Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2014 edition.

PubMed

Minakami, Hisanori; Maeda, Tsugio; Fujii, Tomoyuki; Hamada, Hiromi; Iitsuka, Yoshinori; Itakura, Atsuo; Itoh, Hiroaki; Iwashita, Mitsutoshi; Kanagawa, Takeshi; Kanai, Makoto; Kasuga, Yoshio; Kawabata, Masakiyo; Kobayashi, Kosuke; Kotani, Tomomi; Kudo, Yoshiki; Makino, Yasuo; Matsubara, Shigeki; Matsuda, Hideo; Miura, Kiyonori; Murakoshi, Takeshi; Murotsuki, Jun; Ohkuchi, Akihide; Ohno, Yasumasa; Ohshiba, Yoko; Satoh, Shoji; Sekizawa, Akihiko; Sugiura, Mayumi; Suzuki, Shunji; Takahashi, Tsuneo; Tsukahara, Yuki; Unno, Nobuya; Yoshikawa, Hiroyuki

2014-06-01

The 'Clinical Guidelines for Obstetrical Practice, 2011 edition' were revised and published as a 2014 edition (in Japanese) in April 2014 by the Japan Society of Obstetrics and Gynecology and the Japan Association of Obstetricians and Gynecologists. The aims of this publication include the determination of current standard care practices for pregnant women in Japan, the widespread use of standard care practices, the enhancement of safety in obstetrical practice, the reduction of burdens associated with medico-legal and medico-economical problems, and a better understanding between pregnant women and maternity-service providers. The number of Clinical Questions and Answers items increased from 87 in the 2011 edition to 104 in the 2014 edition. The Japanese 2014 version included a Discussion, a List of References, and some Tables and Figures following the Answers to the 104 Clinical Questions; these additional sections covered common problems and questions encountered in obstetrical practice, helping Japanese readers to achieve a comprehensive understanding. Each answer with a recommendation level of A, B or C was prepared based principally on 'evidence' or a consensus among Japanese obstetricians in situations where 'evidence' was weak or lacking. Answers with a recommendation level of A or B represent current standard care practices in Japan. All 104 Clinical Questions and Answers items, with the omission of the Discussion, List of References, and Tables and Figures, are presented herein to promote a better understanding among English readers of the current standard care practices for pregnant women in Japan. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

Combustion and fires in low gravity

NASA Technical Reports Server (NTRS)

Friedman, Robert

1994-01-01

Fire safety always receives priority attention in NASA mission designs and operations, with emphasis on fire prevention and material acceptance standards. Recently, interest in spacecraft fire-safety research and development has increased because improved understanding of the significant differences between low-gravity and normal-gravity combustion suggests that present fire-safety techniques may be inadequate or, at best, non-optimal; and the complex and permanent orbital operations in Space Station Freedom demand a higher level of safety standards and practices. This presentation outlines current practices and problems in fire prevention and detection for spacecraft, specifically the Space Station Freedom's fire protection. Also addressed are current practices and problems in fire extinguishment for spacecraft.

Sexuality and Islam.

PubMed

Dialmy, Abdessamad

2010-06-01

This paper deals with three major questions: (1) What are the sexual norms defined by the sacred texts (Koran and Sunna)? (2) What are the sexual practices currently observed among Moslems? (3) To which extent are current sexual practices of Moslems dissociated from Islamic sexual norms? Sexual standards in Islam are paradoxical: on the one hand, they allow and actually are an enticement to the exercise of sexuality but, on the other hand, they discriminate between male and female sexuality, between marital and pre- or extramarital sexuality, and between heterosexuality and homosexuality. Men are given more rights with regard to the expression of their sexuality; women are forbidden to have extramarital sex (with their slaves) and both genders to have homosexual relationships. The combination of these paradoxical standards with modernisation leads to the current back and forth swing of sexual practices between repression and openness. Partial modernisation leads to greater sexual tolerance. But restrictive sexual standards have gathered strength and have become idealised as a result of the current radicalisation of Islam. This swing of the pendulum between repression and openness is illustrated by phenomena such as public harassment, premarital sexuality, female pleasure, prostitution, and homosexuality. Currently, Islam is not any more the only reference which provides guidance concerning sexual practices but secularisation of sexual laws is still politically unthinkable today. So the only solution is to achieve reform in the name of Islam, through the reinterpretation of repressive holy texts.

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

PubMed

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

2017-10-01

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

Professional Standards of Practice in Child Custody Examinations.

ERIC Educational Resources Information Center

Howell, Robert J.

Professional standards of practice for psychologists are vital in child custody work. The psychologist should examine all parties involved and should be acutely aware of and compliant with the current state laws as related to child custody. Objectivity is of paramount importance. This can best be achieved if the psychologist is appointed by the…

Mind the Gap: Accounting Information Systems Curricula Development in Compliance with IFAC Standards in a Developing Country

ERIC Educational Resources Information Center

Aleqab, Mahmoud Mohmad Ahmad; Nurunnabi, Mohammad; Adel, Dalia

2015-01-01

The authors examine the consistency between the current practices in designing and teaching accounting information systems (AIS) curricula and the International Federation of Accountants (IFAC) requirements for International Education Practice Statement 2 and International Education Standards 2. Utilizing a survey and interviews data in Jordan,…

12. Children and Adolescents: Standards of Medical Care in Diabetes-2018.

PubMed

2018-01-01

The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC. © 2017 by the American Diabetes Association.

An Overview of Skill Standards Systems in Education & Industry. Systems in the U.S. and Abroad. Volume I.

ERIC Educational Resources Information Center

Institute for Educational Leadership, Washington, DC.

This first volume in a four-volume study of industry- and education-driven skill standards in the United States and other countries describes current practice. Chapter I is the executive summary. Chapter II is an overview of historical and current issues that will affect a voluntary network of industry-based skill standards, competencies, and…

Social work, technology, and ethical practices: a review and evaluation of the national association of social workers' technology standards.

PubMed

Lopez, Amy

2014-10-01

Information and communication technologies (ICTs) are becoming essential to social work practice by providing increased treatment possibilities and reducing barriers to service. While recognizing the importance of ICTs in practice, social work practitioners have had concerns about ethical use. In response, NASW compiled the Standards for Technology and Social Work Practice. While the guidelines set the groundwork, they were not embedded in a process that would allow them to adapt to the swift pace of ICT changes. This article reviews the current Standards, evaluates how these have been implemented by practitioners, and offers suggestions for updates.

Delivery of care consistent with the psychosocial standards in pediatric cancer: Current practices in the United States.

PubMed

Scialla, Michele A; Canter, Kimberly S; Chen, Fang Fang; Kolb, E Anders; Sandler, Eric; Wiener, Lori; Kazak, Anne E

2018-03-01

With published evidence-based Standards for Psychosocial Care for Children with Cancer and their Families, it is important to know the current status of their implementation. This paper presents data on delivery of psychosocial care related to the Standards in the United States. Pediatric oncologists, psychosocial leaders, and administrators in pediatric oncology from 144 programs completed an online survey. Participants reported on the extent to which psychosocial care consistent with the Standards was implemented and was comprehensive and state of the art. They also reported on specific practices and services for each Standard and the extent to which psychosocial care was integrated into broader medical care. Participants indicated that psychosocial care consistent with the Standards was usually or always provided at their center for most of the Standards. However, only half of the oncologists (55.6%) and psychosocial leaders (45.6%) agreed or strongly agreed that their psychosocial care was comprehensive and state of the art. Types of psychosocial care provided included evidence-based and less established approaches but were most often provided when problems were identified, rather than proactively. The perception of state of the art care was associated with practices indicative of integrated psychosocial care and the extent to which the Standards are currently implemented. Many oncologists and psychosocial leaders perceive that the delivery of psychosocial care at their center is consistent with the Standards. However, care is quite variable, with evidence for the value of more integrated models of psychosocial services. © 2017 Wiley Periodicals, Inc.

Academy of nutrition and dietetics: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in sports nutrition and dietetics.

PubMed

Steinmuller, Patricia L; Kruskall, Laura J; Karpinski, Christine A; Manore, Melinda M; Macedonio, Michele A; Meyer, Nanna L

2014-04-01

Sports nutrition and dietetics addresses relationships of nutrition with physical activity, including weight management, exercise, and physical performance. Nutrition plays a key role in the prevention and treatment of obesity and chronic disease and for maintenance of health, and the ability to engage in physical activity, sports, and other aspects of physical performance. Thus, the Sports, Cardiovascular, and Wellness Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Revised 2014 Standards of Practice and Standards of Professional Performance as a resource for Registered Dietitian Nutritionists working in sports nutrition and dietetics to assess their current skill levels and to identify areas for further professional development in this emerging practice area. The revised document reflects advances in sports nutrition and dietetics practice since the original standards were published in 2009 and replaces those standards. The Standards of Practice represents the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standards can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sports nutrition and dietetics. The Standards of Practice and Standards of Professional Performance are complementary resources for Registered Dietitian Nutritionists in sports nutrition and dietetics practice. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Scan posture definition and hip girth measurement: the impact on clothing design and body scanning.

PubMed

Gill, Simeon; Parker, Christopher J

2017-08-01

Ergonomic measurement is central to product design and development; especially for body worn products and clothing. However, there is a large variation in measurement definitions, complicated by new body scanning technology that captures measurements in a posture different to traditional manual methods. Investigations of hip measurement definitions in current clothing measurement practices supports analysis of the effect of scan posture and hip measurement definition on the circumferences of the hip. Here, the hip girth is a key clothing measurement that is not defined in current body scanning measurement standards. Sixty-four participants were scanned in the standard scan posture of a [TC] 2 body scanner, and also in a natural posture similar to that of traditional manual measurement collection. Results indicate that scan posture affects hip girth circumferences, and that some current clothing measurement practices may not define the largest lower body circumference. Recommendations are made concerning how the hip is defined in measurement practice and within body scanning for clothing product development. Practitioner Summary: The hip girth is an important measurement in garment design, yet its measurement protocol is not currently defined. We demonstrate that body posture during body scanning affects hip circumferences, and that current clothing measurement practices may not define the largest lower body circumference. This paper also provides future measurement practice recommendations.

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.

Software Development Standard Processes (SDSP)

NASA Technical Reports Server (NTRS)

Lavin, Milton L.; Wang, James J.; Morillo, Ronald; Mayer, John T.; Jamshidian, Barzia; Shimizu, Kenneth J.; Wilkinson, Belinda M.; Hihn, Jairus M.; Borgen, Rosana B.; Meyer, Kenneth N.;

Characterization and development of truck load spectra and growth factors for current and future pavement design practices in Louisiana : technical summary report.

DOT National Transportation Integrated Search

2011-07-01

Current roadway pavement design practices follow the standards set by the American Society of State : Highway and Transportation Officials (AASHTO), which require the use of an equivalent single axle load : (ESAL-18 kip single axle load) for design t...

National Survey Assessing Perceived Multicultural Competence in Art Therapy Graduate Students

ERIC Educational Resources Information Center

Robb, Megan

2014-01-01

Multicultural competence is essential to contemporary art therapy practice. Current education standards require that culturally sound theories and practices be taught along with self-awareness, but there is little research on the effects of such training in art therapy. The current study examined data from the Multicultural Awareness, Knowledge,…

Wound, Ostomy, and Continence Nursing: Scope and Standards of Practice, 2nd Edition: An Executive Summary.

PubMed

2018-04-25

Wound, ostomy, and continence (WOC) nursing was recognized as a nursing specialty by the American Nurses Association in February 2010, and the Society published the original scope and standards of WOC nursing practice in May 2010. The Wound, Ostomy, and Continence Nursing: Scope and Standards of Practice, 2nd Edition is the definitive resource promoting excellence in professional practice, quality care, and improved patient outcomes in WOC specialty practice. It can be used to articulate the value of WOC nurses to administrators, legislators, payers, patients, and others. The second edition also provides an overview of the scope of WOC nursing practice including a description of the specialty, the history and evolution of WOC nursing, characteristics of WOC nursing practice, and description of the trispecialty. The document describes various WOC nurse roles, populations served, practice settings, care coordination, and collaboration. Educational preparation, levels of practice within WOC specialty nursing, certification, mandate for continuous professional development, ethics, current trends, future considerations and challenges, and standards of WOC nursing practice and professional performance with competencies for each standard are provided. The purpose of this Executive Summary is to describe the process for developing the scope and standards document, provide an overview of the scope of WOC nursing practice, and list the standards of practice and professional performance along with the competencies for each level of WOC nurse provider. The original document is available from the WOCN Society's online book store (www.wocn.org).

Annual Book of ASTM Standards, Part 23: Water; Atmospheric Analysis.

ERIC Educational Resources Information Center

American Society for Testing and Materials, Philadelphia, PA.

Standards for water and atmospheric analysis are compiled in this segment, Part 23, of the American Society for Testing and Materials (ASTM) annual book of standards. It contains all current formally approved ASTM standard and tentative test methods, definitions, recommended practices, proposed methods, classifications, and specifications. One…

In Search of Leadership Standards: Quest or Quagmire? Some Philosophical and Practical Reflections.

ERIC Educational Resources Information Center

Barlosky, Martin

2003-01-01

Examines relationship and differences between accountability and the current quest for education standards. Argues that attempt to reduce complex questions of accountability to monitored compliance with unambiguous standards is conceptually misleading and pragmatically unproductive. Traces focus on leadership standards to Fredrick Taylor's…

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

The History of Preconception Care: Evolving Guidelines and Standards

PubMed Central

Moos, Merry-K.; Curtis, Michele

2006-01-01

This article explores the history of the preconception movement in the United States and the current status of professional practice guidelines and standards. Professionals with varying backgrounds (nurses, nurse practitioners, family practice physicians, pediatricians, nurse midwives, obstetricians/gynecologists) are in a position to provide preconception health services; standards and guidelines for numerous professional organizations, therefore, are explored. The professional nursing organization with the most highly developed preconception health standards is the American Academy of Nurse Midwives (ACNM); for physicians, it is the American College of Obstetricians and Gynecologists (ACOG). These guidelines and standards are discussed in detail. PMID:16710764

Survey of Sterile Admixture Practices in Canadian Hospital Pharmacies: Part 1. Methods and Results

PubMed Central

Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W.

