular medical practice: the assessment of a defendant within the context of the question of criminal responsibility. Since criminal law--especially the laws relevant to assessments of criminal responsibility--may differ from country to country, or rather from jurisdiction to jurisdiction, forensic psychiatrists face the challenge of finding common ground and a common framework to advance these forensic psychiatric assessments. We describe the current situation and argue for internationalizing the discussion about this assessment, pointing to the example provided by assessments of competence.

Impact of Medical Tourism on Cosmetic Surgery in the United States

PubMed Central

Franzblau, Lauren E.

2013-01-01

Summary: Developing countries have been attracting more international patients by building state-of-the-art facilities and offering sought-after healthcare services at a fraction of the cost of the US healthcare system. These price differentials matter most for elective procedures, including cosmetic surgeries, which are paid for out of pocket. It is unclear how this rise in medical tourism will affect the practice of plastic surgery, which encompasses a uniquely large number of elective procedures. By examining trends in the globalization of the cosmetic surgery market, we can better understand the current situation and what plastic surgeons in the United States can expect. In this article, we explore both domestic and foreign factors that affect surgical tourism and the current state of this industry. We also discuss how it may affect the practice of cosmetic surgery within the United States. PMID:25289258

Sinecatechins and imiquimod as proactive sequential therapy of external genital and perianal warts in adults.

PubMed

Schöfer, Helmut; Tatti, Silvio; Lynde, Charles W; Skerlev, Mihael; Hercogová, Jana; Rotaru, Maria; Ballesteros, Juan; Calzavara-Pinton, Piergiacomo

2017-12-01

This review about the proactive sequential therapy (PST) of external genital and perianal warts (EGW) is based on the most current available clinical literature and on the broad clinical experience of a group of international experts, physicians who are well versed in the treatment of human papillomavirus-associated diseases. It provides a practical guide for the treatment of EGW, including epidemiology, etiology, clinical appearance, and diagnostic procedures for these viral infections. Furthermore, the treatment goals and current treatment options, elucidating provider- and patient-applied therapies, and the parameters driving treatment decisions are summarized. Specifically, the mode of action of the topical treatments sinecatechins and imiquimod, as well as the PST for EGW to achieve rapid and sustained clearance is discussed. The group of experts has developed a treatment algorithm giving healthcare providers a practical tool for the treatment of EGW which is very valuable in the presence of many different treatment options.

Integrated care: theory to practice.

PubMed

Stokes, Jonathan; Checkland, Kath; Kristensen, Søren Rud

2016-10-01

'Integrated care' is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team case management is frequently the primary focus of integrated care when implemented internationally. We examine the practical application of integrated care in the NHS in England to exemplify the prevalence of the case management focus. We look at the evidence for effectiveness of multi-disciplinary team case management, for the focus on high-risk groups and for integrated care more generally. We suggest realistic expectations of what integration of care alone can achieve and additional research questions. © The Author(s) 2016.

Clinical practice patterns in the assessment and management of low testosterone in men: an international survey of endocrinologists.

PubMed

Grossmann, Mathis; Anawalt, Bradley D; Wu, Frederick C W

2015-02-01

To document current practices in the approach to low testosterone in older men. Given that recommendations are based on low-level evidence, we hypothesized that there would be a wide variability in clinical practice patterns. Members of all major endocrine and andrological societies were invited to participate in a Web-based survey of the diagnostic work-up and management of a hypothetical index case of a 61-year old overweight man presenting with symptoms suggestive of androgen deficiency, without evidence of hypothalamic-pituitary-gonadal (HPT) axis disease. Nine hundred and forty-three respondents (91·2% adult endocrinologists) from Northern America (63·7%), Europe (12·7%), Oceania (8·2%), Latin America and Caribbean (7·6%), and the Middle East, Asia, or Africa (7·8%) completed the survey. Response rates among participating societies ranged from 4·1-20·0%. There was a wide variability in clinical practice patterns, especially regarding biochemical diagnosis of androgen deficiency, exclusion of HPT axis pathology, and monitoring for prostate cancer. In a man with suggestive symptoms, 42·4% of participants would offer testosterone treatment below a serum total testosterone of 10·4 nmol/l (300 ng/dl). A total of 46·0% of participants were, over the last five years, 'less inclined' to prescribe testosterone to men with nonspecific symptoms and borderline testosterone levels, compared to 'no change' (29·3%) or 'more inclined' (24·7%), P < 0·001. This large-scale international survey shows a wide variability in the management of lowered testosterone in older men, with deviations from current clinical practice guidelines, and a temporal trend towards increasing reluctance to prescribe testosterone to men without classical hypogonadism. These findings highlight the need for better evidence to guide clinicians regarding testosterone therapy. © 2014 John Wiley & Sons Ltd.

Applying a knowledge translation model to the uptake of the Baby Friendly Health Initiative in the Australian health care system.

PubMed

Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

2014-06-01

The Baby Friendly Hospital Initiative is a global, evidence-based, public health initiative. The evidence underpinning the Initiative supports practices promoting the initiation and maintenance of breastfeeding and encourages women's informed infant feeding decisions. In Australia, where the Initiative is known as the Baby Friendly Health Initiative (BFHI) the translation of evidence into practice has not been uniform, as demonstrated by a varying number of maternity facilities in each State and Territory currently accredited as 'baby friendly'. This variance has persisted regardless of BFHI implementation in Australia gaining 'in principle' support at a national and governmental level as well as inclusion in health policy in several states. There are many stakeholders that exert an influence on policy development and health care practices. Identify a theory and model to examine where and how barriers occur in the gap between evidence and practice in the uptake of the BFHI in Australia. Knowledge translation theory and the research to practice pipeline model are used to examine the identified barriers to BFHI implementation and accreditation in Australia. Australian and international studies have identified similar issues that have either enabled implementation of the BFHI or acted as a barrier. Knowledge translation theory and the research to practice pipeline model is of practical value to examine barriers. Recommendations in the form of specific targeted strategies to facilitate knowledge transfer and supportive practices into the Australian health care system and current midwifery practice are included. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Ethics skills laboratory experience for surgery interns.

PubMed

Moon, Margaret R; Hughes, Mark T; Chen, Jiin-Yu; Khaira, Kiran; Lipsett, Pamela; Carrese, Joseph A

2014-01-01

Ethics curricula are nearly universal in residency training programs, but the content and delivery methods are not well described, and there is still a relative paucity of literature evaluating the effect of ethics curricula. Several commentators have called for more ethics curriculum development at the postgraduate level, and specifically in surgery training. We detail our development and implementation of a clinical ethics curriculum for surgery interns. We developed curricula and simulated patient cases for 2 core clinical ethics skills--breaking bad news and obtaining informed consent. Educational sessions for each topic included (1) framework development (discussion of interns' current experience, development of a consensus framework for ethical practice, and comparison with established frameworks) and (2) practice with simulated patient followed by peer and faculty feedback. At the beginning and end of each session, we administered a test of confidence and knowledge about the topics to assess the effect of the sessions. A total of 98 surgical interns participated in the ethics skills laboratory from Spring 2008 to Spring 2011. We identified significant improvement in confidence regarding the appropriate content of informed consent (<0.001) and capacity to break bad news (<0.001). We also identified significant improvement in overall knowledge regarding informed consent (<0.01), capacity assessment (<0.05), and breaking bad news (0.001). Regarding specific components of informed consent, capacity assessment, and breaking bad news, significant improvement was shown in some areas, while we failed to improve knowledge in others. Through faculty-facilitated small group discussion, surgery interns were able to develop frameworks for ethical practice that paralleled established frameworks. Skills-based training in clinical ethics resulted in an increase in knowledge scores and self-reported confidence. Evaluation of 4 annual cohorts of surgery interns demonstrates significant successes and some areas for improvement in this educational intervention. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Competency frameworks for advanced practice nursing: a literature review.

PubMed

Sastre-Fullana, P; De Pedro-Gómez, J E; Bennasar-Veny, M; Serrano-Gallardo, P; Morales-Asencio, J M

2014-12-01

This paper describes a literature review that identified common traits in advanced practice nursing that are specific to competency development worldwide. There is a lack of international agreement on the definition of advanced practice nursing and its core competencies. Despite the lack of consensus, there is an ongoing process worldwide to establish and outline the standards and competencies for advanced practice nursing roles. International agencies, such as the International Council of Nurses, have provided general definitions for advanced practice nursing. Additionally, a set of competency standards for this aim has been developed. A literature review and a directed search of institutional websites were performed to identify specific developments in advanced practice nursing competencies and standards of practice. To determine a competency map specific to international advanced practice nursing, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents and countries. The review process identified 119 relevant journal articles related to advanced practice nursing competencies. Additionally, 97 documents from grey literature that were related to advanced practice nursing competency mapping were identified. From the text analysis, 17 worldwide transversal competency domains emerged. Despite the variety of patterns in international advanced practice nursing development, essential competency domains can be found in most national frameworks for the role development of international advanced practice nursing. These 17 core competencies can be used to further develop instruments that assess the perceived competency of advanced practice nurses. The results of this review can help policy developers and researchers develop instruments to compare advanced practice nursing services in various contexts and to examine their association with related outcomes. © 2014 International Council of Nurses.

Does responsibility drive learning? Lessons from intern rotations in general practice.

PubMed

Cantillon, Peter; Macdermott, Maeve

2008-01-01

The intern (or pre-registration) year has been criticised in the past for its emphasis on service delivery at the expense of educational achievement. It is hoped that new approaches to early postgraduate training such as the foundation programmes in the UK, will make clinical education more structured and effective. Intern placements in non-traditional settings such as general practice have been shown in the past to improve the quality of learning. Little is known however about which features of the general practice learning environment contribute most to the perception of improved learning. This aim of this study was to examine the learning environment in general practice from the perspective of interns, (the learners), to determine the factors that contribute most to motivating effective learning in a general practice setting. This study used a qualitative case study approach to explore the effects of two different learning environments, (general practice and hospital) on learner motivation amongst a small group of interns. We found that the biggest difference between the hospital and general practice learning environments was the increased individual responsibility for patient care experienced by interns in general practice. Greater responsibility was associated with greater motivation for learning. Increased intern responsibility for patient care does appear to motivate learning. More work needs to be done on providing interns in hospital posts with greater patient responsibility within an effective supervisory structure.

Opportunities and methodological challenges in EEG and MEG resting state functional brain network research.

PubMed

van Diessen, E; Numan, T; van Dellen, E; van der Kooi, A W; Boersma, M; Hofman, D; van Lutterveld, R; van Dijk, B W; van Straaten, E C W; Hillebrand, A; Stam, C J

2015-08-01

Electroencephalogram (EEG) and magnetoencephalogram (MEG) recordings during resting state are increasingly used to study functional connectivity and network topology. Moreover, the number of different analysis approaches is expanding along with the rising interest in this research area. The comparison between studies can therefore be challenging and discussion is needed to underscore methodological opportunities and pitfalls in functional connectivity and network studies. In this overview we discuss methodological considerations throughout the analysis pipeline of recording and analyzing resting state EEG and MEG data, with a focus on functional connectivity and network analysis. We summarize current common practices with their advantages and disadvantages; provide practical tips, and suggestions for future research. Finally, we discuss how methodological choices in resting state research can affect the construction of functional networks. When taking advantage of current best practices and avoid the most obvious pitfalls, functional connectivity and network studies can be improved and enable a more accurate interpretation and comparison between studies. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

An Engineering Tool for the Prediction of Internal Dielectric Charging

NASA Astrophysics Data System (ADS)

Rodgers, D. J.; Ryden, K. A.; Wrenn, G. L.; Latham, P. M.; Sorensen, J.; Levy, L.

1998-11-01

A practical internal charging tool has been developed. It provides an easy-to-use means for satellite engineers to predict whether on-board dielectrics are vulnerable to electrostatic discharge in the outer radiation belt. The tool is designed to simulate irradiation of single-dielectric planar or cylindrical structures with or without shielding. Analytical equations are used to describe current deposition in the dielectric. This is fast and gives charging currents to sufficient accuracy given the uncertainties in other aspects of the problem - particularly material characteristics. Time-dependent internal electric fields are calculated, taking into account the effect on conductivity of electric field, dose rate and temperature. A worst-case model of electron fluxes in the outer belt has been created specifically for the internal charging problem and is built into the code. For output, the tool gives a YES or NO decision on the susceptibility of the structure to internal electrostatic breakdown and if necessary, calculates the required changes to bring the system below the breakdown threshold. A complementary programme of laboratory irradiations has been carried out to validate the tool. The results for Epoxy-fibreglass samples show that the code models electric field realistically for a wide variety of shields, dielectric thicknesses and electron spectra. Results for Teflon samples indicate that some further experimentation is required and the radiation-induced conductivity aspects of the code have not been validated.

76 FR 78945 - Summary of Commission Practice Relating to Administrative Protective Orders

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-20

... INTERNATIONAL TRADE COMMISSION Summary of Commission Practice Relating to Administrative Protective Orders AGENCY: U.S. International Trade Commission. ACTION: Summary of Commission practice relating to administrative protective orders. SUMMARY: Since February 1991, the U.S. International Trade...

75 FR 66127 - Summary of Commission Practice Relating to Administrative Protective Orders

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

... INTERNATIONAL TRADE COMMISSION Summary of Commission Practice Relating to Administrative Protective Orders AGENCY: U.S. International Trade Commission. ACTION: Summary of Commission practice relating to administrative protective orders. SUMMARY: Since February 1991, the U.S. International Trade...

Regulatory aspects of oncology drug safety evaluation: past practice, current issues, and the challenge of new drugs.

PubMed

Rosenfeldt, Hans; Kropp, Timothy; Benson, Kimberly; Ricci, M Stacey; McGuinn, W David; Verbois, S Leigh

2010-03-01

The drug development of new anti-cancer agents is streamlined in response to the urgency of bringing effective drugs to market for patients with limited life expectancy. FDA's regulation of oncology drugs has evolved from the practices set forth in Arnold Lehman's seminal work published in the 1950s through the current drafting of a new International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) safety guidance for anti-cancer drug nonclinical evaluations. The ICH combines the efforts of the regulatory authorities of Europe, Japan, and the United States and the pharmaceutical industry from these three regions to streamline the scientific and technical aspects of drug development. The recent development of new oncology drug classes with novel mechanisms of action has improved survival rates for some cancers but also brings new challenges for safety evaluation. Here we present the legacy of Lehman and colleagues in the context of past and present oncology drug development practices and focus on some of the current issues at the center of an evolving harmonization process that will generate a new safety guidance for oncology drugs, ICH S9. The purpose of this new guidance will be to facilitate oncology drug development on a global scale by standardizing regional safety requirements.

Current practice patterns in conservative thumb CMC joint care: survey results.

PubMed

O'Brien, Virginia H; McGaha, Jamie L

2014-01-01

Cross-sectional descriptive survey Best practice for conservative clinical care pathways is not well outlined in the literature for patients with thumb carpometacarpal joint (CMCJ) pain. This self-report survey investigated the current practice patterns of assessments and conservative interventions for the painful thumb CMCJ among hand therapists. An online survey was distributed to members of the American Society of Hand Therapists (ASHT). Questions were included about evaluation measures and intervention techniques used for this population. A descriptive analysis was completed of the results. A total of 23.5% of the ASHT membership responded to the survey. Results were categorized using the International Classification of Functioning and Disability domains as a framework. The survey results report varying use of evaluation measures, therapeutic interventions, including orthotic fabrication, joint protection and patient education all therapeutic interventional techniques, and modalities. Therapists use a comprehensive array of evaluation measures and interventions for body functions and structures in the care of thumb CMC pain. In contrast, more consistent use is needed of psychometrically-sound functional outcome measures that show change in activities and participation. This survey highlights areas to employ current evidence, as well as, future research should address environmental factors and personal factors for this population Not applicable. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Gastroenterology training in Australia: how much is enough?

PubMed

Leung, C; De Cruz, P; Jones, A; Sliwka, G; Bell, S J; Hebbard, G S

2013-04-01

Advanced training in gastroenterology currently consists of 2 years of core training and 1 elective (non-core) year. We surveyed gastroenterologists 2-7 years following completion of training to determine the strengths and weaknesses of their training. All gastroenterologists were invited to participate in an anonymous online survey. There was a 46% response rate (49/110). Eighty-one per cent were male with most aged 36-45. Respondents felt that the current training programme prepared them well for public practice and endoscopy but less well for private practice, ambulatory care, surgical aspects of gastroenterology and functional gastrointestinal disorders. Most had faced challenges transitioning to consultant practice. The majority (53%) spent more than the standard 3 years to complete training in gastroenterology. The top three subspecialty Fellowships were in endoscopy (45%), inflammatory bowel disease (29%) and hepatology (23%). In their elective year, 42% undertook a predominantly clinical year (registrar-type position in general or subspecialty gastroenterology), 28% engaged in research while 24% trained in another specialty. Seventy-eight per cent were in full-time work, and 36% were supervising trainees. Ninety-eight per cent felt that it was beneficial for trainees to move between hospitals during the core years of their advanced training. The current Australian gastroenterology training programme is generally adequate in preparing trainees for consultant practice but could be improved by increased emphasis on areas such as private practice, ambulatory gastroenterology and functional gastrointestinal diseases. Exposure to a variety of experiences by training in several different hospitals during core training was universally viewed as being important. © 2012 The Authors; Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

Supporting culturally and linguistically diverse children with speech, language and communication needs: Overarching principles, individual approaches.

PubMed

Verdon, Sarah; McLeod, Sharynne; Wong, Sandie

2015-01-01

Speech-language pathologists (SLPs) are working with an increasing number of families from culturally and linguistically diverse backgrounds as the world's population continues to become more internationally mobile. The heterogeneity of these diverse populations makes it impossible to identify and document a one size fits all strategy for working with culturally and linguistically diverse families. This paper explores approaches to practice by SLPs identified as specialising in multilingual and multicultural practice in culturally and linguistically diverse contexts from around the world. Data were obtained from ethnographic observation of 14 sites in 5 countries on 4 continents. The sites included hospital settings, university clinics, school-based settings, private practices and Indigenous community-based services. There were 652 individual artefacts collected from the sites which included interview transcripts, photographs, videos, narrative reflections, informal and formal field notes. The data were analysed using Cultural-Historical Activity Theory (Engeström, 1987). From the analysis six overarching Principles of Culturally Competent Practice (PCCP) were identified. These were: (1) identification of culturally appropriate and mutually motivating therapy goals, (2) knowledge of languages and culture, (3) use of culturally appropriate resources, (4) consideration of the cultural, social and political context, (5) consultation with families and communities, and (6) collaboration between professionals. These overarching principles align with the six position statements developed by the International Expert Panel on Multilingual Children's Speech (2012) which aim to enhance the cultural competence of speech pathologists and their practice. The international examples provided in the current study demonstrate the individualised ways that these overarching principles are enacted in a range of different organisational, social, cultural and political contexts. Tensions experienced in enacting the principles are also discussed. This paper emphasises the potential for individual SLPs to enhance their practice by adopting these overarching principles to support the individual children and families in diverse contexts around the world. Copyright © 2015 Elsevier Inc. All rights reserved.

An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction.

PubMed

Rogers, Rebecca G; Pauls, Rachel N; Thakar, Ranee; Morin, Melanie; Kuhn, Annette; Petri, Eckhard; Fatton, Brigitte; Whitmore, Kristene; Kingsberg, Sheryl A; Lee, Joseph

2018-05-01

The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus report. This report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA), and the International Continence Society (ICS), assisted at intervals by many external referees. Internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Importantly, this report is not meant to replace, but rather complement current terminology used in other fields for female sexual health and to clarify terms specific to women with pelvic floor dysfunction. A clinically based terminology report for sexual health in women with pelvic floor dysfunction encompassing over 100 separate definitions, has been developed. Key aims have been to make the terminology interpretable by practitioners, trainees, and researchers in female pelvic floor dysfunction. Interval review (5-10 years) is anticipated to keep the document updated and as widely acceptable as possible. A consensus-based terminology report for female sexual health in women with pelvic floor dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research.

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction.

PubMed

Rogers, Rebecca G; Pauls, Rachel N; Thakar, Ranee; Morin, Melanie; Kuhn, Annette; Petri, Eckhard; Fatton, Brigitte; Whitmore, Kristene; Kinsberg, Sheryl; Lee, Joseph

2018-04-01

The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus report. This report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA), and the International Continence Society (ICS), assisted at intervals by many external referees. Internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Importantly, this report is not meant to replace, but rather complement current terminology used in other fields for female sexual health and to clarify terms specific to women with pelvic floor dysfunction. A clinically based terminology report for sexual health in women with pelvic floor dysfunction encompassing over 100 separate definitions, has been developed. Key aims have been to make the terminology interpretable by practitioners, trainees, and researchers in female pelvic floor dysfunction. Interval review (5-10 years) is anticipated to keep the document updated and as widely acceptable as possible. A consensus-based terminology report for female sexual health in women with pelvic floor dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research. © 2018 Wiley Periodicals, Inc.

Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

PubMed

Sasnett, Bonita; Harris, Susie T; White, Shelly

Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

General internal medicine at the crossroads of prosperity and despair: caring for patients with chronic diseases in an aging society.

PubMed

Larson, E B

2001-05-15

During the past quarter century, general internal medicine has emerged as a vital discipline. In the realm of patient care, it is the integrating discipline par excellence. Ironically, as general internists face the challenge of integrating advances of dizzying speed and complexity, and as their clinical practice becomes increasingly effective, it has become much more difficult for them to earn a living. General internists find themselves at the crossroads of prosperity and despair. Although general medicine research leads the research agenda in many departments of medicine, it is particularly vulnerable. The necessary multidisciplinary "programmatic" infrastructure is expensive, and results often take many years to obtain, particularly in the study of chronic disease. The educational environment in many institutions is particularly difficult for general medicine, both because the current emphasis on technical skills obscures patients' and learners' real needs and because complex patients on general medicine services are now so ill and their turnover so rapid. General internal medicine and geriatrics are synergistic, especially in today's marketplace. A focus on geriatric medicine could help general medicine continue to flourish. General internists are ideally suited to the integrated care of elderly patients with multiple problems, research opportunities are enormous in the geriatric population, and the teaching of geriatrics requires a high level of generalist skills. Problems that plague current generalist practice have unique significance to older patients. Organizations that represent general internists would do well to join forces with many other advocacy groups, especially those representing the interests of elderly patients and geriatric medicine.

Implementation. Improving caries detection, assessment, diagnosis and monitoring.

PubMed

Pitts, N B

2009-01-01

This chapter deals with improving the detection, assessment, diagnosis and monitoring of caries to ensure optimal personalized caries management. This can be achieved by delivering what we have (synthesized evidence and international consensus) better and more consistently, as well as driving research and innovation in the areas where we need them. There is a need to better understand the interrelated pieces of the jigsaw that makes up evidence-based dentistry, i.e. the linkages between (a) research and synthesis, (b) dissemination of research results and (c) the implementation of research findings which should ensure that research findings change practice at the clinician-patient level. The current situation is outlined; it is at the implementation step where preventive caries control seems to have failed in some countries but not others. Opportunities for implementation include: capitalizing on the World Health Organization's global policy for improvement of oral health, which sets out an action plan for health promotion and integrated disease prevention; utilizing the developments around the International Caries Detection and Assessment System wardrobe of options and e-learning; building on initiatives from the International Dental Federation and the American Dental Association and linking these to patients' preferences, the wider moves to wellbeing and health maintenance. Challenges for implementation include the slow pace of evolution around dental remuneration systems and some groups of dentists failing to embrace clinical prevention. In the future, implementation of current and developing evidence should be accompanied by research into getting research findings into routine practice, with impacts on the behaviour of patients, professionals and policy makers. Copyright 2009 S. Karger AG, Basel

International Education and (Dis)Embodied Cosmopolitanisms

ERIC Educational Resources Information Center

Sidhu, Ravinder Kaur; Dall'Alba, Gloria

2012-01-01

This article is a critical examination of practices and representations that constitute international education. While international education has provided substantial contributions and benefits for nation-states and international students, we question the discourses and practices which inform the international education export industry. The…

CREATING: a sustainable plan for biomedical higher education in Saudi Arabia. Phase I

PubMed Central

Cirillo, Nicola; AlShwaimi, Emad; Prime, Stephen S.; Al-Hayani, Abdulmonem

2015-01-01

Biomedical higher education has been acquiring increasing importance worldwide, including the Kingdom of Saudi Arabia, and effective strategies to improve outcomes and competitiveness are key for academic success. The plan presented here is divided into two major phases. Phase 1 (Communication, Research governance, Education planning, Accreditation) deals mainly with adopting a systematic approach to academic activities according to the current international standards. In other words, the aim is to re-organise what is already in place, taking into account current guidelines and strategies that help improve quality of education and research. It is suggested that this is not necessarily to be achieved by major investments but, rather, by a more imaginative and structured work plan. In Phase 2 (Translational practice, Implementation, Networking, Growth), higher education institutions are expected to invest in new strategic resources, to establish strong reciprocal links with international academic partners and industry, and to shift their attention to the hot topics and current academic challenges, leading the way in translational education models and pioneering cutting-edge research. PMID:25901139

Developing professional identity in nursing academics: the role of communities of practice.

PubMed

Andrew, Nicola; Ferguson, Dorothy; Wilkie, George; Corcoran, Terry; Simpson, Liz

2009-08-01

This paper analyses the current standing of nursing within the wider United Kingdom (UK) higher education (HE) environment and considers the development of academic identity within the sector, introducing a technology mediated approach to professional learning and development. A community of practice (CoP) is a way of learning based on collaboration among peers. Individuals come together virtually or physically, with a common purpose, defined by knowledge rather than task [Wenger, E., 1998. Communities of Practice: Learning, Meaning and Identity, sixth ed. Cambridge University Press, Cambridge]. In 2008, a small team of academics at Glasgow Caledonian University, School of Nursing, Midwifery and Community Health created and implemented iCoP, a project undertaken to pilot an international CoP, where novices and expert academics collaborated to debate and discuss the complex transition from clinician to academic. Although not intended as a conventional research project, the developmental journey and emerging online discussion provide an insight into the collective thoughts and opinions of a multi-national group of novice academics. The article also highlights the key challenges, problems and limitations of working in an international online arena with professionals who traditionally work and thrive in a face to face, real time environment.

Pharmacokinetic studies in children: recommendations for practice and research.

PubMed

Barker, Charlotte I S; Standing, Joseph F; Kelly, Lauren E; Hanly Faught, Lauren; Needham, Allison C; Rieder, Michael J; de Wildt, Saskia N; Offringa, Martin

2018-04-19

Optimising the dosing of medicines for neonates and children remains a challenge. The importance of pharmacokinetic (PK) and pharmacodynamic (PD) research is recognised both in medicines regulation and paediatric clinical pharmacology, yet there remain barriers to undertaking high-quality PK and PD studies. While these studies are essential in understanding the dose-concentration-effect relationship and should underpin dosing recommendations, this review examines how challenges affecting the design and conduct of paediatric pharmacological studies can be overcome using targeted pharmacometric strategies. Model-based approaches confer benefits at all stages of the drug life-cycle, from identifying the first dose to be used in children, to clinical trial design, and optimising the dosing regimens of older, off-patent medications. To benefit patients, strategies to ensure that new PK, PD and trial data are incorporated into evidence-based dosing recommendations are needed. This review summarises practical strategies to address current challenges, particularly the use of model-based (pharmacometric) approaches in study design and analysis. Recommendations for practice and directions for future paediatric pharmacological research are given, based on current literature and our joint international experience. Success of PK research in children requires a robust infrastructure, with sustainable funding mechanisms at its core, supported by political and regulatory initiatives, and international collaborations. There is a unique opportunity to advance paediatric medicines research at an unprecedented pace, bringing the age of evidence-based paediatric pharmacotherapy into sight. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Intern as Patient: A Patient Experience Simulation to Cultivate Empathy in Emergency Medicine Residents.

PubMed

Nelson, Sara W; Germann, Carl A; MacVane, Casey Z; Bloch, Rebecca B; Fallon, Timothy S; Strout, Tania D

2018-01-01

Prior work links empathy and positive physician-patient relationships to improved healthcare outcomes. The objective of this study was to analyze a patient experience simulation for emergency medicine (EM) interns as a way to teach empathy and conscientious patient care. We conducted a qualitative descriptive study on an in situ, patient experience simulation held during EM residency orientation. Half the interns were patients brought into the emergency department (ED) by ambulance and half were family members. Interns then took part in focus groups that discussed the experience. Data collected during these focus groups were coded by two investigators using a grounded theory approach and constant comparative methodology. We identified 10 major themes and 28 subthemes in the resulting qualitative data. Themes were in three broad categories: the experience as a patient or family member in the ED; application to current clinical practice; and evaluation of the exercise itself. Interns experienced firsthand the physical discomfort, emotional stress and confusion patients and families endure during the ED care process. They reflected on lessons learned, including the importance of good communication skills, frequent updates on care and timing, and being responsive to the needs and concerns of patients and families. All interns felt this was a valuable orientation experience. Conducting a patient experience simulation may be a practical and effective way to develop empathy in EM resident physicians. Additional research evaluating the effect of participation in the simulation over a longer time period and assessing the effects on residents' actual clinical care is warranted.

Ethiopian adolescents' attitudes and expectations deviate from current infant and young child feeding recommendations.

PubMed

Hadley, Craig; Lindstrom, David; Belachew, Tefera; Tessema, Fasil

2008-09-01

Suboptimal infant and child feeding practices are highly prevalent in many developing countries for reasons that are not entirely understood. Taking an anthropological perspective, we assessed whether nulliparous youth have formulated attitudes and expectations in the domain of infant and child feeding behaviors, the extent to which these varied by location and gender, and the extent to which they deviated from current international recommendations. A population-based sample of 2077 adolescent girls and boys (13-17 years) in southwest Ethiopia answered a questionnaire on infant and young child feeding behaviors. Results indicate high levels of agreement among adolescents on items relating to infant and young child feeding behaviors. Attitudes and intentions deviated widely from current international recommendations. Youth overwhelmingly endorsed items related to early introduction of nonbreast milk liquids and foods. For girls, fewer than 11% agreed that a 5-month infant should be exclusively breastfed and only 26% agreed that a 6-month infant should be consuming some animal source foods. Few sex differences emerged and youth responses matched larger community patterns. The results indicate that attitudes and expectations deviate widely from current international child feeding guidelines among soon to be parents. To the extent that youth models are directive, these findings suggest that youth enter into parenthood with suboptimal information about infant and child feeding. Such information will reproduce poor health across generations as the largest cohort of adolescents ever become parents. These results suggest specific points of entry for adolescent nutrition education interventions.

Dementia registries around the globe and their applications: A systematic review.

PubMed

Krysinska, Karolina; Sachdev, Perminder S; Breitner, John; Kivipelto, Miia; Kukull, Walter; Brodaty, Henry

2017-09-01

Patient registries are valuable tools helping to address significant challenges in research, care, and policy. Registries, well embedded in many fields of medicine and public health, are relatively new in dementia. This systematic review presents the current situation in regards to dementia registries worldwide. We identified 31 dementia registries operating on an international, national, or local level between 1986 and 2016. More than half of the registries aimed to conduct or facilitate research, including preclinical research registries and registries recruiting research volunteers. Other dementia registries collected epidemiological or quality of care data. We present evidence of practical and economic outcomes of registries for research, clinical practice and policy, and recommendations for future development. Global harmonization of recruitment methods and minimum data would facilitate international comparisons. Registries provide a positive return on investment; their establishment and maintenance require ongoing support by government, policy makers, research funding bodies, clinicians, and individuals with dementia and their caregivers. Copyright © 2017 the Alzheimer's Association. All rights reserved.

A Review of Major Nursing Vocabularies and the Extent to Which They Have the Characteristics Required for Implementation in Computer-based Systems

PubMed Central

Henry, Suzanne Bakken; Warren, Judith J.; Lange, Linda; Button, Patricia

1998-01-01

Building on the work of previous authors, the Computer-based Patient Record Institute (CPRI) Work Group on Codes and Structures has described features of a classification scheme for implementation within a computer-based patient record. The authors of the current study reviewed the evaluation literature related to six major nursing vocabularies (the North American Nursing Diagnosis Association Taxonomy 1, the Nursing Interventions Classification, the Nursing Outcomes Classification, the Home Health Care Classification, the Omaha System, and the International Classification for Nursing Practice) to determine the extent to which the vocabularies include the CPRI features. None of the vocabularies met all criteria. The Omaha System, Home Health Care Classification, and International Classification for Nursing Practice each included five features. Criteria not fully met by any systems were clear and non-redundant representation of concepts, administrative cross-references, syntax and grammar, synonyms, uncertainty, context-free identifiers, and language independence. PMID:9670127

Proceedings of the African Pathologists Summit; March 22-23, 2013; Dakar, Senegal: a summary.

PubMed

2015-01-01

This report presents the proceedings of the African Pathologists Summit, held under the auspices of the African Organization for Research and Training in Cancer. To deliberate on the challenges and constraints of the practice of pathology in Sub-Saharan Africa and the avenues for addressing them. Collaborating organizations included the American Society for Clinical Pathology; Association of Pathologists of Nigeria; British Division of the International Academy of Pathology; College of Pathologists of East, Central and Southern Africa; East African Division of the International Academy of Pathology; Friends of Africa-United States and Canadian Academy of Pathology Initiative; International Academy of Pathology; International Network for Cancer Treatment and Research; National Cancer Institute; National Health and Laboratory Service of South Africa; Nigerian Postgraduate Medical College; Royal College of Pathologists; West African Division of the International Academy of Pathology; and Faculty of Laboratory Medicine of the West African College of Physicians. Information on the status of the practice of pathology was based on the experience of the participants, who are current or past practitioners of pathology or are involved in pathology education and research in Sub-Saharan Africa. The deliberations were carried out through presentations and working discussion groups. The significant lack of professional and technical personnel, inadequate infrastructure, limited training opportunities, poor funding of pathology services in Sub-Saharan Africa, and their significant impact on patient care were noted. The urgency of addressing these issues was recognized, and the recommendations that were made are contained in this report.

Characteristics of Queensland physicians and the influence of rural exposure on practice location.

PubMed

Runge, C E; MacKenzie, A; Loos, C; Waller, M; Gabbett, M; Mills, R; Eley, D

2016-08-01

The Queensland branch of the Royal Australasian College of Physicians (RACP) commissioned this study to update their workforce profile and examine rural practice. The present investigation aimed to describe characteristics of Queensland physicians and determine the influence of childhood and training locations on current rural practice. A cross-sectional online survey, conducted 4 July-4 November 2013, was administered to Fellows of The RACP, Queensland. Descriptive statistics report characteristics and logistic regression analyses identify associations and interactions. The outcome measure was current practice location using the Australian Standard Geographic Classification - Remoteness Area. Data were obtained for 633 physicians. Their average age was 49.5 years, a third was female and a quarter was in rural practice. Rural practice was associated with a rural childhood (odds ratio (OR) (95% confidence interval, CI) 1.89 (1.10, 3.27) P = 0.02) and any time spent as an intern (OR 4.07 (2.12, 7.82) P < 0.001) or registrar (OR 4.00 (2.21, 7.26) P < 0.001) in a rural location. Physicians with a rural childhood and rural training were most likely to be in rural practice. However, those who had a metropolitan childhood and a rural internship were approximately five times more likely to be working in rural practice than physicians with no rural exposure (OR 5.33 (1.61, 17.60) P < 0.01). The findings demonstrate the positive effect of rural vocational training on rural practice. A prospective study would determine if recent changes to the Basic Physician Training Pathway and the Basic Paediatric Training Network (more rural training than previous pathways) increases the rate of rural practice. © 2016 Royal Australasian College of Physicians.

Practical Quantum Realization of the Ampere from the Elementary Charge

NASA Astrophysics Data System (ADS)

Brun-Picard, J.; Djordjevic, S.; Leprat, D.; Schopfer, F.; Poirier, W.

2016-10-01

One major change of the future revision of the International System of Units is a new definition of the ampere based on the elementary charge e . Replacing the former definition based on Ampère's force law will allow one to fully benefit from quantum physics to realize the ampere. However, a quantum realization of the ampere from e , accurate to within 10-8 in relative value and fulfilling traceability needs, is still missing despite the many efforts made for the development of single-electron tunneling devices. Starting again with Ohm's law, applied here in a quantum circuit combining the quantum Hall resistance and Josephson voltage standards with a superconducting cryogenic amplifier, we report on a practical and universal programmable quantum current generator. We demonstrate that currents generated in the milliampere range are accurately quantized in terms of e fJ (fJ is the Josephson frequency) with measurement uncertainty of 10-8. This new quantum current source, which is able to deliver such accurate currents down to the microampere range, can greatly improve the current measurement traceability, as demonstrated with the calibrations of digital ammeters. In addition, it opens the way to further developments in metrology and in fundamental physics, such as a quantum multimeter or new accurate comparisons to single-electron pumps.

Singapore Neonatal Resuscitation Guidelines 2016

PubMed Central

Yeo, Cheo Lian; Biswas, Agnihotri; Ee, Teong Tai Kenny; Chinnadurai, Amutha; Baral, Vijayendra Ranjan; Chang, Alvin Shang Ming; Ereno, Imelda Lustestica; Ho, Kah Ying Selina; Poon, Woei Bing; Shah, Varsha Atul; Quek, Bin Huey

2017-01-01

We present the revised Neonatal Resuscitation Guidelines for Singapore. The 2015 International Liaison Committee on Resuscitation Neonatal Task Force’s consensus on science and treatment recommendations (2015), and guidelines from the American Heart Association and European Resuscitation Council were debated and discussed. The final recommendations of the National Resuscitation Council, Singapore, were derived after the task force had carefully reviewed the current available evidence in the literature and addressed their relevance to local clinical practice. PMID:28741001

Certification of international allied professionals in cardiac pacing and electrophysiology: Opportunities?

PubMed Central

Chiu, Christine

2010-01-01

Allied professionals with diverse backgrounds and training are essential to the delivery of quality care to patients with heart rhythm disorders. There is a growing worldwide demand for defined educational requirements and certification pathways to ensure uniformity of knowledge and competence of those practicing in electrophysiology. The present viewpoint article reviews the current deficiencies of education and training, and advocates for the establishment of certification pathways by professional societies. PMID:20101363

Measurements of Aircraft Wake Vortex Separation at High Arrival Rates and a Proposed New Wake Vortex Separation Philosophy

NASA Technical Reports Server (NTRS)

Rutishauser, David; Donohue, George L.; Haynie, Rudolph C.

2003-01-01

This paper presents data and a proposed new aircraft wake vortex separation standard that argues for a fundamental re-thinking of international practice. The current static standard, under certain atmospheric conditions, presents an unnecessary restriction on system capacity. A new approach, that decreases aircraft separation when atmospheric conditions dictate, is proposed based upon the availability of new instrumentation and a better understanding of wake physics.

A Thematic Analysis of Health Care Workers' Adoption of Mindfulness Practices.

PubMed

Valley, Morgan; Stallones, Lorann

2018-05-01

Mindfulness training, which teaches individuals to bring awareness and acceptance to the present moment, has been effective in improving the well-being of health care workers. Limited research examines the adoption of mindfulness practices using health behavior theories. The current study sought to conceptualize hospital health care workers' experiences in adopting mindfulness practices using the Health Belief Model (HBM), a theoretical framework used by health promotion practitioners to design and implement health behavior change interventions. Hospital health care workers in Colorado participated in an 8-week Mindfulness-Based Stress Reduction (MBSR) course. Participants ( n = 19) answered open-ended questions about their experiences adopting mindfulness practices. A theory-driven thematic analysis approach was used to analyze data with key constructs of the HBM acting as the framework for the analysis. Results showed that HBM constructs, including internal cues to action, perceived benefits and barriers, and self-efficacy, helped portray the participants' experiences and challenges in adopting and adhering to the mindfulness practices taught in the MBSR course.

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

Ha, Kyoo-Man, E-mail: ha1999@hotmail.com

In Korea, there is a pervasive feeling of invincibility to the point that people and organizations do not believe that disasters can strike them. This has impact on the level of preparedness for disasters. This study aims to delve into how Korea has to change its governmental policies/practices with some private partners' efforts to mitigate disaster risks. A case study was utilized as the major methodology by comparing exclusive management with inclusive management. These two approaches have been comparatively analyzed via four variables, namely the central government, the local governments, the incident commander, and other stakeholders. The major finding ismore » that Korea's practices and policies have to evolve from the current exclusive management into future-oriented inclusive management. Moreover, the importance of communication, cooperation, collaboration, and multi-discipline coordination is discussed. Additionally, the problem of reductionism and equal participation among all stakeholders, as well as the resistance from vested interests, are recognized and elaborated for Korea and the international community. - Highlights: • Only a few stakeholders in Korea believe that disaster can happen to anyone. This study aims to delve into how Korea has to change its current practices to mitigate disaster risks. • To compare exclusive management with inclusive management, we have examined four comparative variables, namely the central government's policy, local government's strategy, the incident commander's post, and other stakeholders' efforts. • The major finding is that Korea's practices and policies have to evolve from the current exclusive management into future-oriented inclusive management.« less

The virtuous pathologist. An ethical basis for laboratory medicine.

PubMed

Stempsey, W E

1989-06-01

The profession of pathology is a practice in the technical sense used by many philosophers. Such practices have internal goods, which, it is hoped, lead to the attainment of a certain end. The ultimate end of the practice of pathology must be the good of the patient in terms of restoring health. Key internal goods in pathology are technical competence, the proper pathologist-patient relationship, and the proper pathologist-clinician relationship. Virtues are predispositions to act so as to attain the end of the practice and further the internal goods. Technical growth in the practice of pathology must be accompanied by continued attempts to articulate the goals and internal goods of the practice. Only if pathologists are predisposed to act in accordance with proper goals will an ethical practice be assured.