2009-01-01

Background: The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its “General Chapter <797> Pharmaceutical Compounding—Sterile Preparations”, which set a more rigorous and enforceable standard for sterile compounding in the United States. Objectives: To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter <797> standards. Methods: An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter <797> standards, was created and distributed to 193 Canadian hospital pharmacies. Results: A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter <797> standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. Part 1 of this series reports the survey methods and results relating to policies, personnel, raw materials, storage and handling, facilities and equipment, and garments. Part 2 will report results relating to preparation of aseptic products, expiry dating, labelling, process validation, product testing and release, documentation, records, and disposal of hazardous pharmaceuticals. It will also highlight some of the key areas where there is considerable opportunity for improvement. Conclusion: This survey identified numerous deficiences in sterile compounding practices in Canadian hospital pharmacies. Awareness of these deficiencies may create an impetus for critical assessment and improvements in practice. PMID:22478875

Survey of Sterile Admixture Practices in Canadian Hospital Pharmacies: Part 2. More Results and Discussion

PubMed Central

Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W

2009-01-01

Background: The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its “General Chapter <797> Pharmaceutical Compounding—Sterile Preparations”, which set a more rigorous and enforceable standard for sterile compounding in the United States. Objectives: To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter <797> standards. Methods: An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter <797> standards, was created and distributed to 193 Canadian hospital pharmacies. Results: A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter <797> standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. The survey methods for this study and results relating to policies, personnel, raw materials, storage and handling, facilities and equipment, and garments were reported in Part 1. Part 2 reports results relating to preparation of aseptic products, expiry dating, labelling, process validation, product testing and release, documentation, records, and disposal of hazardous pharmaceuticals. It also highlights some of the key areas where there is considerable opportunity for improvement. Conclusion: This survey identified numerous deficiencies in sterile compounding practices in Canadian hospital pharmacies. Awareness of these deficiencies may create an impetus for critical assessment and improvements in practice. PMID:22478890

Survey of sterile admixture practices in canadian hospital pharmacies: part 2. More results and discussion.

PubMed

Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W

2009-05-01

The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its "General Chapter <797> Pharmaceutical Compounding-Sterile Preparations", which set a more rigorous and enforceable standard for sterile compounding in the United States. To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter <797> standards. An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter <797> standards, was created and distributed to 193 Canadian hospital pharmacies. A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter <797> standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. The survey methods for this study and results relating to policies, personnel, raw materials, storage and handling, facilities and equipment, and garments were reported in Part 1. Part 2 reports results relating to preparation of aseptic products, expiry dating, labelling, process validation, product testing and release, documentation, records, and disposal of hazardous pharmaceuticals. It also highlights some of the key areas where there is considerable opportunity for improvement. This survey identified numerous deficiencies in sterile compounding practices in Canadian hospital pharmacies. Awareness of these deficiencies may create an impetus for critical assessment and improvements in practice.

Survey of sterile admixture practices in canadian hospital pharmacies: part 1. Methods and results.

PubMed

Warner, Travis; Nishi, Cesilia; Checkowski, Ryan; Hall, Kevin W

2009-03-01

The 1996 Guidelines for Preparation of Sterile Products in Pharmacies of the Canadian Society of Hospital Pharmacists (CSHP) represent the current standard of practice for sterile compounding in Canada. However, these guidelines are practice recommendations, not enforceable standards. Previous surveys of sterile compounding practices have shown that actual practice deviates markedly from voluntary practice recommendations. In 2004, the United States Pharmacopeia (USP) published its "General Chapter <797> Pharmaceutical Compounding-Sterile Preparations", which set a more rigorous and enforceable standard for sterile compounding in the United States. To assess sterile compounding practices in Canadian hospital pharmacies and to compare them with current CSHP recommendations and USP chapter <797> standards. An online survey, based on previous studies of sterile compounding practices, the CSHP guidelines, and the chapter <797> standards, was created and distributed to 193 Canadian hospital pharmacies. A total of 133 pharmacies completed at least part of the survey, for a response rate of 68.9%. All respondents reported the preparation of sterile products. Various degrees of deviation from the practice recommendations were noted for virtually all areas of the CSHP guidelines and the USP standards. Low levels of compliance were most notable in the areas of facilities and equipment, process validation, and product testing. Availability in the central pharmacy of a clean room facility meeting or exceeding the criteria of International Organization for Standardization (ISO) class 8 is a requirement of the chapter <797> standards, but more than 40% of responding pharmacies reported that they did not have such a facility. Higher levels of compliance were noted for policies and procedures, garbing requirements, aseptic technique, and handling of hazardous products. Part 1 of this series reports the survey methods and results relating to policies, personnel, raw materials, storage and handling, facilities and equipment, and garments. Part 2 will report results relating to preparation of aseptic products, expiry dating, labelling, process validation, product testing and release, documentation, records, and disposal of hazardous pharmaceuticals. It will also highlight some of the key areas where there is considerable opportunity for improvement. This survey identified numerous deficiences in sterile compounding practices in Canadian hospital pharmacies. Awareness of these deficiencies may create an impetus for critical assessment and improvements in practice.

Structured assessment of current mental state in clinical practice: an international study of the reliability and validity of the Current Psychiatric State interview, CPS-50.

PubMed

Falloon, I R H; Mizuno, M; Murakami, M; Roncone, R; Unoka, Z; Harangozo, J; Pullman, J; Gedye, R; Held, T; Hager, B; Erickson, D; Burnett, K

2005-01-01

To develop a reliable standardized assessment of psychiatric symptoms for use in clinical practice. A 50-item interview, the Current Psychiatric State 50 (CPS-50), was used to assess 237 patients with a range of psychiatric diagnoses. Ratings were made by interviewers after a 2-day training. Comparisons of inter-rater reliability on each item and on eight clinical subscales were made across four international centres and between psychiatrists and non-psychiatrists. A principal components analysis was used to validate these clinical scales. Acceptable inter-rater reliability (intra-class coefficient > 0.80) was found for 46 of the 50 items, and for all eight subscales. There was no difference between centres or between psychiatrists and non-psychiatrists. The principal components analysis factors were similar to the clinical scales. The CPS-50 is a reliable standardized assessment of current mental status that can be used in clinical practice by all mental health professionals after brief training. Blackwell Munksgaard 2004

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

Smegal, J.; Lstiburek, J.

There is an increasing market in liquid (or fluid) applied water management barriers for residential applications that could be used in place of tapes and other self-adhering membranes if applied correctly, especially around penetrations in the enclosure. This report discusses current best practices, recommends ways in which the best practices can be improved, and looks at some current laboratory testing and testing standards.

Laboratory considerations of United States Pharmacopeia Chapter <71> sterility tests and its application to pharmaceutical compounding.

PubMed

Hyde, Tiffany D

2014-01-01

The purpose of this article is to describe United States Pharmacopeia Chapter <71> Sterility Tests from the perspective of Current Good Manufacturing Practices in order to aid compounding pharmacists in understanding the details and complexities that are required. Compounding pharmacists face a unique challenge in the industry today, with their compounding practice and the U.S. Food and Drug Administration trying to impose Current Good Manufacturing Practices guidelines. Naturally, this becomes a challenge to contract testing laboratories as well, as they are caught between the testing for non-Current Good Manufacturing Practices compounding standards and Current Good Manufacturing Practices manufacturing. It is important that the compounding pharmacist and their partner testing laboratory work closely together to ensure appropriate requirements are being met.

Teacher Professional Develpment That Meets 21st Century Science Education Standards

NASA Astrophysics Data System (ADS)

van der Veen, Wil E.; Roelofsen Moody, T.

2011-01-01

The National Academies are working with several other groups to develop new National Science Education Standards, with the intention that they will be adopted by all states. It is critical that the science education community uses these new standards when planning teacher professional development and understands the potential implementation challenges. As a first step in developing these new standards, the National Research Council (NRC) recently published a draft Framework for Science Education. This framework describes the major scientific ideas and practices that all students should be familiar with by the end of high school. Following recommendations from the NRC Report "Taking Science to School” (NRC, 2007), it emphasizes the importance of integrating science practices with the learning of science content. These same recommendations influenced the recently revised New Jersey Science Education Standards. Thus, the revised New Jersey standards can be valuable as a case study for curriculum developers and professional development providers. While collaborating with the New Jersey Department of Education on the development of these revised science standards, we identified two critical needs for successful implementation. First, we found that many currently used science activities must be adapted to meet the revised standards and that new activities must be developed. Second, teacher professional development is needed to model the integration of science practices with the learning of science content. With support from the National Space Grant Foundation we developed a week-long Astronomy Institute, which was presented in the summers of 2009 and 2010. We will briefly describe our professional development model and how it helped teachers to bridge the gap between the standards and their current classroom practice. We will provide examples of astronomy activities that were either adapted or developed to meet the new standards. Finally, we will briefly discuss the evaluation results.

Pharmacist perceptions of new competency standards

PubMed Central

Maitreemit, Pagamas; Pongcharoensuk, Petcharat; Kapol, Nattiya; Armstrong, Edward P.

2008-01-01

Objective To suggest revisions to the Thai pharmacy competency standards and determine the perceptions of Thai pharmacy practitioners and faculty about the proposed pharmacy competency standards. Methods The current competency standards were revised by brainstorming session with nine Thai pharmacy experts according to their perceptions of society’s pharmacy needs. The revised standards were proposed and validated by 574 pharmacy practitioners and faculty members by using a written questionnaire. The respondents were classified based on their practice setting. Results The revision of pharmacy competency standard proposed the integration and addition to current competencies. Of 830 distributed questionnaires, 574 completed questionnaires were received (69.2% response rate). The proposed new competency standards contained 7 domains and 46 competencies. The majority of the respondents were supportive of all 46 proposed competencies. The highest ranked domain was Domain 1 (Practice Pharmacy within Laws, Professional Standards, and Ethics). The second and third highest expectations of pharmacy graduates were Domain 4 (Provide pharmaceutical care) and Domain 3 (Communicate and disseminate knowledge effectively). Conclusion The expectation for pharmacy graduates’ competencies were high and respondents encouraged additional growth in multidisciplinary efforts to improve patient care. PMID:25177401

What If? Promising Practices for Improving Schools

ERIC Educational Resources Information Center

Dunn, Rita, Ed.; Griggs, Shirley A., Ed.

2007-01-01

Today, there is little deviation from the standard, business-as-usual practices in the world of education. This book challenges these stale practices and asks the important questions that can improve schools beyond the current state of mediocrity. Written for administrators, supervisors, teachers, parents--even politicians and corporate…

Retrospection and Reflection: The Emerging Influence of an Institutional Professional Recognition Scheme on Professional Development and Academic Practice in a UK University

ERIC Educational Resources Information Center

van der Sluis, Hendrik; Burden, Penny; Huet, Isabel

2017-01-01

Raising the quality and profile of teaching and student learning is something universities across the UK are aspiring to achieve in order to maintain reputations. Currently, the UK Professional Standards Framework (UKPSF) provides a standard by which academic staff can gain professional recognition for their academic practice and many UK…

Creating Standards-Based Technology Education Facilities

ERIC Educational Resources Information Center

Daugherty, Michael K.; Klenke, Andrew M.; Neden, Michael

2008-01-01

One of the most intimidating tasks faced by new or practicing technology education teachers is the challenge of creating new facilities or renovating current facilities for a new purpose. While the fourth program standard in "Advancing Excellence in Technological Literacy: Student Assessment, Professional Development, and Program Standards (AETL)"…

Identifying g: A Review of Current Factor Analytic Practices in the Science of Mental Abilities

ERIC Educational Resources Information Center

Reeve, Charlie L.; Blacksmith, Nikki

2009-01-01

Factor analysis is arguably one of the most important tools in the science of mental abilities. While many studies have been conducted to make recommendations regarding "best practices" concerning its use, it is unknown the degree to which contemporary ability researchers abide by those standards. The current study sought to evaluate the typical…

Water Management of Noninsulating and Insulating Sheathings

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

Smegal, J.; Lstiburek, J.

2012-04-01

There is an increasing market in liquid (or fluid) applied water management barriers for residential applications that could be used in place of tapes and other self-adhering membranes if applied correctly, especially around penetrations in the enclosure. This report discusses current best practices, recommends ways in which the best practices can be improved, and looks at some current laboratory testing and testing standards.

Evidence-based practice for pain identification in cognitively impaired nursing home residents.

PubMed

Sacoco, Christina; Ishikawa, Sally

2014-09-01

Pain identification of cognitively impaired elderly is very challenging. This project aimed to identify best practices for pain assessment in nursing home residents with cognitive impairment and to establish a standardized pain assessment guide to optimize nursing practice and resident outcomes. The Iowa Model of Evidence-Based Practice to Promote Quality of Care guided the project's process. Phase I of the project analyzed data gained from chart reviews on current practices of pain assessment, and Phase II used the results of Phase I to develop, implement, and evaluate an evidence-based practice standard for nursing assessment of pain for cognitively impaired residents. Copyright © 2014 Elsevier Inc. All rights reserved.

16 CFR 18.4 - Size and grade designations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Size and grade designations. 18.4 Section 18.4 Commercial Practices FEDERAL TRADE COMMISSION GUIDES AND TRADE PRACTICE RULES GUIDES FOR THE... consensus of the industry that the grade and size standard set forth in the current edition of American...

The New Racism in Education.

ERIC Educational Resources Information Center

Pressman, Harvey; Gartner, Alan

1986-01-01

Discusses the current practice in the U.S. of standardized testing of teachers as a response to the perceived failures of public schools. Focuses on the position that this practice reduces the already low percentage of minority teachers in the schools. Reviews testing practices in various states and the consequences encountered. (SA)

Clinical Supervision for School Psychologists: National Practices, Trends and Future Implications.

ERIC Educational Resources Information Center

Fischetti, Barbara A.; Crespi, Tony D.

1999-01-01

Survey assesses current practice trends in the clinical supervision of school psychologists. Data indicates that while ten percent of practicing school psychologists were participating in individual and/or group clinical supervision nationwide, respondents were receiving less supervision than recommended by APA or NASP professional standards.…

Guide for curing of Portland cement concrete pavements : volume II.

DOT National Transportation Integrated Search

2006-08-01

Information on the current state of knowledge of curing hydraulic-cement concrete and on current curing practice : was gathered by means of a literature review and a review of current standard guidance. From this information, a : draft guide for curi...

Paramedic specialization: a strategy for better out-of-hospital care.

PubMed

Caffrey, Sean M; Clark, John R; Bourn, Scott; Cole, Jim; Cole, John S; Mandt, Maria; Murray, Jimm; Sibold, Harry; Stuhlmiller, David; Swanson, Eric R

2014-01-01

Demographic, economic, and political forces are driving significant change in the US health care system. Paramedics are a health profession currently providing advanced emergency care and medical transportation throughout the United States. As the health care system demands more team-based care in nonacute, community, interfacility, and tactical response settings, specialized paramedic practitioners could be a valuable and well-positioned resource to meet these needs. Currently, there is limited support for specialty certifications that demand appropriate education, training, or experience standards before specialized practice by paramedics. A fragmented approach to specialty paramedic practice currently exists across our country in which states, regulators, nonprofit organizations, and other health care professions influence and regulate the practice of paramedicine. Multiple other medical professions, however, have already developed effective systems over the last century that can be easily adapted to the practice of paramedicine. Paramedicine practitioners need to organize a profession-based specialty board to organize and standardize a specialty certification system that can be used on a national level. Copyright © 2014 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

15 CFR 10.0 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... current with respect to advancing technology and marketing practices. (e) Role of the National Institute of Standards & Technology. The National Institute of Standards & Technology (NIST) administers these... document; (8) Administers the funds for administrative and technical support services; and (9) Seeks...

Plastic and reconstructive robotic microsurgery--a review of current practices.

PubMed

Saleh, D B; Syed, M; Kulendren, D; Ramakrishnan, V; Liverneaux, P A

2015-08-01

We sought to review the current state of robotics in this specialty. A Pubmed and Medline search was performed using key search terms for a comprehensive review of the whole cross-section of plastic and reconstructive practice. Overall, 28 publications specific to robotic plastic and reconstructive procedures were suitable for appraisal. The current evidence suggests robotics is comparable to standard methods despite its infancy. The possible applications are wide and could translate into superior patient outcomes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Current State of Test Development, Administration, and Analysis: A Study of Faculty Practices.

PubMed

Bristol, Timothy J; Nelson, John W; Sherrill, Karin J; Wangerin, Virginia S

Developing valid and reliable test items is a critical skill for nursing faculty. This research analyzed the test item writing practice of 674 nursing faculty. Relationships between faculty characteristics and their test item writing practices were analyzed. Findings reveal variability in practice and a gap in implementation of evidence-based standards when developing and evaluating teacher-made examinations.

Discharge communication from inpatient care: an audit of written medical discharge summary procedure against the new National Health Service Standard for clinical handover.

PubMed

Reid, Daniel Brooks; Parsons, Shaun R; Gill, Stephen D; Hughes, Andrew J

2015-04-01

To audit written medical discharge summary procedure and practice against Standard Six (clinical handover) of the Australian National Safety and Quality Health Service Standards at a major regional Victorian health service. Department heads were invited to complete a questionnaire about departmental discharge summary practices. Twenty-seven (82%) department heads completed the questionnaire. Seven (26%) departments had a documented discharge summary procedure. Fourteen (52%) departments monitored discharge summary completion and 13 (48%) departments monitored the timeliness of completion. Seven (26%) departments informed the patient of the content of the discharge summary and six (22%) departments provided the patient with a copy. Seven (26%) departments provided training for staff members on how to complete discharge summaries. Completing discharge summaries was usually delegated to the medical intern. The introduction of the National Service Standards prompted an organisation-wide audit of discharge summary practices against the external criterion. There was substantial variation in the organisation's practices. The Standards and the current audit results highlight an opportunity for the organisation to enhance and standardise discharge summary practices and improve communication with general practice.

Emerging Evidence for Instructional Practice: Repeated Viewings of Sign Language Models

ERIC Educational Resources Information Center

Beal-Alvarez, Jennifer S.; Huston, Sandra G.

2014-01-01

Current initiatives in education, such as No Child Left Behind and the National Common Core Standards movement, call for the use of evidence-based practices, or those instructional practices that are supported by documentation of their effectiveness related to student learning outcomes, including students with special needs. While hearing loss is…

Investigating Teachers' Beliefs about the Utility of Epistemic Practices: A Pilot Study of a New Assessment

ERIC Educational Resources Information Center

Hennessey, Maeghan N.; Murphy, P. Karen; Kulikowich, Jonna M.

2013-01-01

Much current research has focused on epistemic beliefs of students. However, teachers' epistemic practices are also important to study because they may influence students' epistemic beliefs. The standards for justification for different content areas necessitate that teachers use diverse pedagogical practices designed to help students develop…

Comparison of current practices of cardiopulmonary perfusion technology in Iran with American Society of Extracorporeal Technology's standards.

PubMed

Faravan, Amir; Mohammadi, Nooredin; Alizadeh Ghavidel, Alireza; Toutounchi, Mohammad Zia; Ghanbari, Ameneh; Mazloomi, Mehran

2016-01-01

Standards have a significant role in showing the minimum level of optimal optimum and the expected performance. Since the perfusion technology staffs play an the leading role in providing the quality services to the patients undergoing open heart surgery with cardiopulmonary bypass machine, this study aimed to assess the standards on how Iranian perfusion technology staffs evaluate and manage the patients during the cardiopulmonary bypass process and compare their practice with the recommended standards by American Society of Extracorporeal Technology. In this descriptive study, data was collected from 48 Iranian public hospitals and educational health centers through a researcher-created questionnaire. The data collection questionnaire assessed the standards which are recommended by American Society of Extracorporeal Technology. Findings showed that appropriate measurements were carried out by the perfusion technology staffs to prevent the hemodilution and avoid the blood transfusion and unnecessary blood products, determine the initial dose of heparin based on one of the proposed methods, monitor the anticoagulants based on ACT measurement, and determine the additional doses of heparin during the cardiopulmonary bypass based on ACT or protamine titration. It was done only in 4.2% of hospitals and health centers. Current practices of cardiopulmonary perfusion technology in Iran are inappropriate based on the standards of American Society of Cardiovascular Perfusion. This represents the necessity of authorities' attention to the validation programs and development of the caring standards on one hand and continuous assessment of using these standards on the other hand.

The U.S. Forest Service's analysis of cumulative effects to wildlife: A study of legal standards, current practice, and ongoing challenges on a National Forest

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

Schultz, Courtney A., E-mail: courtney.schultz@colostate.edu

Cumulative effects analysis (CEA) allows natural resource managers to understand the status of resources in historical context, learn from past management actions, and adapt future activities accordingly. U.S. federal agencies are required to complete CEA as part of environmental impact assessment under the National Environmental Policy Act (NEPA). Past research on CEA as part of NEPA has identified significant deficiencies in CEA practice, suggested methodologies for handling difficult aspects of CEA, and analyzed the rise in litigation over CEA in U.S. courts. This article provides a review of the literature and legal standards related to CEA as it is donemore » under NEPA and then examines current practice on a U.S. National Forest, utilizing qualitative methods in order to provide a detailed understanding of current approaches to CEA. Research objectives were to understand current practice, investigate ongoing challenges, and identify impediments to improvement. Methods included a systematic review of a set of NEPA documents and semi-structured interviews with practitioners, scientists, and members of the public. Findings indicate that the primary challenges associated with CEA include: issues of both geographic and temporal scale of analysis, confusion over the purpose of the requirement, the lack of monitoring data, and problems coordinating and disseminating data. Improved monitoring strategies and programmatic analyses could support improved CEA practice.« less

Determination of death after circulatory arrest by intensive care physicians: A survey of current practice in the Netherlands.

PubMed

Wind, Jentina; van Mook, Walther N K A; Dhanani, Sonny; van Heurn, Ernest W L

2016-02-01

Determination of death is an essential part of donation after circulatory death (DCD). We studied the current practices of determination of death after circulatory arrest by intensive care physicians in the Netherlands, the availability of guidelines, and the occurrence of the phenomenon of autoresuscitation. The Determination of Cardiac Death Practices in Intensive Care Survey was sent to all intensive care physicians. Fifty-five percent of 568 Dutch intensive care physicians responded. Most respondents learned death determination from clinical practice. The most commonly used tests for death determination were flat arterial line tracing, flat electrocardiogram (standard 3-lead electrocardiogram), and fixed and dilated pupils. Rarely used tests were absence pulse by echo Doppler, absent blood pressure by noninvasive monitoring, and unresponsiveness to painful stimulus. No diagnostic test or procedure was uniformly performed, but 80% of respondents perceived a need for standardization of death determination. Autoresuscitation was witnessed by 37%, after withdrawal of treatment or after unsuccessful resuscitation. Extensive variability in the practice of determining death after circulatory arrest exists, and a need for guidelines and standardization, especially if organ donation follows death, is reported. Autoresuscitation is reported; this observation requires attention in further prospective observational studies. Copyright © 2015 Elsevier Inc. All rights reserved.

Development of clinical practice guidelines.

PubMed

Hollon, Steven D; Areán, Patricia A; Craske, Michelle G; Crawford, Kermit A; Kivlahan, Daniel R; Magnavita, Jeffrey J; Ollendick, Thomas H; Sexton, Thomas L; Spring, Bonnie; Bufka, Lynn F; Galper, Daniel I; Kurtzman, Howard

2014-01-01

Clinical practice guidelines (CPGs) are intended to improve mental, behavioral, and physical health by promoting clinical practices that are based on the best available evidence. The American Psychological Association (APA) is committed to generating patient-focused CPGs that are scientifically sound, clinically useful, and informative for psychologists, other health professionals, training programs, policy makers, and the public. The Institute of Medicine (IOM) 2011 standards for generating CPGs represent current best practices in the field. These standards involve multidisciplinary guideline development panels charged with generating recommendations based on comprehensive systematic reviews of the evidence. The IOM standards will guide the APA as it generates CPGs that can be used to inform the general public and the practice community regarding the benefits and harms of various treatment options. CPG recommendations are advisory rather than compulsory. When used appropriately, high-quality guidelines can facilitate shared decision making and identify gaps in knowledge.

Evaluation of LOINC for Representing Constitutional Cytogenetic Test Result Reports

PubMed Central

Heras, Yan Z.; Mitchell, Joyce A.; Williams, Marc S.; Brothman, Arthur R.; Huff, Stanley M.

2009-01-01

Genetic testing is becoming increasingly important to medical practice. Integrating genetics and genomics data into electronic medical records is crucial in translating genetic discoveries into improved patient care. Information technology, especially Clinical Decision Support Systems, holds great potential to help clinical professionals take full advantage of genomic advances in their daily medical practice. However, issues relating to standard terminology and information models for exchanging genetic testing results remain relatively unexplored. This study evaluates whether the current LOINC standard is adequate to represent constitutional cytogenetic test result reports using sample result reports from ARUP Laboratories. The results demonstrate that current standard terminology is insufficient to support the needs of coding cytogenetic test results. The terminology infrastructure must be developed before clinical information systems will be able to handle the high volumes of genetic data expected in the near future. PMID:20351857

Evaluation of LOINC for representing constitutional cytogenetic test result reports.

PubMed

Heras, Yan Z; Mitchell, Joyce A; Williams, Marc S; Brothman, Arthur R; Huff, Stanley M

2009-11-14

Genetic testing is becoming increasingly important to medical practice. Integrating genetics and genomics data into electronic medical records is crucial in translating genetic discoveries into improved patient care. Information technology, especially Clinical Decision Support Systems, holds great potential to help clinical professionals take full advantage of genomic advances in their daily medical practice. However, issues relating to standard terminology and information models for exchanging genetic testing results remain relatively unexplored. This study evaluates whether the current LOINC standard is adequate to represent constitutional cytogenetic test result reports using sample result reports from ARUP Laboratories. The results demonstrate that current standard terminology is insufficient to support the needs of coding cytogenetic test results. The terminology infrastructure must be developed before clinical information systems will be able to handle the high volumes of genetic data expected in the near future.

The contested space: The impact of competency-based education and accreditation on dietetic practice in Australia.