Policies and clinical practices relating to the management of gestational diabetes mellitus in the public health sector, South Africa - a qualitative study.

PubMed

Muhwava, Lorrein Shamiso; Murphy, Katherine; Zarowsky, Christina; Levitt, Naomi

2018-05-10

Women with a prior gestational diabetes have an increased lifetime risk of developing type 2 diabetes. Although post-partum follow-up for GDM women is essential to prevent progression to type 2 diabetes, it is poorly attended. The need for health systems interventions to support postpartum follow-up for GDM women is evident, but there is little knowledge of actual current practice. The aim of this study was to explore current policies and clinical practices relating to antenatal and post-natal care for women with GDM in South Africa, as well as health sector stakeholders' perspectives on the barriers to -- and opportunities for -- delivering an integrated mother - baby health service that extends beyond the first week post-partum, to the infant's first year of life. Following a document review of policy and clinical practice guidelines, in-depth interviews were conducted with 11 key informants who were key policy makers, health service managers and clinicians working in the public health services in South Africa's two major cities (Johannesburg and Cape Town). Data were analysed using qualitative content analysis procedures. The document review and interviews established that it is policy that health services adhere to international guidelines for GDM diagnosis and management, in addition to locally developed guidelines and protocols for clinical practice. All key informants confirmed that lack of postpartum follow-up for GDM women is a significant problem. Health systems barriers include fragmentation of care and the absence of standardised postnatal care for post-GDM women. Key informants also raised patient - related challenges including lack of perceived future risk of developing type 2 diabetes and non-attendance for postpartum follow up, as barriers to postnatal care for GDM women. All participants supported integrated primary health services but cautioned against overloading health workers. Although there is alignment between international guidelines, local policy and reported clinical practice in the management of GDM, there is a gap in continuation of care in the postpartum period. Health systems interventions that support and facilitate active follow-up for women with prior GDM are needed if high rates of progression to type 2 diabetes are to be avoided.

Development of the Paris definition of early Crohn's disease for disease-modification trials: results of an international expert opinion process.

PubMed

Peyrin-Biroulet, Laurent; Billioud, Vincent; D'Haens, Geert; Panaccione, Remo; Feagan, Brian; Panés, Julian; Danese, Silvio; Schreiber, Stefan; Ogata, Haruhiko; Hibi, Toshifumi; Higgins, Peter D R; Beaugerie, Laurent; Chowers, Yehuda; Louis, Edouard; Steinwurz, Flávio; Reinisch, Walter; Rutgeerts, Paul; Colombel, Jean-Frédéric; Travis, Simon; Sandborn, William J

2012-12-01

We report the findings and outputs of an international expert opinion process to develop a definition of early Crohn's disease (CD) that could be used in future disease-modification trials. Nineteen experts on inflammatory bowel diseases held an international expert opinion meeting to discuss and agree on a definition for early CD to be used in disease-modification trials. The process included literature searches for the relevant basic-science and clinical evidence. A published preliminary definition of early CD was used as the basis for development of a proposed definition that was discussed at the expert opinion meeting. The participants then derived a final definition, based on best current knowledge, that it is hoped will be of practical use in disease-modification trials in CD.

Internal Benchmarking for Institutional Effectiveness

ERIC Educational Resources Information Center

Ronco, Sharron L.

2012-01-01

Internal benchmarking is an established practice in business and industry for identifying best in-house practices and disseminating the knowledge about those practices to other groups in the organization. Internal benchmarking can be done with structures, processes, outcomes, or even individuals. In colleges or universities with multicampuses or a…

Practice of clinical forensic medicine in Sri Lanka: does it need a new era?

PubMed

Kodikara, Sarathchandra

2012-07-01

Clinical forensic medicine is a sub-specialty of forensic medicine and is intimately associated with the justice system of a country. Practice of clinical forensic medicine is evolving, but deviates from one jurisdiction to another. Most English-speaking countries practice clinical forensic medicine and forensic pathology separately while most non-English-speaking countries practice forensic medicine which includes clinical forensic medicine and forensic pathology. Unlike the practice of forensic pathology, several countries have informal arrangements to deal with forensic patients and there are no international standards of practice or training in this discipline. Besides, this is rarely a topic of discussion. In the adversarial justice system in Sri Lanka, the designated Government Medical Officers practice both clinical forensic medicine and forensic pathology. Practice of clinical forensic medicine, and its teaching and training in Sri Lanka depicts unique features. However, this system has not undergone a significant revision for many decades. In this communication, the existing legal framework, current procedure of practice, examination for drunkenness, investigations, structure of referrals, reports, subsequent legal procedures, undergraduate, in-service, and postgraduate training are discussed with suggestions for reforms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Conducting international nursing research: challenges and opportunities.

PubMed

Opollo, Jackline Gloria; Opollo, Diana Alaka; Gray, Jennifer; Spies, Lori

2014-11-01

To describe practical experiences before, during and after gaining entry into research fields in Kenya and Uganda. Planning, conducting and implementing international research can be an arduous task. Novice researchers need practical guides to accessing international fields and mitigating challenges met in the field. The researchers conducted three different studies in two developing nations. This paper reviews challenges encountered when conducting international research. Solutions used to overcome these challenges are discussed. Establishing and maintaining effective partnerships is critical to the success of international research efforts. Researchers must be tactful, flexible and creative when handling methodological, ethical and logistical challenges encountered in settings poor in resources. International research provides opportunities for increasing dedication, building cross-cultural competence and advancing health professional practice globally. This paper contributes to nursing scholarship by highlighting the practical challenges of conducting international research. Illustrations aimed at lending insight and encouraging others to expand their dedication to conducting international research are offered.

Towards practical implementation of biophotonics-based solutions for cost-effective monitoring of food quality control (Conference Presentation)

NASA Astrophysics Data System (ADS)

Meglinski, Igor; Popov, Alexey; Bykov, Alexander

2017-03-01

Biophotonics-based diagnostic and imaging modalities have been widely used in various applications associated with the non-invasive imaging of the internal structure of a range biological media from a range of cells cultures to biological tissues. With the fast growing interest in food securities there remains strong demand to apply reliable and cost effective biophotonics-based technologies for rapid screening of freshness, internal defects and quality of major agricultural products. In current presentation the results of application of optical coherence tomography (OCT) and encapsulated optical bio-sensors for quantitative assessment of freshness of agricultural products, such as meat and sea foods, are presented, and their further perspectives are discussed.

International GPS Service for Geodynamics

NASA Technical Reports Server (NTRS)

Zumberge, J. F. (Editor); Urban, M. P. (Editor); Liu, R. (Editor); Neilan, R. E. (Editor)

1996-01-01

This 1995 annual report of the IGS International GPS (Global Positioning System) Service for Geodynamics - describes the second operational year of the service. It provides the many IGS contributing agencies and the rapidly growing user community with essential information on current organizational and technical matters promoting the IGS standards and products (including organizational framework, data processing strategies, and statistics showing the remarkable expansion of the GPS monitoring network, the improvement of IGS performance, and product quality). It also introduces important practical concepts for network densification by integration of regional stations and the combination of station coordinate solutions. There are groups of articles describing general aspects of the IGS, the Associate Analysis Centers (AACs), Data Centers, and IGS stations.

Nanotechnology applications in urology: a review.

PubMed

Maddox, Michael; Liu, James; Mandava, Sree Harsha; Callaghan, Cameron; John, Vijay; Lee, Benjamin R

2014-11-01

The objectives of this review are to discuss the current literature and summarise some of the promising areas with which nanotechnology may improve urological care. A Medline literature search was performed to elucidate all relevant studies of nanotechnology with specific attention to its application in urology. Urological applications of nanotechnology include its use in medical imaging, gene therapy, drug delivery, and photothermal ablation of tumours. In vitro and animal studies have shown initial encouraging results. Further study of nanotechnology for urological applications is warranted to bridge the gap between preclinical studies and translation into clinical practice, but nanomedicine has shown significant potential to improve urological patient care. © 2014 The Authors. BJU International © 2014 BJU International.

Trial-by-trial adaptation of movements during mental practice under force field.

PubMed

Anwar, Muhammad Nabeel; Khan, Salman Hameed

2013-01-01

Human nervous system tries to minimize the effect of any external perturbing force by bringing modifications in the internal model. These modifications affect the subsequent motor commands generated by the nervous system. Adaptive compensation along with the appropriate modifications of internal model helps in reducing human movement errors. In the current study, we studied how motor imagery influences trial-to-trial learning in a robot-based adaptation task. Two groups of subjects performed reaching movements with or without motor imagery in a velocity-dependent force field. The results show that reaching movements performed with motor imagery have relatively a more focused generalization pattern and a higher learning rate in training direction.

Part-time careers in academic internal medicine: a report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine.

PubMed

Linzer, Mark; Warde, Carole; Alexander, R Wayne; Demarco, Deborah M; Haupt, Allison; Hicks, Leroi; Kutner, Jean; Mangione, Carol M; Mechaber, Hilit; Rentz, Meridith; Riley, Joanne; Schuster, Barbara; Solomon, Glen D; Volberding, Paul; Ibrahim, Tod

2009-10-01

To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhance workforce flexibility, and provide high-quality research, patient care, and education in a cost-effective manner. The task force provided a series of detailed steps for operationalizing part-time practice; to do so, key issues were addressed, such as fixed costs, malpractice insurance, space, cross-coverage, mentoring, career development, productivity targets, and flexible scheduling. Recommendations included (1) increasing respect for work-family balance, (2) allowing flexible time as well as part-time employment, (3) directly addressing negative perceptions about part-time faculty, (4) developing policies to allow flexibility in academic advancement, (5) considering part-time faculty as candidates for leadership positions, (6) encouraging granting agencies, including the National Institutes of Health and Veterans Administration, to consider part-time faculty as eligible for research career development awards, and (7) supporting future research in "best practices" for incorporating part-time faculty into academic departments of medicine.

Wind power forecasting: IEA Wind Task 36 & future research issues

DOE PAGES

Giebel, G.; Cline, J.; Frank, H.; ...

2016-10-03

Here, this paper presents the new International Energy Agency Wind Task 36 on Forecasting, and invites to collaborate within the group. Wind power forecasts have been used operatively for over 20 years. Despite this fact, there are still several possibilities to improve the forecasts, both from the weather prediction side and from the usage of the forecasts. The new International Energy Agency (IEA) Task on Forecasting for Wind Energy tries to organise international collaboration, among national meteorological centres with an interest and/or large projects on wind forecast improvements (NOAA, DWD, MetOffice, met.no, DMI,...), operational forecaster and forecast users. The Taskmore » is divided in three work packages: Firstly, a collaboration on the improvement of the scientific basis for the wind predictions themselves. This includes numerical weather prediction model physics, but also widely distributed information on accessible datasets. Secondly, we will be aiming at an international pre-standard (an IEA Recommended Practice) on benchmarking and comparing wind power forecasts, including probabilistic forecasts. This WP will also organise benchmarks, in cooperation with the IEA Task WakeBench. Thirdly, we will be engaging end users aiming at dissemination of the best practice in the usage of wind power predictions. As first results, an overview of current issues for research in short-term forecasting of wind power is presented.« less

International workshop on "professionalism in the practice of medicine- where are we now?"

PubMed

Paltiel, Ora; Lowenstein, Lior; Demma, Jonathan; Manor, Orly

2017-04-03

Medical professionalism refers to attributes, values, behaviors, responsibilities and commitments of physicians that are congruent with the public's expectations. An international workshop on medical professionalism took place at the Dead Sea, Israel, on December 11-12, 2016. The meeting brought together local medical professionals, physicians and others, as well as international experts, to discuss definitions of professionalism and wrestle with current challenges facing the profession including its perceived status and physician satisfaction, unprofessional behavior and its relation to health care quality and patient safety, and professionalism as a learned competence. Individual medical schools reported on educational efforts to promote professionalism in their curricula. Patient complaints as an improvement mechanism were explored on a national and health plan level. I was found that complaints regarding physician behavior are rare in the Israeli context and need to be dealt with expeditiously at a local level in order to be effective tools for change. The meeting provided a venue to understand local and international strategies and mechanism for regulation and self-regulation, highlighting the role of the Israel Medical Association. A major focus of the meeting was on intergenerational differences in attitude and practice and the necessary adaptation of medicine to the digital age. We provide an overview of the topics addressed, synopsis, evaluation and lessons learned in this first-ever national meeting on medical professionalism in Israel.

Palliative Sedation: An Analysis of International Guidelines and Position Statements.

PubMed

Gurschick, Lauren; Mayer, Deborah K; Hanson, Laura C

2015-09-01

To describe the suggested clinical practice of palliative sedation as it is presented in the literature and discuss available guidelines for its use. CINAHL, PubMed, and Web of Science were searched for publications since 1997 for recommended guidelines and position statements on palliative sedation as well as data on its provision. Keywords included palliative sedation, terminal sedation, guidelines, United States, and end of life. Inclusion criteria were palliative sedation policies, frameworks, guidelines, or discussion of its practice, general or oncology patient population, performance of the intervention in an inpatient unit, for humans, and in English. Exclusion criteria were palliative sedation in children, acute illness, procedural, or burns, and predominantly ethical discussions. Guidelines were published by American College of Physicians-American Society of Internal Medicine (2000), Hospice and Palliative Nurses Association (2003), American Academy of Hospice and Palliative Medicine (2006), American Medical Association (2008), Royal Dutch Medical Association (2009), European Association for Palliative Care (2009), National Hospice and Palliative Care Organization (2010), and National Comprehensive Cancer Network (2012). Variances throughout guidelines include definitions of the practice, indications for its use, continuation of life-prolonging therapies, medications used, and timing/prognosis. The development and implementation of institutional-based guidelines with clear stance on the discussed variances is necessary for consistency in practice. Data on provision of palliative sedation after implementation of guidelines needs to be collected and disseminated for a better understanding of the current practice in the United States. © The Author(s) 2014.

36 CFR 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

36 CFR 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

36 CFR 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

36 CFR 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

Applying the Concept of "Best Practice" to International Schools

ERIC Educational Resources Information Center

Codrington, Stephen

2004-01-01

This article explores the appropriateness and implications of adopting and adapting the business-oriented concept of "best practice" in international schools. Because businesses and international schools tend to have contrasting goals and time-frames within which they seek to achieve their objectives, it is expected that "best practice" in schools…

Academic Practice as Explanatory Framework: Reconceptualising International Student Academic Engagement and University Teaching

ERIC Educational Resources Information Center

Kettle, Margaret

2011-01-01

This paper joins growing interest in the concept of practice, and uses it to reconceptualise international student engagement with the demands of study at an Australian university. Practice foregrounds institutional structures and student agency and brings together psychologically- and socially-oriented perspectives on international student…

77 FR 38143 - Proposed Collection; Comment Request for Form 23 and Form 23-EP

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-26

... Form 23, Application for Enrollment to Practice Before the Internal Revenue Service, and Form 23-EP, Application for Enrollment to Practice Before the Internal Revenue Service as an Enrolled Retirement Plan...: Application for Enrollment to Practice Before the Internal Revenue Service. Application for Enrollment to...

Injury prevention strategies at the FIFA 2014 World Cup: perceptions and practices of the physicians from the 32 participating national teams

PubMed Central

McCall, Alan; Davison, Michael; Andersen, Thor Einar; Beasley, Ian; Bizzini, Mario; Dupont, Gregory; Duffield, Rob; Carling, Chris; Dvorak, Jiri

2015-01-01

Purpose The available scientific research regarding injury prevention practices in international football is sparse. The purpose of this study was to quantify current practice with regard to (1) injury prevention of top-level footballers competing in an international tournament, and (2) determine the main challenges and issues faced by practitioners in these national teams. Methods A survey was administered to physicians of the 32 competing national teams at the FIFA 2014 World Cup. The survey included 4 sections regarding perceptions and practices concerning non-contact injuries: (1) risk factors, (2) screening tests and monitoring tools, (3) preventative strategies and (4) reflection on their experience at the World Cup. Results Following responses from all teams (100%), the present study revealed the most important intrinsic (previous injury, accumulated fatigue, agonist:antagonist muscle imbalance) and extrinsic (reduced recovery time, training load prior to and during World Cup, congested fixtures) risk factors during the FIFA 2014 World Cup. The 5 most commonly used tests for risk factors were: flexibility, fitness, joint mobility, balance and strength; monitoring tools commonly used were: medical screen, minutes/matches played, subjective and objective wellness, heart rate and biochemical markers. The 5 most important preventative exercises were: flexibility, core, combined contractions, balance and eccentric. Conclusions The present study showed that many of the National football (soccer) teams’ injury prevention perceptions and practices follow a coherent approach. There remains, however, a lack of consistent research findings to support some of these perceptions and practices. PMID:25878078

Why management and leadership education for internists?

PubMed

Martins, Henrique M G

2010-10-01

Around the world, there is an increasing need for more efficiency in healthcare alongside cost containment. Internal medicine physicians are in a pivotal position in this regard. In many countries, they act as bridges between ambulatory/continuity of care systems and hospital-based intensive care and sophisticated therapies. Within the medical field, they often bridge gaps between many specialities increasingly required to provide modern medical care. These skills of managing complex environments, being sensitive to health economics and using large amounts of information, are not normally taught or developed in programmes of internal medicine. While some skills are natural and acquired through practice, other skills would benefit from insights from the fields of management. On the other hand, it seems critical to have internists playing a leading role in the future care of aging populations, and they are the most likely to understand the needs of these multi-pathology cases. On a practical level, internists face the daily challenges of engaging and leading as many people as possible to provide the best care; this requires very good leadership, negotiation, team-working and change-management skills, all of which can be vastly enhanced with specific education initiatives that are targeted and customised to physicians' needs. Management education for internists should be "spiral", starting from medical school and expanding to incorporate issues as the physician matures into new activities and responsibilities. In practical terms, current internists and residents of internal medicine can be brought into contact with such education by a combination of workshops as well as residential and online courses. Copyright (c) 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Quality indicators for the hospital transfusion chain: a national survey conducted in 100 dutch hospitals.

PubMed

Zijlker-Jansen, P Y; Janssen, M P; van Tilborgh-de Jong, A J W; Schipperus, M R; Wiersum-Osselton, J C

2015-10-01

The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion safety officer (structural indicators), observance of transfusion triggers and mandatory traceability of labile blood components (process indicators). Two voluntary online surveys were sent to all Dutch hospitals for operational years 2011 and 2012 to assess compliance with the guideline recommendations. Most hospitals had a hospital transfusion committee and had appointed a transfusion safety officer (TSO). In 2012, only 23% of hospitals complied with the recommended minimum of four annual transfusion committee meetings and 8 h/week for the TSO. Compliance with the recommended pretransfusion haemoglobin threshold for RBC transfusion was achieved by 90% of hospitals in over 80% of transfusions; 58% of hospitals measured the pretransfusion platelet count in over 80% of platelet transfusions and 87% of hospitals complied with the legally mandatory traceability of blood components in over 95% of transfusions. With the current blood transfusion indicators, it is feasible to monitor aspects of the quality of the hospital transfusion chain and blood transfusion practice and to assess guideline compliance. The results from this study suggest that there are opportunities for significant improvement in blood transfusion practice in the Netherlands. These indicators could potentially be used for national and international benchmarking of blood transfusion practice. © 2015 International Society of Blood Transfusion.

Leadership and emotional intelligence in nursing and midwifery education and practice: a discussion paper.

PubMed

Carragher, Jean; Gormley, Kevin

2017-01-01

A discussion of the concepts of leadership and emotional intelligence in nursing and midwifery education and practice. The need for emotionally intelligent leadership in the health professions is acknowledged internationally throughout the nursing and midwifery literature. The concepts of emotional intelligence and emotional-social intelligence have emerged as important factors for effective leadership in the healthcare professions and require further exploration and discussion. This paper will explore these concepts and discuss their importance in the healthcare setting with reference to current practices in the UK, Ireland and internationally. Discussion paper. A search of published evidence from 1990-2015 using key words (as outlined below) was undertaken from which relevant sources were selected to build an informed discussion. Fostering emotionally intelligent leadership in nursing and midwifery supports the provision of high quality and compassionate care. Globally, leadership has important implications for all stakeholders in the healthcare professions with responsibility for maintaining high standards of care. This includes all grades of nurses and midwives, students entering the professions, managerial staff, academics and policy makers. This paper discusses the conceptual models of leadership and emotional intelligence and demonstrates an important link between the two. Further robust studies are required for ongoing evaluation of the different models of emotional intelligence and their link with effective leadership behaviour in the healthcare field internationally. This is of particular significance for professional undergraduate education to promote ongoing compassionate, safe and high quality standards of care. © 2016 John Wiley & Sons Ltd.

Health technology reassessment of non-drug technologies: current practices.

PubMed

Leggett, Laura; Noseworthy, Tom W; Zarrabi, Mahmood; Lorenzetti, Diane; Sutherland, Lloyd R; Clement, Fiona M

2012-07-01

Obsolescence is a natural phase of the lifecycle of health technologies. Given increasing cost of health expenditures worldwide, health organizations have little choice but to engage in health technology reassessment (HTR); a structured, evidence-based assessment of the medical, social, ethical, and economic effects of a technology, currently used within the healthcare system, to inform optimal use of that technology in comparison to its alternatives. This research was completed to identify and summarize international HTR initiatives for non-drug technologies. A systematic review was performed using the terms disinvestment, obsolescence, obsolete technology, ineffective, reassessment, reinvestment, reallocation, program budgeting, and marginal analysis to search PubMED, MEDLINE, EMBASE, and CINAHL until November 2011. Websites of organizations listed as members of INAHTA and HTAi were hand-searched for gray literature. Documents were excluded if they were unavailable in English, if the title/abstract was irrelevant to HTR, and/or if the document made no mention of current practices. All citations were screened in duplicate with disagreements resolved by consensus. Sixty full-text documents were reviewed and forty were included. One model for reassessment was identified; however, it has never been put into practice. Eight countries have some evidence of past or current work related to reassessment; seven have shown evidence of continued work in HTR. There is negligible focus on monitoring and implementation. HTR is in its infancy. Although health technology reassessments are being conducted, there is no standardized approach. Future work should focus on developing and piloting a comprehensive methodology for completing HTR.

The Canadian critical care nutrition guidelines in 2013: an update on current recommendations and implementation strategies.

PubMed

Dhaliwal, Rupinder; Cahill, Naomi; Lemieux, Margot; Heyland, Daren K

2014-02-01

Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioners and patient decisions about appropriate healthcare for specific clinical circumstances, and are designed to minimize practice variation, improve costs, and improve clinical outcomes. The Canadian Critical Care Practice Guidelines (CCPGs) were first published in 2003 and most recently updated in 2013. A total of 68 new randomized controlled trials were identified since the last version in 2009, 50 of them published between 2009 and 2013. The remaining articles were trials published before 2009 but were not identified in previous iterations of the CCPGs. For clinical practice guidelines to be useful to practitioners, they need to be up-to-date and be reflective of the current body of evidence. Herein we describe the process by which the CCPGs were updated. This process resulted in 10 new sections or clinical topics. Of the old clinical topics, 3 recommendations were upgraded, 4 were downgraded, and 27 remained the same. To influence decision making at the bedside, these updated guidelines need to be accompanied by active guideline implementation strategies. Optimal implementation strategies should be guided by local contextual factors including barriers and facilitators to best practice recommendations. Moreover, evaluating and monitoring performance, such as participating in the International Nutrition Survey of practice, should be part of any intensive care unit's performance improvement strategy. The active implementation of the updated CCPGs may lead to better nutrition care and improved patient outcomes in the critical care setting.

Workplace discrimination: experiences of practicing physicians.

PubMed

Coombs, Alice A Tolbert; King, Roderick K

2005-04-01

In response to a growing concern regarding physician discrimination in the workplace, this study was developed to: (1) describe the types of discrimination that exist for the practicing physician and (2) determine which groups of physicians are more likely to experience the various forms of discrimination. Surveys were mailed to 1930 practicing physicians in Massachusetts. Participants were asked if they had encountered discrimination, how significant the discrimination was against a specific group, the frequency of personal discrimination, and the type of discrimination. Factor analysis identified four types of discrimination: career advancement, punitive behaviors, practice barriers and hiring barriers. A total of 445 responses were received (a 24% response rate). Sixty-three percent of responding physicians had experienced some form of discrimination. Respondents were women (46%), racial/ethnic minorities (42%) and international medical graduates (IMGs) (40%). In addition, 26% of those classified as white were also IMGs. Over 60% of respondents believed discrimination against IMGs was very or somewhat significant. Almost 27% of males acknowledged that gender bias against females was very or somewhat significant. IMGs were more likely to indicate that discrimination against IMGs was significant in their current organization. Of U.S. medical graduates (USMGs) 44% reported that discrimination against IMGs in their current organization was significant. Nonwhites were more likely to report that discrimination based on race/ethnicity was significant. Nearly 29% of white respondents also believed that such discrimination was very or somewhat significant. Physicians practicing in academic, research, and private practice sectors experience discrimination based on gender, ethnic/racial, and IMG status.

The face, the future, and dental practice: how research in craniofacial biology will influence patient care.

PubMed

Townsend, G C; Brook, A H

2014-06-01

It has been a privilege to assemble a group of Australian and international researchers to produce a special issue of the Australian Dental Journal that reflects the cutting edge of research in different aspects of craniofacial biology, and also considers how these advances will influence future education and practice within dentistry. The aim of this special issue is to provide a collection of concept papers and critical reviews on key topics that cover both fundamental and applied research in craniofacial biology and to consider the clinical implications. To do this, four questions have been addressed that lead to the four sections of this issue. These are: How have we come to the present exciting position in craniofacial biology with breakthroughs over the past 50 years? What are current fundamental research topics that are helping us to understand more about craniofacial and general development, possibly leading to future clinical developments? What are the current applied research topics that will influence future clinical practice? Looking forward, what new developments in craniofacial biology may come about that will change the face of dental education and practice? The refereed papers in this special issue are grouped into the four sections that seek to respond to these demanding questions. © 2014 Australian Dental Association.

Use of the International Pharmaceutical Federation’s Basel Statements to Assess and Advance Hospital Pharmacy Practice: A Scoping Review

PubMed Central

Penm, Jonathan; Chaar, Betty; Moles, Rebekah J

2016-01-01

Background: The Basel statements of the International Pharmaceutical Federation, which provide the first global, unified vision for the hospital pharmacy profession, have recently been revised. Originally released in 2008, the Basel statements have since been made available in 21 languages, and thus have the potential for great impact around the world. Objective: To conduct a scoping review to examine the extent and nature of research activity related to the Basel statements. Methods: Google Scholar, PubMed, and International Pharmaceutical Abstracts were searched using the key term “Basel statements” for relevant research articles. From each included study, data were extracted on geographic location, study design, study outcomes, and use of the Basel statements. Results: The search strategy generated 113 results. Further refinement resulted in 14 English-language articles that met the inclusion criteria. Four of these articles focused on adapting the Basel statements to European practice, an initiative of the European Association of Hospital Pharmacists that led to development of the European statements of Hospital Pharmacy. Six studies focused on monitoring hospital pharmacy practice in Uganda, the Pacific island countries, and the Western Pacific Region. These studies provide valuable baseline data to measure and track the development of hospital pharmacy practices in their respective countries and regions. The remaining 4 studies used qualitative methods to explore the barriers to and facilitators of implementation of the Basel statements in South Africa, China, and Australia. Conclusion: The Basel statements have led to multiple initiatives around the world, involving more than 70 countries. The European and Western Pacific regions have been the most active. Current initiatives should be continued to ensure identification and resolution of issues related to sustaining their use over time. PMID:27168634

Barriers to Medical Compassion as a Function of Experience and Specialization: Psychiatry, Pediatrics, Internal Medicine, Surgery, and General Practice.

PubMed

Fernando, Antonio T; Consedine, Nathan S

2017-06-01

Compassion is an expectation of patients, regulatory bodies, and physicians themselves. Most research has, however, studied compassion fatigue rather than compassion itself and has concentrated on the role of the physician. The Transactional Model of Physician Compassion suggests that physician, patient, external environment, and clinical factors are all relevant. Because these factors vary both across different specialities and among physicians with differing degrees of experience, barriers to compassion are also likely to vary. We describe barriers to physician compassion as a function of specialization (psychiatry, general practice, surgery, internal medicine, and pediatrics) and physician experience. We used a cross-sectional study using demographic data, specialization, practice parameters, and the Barriers to Physician Compassion Questionnaire. Nonrandom convenience sampling was used to recruit 580 doctors, of whom 444 belonged to the targeted speciality groups. The sample was characterized before conducting a factorial Multivariate Analysis of Covariance and further post hoc analyses. A 5 (speciality grouping) × 2 (more vs. less physician experience) Multivariate Analysis of Covariance showed that the barriers varied as a function of both speciality and experience. In general, psychiatrists reported lower barriers, whereas general practitioners and internal medicine specialists generally reported greater barriers. Barriers were generally greater among less experienced doctors. Documenting and investigating barriers to compassion in different speciality groups have the potential to broaden current foci beyond the physician and inform interventions aimed at enhancing medical compassion. In addition, certain aspects of the training or practice of psychiatry that enhance compassion may mitigate barriers to compassion in other specialities. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Use of the International Pharmaceutical Federation's Basel Statements to Assess and Advance Hospital Pharmacy Practice: A Scoping Review.

PubMed

Penm, Jonathan; Chaar, Betty; Moles, Rebekah J

2016-01-01

The Basel statements of the International Pharmaceutical Federation, which provide the first global, unified vision for the hospital pharmacy profession, have recently been revised. Originally released in 2008, the Basel statements have since been made available in 21 languages, and thus have the potential for great impact around the world. To conduct a scoping review to examine the extent and nature of research activity related to the Basel statements. Google Scholar, PubMed, and International Pharmaceutical Abstracts were searched using the key term "Basel statements" for relevant research articles. From each included study, data were extracted on geographic location, study design, study outcomes, and use of the Basel statements. The search strategy generated 113 results. Further refinement resulted in 14 English-language articles that met the inclusion criteria. Four of these articles focused on adapting the Basel statements to European practice, an initiative of the European Association of Hospital Pharmacists that led to development of the European statements of Hospital Pharmacy. Six studies focused on monitoring hospital pharmacy practice in Uganda, the Pacific island countries, and the Western Pacific Region. These studies provide valuable baseline data to measure and track the development of hospital pharmacy practices in their respective countries and regions. The remaining 4 studies used qualitative methods to explore the barriers to and facilitators of implementation of the Basel statements in South Africa, China, and Australia. The Basel statements have led to multiple initiatives around the world, involving more than 70 countries. The European and Western Pacific regions have been the most active. Current initiatives should be continued to ensure identification and resolution of issues related to sustaining their use over time.

Surgical Practical Skills Learning Curriculum: Implementation and Interns' Confidence Perceptions.

PubMed

Acosta, Danilo; Castillo-Angeles, Manuel; Garces-Descovich, Alejandro; Watkins, Ammara A; Gupta, Alok; Critchlow, Jonathan F; Kent, Tara S

To provide an overview of the practical skills learning curriculum and assess its effects over time on the surgical interns' perceptions of their technical skills, patient management, administrative tasks, and knowledge. An 84-hour practical skills curriculum composed of didactic, simulation, and practical sessions was implemented during the 2015 to 2016 academic year for general surgery interns. Totally, 40% of the sessions were held during orientation, whereas the remainder sessions were held throughout the academic year. Interns' perceptions of their technical skills, administrative tasks, patient management, and knowledge were assessed by the practical skills curriculum residents' perception survey at various time points during their intern year (baseline, midpoint, and final). Interns were also asked to fill out an evaluation survey at the completion of each session to obtain feedback on the curriculum. General Surgery Residency program at a tertiary care academic institution. 20 General Surgery categorical and preliminary interns. Significant differences were found over time in interns' perceptions on their technical skills, patient management, administrative tasks, and knowledge (p < 0.001 for all). The results were also statistically significant when accounting for a prior boot camp course in medical school, intern status (categorical or preliminary), and gender (p < 0.05 for all). Differences in interns' perceptions occurred both from baseline to midpoint, and from midpoint to final time point evaluations (p < 0.001 for all). Prior surgical boot camp in medical school status, intern status (categorical vs. preliminary), and gender did not differ in the interns' baseline perceptions of their technical skills, patient management, administrative tasks, and knowledge (p > 0.05 for all). Implementation of a Practical Skills Curriculum in surgical internships can improve interns' confidence perception on their technical skills, patient management skills, administrative tasks, and knowledge. Copyright © 2018. Published by Elsevier Inc.

Workshop V: Cultural Perception and Bias/Science Practice and Ethics

NASA Astrophysics Data System (ADS)

Chuan, Kwek Leong; Lin, Jauyn Grace; Pierron-Bohnes, Veronique; Dawson, Silvina Ponce

2015-12-01

Despite the objectivity of science, the local work environment affects the daily activities of scientists. Differences in cultural perception can affect female scientists in the workplace directly. The pressure currently exerted on researchers, on the other hand, is altering how science is practiced and seems to affect women and men differently. In this paper we summarize the discussions that took place on this topic in Workshop V of the 5th IUPAP International Conference on Women in Physics. We present some of the results of the 2010 Global Survey of Physicists analyzed by region and data from France and Taiwan. We also include the recommendations that were formulated at the end of the workshop.

ACCF/AHA/HFSA 2011 survey results: current staffing profile of heart failure programs, including programs that perform heart transplant and mechanical circulatory support device implantation.

PubMed

Jessup, Mariell; Albert, Nancy M; Lanfear, David E; Lindenfeld, JoAnn; Massie, Barry M; Walsh, Mary Norine; Zucker, Mark J

2011-05-01

There have been no published recommendations about staffing needs for a heart failure (HF) clinic or an office setting focused on heart transplant. The goal of this survey was to understand the current staffing environment of HF, transplant, and mechanical circulatory support device (MCSD) programs in the United States and abroad. This report identifies current staffing patterns but does not endorse a particular staffing model. An online survey, jointly sponsored by the American College of Cardiology Foundation (ACCF), American Heart Association (AHA), and the Heart Failure Society of America (HFSA), was sent to the members of all 3 organizations who had identified themselves as interested in HF, heart transplant, or both, between March 12, 2009, and May 12, 2009. The overall response rate to the 1,823 e-mail surveys was 23%. There were 257 unique practices in the United States (81% of total sites) and 58 international sites (19%); approximately 30% of centers were in a cardiovascular group practice and 30% in a medical school hospital setting. The large majority of practices delivered HF care in both an inpatient and outpatient environment, and slightly more centers were implanting MCSDs (47%) than performing cardiac transplantation (39%). Most practices (43%) were small, with <4 staff members, or small- to medium-sized (34%), with 4 to 10 staff members, with only 23% being medium (11-20 staff) or large programs (>20 staff). On average, a U.S. HF practice cared for 1,641 outpatients annually. An average HF program with transplant performed 10 transplants. Although larger programs were able to perform more transplants and see more outpatient HF visits, their clinician staffing volume tended to double for approximately every 500 to 700 additional HF visits annually. The average staffing utilization was 2.65 physician full-time equivalents (FTEs), 2.21 nonphysician practitioner (nurse practitioner or physician assistant) FTEs, and 2.61 nurse coordinator FTEs annually. The HF patient population is growing in number in the United States and internationally, and the clinicians who provide the highly skilled and time-consuming care to this population are under intense scrutiny as a result of focused quality improvement initiatives and reduced financial resources. Staffing guidelines should be developed to ensure that an adequate number of qualified professionals are hired for a given practice volume. These survey results are an initial step in developing such standards. Copyright © 2011. Published by Elsevier Inc.

Assessment of current practice and barriers to antimicrobial prophylaxis in peritoneal dialysis patients.

PubMed

Campbell, Denise J; Brown, Fiona G; Craig, Jonathan C; Gallagher, Martin P; Johnson, David W; Kirkland, Geoffrey S; Kumar, Subramanian K; Lim, Wai H; Ranganathan, Dwarakanathan; Saweirs, Walaa; Sud, Kamal; Toussaint, Nigel D; Walker, Rowan G; Williams, Lesley A; Yehia, Maha; Mudge, David W

2016-04-01

Existing Australasian and international guidelines outline antibiotic and antifungal measures to prevent the development of treatment-related infection in peritoneal dialysis (PD) patients. Practice patterns and rates of PD-related infection vary widely across renal units in Australia and New Zealand and are known to vary significantly from guideline recommendations, resulting in PD technique survival rates that are lower than those achieved in many other countries. The aim of this study was to determine if there is an association between current practice and PD-related infection outcomes and to identify the barriers and enablers to good clinical practice. This is a multicentre network study involving eight PD units in Australia and New Zealand, with a focus on adherence to guideline recommendations on antimicrobial prophylaxis in PD patients. Current practice was established by asking the PD unit heads to respond to a short survey about practice/protocols/policies and a 'process map' was constructed following a face-to-face interview with the primary PD nurse at each unit. The perceived barriers/enablers to adherence to the relevant guideline recommendations were obtained from the completion of 'cause and effect' diagrams by the nephrologist and PD nurse at each unit. Data on PD-related infections were obtained for the period 1 January 2011 to 31 December 2011. Perceived barriers that may result in reduced adherence to guideline recommendations included lack of knowledge, procedural lapses, lack of a centralized patient database, patients with non-English speaking background, professional concern about antibiotic resistance, medication cost and the inability of nephrologists and infectious diseases staff to reach consensus on unit protocols. The definitions of PD-related infections used by some units varied from those recommended by the International Society for Peritoneal Dialysis, particularly with exit-site infection (ESI). Wide variations were observed in the rates of ESI (0.06-0.53 episodes per patient-year) and peritonitis (0.31-0.86 episodes per patient-year). Despite the existence of strongly evidence-based guideline recommendations, there was wide variation in adherence to these recommendations between PD units which might contribute to PD-related infection rates, which varied widely between units. Although individual patient characteristics may account for some of this variability, inconsistencies in the processes of care to prevent infection in PD patients also play a role. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

The Use of Remote Sensing Satellites for Verification in International Law

NASA Astrophysics Data System (ADS)

Hettling, J. K.

The contribution is a very sensitive topic which is currently about to gain significance and importance in the international community. It implies questions of international law as well as the contemplation of new developments and decisions in international politics. The paper will begin with the meaning and current status of verification in international law as well as the legal basis of satellite remote sensing in international treaties and resolutions. For the verification part, this implies giving a definition of verification and naming its fields of application and the different means of verification. For the remote sensing part, it involves the identification of relevant provisions in the Outer Space Treaty and the United Nations General Assembly Principles on Remote Sensing. Furthermore it shall be looked at practical examples: in how far have remote sensing satellites been used to verify international obligations? Are there treaties which would considerably profit from the use of remote sensing satellites? In this respect, there are various examples which can be contemplated, such as the ABM Treaty (even though out of force now), the SALT and START Agreements, the Chemical Weapons Convention and the Conventional Test Ban Treaty. It will be mentioned also that NGOs have started to verify international conventions, e.g. Landmine Monitor is verifying the Mine-Ban Convention. Apart from verifying arms control and disarmament treaties, satellites can also strengthen the negotiation of peace agreements (such as the Dayton Peace Talks) and the prevention of international conflicts from arising. Verification has played an increasingly prominent role in high-profile UN operations. Verification and monitoring can be applied to the whole range of elements that constitute a peace implementation process, ranging from the military aspects through electoral monitoring and human rights monitoring, from negotiating an accord to finally monitoring it. Last but not least the problem of enforcing international obligations needs to be addressed, especially the dependence of international law on the will of political leaders and their respective national interests.

Collaborating internationally on physician leadership development: why now?

PubMed

Chan, Ming-Ka; de Camps Meschino, Diane; Dath, Deepak; Busari, Jamiu; Bohnen, Jordan David; Samson, Lindy Michelle; Matlow, Anne; Sánchez-Mendiola, Melchor

2016-07-04

Purpose This paper aims to highlight the importance of leadership development for all physicians within a competency-based medical education (CBME) framework. It describes the importance of timely international collaboration as a key strategy in promoting physician leadership development. Design/methodology/approach The paper explores published and Grey literature around physician leadership development and proposes that international collaboration will meet the expanding call for development of leadership competencies in postgraduate medical learners. Two grounding frameworks were used: complexity science supports adding physician leadership training to the current momentum of CBME adoption, and relational cultural theory supports the engagement of diverse stakeholders in multiple jurisdictions around the world to ensure inclusivity in leadership education development. Findings An international collaborative identified key insights regarding the need to frame physician leadership education within a competency-based model. Practical implications International collaboration can be a vehicle for developing a globally relevant, generalizable physician leadership curriculum. This model can be expanded to encourage innovation, scholarship and program evaluation. Originality/value A competency-based leadership development curriculum is being designed by an international collaborative. The curriculum is based on established leadership and education frameworks. The international collaboration model provides opportunities for ongoing sharing, networking and diversification.

Consistency of Use and Effectiveness of Household Water Treatment among Indian Households Claiming to Treat Their Water.

PubMed

Rosa, Ghislaine; Clasen, Thomas

2017-07-01

Household water treatment (HWT) can improve drinking water quality and prevent disease if used correctly and consistently by populations at risk. Current international monitoring estimates by the Joint Monitoring Programme for water and sanitation suggest that at least 1.1 billion people practice HWT. These estimates, however, are based on surveys that may overstate the level of consistent use and do not address microbial effectiveness. We sought to assess how HWT is practiced among households identified as HWT users according to these monitoring standards. After a baseline survey (urban: 189 households, rural: 210 households) to identify HWT users, 83 urban and 90 rural households were followed up for 6 weeks. Consistency of reported HWT practices was high in both urban (100%) and rural (93.3%) settings, as was availability of treated water (based on self-report) in all three sampling points (urban: 98.8%, rural: 76.0%). Nevertheless, only 13.7% of urban and 25.8% of rural households identified at baseline as users of adequate HWT had water free of thermotolerant coliforms at all three water sampling points. Our findings raise questions about the value of the data gathered through the international monitoring of HWT as predictors of water quality in the home, as well as questioning the ability of HWT, as actually practiced by vulnerable populations, to reduce exposure to waterborne diseases.