PubMed

Ash, Susan; Palermo, Claire; Gallegos, Danielle

2018-05-06

Competency-based Education (CBE) has underpinned the education of dietitians in Australia since the first Competency Standards (CS) were published; however, little is known about how CBE has influenced dietetic practice. The aim of this paper is to explore how a CBE framework and the CS have influenced dietetic practice in Australia since 1990. A qualitative investigation explored concepts of dietetic practice. Data analysed were original interviews previously undertaken with recent graduate dietitians during 1991 (n = 26), 1998 (n = 23) and 2007 (n = 19) and seven guided discussions with dietitians and employers (n = 28) conducted in 2014 to identify themes. The DAA Competency Standards and Accreditation Manuals/Standards since 1990 were also analysed to triangulate the interview data and to investigate how the CS were interpreted. Themes identified from interviews included: (i) communicating for better care, (ii) scientific enquiry for effective practice, (iii) critical thinking and evidence-based practice and (iv) professionalism, which remained core to dietetic practice over time, but leadership, advocacy, business management and entrepreneurial skills have emerged more strongly as the scope of practice has diversified. The landscape in which dietitians' practice showed increasing complexity and clear boundaries separating professional roles were disappearing. The 2015 CS and the 2017 Accreditation Standards highlighted that competency remains a shifting construct and that professional behaviours change depending on economic and political reasons in the play of power. Accreditation policy and current standards have successfully maintained a standard of dietetic practice across a diverse country but have the potential to constrain innovation. © 2018 Dietitians Association of Australia.

Mandatory Certification Needed in Librarianship.

ERIC Educational Resources Information Center

Williams, Benjamin R.

This report on the need for compulsory, standardized procedures for the certification of librarians (1) provides an historical overview of the subject; (2) identifies three types of certification: compulsory, permissive, and voluntary; (3) outlines current certification practices, requirements, and standards for school librarians; (4) reviews the…

The Status of Secondary Science Education in the United States: Factors That Predict Practice

ERIC Educational Resources Information Center

Smith, Adrienne A.; Banilower, Eric R.; Nelson, Michele M.; Smith, P. Sean

2013-01-01

New K-12 science education standards emphasize teaching and learning grounded in authentic scientific practices. A first step toward supporting teachers' adoption of scientific practice-based pedagogies is to develop a clear picture of how teachers are currently teaching science, and what factors predict their pedagogical choices. A recently…

Un-Standardizing Curriculum: Multicultural Teaching in the Standards-Based Classroom. Second Edition. Multicultural Education Series

ERIC Educational Resources Information Center

Sleeter, Christine E.; Carmona, Judith Flores

2016-01-01

In this second edition of her bestseller, Christine Sleeter and new coauthor Judith Flores Carmona show how educators can learn to teach rich, academically rigorous, multicultural curricula within a standards-based environment. The authors have meticulously updated each chapter to address current changes in education policy and practice. New…

CWLA Standards of Excellence for Services for Abused or Neglected Children and Their Families. Revised Edition.

ERIC Educational Resources Information Center

Child Welfare League of America, Inc., Washington, DC.

Child welfare program standards based on current knowledge, children's developmental needs, and tested ways of meeting these needs most effectively provide benchmarks of excellence that can be used as goals to advance and guide contemporary practice. This book delineates standards for services for abused or neglected children and their families.…

Experimenting Design and Implementation of an Educational Services Management System Based on ISO/IEC 20000 Standard

NASA Astrophysics Data System (ADS)

Lezcano, Jean-Marc; Adachihara, Hatsuo; Prunier, Marc

European higher education organizations are encouraged to implement quality management practices. Existing quality standards and frameworks do not capitalize an important set of best practices addressing educational services delivery. The ISO/IEC 20000 standard, elaborated from IT service management issues, is widening its field of application and may represent an interesting alternative. A specific approach is needed to apprehend the particular nature of educational services, consider the systemic cooperating roles of educational system and learning system, and define ISO/IEC 20000 vocabulary and concepts adapted to the domain. ISO/IEC 20000 may provide an answer to European Standard Guideline compliance and improve educational services management. The current experimentation is expected to cast light on the complexity, practicality and effectiveness of the use of ISO/IEC 20000 in a first field of "non IT" services.

Social work practice in the digital age: therapeutic e-mail as a direct practice methodology.

PubMed

Mattison, Marian

2012-07-01

The author addresses the risks and benefits of incorporating therapeutic e-mail communication into clinical social work practice. Consumer demand for online clinical services is growing faster than the professional response. E-mail, when used as an adjunct to traditional meetings with clients, offers distinct advantages and risks. Benefits include the potential to reach clients in geographically remote and underserved communities, enhancing and extending the therapeutic relationship and improving treatment outcomes. Risks include threats to client confidentiality and privacy, liability coverage for practitioners, licensing jurisdiction, and the lack of competency standards for delivering e-mail interventions. Currently, the social work profession does not have adequate instructive guidelines and best-practice standards for using e-mail as a direct practice methodology. Practitioners need (formal) academic training in the techniques connected to e-mail exchanges with clients. The author describes the ethical and legal risks for practitioners using therapeutic e-mail with clients and identifies recommendations for establishing best-practice standards.

Non-Standard Assessment Practices in the Evaluation of Communication in Australian Aboriginal Children

ERIC Educational Resources Information Center

Gould, Judith

2008-01-01

Australian Aboriginal children typically receive communication assessment services from Standard Australian English (SAE) speaking non-Aboriginal speech-language pathologists (SLPs). Educational assessments, including intelligence testing, are also primarily conducted by non-Aboriginal educational professionals. While the current paper will show…

What Should Common Core Assessments Measure?

ERIC Educational Resources Information Center

Chandler, Kayla; Fortune, Nicholas; Lovett, Jennifer N.; Scherrer, Jimmy

2016-01-01

The Common Core State Standards for mathematics promote ideals about learning mathematics by providing specific standards focused on conceptual understanding and incorporating practices in which students must participate to develop conceptual understanding. Thus, how we define learning is pivotal because our current definition isn't aligned with…

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.

Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada.

PubMed

Sibley, Kathryn M; Straus, Sharon E; Inness, Elizabeth L; Salbach, Nancy M; Jaglal, Susan B

2013-03-20

Balance impairment is common in multiple clinical populations, and comprehensive assessment is important for identifying impairments, planning individualized treatment programs, and evaluating change over time. However, little information is available regarding whether clinicians who treat balance are satisfied with existing assessment tools. In 2010 we conducted a cross-sectional survey of balance assessment practices among physiotherapists in Ontario, Canada, and reported on the use of standardized balance measures (Sibley et al. 2011 Physical Therapy; 91: 1583-91). The purpose of this study was to analyse additional survey data and i) evaluate satisfaction with current balance assessment practices and standardized measures among physiotherapists who treat adult or geriatric populations with balance impairment, and ii) identify factors associated with satisfaction. The questionnaire was distributed to 1000 practicing physiotherapists. This analysis focuses on questions in which respondents were asked to rate their general perceptions about balance assessment, the perceived utility of individual standardized balance measures, whether they wanted to improve balance assessment practices, and why. Data were summarized with descriptive statistics and utility of individual measures was compared across clinical practice areas (orthopaedic, neurological, geriatric or general rehabilitation). The questionnaire was completed by 369 respondents, of which 43.4% of respondents agreed that existing standardized measures of balance meet their needs. In ratings of individual measures, the Single Leg Stance test and Berg Balance Scale were perceived as useful for clinical decision-making and evaluating change over time by over 70% of respondents, and the Timed Up-and-Go test was perceived as useful for decision-making by 56.9% of respondents and useful for evaluating change over time by 62.9% of respondents, but there were significant differences across practice groups. Seventy-nine percent of respondents wanted to improve their assessments, identifying individual, environmental and measure-specific barriers. The most common barriers were lack of time and knowledge. This study offers new information on issues affecting the evaluation of balance in clinical settings from a broad sample of physiotherapists. Continued work to address barriers by specific practice area will be critical for the success of any intervention attempting to implement optimal balance assessment practices in the clinical setting.

Terminal Area Productivity Program: Dynamic Spacing Human Factors

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.

1997-01-01

Dynamic spacing human factors deals with the following human factors issues: define controller limits to incorporating dynamic changes in separation standards; identify timing, planning, and coordination strategies; and consider consistency with current practices, policies, and regulations. The AVOSS technologies will make it possible to reduce separation standards in the terminal area under certain meteorological conditions. This paper contains the following sections: Dynamic space human factors overview, Preliminary tests, and current research status & plans.

Comparison of current practices of cardiopulmonary perfusion technology in Iran with American Society of Extracorporeal Technology’s standards

PubMed Central

Faravan, Amir; Mohammadi, Nooredin; Alizadeh Ghavidel, Alireza; Toutounchi, Mohammad Zia; Ghanbari, Ameneh; Mazloomi, Mehran

2016-01-01

Introduction: Standards have a significant role in showing the minimum level of optimal optimum and the expected performance. Since the perfusion technology staffs play an the leading role in providing the quality services to the patients undergoing open heart surgery with cardiopulmonary bypass machine, this study aimed to assess the standards on how Iranian perfusion technology staffs evaluate and manage the patients during the cardiopulmonary bypass process and compare their practice with the recommended standards by American Society of Extracorporeal Technology. Methods: In this descriptive study, data was collected from 48 Iranian public hospitals and educational health centers through a researcher-created questionnaire. The data collection questionnaire assessed the standards which are recommended by American Society of Extracorporeal Technology. Results: Findings showed that appropriate measurements were carried out by the perfusion technology staffs to prevent the hemodilution and avoid the blood transfusion and unnecessary blood products, determine the initial dose of heparin based on one of the proposed methods, monitor the anticoagulants based on ACT measurement, and determine the additional doses of heparin during the cardiopulmonary bypass based on ACT or protamine titration. It was done only in 4.2% of hospitals and health centers. Conclusion: Current practices of cardiopulmonary perfusion technology in Iran are inappropriate based on the standards of American Society of Cardiovascular Perfusion. This represents the necessity of authorities’ attention to the validation programs and development of the caring standards on one hand and continuous assessment of using these standards on the other hand. PMID:27489600

Instructional Guidelines. Welding.

ERIC Educational Resources Information Center

Fordyce, H. L.; Doshier, Dale

Using the standards of the American Welding Society and the American Society of Mechanical Engineers, this welding instructional guidelines manual presents a course of study in accordance with the current practices in industry. Intended for use in welding programs now practiced within the Federal Prison System, the phases of the program are…

Should PUS Standard Evolve?

NASA Astrophysics Data System (ADS)

Fourtier, Ph.; Nodet, J.; Garcia, G.

2008-08-01

Based on practical experience, the current paper presents position of Thales Alenia Space as a prime contractor, on the use of PUS standard. Questions have raised during past and present applications, which could be justifications for evolutions of the standard. This kind of reporting could be one of the entries for a reactivation of a working group on the PUS standard, taking into account significant experiences accumulated on diverse programs since early 2000.

A need for standardization in visual acuity measurement.

PubMed

Patel, Hina; Congdon, Nathan; Strauss, Glenn; Lansingh, Charles

2017-01-01

Standardization of terminologies and methods is increasingly important in all fields including ophthalmology, especially currently when research and new technology are rapidly driving improvements in medicine. This review highlights the range of notations used by vision care professionals around the world for vision measurement, and the challenges resulting from this practice. The global community is urged to move toward a uniform standard.

Listening to Early Career Teachers: How Can Elementary Mathematics Methods Courses Better Prepare Them to Utilize Standards-Based Practices in Their Classrooms?

ERIC Educational Resources Information Center

Coester, Lee Anne

2010-01-01

This study was designed to gather input from early career elementary teachers with the goal of finding ways to improve elementary mathematics methods courses. Multiple areas were explored including the degree to which respondents' elementary mathematics methods course focused on the NCTM Process Standards, the teachers' current standards-based…

21st Century Standards and Curriculum: Current Research and Practice

ERIC Educational Resources Information Center

Alismail, Halah Ahmed; McGuire, Patrick

2015-01-01

The integration of Common Core State Standards (CCSS) and 21st century skills in the curriculum is not only beneficial to students and teachers, but also necessary to prepare our youth for their future careers. In an age of education where standardized tests determine the success of our schools, it is important to allow students the creativity and…

Redefining the Practice of Peer Review Through Intelligent Automation Part 1: Creation of a Standardized Methodology and Referenceable Database.

PubMed

Reiner, Bruce I

2017-10-01

Conventional peer review practice is compromised by a number of well-documented biases, which in turn limit standard of care analysis, which is fundamental to determination of medical malpractice. In addition to these intrinsic biases, other existing deficiencies exist in current peer review including the lack of standardization, objectivity, retrospective practice, and automation. An alternative model to address these deficiencies would be one which is completely blinded to the peer reviewer, requires independent reporting from both parties, utilizes automated data mining techniques for neutral and objective report analysis, and provides data reconciliation for resolution of finding-specific report differences. If properly implemented, this peer review model could result in creation of a standardized referenceable peer review database which could further assist in customizable education, technology refinement, and implementation of real-time context and user-specific decision support.

40 CFR 469.24 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE CATEGORY... attainable by the application of the best practicable control technology currently available (BPT). Except as...

40 CFR 469.14 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE CATEGORY... by the application of the best practicable control technology currently available (BPT). Except as...

Your Science Classroom: Becoming an Elementary/Middle School Science Teacher

ERIC Educational Resources Information Center

Goldston, M. Jenice; Downey, Laura

2012-01-01

Designed around a practical "practice-what-you-teach" approach to methods instruction, "Your Science Classroom: Becoming an Elementary/Middle School Science Teacher" is based on current constructivist philosophy, organized around 5E inquiry, and guided by the National Science Education Teaching Standards. Written in a reader-friendly style, the…

40 CFR 429.171 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TIMBER PRODUCTS PROCESSING POINT SOURCE CATEGORY Wood Furniture... best practicable control technology currently available (BPT). Except as provided in 40 CFR 125.30...

40 CFR 429.161 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TIMBER PRODUCTS PROCESSING POINT SOURCE CATEGORY Wood Furniture... application of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

12 CFR 390.265 - Real estate lending standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... consistent with safe and sound banking practices; (ii) Be appropriate to the size of the institution and the... institution's policies must be comprehensive, and consistent with safe and sound lending practices, and must..., construction, and absorption rates. • Current and projected lease terms, rental rates, and sales prices...

12 CFR 390.265 - Real estate lending standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... consistent with safe and sound banking practices; (ii) Be appropriate to the size of the institution and the... institution's policies must be comprehensive, and consistent with safe and sound lending practices, and must..., construction, and absorption rates. • Current and projected lease terms, rental rates, and sales prices...

12 CFR 160.101 - Real estate lending standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... consistent with safe and sound banking practices; (ii) Be appropriate to the size of the institution and the... institution's policies must be comprehensive, and consistent with safe and sound lending practices, and must..., construction, and absorption rates. • Current and projected lease terms, rental rates, and sales prices...

12 CFR 160.101 - Real estate lending standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... consistent with safe and sound banking practices; (ii) Be appropriate to the size of the institution and the... institution's policies must be comprehensive, and consistent with safe and sound lending practices, and must..., construction, and absorption rates. • Current and projected lease terms, rental rates, and sales prices...

40 CFR 410.42 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Woven Fabric Finishing... application of the best practicable control technology currently available (BPT). (a) Except as provided in 40...

40 CFR 410.82 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Nonwoven Manufacturing... application of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

40 CFR 410.92 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Felted Fabric Processing... application of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

40 CFR 410.62 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Carpet Finishing... application of the best practicable control technology currently available (BPT). (a) Except as provided in 40...

40 CFR 410.12 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Wool Scouring Subcategory... application of the best practicable control technology currently available (BPT). (a) Except as provided in 40...

40 CFR 410.22 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Wool Finishing Subcategory... application of the best practicable control technology currently available (BPT). (a) Except as provided in 40...

40 CFR 469.14 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2013 CFR

2013-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE... reduction attainable by the application of the best practicable control technology currently available (BPT...

40 CFR 469.24 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2014 CFR

2014-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE... reduction attainable by the application of the best practicable control technology currently available (BPT...

40 CFR 469.24 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2012 CFR

2012-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE... reduction attainable by the application of the best practicable control technology currently available (BPT...

40 CFR 469.24 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2013 CFR

2013-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE... reduction attainable by the application of the best practicable control technology currently available (BPT...

40 CFR 469.14 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2012 CFR

2012-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE... reduction attainable by the application of the best practicable control technology currently available (BPT...

40 CFR 469.14 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2014 CFR

2014-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE... reduction attainable by the application of the best practicable control technology currently available (BPT...

40 CFR 469.24 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2011 CFR

2011-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE CATEGORY... attainable by the application of the best practicable control technology currently available (BPT). Except as...

40 CFR 469.14 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2011 CFR

2011-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE CATEGORY... by the application of the best practicable control technology currently available (BPT). Except as...

40 CFR 463.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... representing the degree of effluent reduction attainable by the application of the best practicable control... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS PLASTICS MOLDING AND FORMING POINT SOURCE CATEGORY... reduction attainable by the application of the best practicable control technology currently available...

40 CFR 463.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... representing the degree of effluent reduction attainable by the application of the best practicable control... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS PLASTICS MOLDING AND FORMING POINT SOURCE CATEGORY... reduction attainable by the application of the best practicable control technology currently available...

78 FR 46589 - Solicitation of Written Comments on the Draft Report of the National Adult Immunization Standards...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-01

... the National Adult Immunization Standards of Practice for Consideration by the National Vaccine... charged the NVAC with examining the current adult immunization environment by updating adult immunization... Services, 200 Independence Ave. SW., Room 745.H.5, Washington, DC 20201, Attention: Adult Immunization...

77 FR 6774 - United States Standards for Grades of Eggplant

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... that mixing colors and/or types of eggplant in a specialty pack is a current marketing practice. The U... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service [Doc. AMS-FV-11-0052] United States Standards for Grades of Eggplant AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice. SUMMARY: The...

Implementing Standards-Based Mathematics Instruction: A Casebook for Professional Development.

ERIC Educational Resources Information Center

Stein, Mary Kay; Smith, Margaret Schwan; Henningsen, Marjorie A.; Silver, Edward A.

Teachers and teacher educators interested in synthesizing their current practice with new mathematics standards will welcome this highly useful volume. The QUASAR Project at the University of Pittsburgh presents prevalent cases of mathematics instruction drawn from their research of nearly 500 classroom lessons. The Mathematical Tasks…

The role of MRI in musculoskeletal practice: a clinical perspective

PubMed Central

Dean Deyle, Gail

2011-01-01

This clinical perspective presents an overview of current and potential uses for magnetic resonance imaging (MRI) in musculoskeletal practice. Clinical practice guidelines and current evidence for improved outcomes will help providers determine the situations when an MRI is indicated. The advanced competency standard of examination used by physical therapists will be helpful to prevent overuse of musculoskeletal imaging, reduce diagnostic errors, and provide the appropriate clinical context to pathology revealed on MRI. Physical therapists are diagnostically accurate and appropriately conservative in their use of MRI consistent with evidence-based principles of diagnosis and screening. PMID:22851878

Sharing and re-use of phylogenetic trees (and associated data) to facilitate synthesis.

PubMed

Stoltzfus, Arlin; O'Meara, Brian; Whitacre, Jamie; Mounce, Ross; Gillespie, Emily L; Kumar, Sudhir; Rosauer, Dan F; Vos, Rutger A

2012-10-22

Recently, various evolution-related journals adopted policies to encourage or require archiving of phylogenetic trees and associated data. Such attention to practices that promote sharing of data reflects rapidly improving information technology, and rapidly expanding potential to use this technology to aggregate and link data from previously published research. Nevertheless, little is known about current practices, or best practices, for publishing trees and associated data so as to promote re-use. Here we summarize results of an ongoing analysis of current practices for archiving phylogenetic trees and associated data, current practices of re-use, and current barriers to re-use. We find that the technical infrastructure is available to support rudimentary archiving, but the frequency of archiving is low. Currently, most phylogenetic knowledge is not easily re-used due to a lack of archiving, lack of awareness of best practices, and lack of community-wide standards for formatting data, naming entities, and annotating data. Most attempts at data re-use seem to end in disappointment. Nevertheless, we find many positive examples of data re-use, particularly those that involve customized species trees generated by grafting to, and pruning from, a much larger tree. The technologies and practices that facilitate data re-use can catalyze synthetic and integrative research. However, success will require engagement from various stakeholders including individual scientists who produce or consume shareable data, publishers, policy-makers, technology developers and resource-providers. The critical challenges for facilitating re-use of phylogenetic trees and associated data, we suggest, include: a broader commitment to public archiving; more extensive use of globally meaningful identifiers; development of user-friendly technology for annotating, submitting, searching, and retrieving data and their metadata; and development of a minimum reporting standard (MIAPA) indicating which kinds of data and metadata are most important for a re-useable phylogenetic record.

Ethics and maternity care: from principles to practice.

PubMed

Lothian, Judith A

2009-01-01

In this column, the associate editor of The Journal of Perinatal Education (JPE) discusses the decision to devote an issue of JPE to the ethics of childbirth and maternity care. The current crisis in maternity care mandates a careful look at the ethical principles that provide the foundation for practice. The contents of this special issue include: a broad overview of ethics of childbearing, historical perspectives and contemporary understanding of informed decision making, the ethical issues faced by childbirth educators, and the challenges and moral distress experienced by childbirth educators and other maternity care providers when their values, beliefs, and ethical standards are in conflict with standard maternity care practices.

40 CFR 427.102 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... technology currently available. 427.102 Section 427.102 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ASBESTOS MANUFACTURING POINT SOURCE CATEGORY Vapor... reduction attainable by the application of the best practicable control technology currently available...

Maternal-Fetal Medicine Physician and Fellow Perceptions of Business in Medicine.

PubMed

Porter, Blake; Iriye, Brian; Ghamsary, Mark

2018-01-01

 Principles of practice management provide a foundation for clinical success and performance improvement. Scant data exist regarding maternal-fetal medicine (MFM) physicians' knowledge of these topics. We hypothesize that physicians enter practice with inadequate education in practice management.  Surveys were emailed to members of the Society for Maternal-Fetal Medicine rating their knowledge and capabilities in practice management topics, and respondents assessed their current institution's business in the medical curriculum.  A total of 325 (14.4%) physicians responded: 63 fellows in training and 262 MFM physician subspecialists. Practicing physicians reported learning most of their knowledge "in practice after fellowship" (85%) or "never at all" (10%). Only 3% of respondents had adequate business education during fellowship, and only 5% felt prepared to teach business principles. However, 85% of those surveyed agreed that this material should be taught during the fellowship. Among MFM subspecialists and fellows in training at institutions with fellowships, 60% reported no current curriculum for practice management, and those with current curricula reported it had "limited" or "no value" (76%).  There is a significant desire for practice management curricula during MFM fellowship, and current training is insufficient. With many MFM physicians ill-prepared to teach these principles, professional education from other financial fields, and standardized education in practice management from current expert sources is needed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Embracing Change: Adapting and Evolving Your Distance Learning Library Services to Meet the New ACRL Distance Learning Library Services Standards

ERIC Educational Resources Information Center

Marcum, Brad

2016-01-01

This article examines the update and revision of the current Association of College and Research Libraries (ACRL) Distance Learning Standards that has been proposed and submitted to the ACRL Standards Committee. An in-depth analysis of the update is included, along with some comparisons between the old and new. Practical advice detailing…

Reliability, Validity, and Factor Structure of the Current Assessment Practice Evaluation-Revised (CAPER) in a National Sample.

PubMed

Lyon, Aaron R; Pullmann, Michael D; Dorsey, Shannon; Martin, Prerna; Grigore, Alexandra A; Becker, Emily M; Jensen-Doss, Amanda

2018-05-11

Measurement-based care (MBC) is an increasingly popular, evidence-based practice, but there are no tools with established psychometrics to evaluate clinician use of MBC practices in mental health service delivery. The current study evaluated the reliability, validity, and factor structure of scores generated from a brief, standardized tool to measure MBC practices, the Current Assessment Practice Evaluation-Revised (CAPER). Survey data from a national sample of 479 mental health clinicians were used to conduct exploratory and confirmatory factor analyses, as well as reliability and validity analyses (e.g., relationships between CAPER subscales and clinician MBC attitudes). Analyses revealed competing two- and three-factor models. Regardless of the model used, scores from CAPER subscales demonstrated good reliability and convergent and divergent validity with MBC attitudes in the expected directions. The CAPER appears to be a psychometrically sound tool for assessing clinician MBC practices. Future directions for development and application of the tool are discussed.

Executable Architecture of Net Enabled Operations: State Machine of Federated Nodes

DTIC Science & Technology

2009-11-01

verbal descriptions from operators) of the current Command and Control (C2) practices into model form. In theory these should be Standard Operating...faudra une grande quantité de données pour faire en sorte que le modèle reflète les processus véritables, les auteurs recommandent que la machine à...descriptions from operators) of the current C2 practices into model form. In theory these should be SOPs that execute as a thread from start to finish. The

Standardized Effect Sizes for Moderated Conditional Fixed Effects with Continuous Moderator Variables

PubMed Central

Bodner, Todd E.

2017-01-01

Wilkinson and Task Force on Statistical Inference (1999) recommended that researchers include information on the practical magnitude of effects (e.g., using standardized effect sizes) to distinguish between the statistical and practical significance of research results. To date, however, researchers have not widely incorporated this recommendation into the interpretation and communication of the conditional effects and differences in conditional effects underlying statistical interactions involving a continuous moderator variable where at least one of the involved variables has an arbitrary metric. This article presents a descriptive approach to investigate two-way statistical interactions involving continuous moderator variables where the conditional effects underlying these interactions are expressed in standardized effect size metrics (i.e., standardized mean differences and semi-partial correlations). This approach permits researchers to evaluate and communicate the practical magnitude of particular conditional effects and differences in conditional effects using conventional and proposed guidelines, respectively, for the standardized effect size and therefore provides the researcher important supplementary information lacking under current approaches. The utility of this approach is demonstrated with two real data examples and important assumptions underlying the standardization process are highlighted. PMID:28484404

Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 Standards of Practice and Standards of Professional Performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

PubMed

Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

2014-09-01

Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

PubMed

Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

2014-09-01

Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Academic Research Record-Keeping: Best Practices for Individuals, Group Leaders, and Institutions

PubMed Central

Schreier, Alan A.; Wilson, Kenneth; Resnik, David

2014-01-01

During the last half of the 20th century, social and technological changes in academic research groups have challenged traditional research record-keeping practices, making them either insufficient or obsolete. New practices have developed but standards (best practices) are still evolving. Based on the authors’ review and analysis of a number of sources, they present a set of systematically compiled best practices for research record-keeping for academic research groups. These best practices were developed as an adjunct to a research project on research ethics aimed at examining the actual research record-keeping practices of active academic scientists and their impact on research misconduct inquiries. The best practices differentiate and provide separate standards for three different levels within the university: the individual researcher, the research group leader, and the department/institution. They were developed using a combination of literature reviews, surveys of university integrity officials, focus groups of active researchers, and inspection of university policies on research record-keeping. The authors believe these best practices constitute a “snapshot” of the current normative standards for research records within the academic research community. They are offered as ethical and practical guidelines subject to continuing evolution and not as absolute rules. They may be especially useful in training the next generation of researchers. PMID:16377817

Leveraging Observation Tools for Instructional Improvement: Exploring Variability in Uptake of Ambitious Instructional Practices

ERIC Educational Resources Information Center

Cohen, Julie; Schuldt, Lorien Chambers; Brown, Lindsay; Grossman, Pamela

2016-01-01

Background/Context: Current efforts to build rigorous teacher evaluation systems has increased interest in standardized classroom observation tools as reliable measures for assessing teaching. However, many argue these instruments can also be used to effect change in classroom practice. This study investigates a model of professional development…

On the Theoretical and Practical Consistency of Neoclassicism as a Theoretical Platform of Economic Disciplines

ERIC Educational Resources Information Center

Dyshaeva, Lyudmila

2017-01-01

The article discusses the scientific and practical validity of the neoclassical theory, which forms the basis of training courses in economic theory and institutional economics in accordance with the current Educational Standards of the Russian Federation. Critical analysis of the "supply economy" theory that emerged in line with…

Accounting practice diversity in the healthcare industry.