Framework for Evaluating the Impact of Advanced Practice Nursing Roles.

PubMed

Bryant-Lukosius, Denise; Spichiger, Elisabeth; Martin, Jacqueline; Stoll, Hansruedi; Kellerhals, Sabine Degen; Fliedner, Monica; Grossmann, Florian; Henry, Morag; Herrmann, Luzia; Koller, Antje; Schwendimann, René; Ulrich, Anja; Weibel, Lukas; Callens, Betty; De Geest, Sabina

2016-03-01

To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the need for guidance to generate strategic evaluation data. This article describes an evaluation framework developed to inform decisions about the effective utilization of APN roles across the country. A participatory approach was used by an international group of stakeholders. Published literature and an evidenced-based framework for introducing APN roles were analyzed and applied to define the purpose, target audiences, and essential elements of the evaluation framework. Through subsequent meetings and review by an expert panel, the framework was developed and refined. A framework to evaluate different types of APN roles as they evolve to meet dynamic population health, practice setting, and health system needs was created. It includes a matrix of key concepts to guide evaluations across three stages of APN role development: introduction, implementation, and long-term sustainability. For each stage, evaluation objectives and questions examining APN role structures, processes, and outcomes from different perspectives (e.g., patients, providers, managers, policy-makers) were identified. A practical, robust framework based on well-established evaluation concepts and current understanding of APN roles can be used to conduct systematic evaluations. The evaluation framework is sufficiently generic to allow application in developed countries globally, both for evaluation as well as research purposes. © 2016 Sigma Theta Tau International.

Public nutrition in complex emergencies.

PubMed

Young, Helen; Borrel, Annalies; Holland, Diane; Salama, Peter

Public nutrition is a broad-based, problem-solving approach to addressing malnutrition in complex emergencies that combines analysis of nutritional risk and vulnerability with action-oriented strategies, including policies, programmes, and capacity development. This paper focuses on six broad areas: nutritional assessment, distribution of a general food ration, prevention and treatment of moderate malnutrition, treatment of severe malnutrition in children and adults, prevention and treatment of micronutrient deficiency diseases, and nutritional support for at-risk groups, including infants, pregnant and lactating women, elderly people, and people living with HIV. Learning and documenting good practice from previous emergencies, the promotion of good practice in current emergencies, and adherence to international standards and guidelines have contributed to establishing the field of public nutrition. However, many practical challenges reduce the effectiveness of nutritional interventions in complex emergencies, and important research and programmatic questions remain.

Intermittent kangaroo mother care: a NICU protocol.

PubMed

Davanzo, Riccardo; Brovedani, Pierpaolo; Travan, Laura; Kennedy, Jacqueline; Crocetta, Anna; Sanesi, Cecilia; Strajn, Tamara; De Cunto, Angela

2013-08-01

The practice of kangaroo mother care (KMC) is steadily increasing in high-tech settings due to its proven benefits for both infants and parents. In spite of that, clear guidelines about how to implement this method of care are lacking, and as a consequence, some restrictions are applied in many neonatal intensive care units (NICUs), preventing its practice. Based on recommendations from the Expert Group of the International Network on Kangaroo Mother Care, we developed a hospital protocol in the neonatal unit of the Institute for Maternal and Child Health in Trieste, Italy, a level 3 unit, aimed to facilitate and promote KMC implementation in high-tech settings. Our guideline is therefore proposed, based both on current scientific literature and on practical considerations and experience. Future adjustments and improvements would be considered based on increasing clinical KMC use and further knowledge.

Computational design and refinement of self-heating lithium ion batteries

NASA Astrophysics Data System (ADS)

Yang, Xiao-Guang; Zhang, Guangsheng; Wang, Chao-Yang

2016-10-01

The recently discovered self-heating lithium ion battery has shown rapid self-heating from subzero temperatures and superior power thereafter, delivering a practical solution to poor battery performance at low temperatures. Here, we describe and validate an electrochemical-thermal coupled model developed specifically for computational design and improvement of the self-heating Li-ion battery (SHLB) where nickel foils are embedded in its structure. Predicting internal cell characteristics, such as current, temperature and Li-concentration distributions, the model is used to discover key design factors affecting the time and energy needed for self-heating and to explore advanced cell designs with the highest self-heating efficiency. It is found that ohmic heat generated in the nickel foil accounts for the majority of internal heat generation, resulting in a large internal temperature gradient from the nickel foil toward the outer cell surface. The large through-plane temperature gradient leads to highly non-uniform current distribution, and more importantly, is found to be the decisive factor affecting the heating time and energy consumption. A multi-sheet cell design is thus proposed and demonstrated to substantially minimize the temperature gradient, achieving 30% more rapid self-heating with 27% less energy consumption than those reported in the literature.

Impediments to global surveillance of infectious diseases: consequences of open reporting in a global economy.

PubMed Central

Cash, R. A.; Narasimhan, V.

2000-01-01

Globalization has led to an increase in the spread of emerging and re-emerging infectious diseases. International efforts are being launched to control their dissemination through global surveillance, a major hindrance to which is the failure of some countries to report outbreaks. Current guidelines and regulations on emerging and re-emerging infectious diseases do not sufficiently take into account the fact that when developing countries report outbreaks they often derive few benefits and suffer disproportionately heavy social and economic consequences. In order to facilitate full participation in global surveillance by developing countries there should be: better and more affordable diagnostic capabilities to allow for timely and accurate information to be delivered in an open and transparent fashion; accurate, less sensationalist news reporting of outbreaks of diseases; adherence by countries to international regulations, including those of the World Trade Organization and the International Health Regulations; financial support for countries that are economically damaged by the diseases in question. The article presents two cases--plague in India and cholera in Peru--that illuminate some of the limitations of current practices. Recommendations are made on measures that could be taken by WHO and the world community to make global surveillance acceptable. PMID:11143197

Demonstrating successful aging using the International Collaborative Study for Oral Health Outcomes.

PubMed

Atchison, K A; Andersen, R M

2000-01-01

As the lifespan increases and people are faced with 15 to 20 years of "old age," we ask what one considers successful aging with respect to oral health. We propose a comprehensive combination of outcome variables, maintenance of teeth, manageable periodontal condition, positive perceived oral health, satisfaction with their access to and receipt of dental services, and minimal functional problems, that together comprise a definition of successful aging. The International Collaborative Study for Oral Health Outcomes provides a data set for exploring the oral health of a diverse sample of older adults in US and international sites using the modified Andersen Behavioral Model. The percent of adults who report no natural teeth ranged from 16 percent in San Antonio to 59 percent in New Zealand. Seventy percent or more of the adults from each site rated their oral health as good/fair or better except in Poland. The current cohort of older adults is faring better on some indicators than others; nevertheless, ethnic minorities and poorer countries still demonstrate inequities. Dentistry must attempt to educate individuals early in their lifespan that a combination of personal oral health practices and current dental techniques offers the potential for successful oral health throughout one's lifetime.

Global health training and international clinical rotations during residency: current status, needs, and opportunities.

PubMed

Drain, Paul K; Holmes, King K; Skeff, Kelley M; Hall, Thomas L; Gardner, Pierce

2009-03-01

Increasing international travel and migration have contributed to globalization of diseases. Physicians today must understand the global burden and epidemiology of diseases, the disparities and inequities in global health systems, and the importance of cross-cultural sensitivity. To meet these needs, resident physicians across all specialties have expressed growing interest in global health training and international clinical rotations. More residents are acquiring international experience, despite inadequate guidance and support from most accreditation organizations and residency programs. Surveys of global health training, including international clinical rotations, highlight the benefits of global health training as well as the need for a more coordinated approach. In particular, international rotations broaden a resident's medical knowledge, reinforce physical examination skills, and encourage practicing medicine among underserved and multicultural populations. As residents recognize these personal and professional benefits, a strong majority of them seek to gain international clinical experience. In conclusion, with feasible and appropriate administrative steps, all residents can receive global health training and be afforded the accreditation and programmatic support to participate in safe international rotations. The next steps should address accreditation for international rotations and allowance for training away from continuity clinics by residency accreditation bodies, and stipend and travel support for six or more weeks of call-free elective time from residency programs.

36 CFR § 902.52 - Records related solely to internal personnel rules and practices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Corporation Records § 902.52 Records related solely to internal personnel rules and practices. (a) Records... hiring, training, promotion, demotion, and discharge of employees, and management plans, records, or... protection of any record related to internal personnel rules and practices dealing with the relations between...

Preparing children for international travel: need for training and pediatric-focused research.

PubMed

Hagmann, Stefan H F; Leshem, Eyal; Fischer, Philip R; Stauffer, William M; Barnett, Elizabeth D; Christenson, John C

2014-01-01

The International Society of Travel Medicine (ISTM) Pediatric Interest Group (PedIG) was created in 2010. We studied the group's professional characteristics and practice patterns to identify clinical areas requiring further training and research related to pediatric international travel. PedIG members were emailed a two-part online questionnaire in September 2011, which comprised questions about professional and practice details, followed by a survey regarding decisions on nine patient scenarios that represent common pediatric pre-travel health challenges. Ninety-three (34%) of 273 members completed the survey. Most were physicians (80%) having a primary specialization in pediatrics (55%) and family medicine (19%). About a third (37%) had acquired the ISTM Certificate in Travel Health (CTH); 14 and 11% chose not to provide malaria chemoprophylaxis for a 2-month-old infant and a 13-year-old child traveling to West Africa, respectively. Azithromycin for empiric treatment of travelers' diarrhea in a 2-year-old traveler to Thailand and Mexico was suggested by 74 and 58%, respectively, while the use of acetazolamide for a 2-month old infant traveling to a high-altitude destination was rarely (13%) chosen. In vaccine-focused scenarios, 71, 69, 21, and 10% would prescribe the meningococcal vaccine for a 6-month-old traveler to Burkina Faso, Japanese encephalitis vaccine to a 10-year-old traveler to Cambodia, hepatitis A vaccine to a 6-month-old traveler to El Salvador, and the typhoid vaccine to a 1-year-old traveler to India, respectively. Members of the PedIG have diverse professional and practice backgrounds. Lack of awareness of established guidelines may place international pediatric travelers at risk for travel-associated morbidity. Strategies are needed to facilitate education and support research in pediatric travel medicine to formulate evidence-based guidelines wherever they are currently missing. © 2014 International Society of Travel Medicine.

The updating of clinical practice guidelines: insights from an international survey

PubMed Central

2011-01-01

Background Clinical practice guidelines (CPGs) have become increasingly popular, and the methodology to develop guidelines has evolved enormously. However, little attention has been given to the updating process, in contrast to the appraisal of the available literature. We conducted an international survey to identify current practices in CPG updating and explored the need to standardize and improve the methods. Methods We developed a questionnaire (28 items) based on a review of the existing literature about guideline updating and expert comments. We carried out the survey between March and July 2009, and it was sent by email to 106 institutions: 69 members of the Guidelines International Network who declared that they developed CPGs; 30 institutions included in the U.S. National Guideline Clearinghouse database that published more than 20 CPGs; and 7 institutions selected by an expert committee. Results Forty-four institutions answered the questionnaire (42% response rate). In the final analysis, 39 completed questionnaires were included. Thirty-six institutions (92%) reported that they update their guidelines. Thirty-one institutions (86%) have a formal procedure for updating their guidelines, and 19 (53%) have a formal procedure for deciding when a guideline becomes out of date. Institutions describe the process as moderately rigorous (36%) or acknowledge that it could certainly be more rigorous (36%). Twenty-two institutions (61%) alert guideline users on their website when a guideline is older than three to five years or when there is a risk of being outdated. Twenty-five institutions (64%) support the concept of "living guidelines," which are continuously monitored and updated. Eighteen institutions (46%) have plans to design a protocol to improve their guideline-updating process, and 21 (54%) are willing to share resources with other organizations. Conclusions Our study is the first to describe the process of updating CPGs among prominent guideline institutions across the world, providing a comprehensive picture of guideline updating. There is an urgent need to develop rigorous international standards for this process and to minimize duplication of effort internationally. PMID:21914177

Living kidney donation and masked nationalism in Israel.

PubMed

Epstein, Miran

2017-01-01

This paper draws attention to a current trend of masked conditional-nationalist living kidney donation in Israel, to which the local transplant system has been turning a blind eye. The paper seeks to make the international transplant and bioethics communities aware of this disturbing trend. It also explains why it is wrong and suggests how to tackle it. Finally, it calls on the Israeli system to bring the practice to a halt for the benefit of all parties involved.

Debris Removal: An Opportunity for Cooperative Research?

NASA Technical Reports Server (NTRS)

Johnson, Nicholas L.

2007-01-01

Space debris mitigation practices will be insufficient to prevent the continued growth of the Earth satellite population. Removal of orbital debris can improve the reliability of present and future space systems. The challenges of developing an effective, affordable debris removal capability are considerable. The time is right for a new look at space remediation concepts. In concert with or following the current IAA study An international approach to the remediation of the near-Earth space environment will likely be required.

Evaluation of nanoparticle immunotoxicity

NASA Astrophysics Data System (ADS)

Dobrovolskaia, Marina A.; Germolec, Dori R.; Weaver, James L.

2009-07-01

The pharmaceutical industry is developing increasing numbers of drugs and diagnostics based on nanoparticles, and evaluating the immune response to these diverse formulations has become a challenge for scientists and regulatory agencies alike. An international panel of scientists and representatives from various agencies and companies reviewed the imitations of current tests at a workshop held at the National Cancer Institute in Frederick, Maryland. This article outlines practical strategies for identifying and controlling interferences in common evaluation methods and the implications for regulation.

Neutron Scattering and the 30 S Ribosomal Subunit of E. Coli

DOE R&D Accomplishments Database

Moore, P. B.; Engelman, D. M.; Langer, J. A.; Ramakrishnan, V. R.; Schindler, D. G.; Schoenborn, B. P.; Sillers, I. Y.; Yabuki, S.

1982-06-01

This paper reviews the progress made in the study of the internal organization of the 30 S ribosomal subunit of E. coli by neutron scattering since 1975. A map of that particle showing the position of 14 of the subunit's 21 proteins is presented, and the methods currently used for collecting and analyzing such data are discussed. Also discussed is the possibility of extending the interpretation of neutron mapping data beyond the limits practical today.

Telemedicine uptake among Genetics Professionals in Europe: room for expansion.

PubMed

Otten, Ellen; Birnie, Erwin; Lucassen, Anneke M; Ranchor, Adelita V; Van Langen, Irene M

2016-02-01

Today's economic challenges and the changing landscape of clinical genetics are forcing us to consider alternative ways of providing genetic services, to comply with budget limitations and at the same time meeting the demands of increasing patient numbers and patient-centered care delivery. Telegenetics could be an effective and efficient way of counseling, but its use in Europe is not widely reported, nor is there evidence of international collaboration. We conducted an online survey among 929 genetics professionals, to explore the current availability and use of different telegenetics modalities in Europe. Our questionnaire was completed by 104 clinically active European genetics professionals. Telephone genetic counseling was used by 17% of respondents. Videoconferencing facilities were available to 24%, but only 9% of them used these for patient counseling. Various barriers to availability and use were cited, ranging from practical constraints, lack of professional support/knowledge, to lack of perceived suitability and need. The results show that telegenetics modalities are not currently in widespread use by our respondents, in part due to perceived barriers. To meet the changing economic, genetic, and societal circumstances, we recommend consideration of greater integration of telegenetics into regular clinical genetic care, to supplement existing care modalities. Professional cooperation, sharing knowledge, and establishing guidelines on a national and international level could contribute to successful and more widespread implementation of telegenetics. However, the perceived practical and regulatory barriers have to be overcome.

Recent advances in transfusions in neonates/infants

PubMed Central

Goel, Ruchika; Josephson, Cassandra D.

2018-01-01

Transfusions of red blood cells (RBCs), platelets, and plasma are critical therapies for infants and neonates (particularly preterm neonates) in the neonatal intensive care unit, who are the most frequently transfused subpopulation across all ages. Although traditionally a significant gap has existed between the blood utilization and the evidence base essential to adequately guide transfusion practices in infants and neonates, pediatric transfusion medicine is evolving from infancy and gradually coming of age. It is entering an exciting era with recognition as an independent discipline, a new and evolving high-quality evidence base for transfusion practices, novel technologies and therapeutics, and national/international collaborative research, educational, and clinical efforts. Triggers and thresholds for red cell transfusion are accumulating evidence with current phase III clinical trials. Ongoing trials and studies of platelet and plasma transfusions in neonates are anticipated to provide high-quality evidence in years to come. This article aims to summarize the most current evidence-based practices regarding blood component therapy in neonates. Data on the use of specific components (RBCs, plasma, and platelets) are provided. We attempt to define thresholds for anemia, thrombocytopenia, and abnormal coagulation profile in neonates to highlight the difficulties in having a specific cutoff value in neonates and preterm infants. Indications for transfusion of specific products, transfusion thresholds, and current practices and guidelines are provided, and possible adverse outcomes and complications are discussed. Finally, the critical research knowledge gaps in these practices as well as ongoing and future research areas are discussed. In an era of personalized medicine, neonatal transfusion decisions guided by a strong evidence base must be the overarching goal, and this underlies all of the strategic initiatives in pediatric and neonatal transfusion research highlighted in this article. PMID:29904575

A Mismatch Between Athlete Practice and Current Sports Nutrition Guidelines Among Elite Female and Male Middle- and Long-Distance Athletes.

PubMed

Heikura, Ida A; Stellingwerff, Trent; Mero, Antti A; Uusitalo, Arja Leena Tuulia; Burke, Louise M

2017-08-01

Contemporary nutrition guidelines promote a variety of periodized and time-sensitive recommendations, but current information regarding the knowledge and practice of these strategies among world-class athletes is limited. The aim of this study was to investigate this theme by implementing a questionnaire on dietary periodization practices in national/international level female (n = 27) and male (n = 21) middle- and long-distance runners/race-walkers. The questionnaire aimed to gain information on between and within-day dietary choices, as well as timing of pre- and posttraining meals and practices of training with low or high carbohydrate (CHO) availability. Data are shown as percentage (%) of all athletes, with differences in responses between subgroups (sex or event) shown as Chi-square x 2 when p < .05. Nearly two-thirds of all athletes reported that they aim to eat more food on, or after, hard training days. Most athletes said they focus on adequate fueling (96%) and adequate CHO and protein (PRO) recovery (87%) around key sessions. Twenty-six percent of athletes (11% of middle vs 42% of long-distance athletes [x 2 (1, n = 46) = 4.308, p = .038, phi = 0.3])) reported to undertake training in the fasted state, while 11% said they periodically restrict CHO intake, with 30% ingesting CHO during training sessions. Our findings show that elite endurance athletes appear to execute pre- and post-key session nutrition recovery recommendations. However, very few athletes deliberately undertake some contemporary dietary periodization approaches, such as training in the fasted state or periodically restricting CHO intake. This study suggests mismatches between athlete practice and current and developing sports nutrition guidelines.

Congruence of the current practices in Hymenoptera venom allergic patients in Poland with EAACI guidelines

PubMed Central

Cichocka-Jarosz, Ewa; Diwakar, Lavanya; Brzyski, Piotr; Tobiasz-Adamczyk, Beata; Lis, Grzegorz; Pietrzyk, Jacek J.