PubMed

Robbins, W A; Turpin, R

1993-05-01

A recent study examining accounting practices currently being used to prepare annual hospital financial statements indicates relatively little diversity, regardless of organizational type or size. The study's findings should interest those concerned with healthcare accounting and financial reporting issues, especially healthcare administrators and members of standards setting boards who participate in accounting policy deliberations.

40 CFR 440.142 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2011 CFR

2011-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ORE MINING AND DRESSING POINT SOURCE CATEGORY Gold Placer Mine... application of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

40 CFR 410.72 - Effluent limitations representing the degree of effluent reduction attainable by the application...

Code of Federal Regulations, 2010 CFR

2010-07-01

... degree of effluent reduction attainable by the application of the best practicable control technology... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Stock and Yarn Finishing... application of the best practicable control technology currently available (BPT). (a) Except as provided in 40...

A Humanizing Pedagogy: Reinventing the Principles and Practice of Education as a Journey toward Liberation

ERIC Educational Resources Information Center

Salazar, Maria del Carmen

2013-01-01

Students and educators are constrained from finding meaning in the current educational system as a result of the tension between educators' pedagogical practices and systemic constraints, such as high-stakes standardized tests and district-mandated instructional curriculum. Such restrictive educational policies limit educators from developing…

Evaluating the Strength of School Tobacco Policies: The Development of a Practical Rating System

ERIC Educational Resources Information Center

Boyce, Jennifer C.; Mueller, Nancy B.; Hogan-Watts, Melissa; Luke, Douglas A.

2009-01-01

Background: School tobacco control policies vary widely in their strength, extensiveness, and enforcement. Currently, no standardized method exists to assess the comprehensiveness of school tobacco policies. The purpose of this study was to develop a new practical rating system for school tobacco policies, assess its reliability, and present…

Science Curriculum Resource Handbook: A Practical Guide for K-12 Science Curriculum.

ERIC Educational Resources Information Center

Cheek, Dennis W., Ed.; And Others

This handbook is one of a series of practical references for curriculum developers, education faculty, veteran teachers, and student teachers. The handbook is designed to provide basic information on the background of the science curriculum, and current information on publications, standards, and special materials for K-12 science. Part 1 contains…

40 CFR 423.12 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... technology currently available (BPT). 423.12 Section 423.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS STEAM ELECTRIC POWER GENERATING POINT SOURCE... by the application of the best practicable control technology currently available (BPT). (a) In...

Preschool Teacher Well-Being: A Review of the Literature

ERIC Educational Resources Information Center

Hall-Kenyon, Kendra M.; Bullough, Robert V.; MacKay, Kathryn Lake; Marshall, Esther E.

2014-01-01

Much is changing in preschool education. Current reform primarily emphasizes standardized practice, academic outcomes, and accountability. Little attention has been given to how these changes are impacting the well-being of teachers. The purpose of this review is to summarize the current literature on preschool teacher well-being and identify…

40 CFR 434.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... technology currently available (BPT). 434.42 Section 434.42 Protection of Environment ENVIRONMENTAL... BPT, BAT, BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Alkaline Mine Drainage § 434.42... of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

40 CFR 434.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... technology currently available (BPT). 434.42 Section 434.42 Protection of Environment ENVIRONMENTAL... BPT, BAT, BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Alkaline Mine Drainage § 434.42... of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

40 CFR 434.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... technology currently available (BPT). 434.32 Section 434.32 Protection of Environment ENVIRONMENTAL..., BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Acid or Ferruginous Mine Drainage § 434.32... of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

40 CFR 434.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... technology currently available (BPT). 434.32 Section 434.32 Protection of Environment ENVIRONMENTAL..., BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Acid or Ferruginous Mine Drainage § 434.32... of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

40 CFR 434.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... technology currently available (BPT). 434.42 Section 434.42 Protection of Environment ENVIRONMENTAL... BPT, BAT, BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Alkaline Mine Drainage § 434.42... of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

A Tool for Estimating Variability in Wood Preservative Treatment Retention

Treesearch

Patricia K. Lebow; Adam M. Taylor; Timothy M. Young

2015-01-01

Composite sampling is standard practice for evaluation of preservative retention levels in preservative-treated wood. Current protocols provide an average retention value but no estimate of uncertainty. Here we describe a statistical method for calculating uncertainty estimates using the standard sampling regime with minimal additional chemical analysis. This tool can...

77 FR 56251 - Aviation Rulemaking Advisory Committee (ARAC); New Task Assignment for the ARAC: Establishment of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-12

... with the Airman Certification Standards documents; and to propose knowledge test item bank questions... ensure that knowledge test item bank questions are consistent with both the Airman Certification... knowledge and risk management into each Area of Operation in the current Practical Test Standards documents...

Evaluating and Training Substance Abuse Counselors: A Pilot Study Assessing Standardized Patients as Authentic Clients

ERIC Educational Resources Information Center

Fussell, Holly E.; Lewy, Colleen S.; McFarland, Bentson H.

2009-01-01

Clinician training and supervision are needed to transfer evidence-based practices to community-based treatment organizations. Standardized patients (SPs) are used for clinician training and evaluating. However, to be effective for substance abuse counselors, SPs must realistically portray substance abuse treatment clients. The current study…

Defining the Path Forward: Guidance for Laboratory Medicine Guidelines

PubMed Central

Jones, Patricia M.; Chin, Alex C.; Christenson, Robert H.

2015-01-01

The National Academy of Clinical Biochemistry (NACB) has developed consensus-based guidelines for the laboratory evaluation and monitoring of patients with specified disorders for two decades. In 1997, the NACB recognized the need to standardize the process of guideline development and promulgated its first Standard Operating Procedure (SOP) for this purpose. In 2010, the American Association of Clinical Chemistry (AACC) and NACB created the Evidence-Based Laboratory Medicine Committee (EBLMC). Among other roles, this group was given responsibility to provide oversight of clinical practice guideline development in accordance with SOP guidance and using currently accepted good practices. In 2011, the U.S. Institute of Medicine (IOM) published two reports of relevance: ‘Clinical Practice Guidelines We Can Trust’ and ‘Finding What Works in Health Care – Standards for Systematic Reviews.’ These reports were created as part of a response to a legislative mandate from the U.S. Congress requesting that steps be taken to implement recommendations from lOM’s report on ‘Knowing What Works in Health Care’ (2008). The latest revision of the laboratory medicine practice guidelines (LMPG) SOP was in part driven by these reports. NACB continues to develop LMPGs at a rate of roughly one per year through standard processes detailed in its 2014 revision of the SOP. This article describes the NACB and EBLMC experience in developing LMPGs with a focus on the evolution and use of the latest SOP. AACC and NACB have established a solid track record in collaboratively working with many clinical societies and professional organizations on clinical practice guideline development. Presently, three LMPG’s are in various stages of development and all with the collaboration of other clinical/professional groups. The practices and tools being used for current LMPGs in progress are also highlighted in the context of the challenges that presently exist for effective clinical practice guideline development in the U.S. PMID:27683491

Comparative effect of integrated pest management and farmers' standard pest control practice for managing insect pests on cabbage (Brassica spp.).

PubMed

Reddy, Gadi V P

2011-08-01

Studies were conducted on experimental cabbage plantings in 2009 and on experimental and commercial plantings in 2010, comparing farmers' current chemical standard pesticide practices with an integrated pest management (IPM) program based on the use of neem (Aza-Direct) and DiPel (Bacillus thuringiensis). In experimental plantings, the IPM program used six or eight applications of neem and DiPel on a rotational basis. The standard-practice treatments consisted of six or eight applications of carbaryl and malathion or control treatment. The IPM treatments reduced pest populations and damage, resulting in a better yield than with the standard chemical or control treatment. When IPM treatment included three applications of neem plus three applications of DiPel (on a rotational basis in experimental fields), it again reduced the pest population and damage and produced a better yield than the standard practice. The lower input costs of the IPM program resulted in better economic returns in both trials. The IPM components neem and DiPel are suitable for use in an IPM program for managing insect pests on cabbage (Brassica spp.). Copyright © 2011 Society of Chemical Industry.

Atrial Arrhythmias and Their Implications for Space Flight - Introduction

NASA Technical Reports Server (NTRS)

Polk, J. D.; Barr, Y. R.; Bauer, P.; Hamilton, D. R.; Kerstman, E.; Tarver, B.

2010-01-01

This panel will discuss the implications of atrial arrhythmias in astronauts from a variety of perspectives; including historical data, current practices, and future challenges for exploration class missions. The panelists will present case histories, outline the evolution of current NASA medical standards for atrial arrhythmias, discuss the use of predictive tools, and consider potential challenges for current and future missions.

Formal Verification for a Next-Generation Space Shuttle

NASA Technical Reports Server (NTRS)

Nelson, Stacy D.; Pecheur, Charles; Koga, Dennis (Technical Monitor)

2002-01-01

This paper discusses the verification and validation (V&2) of advanced software used for integrated vehicle health monitoring (IVHM), in the context of NASA's next-generation space shuttle. We survey the current VBCV practice and standards used in selected NASA projects, review applicable formal verification techniques, and discuss their integration info existing development practice and standards. We also describe two verification tools, JMPL2SMV and Livingstone PathFinder, that can be used to thoroughly verify diagnosis applications that use model-based reasoning, such as the Livingstone system.

A Clinician-Centered Evaluation of the Usability of AHLTA and Automated Clinical Practice Guidelines at TAMC

DTIC Science & Technology

2011-03-31

evidence based medicine into clinical practice. It will decrease costs and enable multiple stakeholders to work in an open content/source environment to exchange clinical content, develop and test technology and explore processes in applied CDS. Design: Comparative study between the KMR infrastructure and capabilities developed as an open source, vendor agnostic solution for aCPG execution within AHLTA and the current DoD/MHS standard evaluating: H1: An open source, open standard KMR and Clinical Decision Support Engine can enable organizations to share domain

Fundamental contradictions in cultural competence.

PubMed

Johnson, Yvonne M; Munch, Shari

2009-07-01

Cultural competence (CC) is considered highly relevant to social work practice with clients belonging to ethnic and racial minority groups, as the burgeoning literature and creation of practice standards on CC attest. However, examination of the conceptual underpinnings of CC reveals several major anomalies. The authors argue that several aspects of CC contradict central social work concepts or are at odds with current, standard social work practice. These contradictions extend to the epistemological foundations of CC and the rights and dignity of the individual. To further stress the conceptual tensions at the heart of CC, the authors incorporate recent philosophical work addressing collective identities and group rights. The question of whether culturally competent practice is achievable is also addressed. The authors urge academicians and practitioners to thoroughly examine the theoretical and ethical bases of CC because of their highly important ramifications for social work practice.

Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada

PubMed Central

2013-01-01

Background Balance impairment is common in multiple clinical populations, and comprehensive assessment is important for identifying impairments, planning individualized treatment programs, and evaluating change over time. However, little information is available regarding whether clinicians who treat balance are satisfied with existing assessment tools. In 2010 we conducted a cross-sectional survey of balance assessment practices among physiotherapists in Ontario, Canada, and reported on the use of standardized balance measures (Sibley et al. 2011 Physical Therapy; 91: 1583-91). The purpose of this study was to analyse additional survey data and i) evaluate satisfaction with current balance assessment practices and standardized measures among physiotherapists who treat adult or geriatric populations with balance impairment, and ii) identify factors associated with satisfaction. Methods The questionnaire was distributed to 1000 practicing physiotherapists. This analysis focuses on questions in which respondents were asked to rate their general perceptions about balance assessment, the perceived utility of individual standardized balance measures, whether they wanted to improve balance assessment practices, and why. Data were summarized with descriptive statistics and utility of individual measures was compared across clinical practice areas (orthopaedic, neurological, geriatric or general rehabilitation). Results The questionnaire was completed by 369 respondents, of which 43.4% of respondents agreed that existing standardized measures of balance meet their needs. In ratings of individual measures, the Single Leg Stance test and Berg Balance Scale were perceived as useful for clinical decision-making and evaluating change over time by over 70% of respondents, and the Timed Up-and-Go test was perceived as useful for decision-making by 56.9% of respondents and useful for evaluating change over time by 62.9% of respondents, but there were significant differences across practice groups. Seventy-nine percent of respondents wanted to improve their assessments, identifying individual, environmental and measure-specific barriers. The most common barriers were lack of time and knowledge. Conclusions This study offers new information on issues affecting the evaluation of balance in clinical settings from a broad sample of physiotherapists. Continued work to address barriers by specific practice area will be critical for the success of any intervention attempting to implement optimal balance assessment practices in the clinical setting. PMID:23510277

Animal Health and Welfare Issues Facing Organic Production Systems

PubMed Central

Sutherland, Mhairi A.; Webster, Jim; Sutherland, Ian

2013-01-01

Simple Summary The demand for organically grown, animal derived produce is increasing due to a growing desire for consumer products that have minimal chemical inputs and high animal welfare standards. Evaluation of the scientific literature suggests that a major challenge facing organic animal production systems is the management and treatment of health-related issues. However, implementation of effective management practices can help organic animal producers achieve and maintain high standards of health and welfare, which is necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. Abstract The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. PMID:26479750

Promoting Evidence-Based Practice at a Primary Stroke Center: A Nurse Education Strategy.