2011-01-01

Introduction Venom immunotherapy (VIT) practice is the definitive treatment for patients with potentially fatal allergic reactions to Hymenoptera stings. The aim is assesing compliance of VIT practice in Poland with the current European Academy of Allergy and Clinical Immunology (EAACI) guidance. Material and methods A multicentre study was carried out using a structured questionnaire which was sent by post to all VIT practitioners in Poland. Some questionnaire items were altered, in comparison to original version by adding additional answer options or alowing multiple answer option. The response rate was 100%. The obtained results were compared with the published EAACI guidelines. Results Twenty-six Polish centres took part in the survey. SSIgE and skin prick tests (SPT) are together used as the first line of investigation, whereas confirmatory intradermal tests (IDT) are applied in half of centres. Only a few centres measure baseline serum tryptase levels. The ultra-rush protocol is preferred. Antihistamine pre-medication is routinely practiced. A target dose equal to 100 µg is used in most centres. A 6-week interval between booster doses is the most frequent. Five years is considered as an optimal VIT duration. Before the VIT completion, SSIgE is evaluated in fifty percent of centres, whereas sting challenge is considered by half of responders. Conclusions There are some differences between current practice in Poland and the EAACI recommendations, indicating areas requiring better compliance. Comparision between Poland and the United Kingdom revealed that health service organization and health care funding may play a major role in the provision of allergy services. This may affect the extent to which international guidance may be applied in individual countries. It is worth considering conducting the same survey in other European countries. PMID:22291828

Safeguards Guidance Document for Designers of Commercial Nuclear Facilities: International Nuclear Safeguards Requirements and Practices For Uranium Enrichment Plants

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

Robert Bean; Casey Durst

2009-10-01

This report is the second in a series of guidelines on international safeguards requirements and practices, prepared expressly for the designers of nuclear facilities. The first document in this series is the description of generic international nuclear safeguards requirements pertaining to all types of facilities. These requirements should be understood and considered at the earliest stages of facility design as part of a new process called “Safeguards-by-Design.” This will help eliminate the costly retrofit of facilities that has occurred in the past to accommodate nuclear safeguards verification activities. The following summarizes the requirements for international nuclear safeguards implementation at enrichmentmore » plants, prepared under the Safeguards by Design project, and funded by the U.S. Department of Energy (DOE) National Nuclear Security Administration (NNSA), Office of NA-243. The purpose of this is to provide designers of nuclear facilities around the world with a simplified set of design requirements and the most common practices for meeting them. The foundation for these requirements is the international safeguards agreement between the country and the International Atomic Energy Agency (IAEA), pursuant to the Treaty on the Non-proliferation of Nuclear Weapons (NPT). Relevant safeguards requirements are also cited from the Safeguards Criteria for inspecting enrichment plants, found in the IAEA Safeguards Manual, Part SMC-8. IAEA definitions and terms are based on the IAEA Safeguards Glossary, published in 2002. The most current specification for safeguards measurement accuracy is found in the IAEA document STR-327, “International Target Values 2000 for Measurement Uncertainties in Safeguarding Nuclear Materials,” published in 2001. For this guide to be easier for the designer to use, the requirements have been restated in plainer language per expert interpretation using the source documents noted. The safeguards agreement is fundamentally a legal document. As such, it is written in a legalese that is understood by specialists in international law and treaties, but not by most outside of this field, including designers of nuclear facilities. For this reason, many of the requirements have been simplified and restated. However, in all cases, the relevant source document and passage is noted so that readers may trace the requirement to the source. This is a helpful living guide, since some of these requirements are subject to revision over time. More importantly, the practices by which the requirements are met are continuously modernized by the IAEA and nuclear facility operators to improve not only the effectiveness of international nuclear safeguards, but also the efficiency. As these improvements are made, the following guidelines should be updated and revised accordingly.« less

Evaluation of the Impact of NCI Summer Curriculum on Cancer Prevention’s on Participants from Low- and Middle Income Countries

PubMed Central

Williams, Makeda J.; Otero, Isabel V.; Harford, Joe B.

2013-01-01

The NCI Summer Curriculum on Cancer Prevention provides scientists and health care professionals training in principles and practices of cancer prevention and control, and molecular biology and genetics of cancer. Originally intended for U.S. scientists, the Curriculum’s enrollment of international scientists has increased steadily. The objective of the current study was to evaluate the Curriculum’s impact on knowledge, skills and career accomplishments of the international participants from low- and middle-income countries (LMIC). International participants from 1998 to 2009 completed questionnaires regarding knowledge, overall experience and accomplishments directly associated with the Curriculum. Almost all respondents agreed the Curriculum enhanced their knowledge and skills, prepared them to contribute to cancer control activities in their home countries and addressed specific needs and achieve research goals. The NCI Summer Curriculum on Cancer Prevention gives international participants a unique opportunity to enhance their knowledge and effectively contribute to cancer control activities in their home country. PMID:23355281

How good are the internal controls in your group practice? Ten questions to contemplate.

PubMed

Grant, Barbara J; Foley, Lori A

2002-01-01

Internal controls are the methods and procedures used by any business to prevent or detect errors, safeguard assets (especially cash) from being misappropriated, and encourage staff adherence to prescribed managerial policies. Internal controls in a medical practice differ depending on the size and complexity of the practice. The key, however, is that they prevent or detect errors and efforts to circumvent the established policies and procedures of the organization. How good are the internal controls in your group practice? This article identifies ten questions you should use to evaluate your risk of asset misappropriation.

Sixty years of fear appeal research: current state of the evidence.

PubMed

Ruiter, Robert A C; Kessels, Loes T E; Peters, Gjalt-Jorn Y; Kok, Gerjo

2014-04-01

Fear arousal is widely used in persuasive campaigns and behavioral change interventions. Yet, experimental evidence argues against the use of threatening health information. The authors reviewed the current state of empirical evidence on the effectiveness of fear appeals. Following a brief overview of the use of fear arousal in health education practice and the structure of effective fear appeals according to two main theoretical frameworks-protection motivation theory and the extended parallel process model-the findings of six meta-analytic studies in the effectiveness of fear appeals are summarized. It is concluded that coping information aimed at increasing perceptions of response effectiveness and especially self-efficacy is more important in promoting protective action than presenting threatening health information aimed at increasing risk perceptions and fear arousal. Alternative behavior change methods than fear appeals should be considered. © 2014 The Authors. International Journal of Psychology published by John Wiley © Sons Ltd on behalf of International Union of Psychological Science.

Determinants of internal migrant health and the healthy migrant effect in South India: a mixed methods study.

PubMed

Dodd, Warren; Humphries, Sally; Patel, Kirit; Majowicz, Shannon; Little, Matthew; Dewey, Cate

2017-09-12

Internal labour migration is an important and necessary livelihood strategy for millions of individuals and households in India. However, the precarious position of migrant workers within Indian society may have consequences for the health of these individuals. Previous research on the connections between health and labour mobility within India have primarily focused on the negative health outcomes associated with this practice. Thus, there is a need to better identify the determinants of internal migrant health and how these determinants shape migrant health outcomes. An exploratory mixed methods study was conducted in 26 villages in the Krishnagiri district of Tamil Nadu. Sixty-six semi-structured interviews were completed using snowball sampling, followed by 300 household surveys using multi-stage random sampling. For qualitative data, an analysis of themes and content was completed. For quantitative data, information on current participation in internal labour migration, in addition to self-reported morbidity and determinants of internal migrant health, was collected. Morbidity categories were compared between migrant and non-migrant adults (age 14-65 years) using a Fisher's exact test. Of the 300 households surveyed, 137 households (45.7%) had at least one current migrant member, with 205 migrant and 1012 non-migrant adults (age 14-65 years) included in this study. The health profile of migrant and non-migrants was similar in this setting, with 53 migrants (25.9%) currently suffering from a health problem compared to 273 non-migrants (27.0%). Migrant households identified both occupational and livelihood factors that contributed to changes in the health of their migrant members. These determinants of internal migrant health were corroborated and further expanded on through the semi-structured interviews. Internal labour migration in and of itself is not a determinant of health, as participation in labour mobility can contribute to an improvement in health, a decline in health, or no change in health among migrant workers. Targeted public health interventions should focus on addressing the determinants of internal migrant health to enhance the contributions these individuals can make to their households and villages of origin.

Update in outpatient general internal medicine: practice-changing evidence published in 2014.

PubMed

Sundsted, Karna K; Wieland, Mark L; Szostek, Jason H; Post, Jason A; Mauck, Karen F

2015-10-01

The practice of outpatient general internal medicine requires a diverse and evolving knowledge base. General internists must identify practice-changing shifts in the literature and reflect on their impact. Accordingly, we conducted a review of practice-changing articles published in outpatient general internal medicine in 2014. To identify high-quality, clinically relevant publications, we reviewed all titles and abstracts published in the following primary data sources in 2014: New England Journal of Medicine, Journal of the American Medical Association (JAMA), Annals of Internal Medicine, JAMA Internal Medicine, and the Cochrane Database of Systematic Reviews. All 2014 primary data summaries from Journal Watch-General Internal Medicine and ACP JournalWise also were reviewed. The authors used a modified Delphi method to reach consensus on inclusion of 8 articles using the following criteria: clinical relevance to outpatient internal medicine, potential for practice change, and strength of evidence. Clusters of important articles around one clinical question were considered as a single-candidate series. The article merits were debated until consensus was reached on the final 8, spanning a variety of topics commonly encountered in outpatient general internal medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessment of electrochemical properties of a biogalvanic system for tissue characterisation

PubMed Central

Chandler, J.H.; Culmer, P.R.; Jayne, D.G.; Neville, A.

2015-01-01

Biogalvanic characterisation is a promising method for obtaining health-specific tissue information. However, there is a dearth of understanding in the literature regarding the underlying galvanic cell, electrode reactions and their controlling factors which limits the application of the technique. This work presents a parametric electrochemical investigation into a zinc–copper galvanic system using salt (NaCl) solution analogues at physiologically-relevant concentrations (1.71, 17.1 & 154 mM). The potential difference at open cell, closed cell maximum current and the internal resistance (based on published characterisation methods) were measured. Additionally, independent and relative polarisation scans of the electrodes were performed to improve understanding of the system. Our findings suggest that the prominent reaction at the cathode is that of oxygen-reduction, not hydrogen-evolution. Results indicate that cell potentials are influenced by the concentration of dissolved oxygen at low currents and maximum closed cell currents are limited by the rate of oxygen diffusion to the cathode. Characterised internal resistance values for the salt solutions did not correspond to theoretical values at the extremes of concentration (1.71 and 154 mM) due to electrode resistance and current limitation. Existing biogalvanic models do not consider these phenomena and should be improved to advance the technique and its practical application. PMID:25460609

Abandoned babies and absent policies.

PubMed

Mueller, Joanne; Sherr, Lorraine

2009-12-01

Although infant abandonment is a historical problem, we know remarkably little about the conditions or effects of abandonment to guide evidence driven policies. This paper briefly reviews the existing international evidence base with reference to potential mental health considerations before mapping current UK guidelines and procedures, and available incidence data. Limitations arising from these findings are discussed with reference to international practice, and interpreted in terms of future pathways for UK policy. A systematic approach was utilized to gather available data on policy information and statistics on abandoned babies in the UK. A review of the limited literature indicates that baby abandonment continues to occur, with potentially wide-ranging mental health ramifications for those involved. However, research into such consequences is lacking, and evidence with which to understand risk factors or motives for abandonment is scarce. International approaches to the issue remain controversial with outcomes unclear. Our systematic search identified that no specific UK policy relating to baby abandonment exists, either nationally or institutionally. This is compounded by a lack of accurate of UK abandonment statistics. Data that does exist is not comprehensive and sources are incompatible, resulting in an ambiguous picture of UK baby abandonment. Available literature indicates an absence of clear provision, policy and research on baby abandonment. Based on current understanding of maternal and child mental health issues likely to be involved in abandonment, existing UK strategy could be easily adapted to avoid the 'learning from scratch' approach. National policies on recording and handling of baby abandonments are urgently needed, and future efforts should be concentrated on establishing clear data collection frameworks to inform understanding, guide competent practice and enable successfully targeted interventions.

Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems.

PubMed

Jensen, Todd M; Lippold, Melissa A; Mills-Koonce, Roger; Fosco, Gregory M

2017-03-07

The stepfamily literature is replete with between-group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well-being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent-child, parent-child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent-child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent-child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice. © 2017 Family Process Institute.

Integrating emerging earth science technologies into disaster risk management: an enterprise architecture approach

NASA Astrophysics Data System (ADS)

Evans, J. D.; Hao, W.; Chettri, S. R.

2014-12-01

Disaster risk management has grown to rely on earth observations, multi-source data analysis, numerical modeling, and interagency information sharing. The practice and outcomes of disaster risk management will likely undergo further change as several emerging earth science technologies come of age: mobile devices; location-based services; ubiquitous sensors; drones; small satellites; satellite direct readout; Big Data analytics; cloud computing; Web services for predictive modeling, semantic reconciliation, and collaboration; and many others. Integrating these new technologies well requires developing and adapting them to meet current needs; but also rethinking current practice to draw on new capabilities to reach additional objectives. This requires a holistic view of the disaster risk management enterprise and of the analytical or operational capabilities afforded by these technologies. One helpful tool for this assessment, the GEOSS Architecture for the Use of Remote Sensing Products in Disaster Management and Risk Assessment (Evans & Moe, 2013), considers all phases of the disaster risk management lifecycle for a comprehensive set of natural hazard types, and outlines common clusters of activities and their use of information and computation resources. We are using these architectural views, together with insights from current practice, to highlight effective, interrelated roles for emerging earth science technologies in disaster risk management. These roles may be helpful in creating roadmaps for research and development investment at national and international levels.

Meeting the criteria of a nursing diagnosis classification: Evaluation of ICNP, ICF, NANDA and ZEFP.

PubMed

Müller-Staub, Maria; Lavin, Mary Ann; Needham, Ian; van Achterberg, Theo

2007-07-01

Few studies described nursing diagnosis classification criteria and how classifications meet these criteria. The purpose was to identify criteria for nursing diagnosis classifications and to assess how these criteria are met by different classifications. First, a literature review was conducted (N=50) to identify criteria for nursing diagnoses classifications and to evaluate how these criteria are met by the International Classification of Nursing Practice (ICNP), the International Classification of Functioning, Disability and Health (ICF), the International Nursing Diagnoses Classification (NANDA), and the Nursing Diagnostic System of the Centre for Nursing Development and Research (ZEFP). Using literature review based general and specific criteria, the principal investigator evaluated each classification, applying a matrix. Second, a convenience sample of 20 nursing experts from different Swiss care institutions answered standardized interview forms, querying current national and international classification state and use. The first general criterion is that a diagnosis classification should describe the knowledge base and subject matter for which the nursing profession is responsible. ICNP) and NANDA meet this goal. The second general criterion is that each class fits within a central concept. The ICF and NANDA are the only two classifications built on conceptually driven classes. The third general classification criterion is that each diagnosis possesses a description, diagnostic criteria, and related etiologies. Although ICF and ICNP describe diagnostic terms, only NANDA fulfils this criterion. The analysis indicated that NANDA fulfilled most of the specific classification criteria in the matrix. The nursing experts considered NANDA to be the best-researched and most widely implemented classification in Switzerland and internationally. The international literature and the opinion of Swiss expert nurses indicate that-from the perspective of classifying comprehensive nursing diagnoses-NANDA should be recommended for nursing practice and electronic nursing documentation. Study limitations and future research needs are discussed.

An international fellowship training program in pediatric emergency medicine: establishing a new subspecialty in the Land of the Dragon.

PubMed

Goldman, Ran D; Cheng, Adam; Jarvis, Anna; Keogh, Kelly; Lu, Guo-ping; Wang, Jian-she; Kissoon, Niranjan; Larson, Charles

2011-12-01

The health care system reform in the People's Republic of China has brought plans for establishment of a universal coverage for basic health services, including services for children. This effort demands significant change in health care planning. Pediatric emergency medicine (PEM) is not currently identified as a specialty in China, and emergency medicine systems suffer from lack of appropriate training.In 2006, the Centre for International Child Health and the Department of Pediatrics, British Columbia Children's Hospital, Vancouver, Canada, initiated a fellowship training program in PEM for pediatricians working in emergency departments or critical care settings with the Children's Hospital of Fudan University, China. The main objective was to upgrade the professional and clinical experience of emergency physicians practicing PEM and build PEM capacity throughout China by training the future trainers. After selecting trainees, the program included a structured curriculum over 2 years of training in China by Canadian and Australian PEM faculty and then practical exposure to PEM in Canada. All trainees underwent a structured evaluation after their final rotation in Canada. A total of 12 trainees completed the first 2 program cycles. The trainees considered the "overall rating of the training experience" as "excellent" (10/12) or "good" (2/12). All trainees considered the program as a relevant training to their practice and felt it will change their practice. They reported the program to be effective, with excellent complexity of content. Despite its current success, the program faces challenges in the development of the new subspecialty and ensuring its acceptance among other health care providers and decision makers. Identification and preparation of a capable training force to lead educational activities in China are daunting tasks. Time constraints, funding, and language barriers are other challenges. Future effort should be focused on improving and sustaining resuscitation capacity and enhancing triage systems.

Ethiopia Adolescents’ Attitudes and Expectations Deviate from Current Infant and Young Child Feeding Recommendations4

PubMed Central

Hadley, Craig; Lindstrom, David; Belachew, Tefera; Tessema, Fasil

2008-01-01

Purpose Sub-optimal infant and child feeding practices are highly prevalent in many developing countries for reasons that are not entirely understood. Taking an anthropological perspective, we assess whether nulliparous youth have formulated attitudes and expectations in the domain of infant and child feeding behaviors, the extent to which these varied by location and gender, and the extent to which they deviated from current international recommendations. Methods A population-based sample of 2077 adolescent girls and boys (13–17 years) in southwest Ethiopia answered a questionnaire on infant and young child feeding behaviors. Results Results indicate high levels of agreement among adolescents on items relating to infant and young child feeding behaviors. Attitudes and intentions deviated widely from current international recommendations. Youth overwhelmingly endorsed items related to early introduction of non-breast milk liquids and foods. For girls, fewer than 11% agreed that a 5 month infant should be exclusively breastfed and only 26% agreed that a 6 month infant should be consuming some animal source foods. Few sex differences emerged and youth responses matched larger community patterns. Conclusions The results indicate that attitudes and expectations deviate widely from current international child feeding guidelines among soon to be parents. To the extent that youth models are directive, these findings suggest that youth enter into parenthood with suboptimal information about infant and child feeding. Such information will reproduce poor health across generations as the largest cohort of adolescents ever become parents. These results suggest specific points of entry for adolescent nutrition education interventions. PMID:18710680

Surviving the Implementation of a New Science Curriculum

NASA Astrophysics Data System (ADS)

Lowe, Beverly; Appleton, Ken

2015-12-01

Queensland schools are currently teaching with the first National Curriculum for Australia. This new curriculum was one of a number of political responses to address the recurring low scores in literacy, mathematics, and science that continue to hold Australia in poor international rankings. Teachers have spent 2 years getting to know the new science curriculum through meetings, training, and exploring the new Australian curriculum documents. This article examines the support and preparation for implementation provided in two regional schools, with a closer look at six specific teachers and their science teaching practices as they attempted to implement the new science curriculum. The use of a survey, field observations, and interviews revealed the schools' preparation practices and the teachers' practices, including the support provided to implement the new science curriculum. A description and analysis of school support and preparation as well as teachers' views of their experiences implementing the new science curriculum reveal both achievements and shortcomings. Problematic issues for the two schools and teachers include time to read and comprehend the curriculum documents and content expectations as well as time to train and change the current processes effectively. The case teachers' experiences reveal implications for the successful and effective implementation of new curriculum and curriculum reform.

The implementation of tissue banking experiences for setting up a cGMP cell manufacturing facility.

PubMed

Arjmand, Babak; Emami-Razavi, Seyed Hassan; Larijani, Bagher; Norouzi-Javidan, Abbas; Aghayan, Hamid Reza

2012-12-01

Cell manufacturing for clinical applications is a unique form of biologics manufacturing that relies on maintenance of stringent work practices designed to ensure product consistency and prevent contamination by microorganisms or by another patient's cells. More extensive, prolonged laboratory processes involve greater risk of complications and possibly adverse events for the recipient, and so the need for control is correspondingly greater. To minimize the associate risks of cell manufacturing adhering to international quality standards is critical. Current good tissue practice (cGTP) and current good manufacturing practice (cGMP) are examples of general standards that draw a baseline for cell manufacturing facilities. In recent years, stem cell researches have found great public interest in Iran and different cell therapy projects have been started in country. In this review we described the role of our tissue banking experiences in establishing a new cGMP cell manufacturing facility. The authors concluded that, tissue banks and tissue banking experts can broaden their roles from preparing tissue grafts to manufacturing cell and tissue engineered products for translational researches and phase I clinical trials. Also they can collaborate with cell processing laboratories to develop SOPs, implement quality management system, and design cGMP facilities.

Status of internal quality control for thyroid hormones immunoassays from 2011 to 2016 in China.

PubMed

Zhang, Shishi; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2018-01-01

Internal quality control (IQC) plays a key role in the evaluation of precision performance in clinical laboratories. This report aims to present precision status of thyroid hormones immunoassays from 2011 to 2016 in China. Through Clinet-EQA reporting system, IQC information of Triiodothyronine and Thyroxine in the form of free and total (FT3, TT3, FT4, TT4), as well as Thyroid Stimulating Hormone (TSH) were collected from participant laboratories submitting IQC data in February, 2011-2016. For each analyte, current CVs were compared among different years and measurement systems. Percentages of laboratories meeting five allowable imprecision specifications (pass rates) were also calculated. Analysis of IQC practice was conducted to constitute a complete report. Current CVs were decreasing significantly but pass rates increasing only for FT3 during 6 years. FT3, TT3, FT4, and TT4 had the highest pass rates comparing with 1/3TEa imprecision specification but TSH had this comparing with minimum imprecision specification derived from biological variation. Constituent ratios of four mainstream measurement systems changed insignificantly. In 2016, precision performance of Abbott and Roche systems were better than Beckman and Siemens systems for all analytes except FT3 had Siemens also better than Beckman. Analysis of IQC practice demonstrated wide variation and great progress in aspects of IQC rules and control frequency. With change of IQC practice, only FT3 had precision performance improved in 6 years. However, precision status of five analytes in China was still unsatisfying. Ongoing investigation and improvement of IQC have yet to be achieved. © 2017 Wiley Periodicals, Inc.