PubMed

Case, Christina Anne

Promoting a culture of evidence-based practice within a health care facility is a priority for health care leaders and nursing professionals; however, tangible methods to promote translation of evidence to bedside practice are lacking. The purpose of this quality improvement project was to design and implement a nursing education intervention demonstrating to the bedside nurse how current evidence-based guidelines are used when creating standardized stroke order sets at a primary stroke center, thereby increasing confidence in the use of standardized order sets at the point of care and supporting evidence-based culture within the health care facility. This educational intervention took place at a 286-bed community hospital certified by the Joint Commission as a primary stroke center. Bedside registered nurse (RN) staff from 4 units received a poster presentation linking the American Heart Association's and American Stroke Association's current evidence-based clinical practice guidelines to standardized stroke order sets and bedside nursing care. The 90-second oral poster presentation was delivered by a graduate nursing student during preshift huddle. The poster and supplemental materials remained in the unit break room for 1 week for RN viewing. After the pilot unit, a pdf of the poster was also delivered via an e-mail attachment to all RNs on the participating unit. A preintervention online survey measured nurses' self-perceived likelihood of performing an ordered intervention based on whether they were confident the order was evidence based. The preintervention survey also measured nurses' self-reported confidence in their ability to explain how the standardized order sets are derived from current evidence. The postintervention online survey again measured nurses' self-reported confidence level. However, the postintervention survey was modified midway through data collection, allowing for the final 20 survey respondents to retrospectively rate their confidence before and after the educational intervention. This modification ensured that the responses for each individual participant in this group were matched. Registered nurses reported a significant increase in perceived confidence in ability to explain how standardized stroke order sets reflect current evidence after the intervention (n = 20, P < .001). This sample was matched for each individual respondent. No significant change was shown in unmatched group mean self-reported confidence ratings overall after the intervention or separately by unit for the progressive care unit, critical care unit, or intensive care unit (n = 89 preintervention, n = 43 postintervention). However, the emergency department demonstrated a significant increase in group mean perceived confidence scores (n = 20 preintervention, n = 11 postintervention, P = .020). Registered nurses reported a significantly higher self-perceived likelihood of performing an ordered nursing intervention when they were confident that the order was evidence based compared with if they were unsure the order was evidence based (n = 88, P < .001). This nurse education strategy increased RNs' confidence in ability to explain the path from evidence to bedside nursing care by demonstrating how evidence-based clinical practice guidelines provide current evidence used to create standardized order sets. Although further evaluation of the intervention's effectiveness is needed, this educational intervention has the potential for generalization to different types of standardized order sets to increase nurse confidence in utilization of evidence-based practice.

Standard Test Methods for Textile Composites

NASA Technical Reports Server (NTRS)

Masters, John E.; Portanova, Marc A.

1996-01-01

Standard testing methods for composite laminates reinforced with continuous networks of braided, woven, or stitched fibers have been evaluated. The microstructure of these textile' composite materials differs significantly from that of tape laminates. Consequently, specimen dimensions and loading methods developed for tape type composites may not be applicable to textile composites. To this end, a series of evaluations were made comparing testing practices currently used in the composite industry. Information was gathered from a variety of sources and analyzed to establish a series of recommended test methods for textile composites. The current practices established for laminated composite materials by ASTM and the MIL-HDBK-17 Committee were considered. This document provides recommended test methods for determining both in-plane and out-of-plane properties. Specifically, test methods are suggested for: unnotched tension and compression; open and filled hole tension; open hole compression; bolt bearing; and interlaminar tension. A detailed description of the material architectures evaluated is also provided, as is a recommended instrumentation practice.

Peer Review Practices for Evaluating Biomedical Research Grants: A Scientific Statement From the American Heart Association.

PubMed

Liaw, Lucy; Freedman, Jane E; Becker, Lance B; Mehta, Nehal N; Liscum, Laura

2017-08-04

The biomedical research enterprise depends on the fair and objective peer review of research grants, leading to the distribution of resources through efficient and robust competitive methods. In the United States, federal funding agencies and foundations collectively distribute billions of dollars annually to support biomedical research. For the American Heart Association, a Peer Review Subcommittee is charged with establishing the highest standards for peer review. This scientific statement reviews the current literature on peer review practices, describes the current American Heart Association peer review process and those of other agencies, analyzes the strengths and weaknesses of American Heart Association peer review practices, and recommends best practices for the future. © 2017 American Heart Association, Inc.

Is the public being protected? Prevention of suboptimal medical practice through training programs and credentialing examinations.

PubMed

Tamblyn, R

1994-06-01

Governments have traditionally looked to the medical profession for leadership in health planning and have charged the profession with the responsibility of establishing and monitoring standards of medical practice. Training program accreditation and licensure/certification exams have been used as the primary methods of preventing unqualified individuals from entering medical practice. Despite the critical nature of the decision made at the time of licensure/certification, there is no information about the validity of these examinations for predicting subsequent practice and health outcome. In this article, the assumptions implicit in the current use of licensing/certifying examinations are identified, the relevant evidence is reviewed, and the implications of this evidence for current methods of measurement are discussed.

Assessment of the NASA Flight Assurance Review Program

NASA Technical Reports Server (NTRS)

Holmes, J.; Pruitt, G.

1983-01-01

The NASA flight assurance review program to develop minimum standard guidelines for flight assurance reviews was assessed. Documents from NASA centers and NASA headquarters to determine current design review practices and procedures were evaluated. Six reviews were identified for the recommended minimum. The practices and procedures used at the different centers to incorporate the most effective ones into the minimum standard review guidelines were analyzed and guidelines for procedures, personnel and responsibilies, review items/data checklist, and feedback and closeout were defined. The six recommended reviews and the minimum standards guidelines developed for flight assurance reviews are presented. Observations and conclusions for further improving the NASA review and quality assurance process are outlined.

Medical home implementation: a sensemaking taxonomy of hard and soft best practices.

PubMed

Hoff, Timothy

2013-12-01

The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. I found two distinct taxonomies of implementation best practices, which I labeled "hard" and "soft" because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. © 2013 Milbank Memorial Fund.

Roadwaste : issues and options.

DOT National Transportation Integrated Search

1998-06-01

The Oregon Department of Transportation (ODOT) is conducting a study to determine roadwaste management options. Phase 1 consisted of a thorough review of regulations and standards, roadwaste characterization, current management practices, and new tec...

Updated standards and processes for accreditation of echocardiographic laboratories from The European Association of Cardiovascular Imaging.

PubMed

Popescu, Bogdan A; Stefanidis, Alexandros; Nihoyannopoulos, Petros; Fox, Kevin F; Ray, Simon; Cardim, Nuno; Rigo, Fausto; Badano, Luigi P; Fraser, Alan G; Pinto, Fausto; Zamorano, Jose Luis; Habib, Gilbert; Maurer, Gerald; Lancellotti, Patrizio; Andrade, Maria Joao; Donal, Erwan; Edvardsen, Thor; Varga, Albert

2014-07-01

Standards for echocardiographic laboratories were proposed by the European Association of Echocardiography (now the European Association of Cardiovascular Imaging) 7 years ago in order to raise standards of practice and improve the quality of care. Criteria and requirements were published at that time for transthoracic, transoesophageal, and stress echocardiography. This paper reassesses and updates the quality standards to take account of experience and the technical developments of modern echocardiographic practice. It also discusses quality control, the incentives for laboratories to apply for accreditation, the reaccreditation criteria, and the current status and future prospects of the laboratory accreditation process. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Payment models to support population health management.

PubMed

Huerta, Timothy R; Hefner, Jennifer L; McAlearney, Ann Scheck

2014-01-01

To survey the policy-driven financial controls currently being used to drive physician change in the care of populations. This paper offers a review of current health care payment models and discusses the impact of each on the potential success of PHM initiatives. We present the benefits of a multi-part model, combining visit-based fee-for-service reimbursement with a monthly "care coordination payment" and a performance-based payment system. A multi-part model removes volume-based incentives and promotes efficiency. However, it is predicated on a pay-for-performance framework that requires standardized measurement. Application of this model is limited due to the current lack of standardized measurement of quality goals that are linked to payment incentives. Financial models dictated by health system payers are inextricably linked to the organization and management of health care. There is a need for better measurements and realistic targets as part of a comprehensive system of measurement assessment that focuses on practice redesign, with the goal of standardizing measurement of the structure and process of redesign. Payment reform is a necessary component of an accurate measure of the associations between practice transformation and outcomes important to both patients and society.

Standardized Predictive Testing: Practices, Policies, and Outcomes

ERIC Educational Resources Information Center

Barton, Lisette; Willson, Pamela; Langford, Rae; Schreiner, Barbara

2014-01-01

The aims of this study were to describe current policy practice related to the use of the HESI™ Exit Exam in schools of nursing and to determine which policies result in higher HESI Exit Scores. Deans and directors of nursing schools that administered Elsevier HESI Exit Exam to students during the 2010 academic year were queried. Data were…

Standard Chinese: A Modular Approach. Student Workbook. Module 3: Money; Module 4: Directions.

ERIC Educational Resources Information Center

Defense Language Inst., Monterey, CA.

Texts in spoken Standard Chinese were developed to improve and update Chinese materials and to reflect current usage in Beijing and Taipei. The focus is on communicating in Chinese in practical situations. The overall course is organized into 10 situational modules, student workbooks, and resource modules. This workbook covers the money and…

Standard Chinese: A Modular Approach. Student Text. Module 3: Money; Module 4: Directions.

ERIC Educational Resources Information Center

Defense Language Inst., Monterey, CA.

Texts in spoken Standard Chinese were developed to improve and update Chinese materials to reflect current usage in Beijing and Taipei. The focus is on communicating in practical situations, and the texts summarize and supplement tapes. The overall course is organized into 10 situational modules, student workbooks, and resource modules. This text…

Standard Chinese: A Modular Approach. Student Text. Module 1: Orientation; Module 2: Biographic Information.

ERIC Educational Resources Information Center

Defense Language Inst., Monterey, CA.

Texts in spoken Standard Chinese were developed to improve and update Chinese materials to reflect current usage in Beijing and Taipei. The focus is on communicating in Chinese in practical situations, and the texts summarize and supplement tapes. The overall course is organized into 10 situational modules, student workbooks, and resource modules.…

Standard Chinese: A Modular Approach. Student Workbook. Module 1: Orientation; Module 2: Biographic Information.

ERIC Educational Resources Information Center

Defense Language Inst., Monterey, CA.

Texts in spoken Standard Chinese were developed to improve and update Chinese materials to reflect current usage in Beijing and Taipei. The focus is on communicating in Chinese in practical situations. The overall course is organized into 10 modules, student workbooks, and resource modules. This workbook covers the orientation and biographic…

Oral Language Proficiency Testing at the Foreign Service Institute. An Update--1983.

ERIC Educational Resources Information Center

Crawford, Gary D.; And Others

The Foreign Service Institute (FSI) has been engaged in oral language proficiency testing theory and practice for more than 20 years. The FSI test has been consistent during this time in format, evaluation criteria, performance standards, and level definitions. Current concerns about the degree of standardization of the format and the strength of…

40 CFR 434.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... technology currently available (BPT). 434.32 Section 434.32 Protection of Environment ENVIRONMENTAL... BPT, BAT, BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Acid or Ferruginous Mine Drainage § 434... application of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

40 CFR 434.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... technology currently available (BPT). 434.32 Section 434.32 Protection of Environment ENVIRONMENTAL... BPT, BAT, BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Acid or Ferruginous Mine Drainage § 434... application of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

40 CFR 434.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... technology currently available (BPT). 434.42 Section 434.42 Protection of Environment ENVIRONMENTAL..., BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Alkaline Mine Drainage § 434.42 Effluent... practicable control technology currently available (BPT). Except as provided in 40 CFR 125.30-125.32, 40 CFR...

40 CFR 434.42 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... technology currently available (BPT). 434.42 Section 434.42 Protection of Environment ENVIRONMENTAL..., BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Alkaline Mine Drainage § 434.42 Effluent... practicable control technology currently available (BPT). Except as provided in 40 CFR 125.30-125.32, 40 CFR...

40 CFR 434.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... technology currently available (BPT). 434.32 Section 434.32 Protection of Environment ENVIRONMENTAL... BPT, BAT, BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Acid or Ferruginous Mine Drainage § 434... application of the best practicable control technology currently available (BPT). Except as provided in 40 CFR...

Pediatric endocrine society survey of diabetes practices in the United States: What is the current state?

PubMed

Guttmann-Bauman, I; Thornton, P; Adhikari, S; Reifschneider, K; Wood, M A; Hamby, T; Rubin, K

2018-03-26

The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March, 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. Ninety-three unique entries from the US were entered into analysis. Care is predominantly delivered by multidisciplinary teams, based at academic institutions (65.6%), with >85% of the provider types being physicians. Each 1.0 full time equivalent certified diabetes educators serves on average 367 diabetic youth. Fee-for-service remains the standard method of reimbursement with 57% of practices reporting financial loss. Survey respondents identified under-reimbursement as a major barrier to improving patient outcomes and lack of behavioral health (BH) providers as a key gap in services provided. Our survey reveals wide variation in all aspects of pediatric diabetes care delivery in the United States. Pediatric Endocrinologists responding to the survey identified a lack of resources and the current fee for service payment model as a major impediment to practice and the lack of integrated BH staff as a key gap in service. The respondents strongly support its organizations' involvement in the dissemination of standards for care delivery and advocacy for a national payment model aligned with chronic diabetes care in the context of our emerging value-based healthcare system. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

MR-guided focused ultrasound surgery, present and future

PubMed Central

Schlesinger, David; Benedict, Stanley; Diederich, Chris; Gedroyc, Wladyslaw; Klibanov, Alexander; Larner, James

2013-01-01

MR-guided focused ultrasound surgery (MRgFUS) is a quickly developing technology with potential applications across a spectrum of indications traditionally within the domain of radiation oncology. Especially for applications where focal treatment is the preferred technique (for example, radiosurgery), MRgFUS has the potential to be a disruptive technology that could shift traditional patterns of care. While currently cleared in the United States for the noninvasive treatment of uterine fibroids and bone metastases, a wide range of clinical trials are currently underway, and the number of publications describing advances in MRgFUS is increasing. However, for MRgFUS to make the transition from a research curiosity to a clinical standard of care, a variety of challenges, technical, financial, clinical, and practical, must be overcome. This installment of the Vision 20/20 series examines the current status of MRgFUS, focusing on the hurdles the technology faces before it can cross over from a research technique to a standard fixture in the clinic. It then reviews current and near-term technical developments which may overcome these hurdles and allow MRgFUS to break through into clinical practice. PMID:23927296

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.