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

Rosa, Josianne Claudia Sales, E-mail: jcsrosa@usp.br; Sánchez, Luis E., E-mail: lsanchez@usp.br

Considering ecosystem services (ES) could foster innovation and improve environmental and social impact assessment (ESIA) practice, but is the potential being fulfilled? In order to investigate how ES have been treated in recent international practice, three questions are asked: (i) were the tasks of an ES analysis carried out? (ii) how is such analysis integrated with other analysis presented in the ESIA? (iii) does ES analysis result in additional or improved mitigation or enhancement measures? These research questions were unfolded into 15 auxiliary questions for reviewing five ESIA reports prepared for mining, hydroelectric and transportation infrastructure projects in Africa, Asiamore » and South America. All cases incorporated ES into ESIA to meet a requirement of the International Finance Corporation's Performance Standards on Environmental and Social Sustainability. It was found that: (i) in only three cases most tasks recommended by current guidance were adopted (ii) all reports feature a dedicated ES chapter or section, but in three of them no evidence was found that the ES analysis was integrated within impact assessment (iii) in the two ESIAs that followed guidance, ES analysis resulted in specific mitigation measures. Few evidence was found that the ES concept is improving current ESIA practice. Key challenges are: (i) integrating ES analysis in such a way that it does not duplicate other analysis; (ii) adequately characterizing the beneficiaries of ES; and (iii) quantifying ES supply for impact prediction. - Highlights: • Incorporating ecosystem services analysis in impact assessment can improve results. • Additional impacts and mitigation were identified. • Challenges include developing appropriate indicators for impact prediction. • A key challenge is integrating the concept in such a way that it does not duplicate other analysis.« less

[Convergence of healthcare regulation in the Americas: history, development, and new challenges].

PubMed

Silva, Ana Paula Jucá; Tagliari, Patrícia Oliveira Pereira

2016-05-01

The present article describes the changing relationship among healthcare regulatory authorities in various international settings, with special emphasis on the Americas. As other sectors, healthcare also faces the need to regulate international practices, while at the same time taking into consideration the specific realities of each country. Regulatory convergence - a movement towards technical alignment to enable the adoption of local regulatory mechanisms that take into account internationally recognized standards and principles to promote a single sanitary goal - has emerged as a means to address this challenge. Organizations that already use this tool, such as the International Conference of Drug Regulatory Authorities (ICDRA), Pan American Network for Drug Regulatory Harmonization (PANDRH), International Generic Drug Regulators Programme (IGDRP), and the International Medical Device Regulators Forum (IMDRF), among others, are currently working to gather knowledge, data, and specialists from different countries to build an international technical and scientific standard that can be used for decision-making by local regulators. This would ensure convergence of national regulations despite the need to adapt international standards to local needs, structure, and capacities. The most recent resolutions issued by the World Health Organization recognize the need to bring regulatory systems closer to the reality of national healthcare systems, and underscore the advantages of using existing local guidelines as input for cooperation with regulatory authorities.

Piecing the puzzle together: case studies of international research in health-promoting sports clubs.

PubMed

Kokko, Sami; Donaldson, Alex; Geidne, Susanna; Seghers, Jan; Scheerder, Jeroen; Meganck, Jeroen; Lane, Aoife; Kelly, Bridget; Casey, Meghan; Eime, Rochelle; Villberg, Jari; Kannas, Lasse

2016-03-01

This paper seeks to review the current international health-promoting sports club (HPSC) research, drawing together findings based on case studies from various countries to illustrate the status of HPSCs. In addition, future challenges for HPSC research and implementation are considered. The review includes six case studies from five countries. In summary, there are two major research themes in this area, namely 'research into HPSC activity' and 'research into HPSC networks'. The first theme investigates the extent to which sports clubs and/or national sports organisations invest in health promotion (HP) - both in policy and practice. The latter theme is driven by an intention to widen the scope of HPSCs to reach novel internal actors, like parents, siblings, etc., and/or external non-sporting bodies, like communities, schools, etc. The future challenges for HPSC research require a better understanding of the motives, barriers and capacities of sports clubs and coaches. Sports organisations, clubs and coaches generally support the intent of the HPSC concept, but even with the best evidence- or theory-based HP programmes/guidelines/standards, nothing will happen in practice if the nature and capacities of sports clubs are not better acknowledged. Therefore, a call for embracing implementation science is finally made to enhance implementation. © The Author(s) 2015.

Chest tube drainage of pleural effusions--an audit of current practice and complications at Hutt Hospital.

PubMed

Epstein, Erica; Jayathissa, Sisira; Dee, Stephen

2012-05-11

The aims of the study were to review small-bore chest tube insertion practices for drainage of pleural fluid at Hutt Valley District Health Board (HVDHB), to assess complications, and compare the findings with international data. Retrospective analysis of clinical records was completed on all chest tube insertions for drainage of pleural fluid at HVDHB from December 2008 to November 2009. Descriptive statistics were used to present demographics and tube-associated complications. Comparison was made to available similar international data. Small-bore tubes comprised 59/65 (91%) chest tube insertions and 23/25 (92%) complications. Available comparative data was limited. Ultrasound was used in 36% of insertions. Nearly half of chest drains placed for empyema required subsequent cardiothoracic surgical intervention. Chest drain complication rates at HVDHB were comparable to those seen internationally. Referral rates to cardiothoracic surgery for empyema were within described ranges. The importance of procedural training for junior medical staff, optimising safety of drain insertions with ultrasound guidance, and clear clinical governance for chest tube insertions are important in minimising harm from this procedure. Specialist societies need to take a leadership in providing guidance on chest drain insertions to secondary and tertiary hospitals in Australia and New Zealand.

International perspectives on sharing clinical data with patients.

PubMed

Prey, Jennifer E; Polubriaginof, Fernanda; Kuperman, Gilad J; Tiase, Victoria; Collins, Sarah A; Vawdrey, David K

2016-02-01

Engaging patients in their care has become a topic of increasing importance, and enabling patients to have access to their clinical data is a key aspect of such engagement. We investigated, on an international scale, the current state of approaches for providing patients with access to their own clinical information. Individuals from 28 countries were invited to participate in a cross-sectional semi-structured interview. Interview questions focused on social and cultural influences that affected patient engagement activities, government support for current and planned initiatives, data ownership models, and technical issues. Interviews were conducted with individuals from 16 countries representing six continents. Respondents reported substantive initiatives for providing information to patients in the majority of countries interviewed. These initiatives were diverse in nature and stage of implementation. Enabling patient access to data is occurring on an international scale. There is considerable variability in the level of maturity, the degree of government involvement, the technical infrastructure, and the plans for future development across the world. As informaticians, we are still in the early stages of deploying patient engagement technologies and have yet to identify optimal strategies in this arena. Efforts to improve patient access to data are active on a global-scale. There are many open questions about best practices and much can be learned by adopting an international perspective to guide future implementation efforts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Internal Medicine Residents' Beliefs, Attitudes, and Experiences Relating to Palliative Care: A Qualitative Study.

PubMed

Kawaguchi, S; Mirza, R; Nissim, R; Ridley, J

2017-05-01

Internal medicine residents are frequently called upon to provide palliative care to hospitalized patients, but report feeling unprepared to do so effectively. Curricular development to enhance residents' palliative care skills and competencies requires an understanding of current beliefs, attitudes and learning priorities. We conducted a qualitative study consisting of semi-structured interviews with ten internal medicine residents to explore their understanding of and experiences with palliative care. All of the residents interviewed had a sound theoretical understanding of palliative care, but faced many challenges in being able to provide care in practice. The challenges described by residents were system-related, patient-related and provider-related. They identified several priority areas for further learning, and discussed ways in which their current education in palliative care could be enhanced. Our findings provide important insights to guide curricular development for internal medicine trainees. The top five learning priorities in palliative care that residents identified in our study were: 1) knowing how and when to initiate a palliative approach, 2) improving communication skills, 3) improving symptom management skills, 4) identifying available resources, and 5) understanding the importance of palliative care. Residents felt that their education in palliative care could be improved by having a mandatory rotation in palliative care, more frequent didactic teaching sessions, more case-based teaching from palliative care providers, opportunities to be directly observed, and increased support from palliative care providers after-hours.

The American Society of Clinical Oncology's Efforts to Support Global Cancer Medicine

PubMed Central

El-Saghir, Nagi S.; Cufer, Tanja; Cazap, Eduardo; de Guzman, Roselle; Othieno-Abinya, Nicholas Anthony; Sanchez, Jose Angel; Pyle, Doug

2016-01-01

Despite much progress in the management of malignant diseases, the number of new cases and cancer-related deaths continues to rise around the world. More than half of new cases occur in economically developing countries, where more than two thirds of cancer deaths are expected. However, implementation of all necessary steps to accomplish the dissemination of state-of-the-art prevention, diagnosis, and management will require increased allocation of resources, and, more importantly, harmonization of the efforts of hundreds of national and international public health agencies, policy-setting bodies, governments, pharmaceutical companies, and philanthropic organizations. More than 30% of the members of the American Society of Clinical Oncology (ASCO) reside and practice outside US borders, and more than half of attendees at all of the scientific congresses and symposia organized by ASCO are international. As cancer has become an increasingly global disease, ASCO has evolved as a global organization. The ASCO Board of Directors currently includes members from France, Brazil, and Canada. In 2013, the ASCO Board of Directors identified a number of strategic priorities for the future. Recognizing the importance of non-US members to the society, their first strategic priority was improving the society's service to non-US members and defining these members' identity in the international oncology community. This article reviews current ASCO activities in the international arena and its future plans in global oncology. PMID:26578614

Current Legislation on Admission of Mentally Ill Patients in China

PubMed Central

Shao, Yang; Xie, Bin; Good, Mary-Jo DelVecchio; Good, Byron J.

2009-01-01

Objective To date, there is no systematic analysis of mental health laws and their implementation across the People’s Republic of China. This article aims to describe and analyze current legal frameworks for voluntary and involuntary admissions of mentally ill patients in the five cities of China that currently have municipal mental health regulations. Methods Information on the legislation and practice of involuntary admission in the five cities was gathered and assessed using the “WHO Checklist on Mental Health Legislation.” The checklist was completed for each city by a group of psychiatrists trained in mental health legislation. Results Although the mental health regulations in these five cities cover the basic principles needed to meet international standards of mental health legislation, some defects in the legislation remain. In particular, these regulations lack detail in specifying procedures for dealing with admission and treatment and lack oversight and review mechanisms and procedures for appeal of involuntary admission and treatment. Conclusions A more comprehensive and enforceable national mental health act is needed in order to ensure the rights of persons suffering mental illness in terms of admission and treatment procedures. In addition, more research is needed to understand how the current municipal regulations of mental health services in these cities are implemented in routine practice. PMID:19913300

Analysis of the current rib support practices and techniques in U.S. coal mines

PubMed Central

Mohamed, Khaled M.; Murphy, Michael M.; Lawson, Heather E.; Klemetti, Ted

2016-01-01

Design of rib support systems in U.S. coal mines is based primarily on local practices and experience. A better understanding of current rib support practices in U.S. coal mines is crucial for developing a sound engineering rib support design tool. The objective of this paper is to analyze the current practices of rib control in U.S. coal mines. Twenty underground coal mines were studied representing various coal basins, coal seams, geology, loading conditions, and rib control strategies. The key findings are: (1) any rib design guideline or tool should take into account external rib support as well as internal bolting; (2) rib bolts on their own cannot contain rib spall, especially in soft ribs subjected to significant load—external rib control devices such as mesh are required in such cases to contain rib sloughing; (3) the majority of the studied mines follow the overburden depth and entry height thresholds recommended by the Program Information Bulletin 11-29 issued by the Mine Safety and Health Administration; (4) potential rib instability occurred when certain geological features prevailed—these include draw slate and/or bone coal near the rib/roof line, claystone partings, and soft coal bench overlain by rock strata; (5) 47% of the studied rib spall was classified as blocky—this could indicate a high potential of rib hazards; and (6) rib injury rates of the studied mines for the last three years emphasize the need for more rib control management for mines operating at overburden depths between 152.4 m and 304.8 m. PMID:27648341

Best practice guidelines for stroke in Cameroon: An innovative and participatory knowledge translation project.

PubMed

Cockburn, Lynn; Fanfon, Timothy N; Bramall, Alexa; Ngole, Eta M; Kuwoh, Pius; Anjonga, Emmanuel; Difang, Brenda M E; Kiani, Shirin; Muso, Petra S; Trivedi, Navjyot; Sama, Julius; Teboh, Sylvian

2014-01-01

Although the adherence to stroke guidelines in high-income countries has been shown to be associated with improved patient outcomes, the research, development and implementation of rehabilitation related guidelines in African countries is lacking. The purpose of this article is to describe how a group of front-line practitioners collaborated with academics and students to develop best practice guidelines (BPG) for the management and rehabilitation of stroke in adult patients in Cameroon. A working group was established and adapted internationally recognised processes for the development of best practice guidelines. The group determined the scope of the guidelines, documented current practices, and critically appraised evidence to develop guidelines relevant to the Cameroon context. The primary result of this project is best practice guidelines which provided an overview of the provision of stroke rehabilitation services in the region, and made 83 practice recommendations to improve these services. We also report on the successes and challenges encountered during the process, and the working group's recommendations aimed at encouraging others to consider similar projects. This project demonstrated that there is interest and capacity for improving stroke rehabilitation practices and for stroke guideline development in Africa.

The International Association for Promoting Geoethics: Mission, Organization, and Activities

NASA Astrophysics Data System (ADS)

Kieffer, S. W.; Peppoloni, S.; Di Capua, G.

2017-12-01

The International Association for Promoting Geoethics (IAPG) was founded in 2012, during the 34th IGC in Brisbane (Australia), to provide a multidisciplinary platform for widening the discussion and creating awareness about principles and problems of ethics as applied to the geosciences. It is a scientific, non-governmental, non-political, non-profit, non-party institution, headquartered at the Italian Institute of Geophysics and Volcanology in Rome, Italy. IAPG focuses on behaviors and practices where human activities interact with the Earth system, and deals with the ethical, social and cultural implications of geoscience knowledge, education, research, practice and communication. Its goal is to enhance awareness of the social role and responsibility of geoscientists in conducting their activities such as geoeducation, sustainability, and risk prevention. IAPG is a legally recognized non-profit association with members in 115 countries on 5 continents, and currently has 26 national sections. As of the date of this abstract, IAPG has been involved with approximately 70 international meetings (scientific conferences, symposia, seminars, workshops, expositions, etc.). Other activities range from exchanging information with newsletters, blogs, social networks and publications; promoting the creation of working groups and encouraging the participation of geoscientists within universities and professional associations for the development of geoethics themes; and cooperating with national and international organizations whose aims are complementary, e.g., International Union of Geological Sciences (IUGS), American Geosciences Institute (AGI), Geological Society of America (GSA), Geological Society of London (GSL), Geoscience Information in Africa - Network (GIRAF), American Geophysical Union (AGU), International Association for Engineering Geology and the Environment (IAEG), International Association of Hydrogeologists (IAH), Association of Environmental & Engineering Geologists (AEG), International Geoscience Education Organization (IGEO), etc. Finally, IAPG is involved in activities to disseminate geological knowledge in society through "ad hoc" events for the general public and courses for professionals and students. More about IAPG at www.geoethics.org.

Dynamics of the Earth's Inner Magnetosphere and its Connection to the Ionosphere: Current Understanding and Challenges

NASA Technical Reports Server (NTRS)

Zheng, Yihua

2010-01-01

The Earth's inner magnetosphere, a vast volume in space spanning from 1.5 Re (Earth radii) to 10 Re, is a host to a variety of plasma populations (with energy from 1 eV to few MeV) and physical processes where most of which involve plasma and field coupling. As a gigantic particle accelerator, the inner magnetosphere includes three overlapping regions: the plasmasphere, the ring current, and the Van Allen radiation belt. The complex structures and dynamics of these regions are externally driven by solar activities and internally modulated by intricate interactions and coupling. As a major constituent of Space Weather, the inner magnetosphere is both scientifically intriguing and practically important to our society. In this presentation, I will discuss our recent results from the Comprehensive Ring Current Model, in the context of our current understanding of the inner magnetosphere in general and challenges ahead in making further progresses.

Dynamics of the Earth's Inner Magnetosphere and Its Connection to the Ionosphere: Current Understanding and Challenges

NASA Technical Reports Server (NTRS)

Zheng, Yihua

2011-01-01

The Earth's inner magnetosphere, a vast volume in space spanning from 1.5 Re (Earth radii) to 10 Re, is a host to a variety of plasma populations (with energy from 1 eV to few MeV) and physical processes where most of which involve plasma and field coupling. As a gigantic particle accelerator, the inner magnetosphere includes three overlapping regions: the plasmasphere, the ring current, and the Van Allen radiation belt. The complex structures and dynamics of these regions are externally driven by solar activities and internally modulated by intricate interactions and coupling. As a major constituent of Space Weather, the inner magnetosphere is both scientifically intriguing and practically important to our society. In this presentation, I will discuss our recent results from the Comprehensive Ring Current Model, in the context of our current understanding of the inner magnetosphere in general and challenges ahead in making further progresses.

Management of prediabetes: a comparison of the treatment approaches utilized by a family practice clinic and an internal medicine/endocrinology practice.

PubMed

Anderson, Zachary L; Scopelliti, Emily M; Trompeter, Jessica M; Havrda, Dawn E

2015-02-01

To compare the management of prediabetes between a family practice clinic and internal medicine/endocrinology practice. A randomized, retrospective evaluation of the medical history in 168 eligible patients with a diagnosis of prediabetes or abnormal blood glucose (BG) at a family practice clinic (n = 78) and an internal medicine/endocrinology practice (n = 90). The internal medicine/endocrinology practice provided more counseling regarding lifestyle modifications (91.1% vs 76.9%, P = .039), specific physical activity recommendations (26.7% vs 7.7%, P = .003), and recommended more patients receive 150 minutes/week of moderate exercise (8.9% vs 1.3%, P = .038). The family practice clinic provided more written dietary information (16.9% vs 13.3%, P = .044) and specific weight loss goals (20.5% vs 6.7%, P = .015). The internal medicine/endocrinology practice initiated pharmacological therapy in more patients (51.1% vs 3.8%, P< .001) and had a significant decrease in fasting BG from baseline compared to the family practice clinic (-9.0 vs -5.6 mg/dL, P< .001). Providers are likely to initiate nonpharmacological therapy but may not provide specific education recommended by the American Diabetes Association. The integration of a multidisciplinary team to provide guideline-based nonpharmacologic counseling may be beneficial in improving outcomes in the management of prediabetes. © The Author(s) 2013.

Robotic totally endoscopic triple coronary artery bypass grafting on the arrested heart: report of the first successful clinical case.

PubMed

Bonatti, Johannes; Rehman, Atiq; Schwartz, Kimberly; Deshpande, Seema; Kon, Zachary; Lehr, Eric; Zimrin, David; Griffith, Bartley

2010-12-01

Robotic technology enables "port only" totally endoscopic coronary artery bypass grafting (TECAB). During early procedure development only single bypass grafts were feasible. Because current referral practice for coronary bypass surgery mostly includes multivessel disease, performance of multiple endoscopic bypass grafts is desirable. We report a case in which a patient received a right internal mammary artery bypass graft to the left anterior descending artery and a left internal mammary artery jump graft to 2 obtuse marginal branches. The procedure was performed through 5 ports on the arrested heart using the daVinci S robotic surgical system. This is the first reported triple bypass grafting procedure using an arrested heart approach.

Financial reporting practices: a comprehensive evaluation.

PubMed

Godwin, Norman H; Mueller, Jennifer M

2005-01-01

A distinguishing characteristic of high performance organizations is a strong internal control structure-controls that ensure patient care, compliance with regulations, internal efficiencies, and financial reporting. It is controls on financial reporting that are receiving a great deal of attention under a new law, the Sarbanes-Oxley Act of 2002. Public companies are now required by law to document controls over financial reporting, in order to fully address exposures and the effectiveness of current controls. Though many healthcare organizations are not directly affected by the law, regulatory agencies could follow suit and require similar compliance. In fact, several states have introduced bills that require nonprofit organizations to adhere to portions of the act. This article provides a guide for organizations desiring to stay ahead of the curve.

Practical Unitary Simulator for Non-Markovian Complex Processes

NASA Astrophysics Data System (ADS)

Binder, Felix C.; Thompson, Jayne; Gu, Mile

2018-06-01

Stochastic processes are as ubiquitous throughout the quantitative sciences as they are notorious for being difficult to simulate and predict. In this Letter, we propose a unitary quantum simulator for discrete-time stochastic processes which requires less internal memory than any classical analogue throughout the simulation. The simulator's internal memory requirements equal those of the best previous quantum models. However, in contrast to previous models, it only requires a (small) finite-dimensional Hilbert space. Moreover, since the simulator operates unitarily throughout, it avoids any unnecessary information loss. We provide a stepwise construction for simulators for a large class of stochastic processes hence directly opening the possibility for experimental implementations with current platforms for quantum computation. The results are illustrated for an example process.

Improving data availability for brain image biobanking in healthy subjects: Practice-based suggestions from an international multidisciplinary working group

PubMed Central

Shenkin, Susan D.; Pernet, Cyril; Nichols, Thomas E.; Poline, Jean-Baptiste; Matthews, Paul M.; van der Lugt, Aad; Mackay, Clare; Lanyon, Linda; Mazoyer, Bernard; Boardman, James P.; Thompson, Paul M.; Fox, Nick; Marcus, Daniel S.; Sheikh, Aziz; Cox, Simon R.; Anblagan, Devasuda; Job, Dominic E.; Dickie, David Alexander; Rodriguez, David; Wardlaw, Joanna M.

2017-01-01

Brain imaging is now ubiquitous in clinical practice and research. The case for bringing together large amounts of image data from well-characterised healthy subjects and those with a range of common brain diseases across the life course is now compelling. This report follows a meeting of international experts from multiple disciplines, all interested in brain image biobanking. The meeting included neuroimaging experts (clinical and non-clinical), computer scientists, epidemiologists, clinicians, ethicists, and lawyers involved in creating brain image banks. The meeting followed a structured format to discuss current and emerging brain image banks; applications such as atlases; conceptual and statistical problems (e.g. defining ‘normality’); legal, ethical and technological issues (e.g. consents, potential for data linkage, data security, harmonisation, data storage and enabling of research data sharing). We summarise the lessons learned from the experiences of a wide range of individual image banks, and provide practical recommendations to enhance creation, use and reuse of neuroimaging data. Our aim is to maximise the benefit of the image data, provided voluntarily by research participants and funded by many organisations, for human health. Our ultimate vision is of a federated network of brain image biobanks accessible for large studies of brain structure and function. PMID:28232121

A preliminary qualitative exploration of dietitians' engagement with genetics and nutritional genomics: perspectives from international leaders.

PubMed

Li, Sherly X; Collins, Jorja; Lawson, Stephanie; Thomas, Jane; Truby, Helen; Whelan, Kevin; Palermo, Claire

2014-01-01

This qualitative study explored the underlying determinants of dietitians' current practice and attitudes about nutritional genomics. Sixteen semi-structured interviews were conducted with international leaders selected across each domain of dietetics practice from Australia (n=8) and the United Kingdom (n=8). Interviews explored knowledge, involvement, perceived role, and attitudes about the benefits and barriers of genetics and nutritional genomics. Interviews were transcribed and analysed using thematic analysis. Five key themes were identified: (i) acknowledgment that there are wide applications for nutritional genomics; (ii) a general lack of awareness of nutritional genomics that underlies a knowledge, skills, and confidence gap; (iii) dietitians are patient-orientated and thus are receptive to the public's needs; (iv) the legitimacy of commercialised nutritional genomics products and services; and (v) prioritisation of nutritional genomics amongst other practice-related commitments as well as the influence of the workplace setting. In order for healthcare services to prepare for the application of nutritional genomics, these social, political, attitudinal, and awareness issues amongst dietitians need to be addressed. Further education in nutritional genomics may help to build awareness, continued research is crucial in determining utility, whilst establishing a healthcare system that supports and rewards this approach may cultivate its adoption.

Improving data availability for brain image biobanking in healthy subjects: Practice-based suggestions from an international multidisciplinary working group.

PubMed

Shenkin, Susan D; Pernet, Cyril; Nichols, Thomas E; Poline, Jean-Baptiste; Matthews, Paul M; van der Lugt, Aad; Mackay, Clare; Lanyon, Linda; Mazoyer, Bernard; Boardman, James P; Thompson, Paul M; Fox, Nick; Marcus, Daniel S; Sheikh, Aziz; Cox, Simon R; Anblagan, Devasuda; Job, Dominic E; Dickie, David Alexander; Rodriguez, David; Wardlaw, Joanna M

2017-06-01

Brain imaging is now ubiquitous in clinical practice and research. The case for bringing together large amounts of image data from well-characterised healthy subjects and those with a range of common brain diseases across the life course is now compelling. This report follows a meeting of international experts from multiple disciplines, all interested in brain image biobanking. The meeting included neuroimaging experts (clinical and non-clinical), computer scientists, epidemiologists, clinicians, ethicists, and lawyers involved in creating brain image banks. The meeting followed a structured format to discuss current and emerging brain image banks; applications such as atlases; conceptual and statistical problems (e.g. defining 'normality'); legal, ethical and technological issues (e.g. consents, potential for data linkage, data security, harmonisation, data storage and enabling of research data sharing). We summarise the lessons learned from the experiences of a wide range of individual image banks, and provide practical recommendations to enhance creation, use and reuse of neuroimaging data. Our aim is to maximise the benefit of the image data, provided voluntarily by research participants and funded by many organisations, for human health. Our ultimate vision is of a federated network of brain image biobanks accessible for large studies of brain structure and function. Copyright © 2017 Elsevier Inc. All rights reserved.

Measuring determinants of career satisfaction of anesthesiologists: validation of a survey instrument.

PubMed

Afonso, Anoushka M; Diaz, James H; Scher, Corey S; Beyl, Robbie A; Nair, Singh R; Kaye, Alan David

2013-06-01

To measure the parameter of job satisfaction among anesthesiologists. Survey instrument. Academic anesthesiology departments in the United States. 320 anesthesiologists who attended the annual meeting of the ASA in 2009 (95% response rate). The anonymous 50-item survey collected information on 26 independent demographic variables and 24 dependent ranked variables of career satisfaction among practicing anesthesiologists. Mean survey scores were calculated for each demographic variable and tested for statistically significant differences by analysis of variance. Questions within each domain that were internally consistent with each other within domains were identified by Cronbach's alpha ≥ 0.7. P-values ≤ 0.05 were considered statistically significant. Cronbach's alpha analysis showed strong internal consistency for 10 dependent outcome questions in the practice factor-related domain (α = 0.72), 6 dependent outcome questions in the peer factor-related domain (α = 0.71), and 8 dependent outcome questions in the personal factor-related domain (α = 0.81). Although age was not a variable, full-time status, early satisfaction within the first 5 years of practice, working with respected peers, and personal choice factors were all significantly associated with anesthesiologist job satisfaction. Improvements in factors related to job satisfaction among anesthesiologists may lead to higher early and current career satisfaction. Copyright © 2013 Elsevier Inc. All rights reserved.

Fanny M. Cheung: Award for Distinguished Contributions to the International Advancement of Psychology.

PubMed

2012-11-01

Presents a short biography of one of the co-recipients of the American Psychological Association's Award for Distinguished Contributions to the International Advancement of Psychology. One of the 2012 winners is Fanny M. Cheung for her outstanding contributions to the assessment of cross-cultural psychopathology, personality psychology, and gender issues, as well as her longstanding efforts in support of the development and advancement of psychology in Asia. Cheung has been a pioneer of international psychology. While leading the effort to standardize the Chinese MMPI, and as the president of the International Test Commission, she has advocated for best practices in cross-cultural assessment. By adopting a combined emic-etic approach to developing the Chinese Personality Assessment Inventory, the first Asian personality measure translated into six other languages, she overcame the ethnocentricism found in both the etic and emic approaches. As the current editor of the Asian Journal of Social Psychology and in her 20-year involvement in the International Association of Applied Psychology, she has facilitated mutual support for international psychologists and fostered their voices in mainstream psychology. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Development of a Self-Report Checklist to Assess Dementia Care by Nurses in Hospital Settings.

PubMed

Ikegami, Chikako; Ota, Katsumasa

2018-03-01

Nurses working at general hospitals face difficulties in providing dementia care. The current study examined aged care nurses' dementia care practices in the hospital setting and developed a dementia care checklist that nurses can use to review their own care practice. A self-administered questionnaire was given to 676 participants; responses were collected from 595 participants. Exploratory factor analysis identified six factors (e.g., patient understanding prompted by concern and interest for the patient, respect for patients' voluntary behavior, early detection of abnormalities) among the questionnaire's 28 items. This analysis provided a framework for the checklist and verified that it had satisfactory internal consistency and construct validity. The frequency of care practices varied with participants' knowledge of dementia care requirements, satisfaction with their own dementia care practice, confidence in their ability to judge patients' physical condition, and cooperation with colleagues. This checklist might improve dementia care in hospital settings. [Res Gerontol Nurs. 2018; 11(2):91-102.]. © 2018 Ikegami and Ota.

Survey of expert practice and perceptions of the supporting clinical evidence for the management of uveitis-related cataract and cystoid macular oedema.

PubMed

Sreekantam, Sreekanth; Denniston, Alastair K O; Murray, Philip I

2011-10-01

To survey the practice of uveitis experts in the management of uveitic cataract and cystoid macular oedema (CMO). A structured questionnaire containing two clinical scenarios was sent to members of the International Uveitis Study Group (IUSG). The questionnaire surveyed both respondents' current practice and their perception of the supporting clinical evidence. For uveitic cataract, 70% required a 3-month inflammation-free period before surgery, and 76% gave a prophylactic preoperative systemic corticosteroid. For uveitic CMO, 87% gave corticosteroids, usually orally. Preferred second-line agents were methotrexate (39%), cyclosporin (24%), azathioprine (17%), and mycophenolate (7%). Respondents suggested the evidence underlying their decisions was either absent or relatively weak (levels III or IV), and in most cases personal experience was a factor. This survey highlights areas of consensus and variation among uveitis experts in managing uveitic cataract and CMO, and emphasizes the need for further clinical trials to establish the best practice.

Weaponisation of Space - Some Legal Considerations

NASA Astrophysics Data System (ADS)

Jolly, C.

2002-01-01

This paper will examine a current national initiative from the United States of America to achieve greater national security through the `weaponisation' of extra-atmospheric space. We will propose a synthesis of the current international legal framework pertaining to military activities in space. Based on the analysis of the legal regime and on some current national and regional political initiatives, we will make some practical recommendations to prevent an arms race in space. Civil remote sensing, telecommunications, and launchers launch vehicle technologies have all benefited from a military heritage. They are dual use technologies, in other words, technologies that have both military and civilian applications. In fact, space has always been militarised, ever since the first satellites were put in orbit for reconnaissance missions. But recently, some national policies and technological advances are making the militarisation of space less `discrete'. Military assets from different countries are already stationed in orbit (e.g. reconnaissance and navigation satellites), but they might soon be joined by new `space weapons' with lethal strike capabilities. Currently, in the United States, military and civilian space activities are being closely intertwined. A typical example is the call of the NASA Administrator Sean O'Keefe, a former Secretary of the Navy, for closer cooperation on research and development between NASA and the Department of Defense. Concerning plans to station weapons in space, the American Air Force Space Command issued, in February 2000, its `Strategic Master Plan for FY02 and Beyond'. It states that the United States "...future Air Force Space Command capabilities will enable a fully integrated Aerospace Force to rapidly engage military forces worldwide. [...] Full spectrum dominance in the space medium will be achieved through total space situational awareness, protection of friendly space assets, prevention of unauthorized use of those assets, negation of adversarial use of space and a fully-capable National Missile Defense (NMD). [American] ICBMs will continue to provide a credible strategic deterrence, while advanced, conventional weapons operating in or through space will provide our National Command Authorities (NCA) with formidable and flexible options for prompt, global, conventional strike." As we will see in this paper, the current international legal framework restricting the stationing and use of weapons in space is composed mainly of three treaties. They are: the Treaty between the United States of America and the Union of Soviet Socialist Republics on the Limitation of Anti-Ballistic Missile Systems (1972), called commonly the `ABM treaty', the `Outer Space Treaty' (1967) and the Treaty Banning Nuclear Weapon Tests in the Atmosphere, in Outer Space and Under Water (1963). We will also see that - contrary to public opinion - those current legal instruments, even coupled with other international legal texts, do not prohibit the `weaponisation' of space. For instance, The Article Four of the Outer Space Treaty is often cited as the main legal argument against militarisation of space. This article does indeed prohibit the installation or stationing of "any objects carrying nuclear weapons or any other kinds of weapons of mass destruction", "in orbit around the Earth", "on celestial bodies", "in outer space" and "in any other manner". But, aside from the weapons identified (nuclear weapons and weapons of mass destruction), nothing prohibits a government signatory to the Outer Space Treaty, to actually station other types of weapons in space, such as laser-based systems. In this paper, the current situation of potential `weaponisation' of space, the international impacts of such a policy and the gaps of the international legal framework concerning the militarisation of space, will prompt some comments and practical recommendations.

Effectiveness of an Online Educational Module in Improving Evidence-Based Practice Skills of Practicing Registered Nurses.

PubMed

Moore, Lora

2017-10-01

Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses. © 2017 Sigma Theta Tau International.

Opinions of Practicing Surgeons on the Appropriateness of Published Indications for Use of Damage Control Surgery in Trauma Patients: An International Cross-Sectional Survey.

PubMed

Roberts, Derek J; Zygun, David A; Faris, Peter D; Ball, Chad G; Kirkpatrick, Andrew W; Stelfox, Henry T

2016-09-01

Variation in use of damage control (DC) surgery across trauma centers may be partially driven by surgeon uncertainty as to when it is appropriately indicated. We sought to determine opinions of practicing surgeons on the appropriateness of published indications for trauma DC surgery. We asked 384 trauma centers in the United States, Canada, and Australasia to nominate 1 to 3 surgeons at their center to participate in a survey about DC surgery. We then asked nominated surgeons their opinions on the appropriateness (benefit-to-harm ratio) of 43 literature-derived indications for use of DC surgery in adult civilian trauma patients. In total, 232 (64.8%) trauma centers nominated 366 surgeons, of whom 201 (56.0%) responded. Respondents rated 15 (78.9%) preoperative and 23 (95.8%) intraoperative indications to be appropriate. Indications respondents agreed had the greatest expected benefit included a temperature <34°C, arterial pH <7.2, and laboratory-confirmed (international normalized ratio/prothrombin time and/or partial thromboplastin time >1.5 times normal) or clinically observed coagulopathy in the pre- or intraoperative setting; administration of >10 units of packed red blood cells; requirement for a resuscitative thoracotomy in the emergency department; and identification of a juxtahepatic venous injury or devascularized or destroyed pancreas, duodenum, or pancreaticoduodenal complex during operation. Ratings were consistent across subgroups of surgeons with different training, experience, and practice settings. We identified 38 indications that practicing surgeons agreed appropriately justified the use of DC surgery. Until further studies become available, these indications constitute a consensus opinion that can be used to guide practice in the current era of changing trauma resuscitation practices. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

"Selling It as a Holistic Health Provision and Not Just about Condoms..." Sexual Health Services in School Settings: Current Models and Their Relationship with Sex and Relationships Education Policy and Provision

ERIC Educational Resources Information Center

Formby, Eleanor; Hirst, Julia; Owen, Jenny; Hayter, Mark; Stapleton, Helen

2010-01-01

In this article we discuss the findings from a recent study of UK policy and practice in relation to sexual health services for young people, based in--or closely linked with--schools. This study formed part of a larger project, completed in 2009, which also included a systematic review of international research. The findings discussed in this…

Clinical supervision in the 21st century: revisiting pressing needs and impressing possibilities.

PubMed

Watkins, C Edward

2014-01-01

What are some of the most pressing needs currently confronting clinical supervision? In this paper, I give attention to that question. Drawing on two 1990 reviews for comparative purposes, I examine where supervision is now relative to four areas: (a) supervision training and practice; (b) measurement; (c) difference and diversity; and (d) research. Lines of advance, pressing needs, and potential remedies are considered across each area. Effort is made to accentuate the "robustly international" nature of clinical supervision and its increasing globalization.

Current Launch Vehicle Practice and Data Base Assessment. Volume 1. Executive Summary and Report Body

DTIC Science & Technology

1989-06-01

resulted in an increase of the intermediate seal purge pressure, revised redlines, and a design change from a lift-off seal to a labyrinth seal design. This...engine 0003 caused fa&i!ure of the primary lox seal and an uncontained engine fire. The redline cut was set by a HPOTP overspeed. This failure...occurred as a result of undetected internal HEX damage caused during arc welding which resulted in an engine fire. HEX coil leakage resulted in an

Singapore Paediatric Resuscitation Guidelines 2016.

PubMed

Ong, Gene Yong Kwang; Chan, Irene Lai Yeen; Ng, Agnes Suah Bwee; Chew, Su Yah; Mok, Yee Hui; Chan, Yoke Hwee; Ong, Jacqueline Soo May; Ganapathy, Sashikumar; Ng, Kee Chong

2017-07-01

We present the revised 2016 Singapore paediatric resuscitation guidelines. The International Liaison Committee on Resuscitation's Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, as well as the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council released in October 2015, were debated and discussed by the workgroup. The final recommendations for the Singapore Paediatric Resuscitation Guidelines 2016 were derived after carefully reviewing the current available evidence in the literature and balancing it with local clinical practice. Copyright: © Singapore Medical Association.

Attitudes toward menstruation. International Committee on Applied Research in Population.

PubMed

Whelan, E M

1975-04-01

Historically, various interpretations of the menstrual process have been reflected in a wide, and usually negative, range of social attitudes toward menstruation. Recent clinical experience with continuation of the modern hormonal and mechanical methods of contraception that induce changes in the normal menstrual pattern suggests the need to understand current variations in attitudes and practices related to menstruation. This paper briefly outlines historical Western, Orthodox Jewish and Muslim, and contemporary US women's attitudes toward menstruation and begins to explore their relationship to contraceptive continuation.

Simplified diagnostic coding sheet for computerized data storage and analysis in ophthalmology.

PubMed

Tauber, J; Lahav, M

1987-11-01

A review of currently-available diagnostic coding systems revealed that most are either too abbreviated or too detailed. We have compiled a simplified diagnostic coding sheet based on the International Coding and Diagnosis (ICD-9), which is both complete and easy to use in a general practice. The information is transferred to a computer, which uses the relevant (ICD-9) diagnoses as database and can be retrieved later for display of patients' problems or analysis of clinical data.

Commitment to and preparedness for sustainable supply chain management in the oil and gas industry.

PubMed

Wan Ahmad, Wan Nurul K; Rezaei, Jafar; Tavasszy, Lóránt A; de Brito, Marisa P

2016-09-15

Our current dependency on the oil and gas (O&G) industry for economic development and social activities necessitates research into the sustainability of the industry's supply chains. At present, studies on sustainable supply chain management (SSCM) practices in the industry do not include firm-internal factors that affect the sustainability strategies employed by different functional areas of its supply chains. Our study aims to address this gap by identifying the relevant internal factors and exploring their relationship with SSCM strategies. Specifically, we discuss the commitment to and preparedness for sustainable practices of companies that operate in upstream and downstream O&G supply chain. We study the impact of these factors on their sustainability strategies of four key supply chain functions: supplier management, production management, product stewardship and logistics management. The analyses of data collected through a survey among 81 companies show that management preparedness may enhance sustainable supply chain strategies in the O&G industry more than commitment does. Among the preparedness measures, management of supply chain operational risks is found to be vital to the sustainability of all supply chain functions except for production management practices. The findings also highlight the central importance of supplier and logistics management to the achievement of sustainable O&G supply chains. Companies must also develop an organizational culture that encourages, for example, team collaboration and proactive behaviour to finding innovative sustainability solutions in order to translate commitment to sustainable practices into actions that can produce actual difference to their SSCM practices. Copyright © 2016 Elsevier Ltd. All rights reserved.

Use of routine interventions in vaginal labor and birth: findings from the Maternity Experiences Survey.

PubMed

Chalmers, Beverley; Kaczorowski, Janusz; Levitt, Cheryl; Dzakpasu, Susie; O'Brien, Beverley; Lee, Lily; Boscoe, Madeline; Young, David

2009-03-01

Intervention rates in maternity practices vary considerably across Canadian provinces and territories. The objective of this study was to describe the use of routine interventions and practices in labor and birth as reported by women in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System. Rates of interventions and practices are considered in the light of current evidence and both Canadian and international recommendations. A sample of 8,244 estimated eligible women was identified from a randomly selected sample of recently born infants drawn from the May 2006 Canadian Census and stratified primarily by province and territory. Birth mothers living with their infants at the time of interview were invited to participate in a computer-assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews averaged 45 minutes long and were completed when infants were between 5 and 10 months old (9-14 mo in the territories). Completed responses were obtained from 6,421 women (78%). Women frequently reported electronic fetal monitoring, a health care practitioner starting or speeding up their labor (or trying to do so), epidural anesthesia, episiotomy, and a supine position for birth. Some women also reported pubic or perineal shaves, enemas, and pushing on the top of their abdomen. Several practices and interventions were commonly reported in labor and birth in Canada, although evidence and Canadian and international guidelines recommend against their routine use. Practices not recommended for use at all, such as shaving, were also reported.