Sterilization and disinfection in the physician's office.

PubMed Central

Drummond, D C; Skidmore, A G

1991-01-01

OBJECTIVE: To review the principles and practice of sterilization and disinfection of medical instruments in the office setting. DATA SOURCES: Searches of MEDLINE for articles published from 1980 to 1990 on disinfection, sterilization, cross infection, surgical instruments and iatrogenic disease, bibliographies, standard texts and reference material located in a central processing department. STUDY SELECTION: We reviewed surveys of decontamination practices in physicians' offices, reviews of current recommendations for office decontamination procedures, case reports of cross infection in offices and much of the standard reference material on decontamination theory and practice. DATA SYNTHESIS: There have been few surveys of physicians' decontamination practices and few case reports of cross infection. Office practitioners have little access to practical information on sterilization and disinfection. CONCLUSION: The increasing threat of cross infection from medical instruments calls for greater knowledge about decontamination. We have adapted material from various sources and offer a primer on the subject. PMID:1913427

Roadwaste management : a tool for developing district plans.

DOT National Transportation Integrated Search

2000-10-01

The Oregon Department of Transportation (ODOT) conducted a study to examine roadwaste management options. Phase 1 consisted of a thorough review of regulations and standards, roadwaste characterization, current management practices, and new technolog...

The role of quality assurance in future midwifery practice.

PubMed

Dawson, J

1993-08-01

Recent recommendations have been made which would give midwives a more central role in maternity care and a greater degree of independence than they currently enjoy. This paper argues that midwives' current attitudes to quality assurance are incompatible with this enhanced role. Research conducted in three health districts is described, which explored the perceptions of nurses, midwives and managers towards quality assurance. The findings indicate that quality assurance (in whatever form that concept is operationalized) is a demonstration of accountability. For managers this accountability is primarily for the service as a whole, whilst nurses and midwives view their accountability as being owed to patients/clients. The main methodology which the study identified as being used for monitoring nursing care was the development and auditing of explicit standards. This approach has been actively promoted by the Royal College of Nursing, enabling nurses to regain control of the purely professional aspects of the nursing profession. Midwives in the study districts showed a marked reluctance to adopt such a strategy, taking the view that as independent practitioners consensus standards would be unacceptable. It is argued that this attitude is inconsistent with the basic principle that professionals are accountable for both demonstrating and developing the quality of professional practice. It is further suggested that midwives currently have an opportunity to regain professional control of midwifery practice, which will be lost unless they are prepared to take responsibility for evaluating the standards for which they are accountable.

Historical Evolution of NASA Standard Materials Testing with Hypergolic Propellants and Ammonia (NASA Standard 6001 Test 15)

NASA Technical Reports Server (NTRS)

Greene, Benjamin; McClure, Mark B.

2012-01-01

The NASA Johnson Space Center White Sands Test Facility (WSTF) has performed testing of hazardous and reactive aerospace fluids, including hypergolic propellants, with materials since the 1960s with the Apollo program. Amongst other test activities, Test 15 is a NASA standard test for evaluating the reactivity of materials with selected aerospace fluids, in particular hydrazine, monomethylhydrazine, uns-dimethylhydrazine, Aerozine 50, dinitrogen tetroxide oxidizers, and ammonia. This manuscript provides an overview of the history of Test 15 over a timeline ranging from prior to its development and first implementation as a NASA standard test in 1974 to its current refinement. Precursor documents to NASA standard tests, as they are currently known, are reviewed. A related supplementary test, international standardization, and enhancements to Test 15 are also discussed. Because WSTF was instrumental in the development and implementation of Test 15, WSTF experience and practices are referred to in this manuscript.

The RICORDO approach to semantic interoperability for biomedical data and models: strategy, standards and solutions

PubMed Central

2011-01-01

Background The practice and research of medicine generates considerable quantities of data and model resources (DMRs). Although in principle biomedical resources are re-usable, in practice few can currently be shared. In particular, the clinical communities in physiology and pharmacology research, as well as medical education, (i.e. PPME communities) are facing considerable operational and technical obstacles in sharing data and models. Findings We outline the efforts of the PPME communities to achieve automated semantic interoperability for clinical resource documentation in collaboration with the RICORDO project. Current community practices in resource documentation and knowledge management are overviewed. Furthermore, requirements and improvements sought by the PPME communities to current documentation practices are discussed. The RICORDO plan and effort in creating a representational framework and associated open software toolkit for the automated management of PPME metadata resources is also described. Conclusions RICORDO is providing the PPME community with tools to effect, share and reason over clinical resource annotations. This work is contributing to the semantic interoperability of DMRs through ontology-based annotation by (i) supporting more effective navigation and re-use of clinical DMRs, as well as (ii) sustaining interoperability operations based on the criterion of biological similarity. Operations facilitated by RICORDO will range from automated dataset matching to model merging and managing complex simulation workflows. In effect, RICORDO is contributing to community standards for resource sharing and interoperability. PMID:21878109

Current Trends in Nursing Informatics: Results of an International Survey.

PubMed

Peltonen, Laura-Maria; Alhuwail, Dari; Ali, Samira; Badger, Martha K; Eler, Gabrielle Jacklin; Georgsson, Mattias; Islam, Tasneem; Jeon, Eunjoo; Jung, Hyunggu; Kuo, Chiu-Hsiang; Lewis, Adrienne; Pruinelli, Lisiane; Ronquillo, Charlene; Sarmiento, Raymond Francis; Sommer, Janine; Tayaben, Jude L; Topaz, Maxim

2016-01-01

Nursing informatics (NI) can help provide effective and safe healthcare. This study aimed to describe current research trends in NI. In the summer 2015, the IMIA-NI Students Working Group created and distributed an online international survey of the current NI trends. A total of 402 responses were submitted from 44 countries. We identified a top five NI research areas: standardized terminologies, mobile health, clinical decision support, patient safety and big data research. NI research funding was considered to be difficult to acquire by the respondents. Overall, current NI research on education, clinical practice, administration and theory is still scarce, with theory being the least common. Further research is needed to explain the impact of these trends and the needs from clinical practice.

Academy of Nutrition and Dietetics: Standards of professional performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Sustainable, Resilient, and Healthy Food and Water Systems.

PubMed

Tagtow, Angie; Robien, Kim; Bergquist, Erin; Bruening, Meg; Dierks, Lisa; Hartman, Barbara E; Robinson-O'Brien, Ramona; Steinitz, Tamara; Tahsin, Bettina; Underwood, Teri; Wilkins, Jennifer

2014-03-01

Sustainability is the ability of a system to be maintained over the long term. Resilience is the ability of a system to withstand disturbances and continue to function in a sustainable manner. Issues of sustainability and resilience apply to all aspects of nutrition and dietetics practice, can be practiced at both the program and systems level, and are broader than any one specific practice setting or individual intervention. Given an increasing need to apply principles of sustainability and resilience to nutrition and dietetics practice, as well as growing interest among the public and by Registered Dietitian Nutritionists of health issues related to food and water systems, the Hunger and Environmental Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Standards of Professional Performance as a tool for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems to assess their current skill levels and to identify areas for further professional development in this emerging practice area. This Standards of Professional Performance document covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how sustainable, resilient, and healthy food and water systems principles can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Scientific and Legal Perspectives on Science Generated for Regulatory Activities

PubMed Central

Henry, Carol J.; Conrad, James W.

2008-01-01

This article originated from a conference that asked “Should scientific work conducted for purposes of advocacy before regulatory agencies or courts be judged by the same standards as science conducted for other purposes?” In the article, which focuses on the regulatory advocacy context, we argue that it can be and should be. First, we describe a set of standards and practices currently being used to judge the quality of scientific research and testing and explain how these standards and practices assist in judging the quality of research and testing regardless of why the work was conducted. These standards and practices include the federal Information Quality Act, federal Good Laboratory Practice standards, peer review, disclosure of funding sources, and transparency in research policies. The more that scientific information meets these standards and practices, the more likely it is to be of high quality, reliable, reproducible, and credible. We then explore legal issues that may be implicated in any effort to create special rules for science conducted specifically for a regulatory proceeding. Federal administrative law does not provide a basis for treating information in a given proceeding differently depending on its source or the reason for which it was generated. To the contrary, this law positively assures that interested persons have the right to offer their technical expertise toward the solution of regulatory problems. Any proposal to subject scientific information generated for the purpose of a regulatory proceeding to more demanding standards than other scientific information considered in that proceeding would clash with this law and would face significant administrative complexities. In a closely related example, the U.S. Environmental Protection Agency considered but abandoned a program to implement standards aimed at “external” information. PMID:18197313

Scientific and legal perspectives on science generated for regulatory activities.

PubMed

Henry, Carol J; Conrad, James W

2008-01-01

This article originated from a conference that asked "Should scientific work conducted for purposes of advocacy before regulatory agencies or courts be judged by the same standards as science conducted for other purposes?" In the article, which focuses on the regulatory advocacy context, we argue that it can be and should be. First, we describe a set of standards and practices currently being used to judge the quality of scientific research and testing and explain how these standards and practices assist in judging the quality of research and testing regardless of why the work was conducted. These standards and practices include the federal Information Quality Act, federal Good Laboratory Practice standards, peer review, disclosure of funding sources, and transparency in research policies. The more that scientific information meets these standards and practices, the more likely it is to be of high quality, reliable, reproducible, and credible. We then explore legal issues that may be implicated in any effort to create special rules for science conducted specifically for a regulatory proceeding. Federal administrative law does not provide a basis for treating information in a given proceeding differently depending on its source or the reason for which it was generated. To the contrary, this law positively assures that interested persons have the right to offer their technical expertise toward the solution of regulatory problems. Any proposal to subject scientific information generated for the purpose of a regulatory proceeding to more demanding standards than other scientific information considered in that proceeding would clash with this law and would face significant administrative complexities. In a closely related example, the U.S. Environmental Protection Agency considered but abandoned a program to implement standards aimed at "external" information.

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.

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.

Spray-on-skin cells in burns: a common practice with no agreed protocol.

PubMed

Allouni, Ammar; Papini, Remo; Lewis, Darren

2013-11-01

Cultured epithelial autograft (CEA) has been used for skin coverage after burn wound excision since 1981. It is used in burn units and centres throughout the U.K.; however, there appears to be no agreed standards of practice. We aimed to investigate the experience and current practice with its usage in the management of acute burn injury. An online survey was sent to twenty-five burns consultants in the U.K., who are members of the British Burn Association. We received 14 responses. Rarely have the responders agreed to the same practice in most of the questions. Different choices were given by responders with regards the indications for cell culture, techniques used, primary and secondary dressings used, first wound review timing, and measures used to evaluate outcomes. In the current economic environment, the NHS needs to rationalize services on the basis of cost effectiveness. CEA is an expensive procedure that requires an adequately sterile laboratory, special equipments and highly experienced dedicated staff. When dealing with expensive management options, it is important to have an agreed protocol that can form the standard that can be referred to when auditing practices and results to improve burn management and patients' care. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Is the medical justice system broken?

PubMed

Howard, Philip K

2003-09-01

The current lawsuit culture is creating a crisis in US health care. The broad perception that anyone can sue for almost anything has fundamentally altered the practice of medicine, eroding the quality and availability of health care. Current reform proposals to "cap" one category of damages are not nearly ambitious enough. Providing relief to doctors squeezed by insurance premiums is important but will not heal the deep distrust that skews daily decisions, nor will it provide incentives to overhaul outdated practices. The United States needs an entirely new system of medical justice. Its first goal is to be reliable: reliable in protecting patients against bad practices, reliable in protecting physicians who act reasonably, and reliable in interpreting standards of care.

Balance Assessment Practices and Use of Standardized Balance Measures Among Ontario Physical Therapists

PubMed Central

Sibley, Kathryn M.; Straus, Sharon E.; Inness, Elizabeth L.; Salbach, Nancy M.

2011-01-01

Background Balance impairment is a significant problem for older adults, as it can influence daily functioning. Treating balance impairment in this population is a major focus of physical therapist practice. Objective The purpose of this study was to document current practices in clinical balance assessment and compare components of balance assessed and measures used across practice areas among physical therapists. Design This was a cross-sectional study. Methods A survey questionnaire was mailed to 1,000 practicing physical therapists in Ontario, Canada. Results Three hundred sixty-nine individuals completed the survey questionnaire. More than 80% of respondents reported that they regularly (more than 60% of the time) assessed postural alignment, static and dynamic stability, functional balance, and underlying motor systems. Underlying sensory systems, cognitive contributions to balance, and reactive control were regularly assessed by 59.6%, 55.0%, and 41.2% of the respondents, respectively. The standardized measures regularly used by the most respondents were the single-leg stance test (79.1%), the Berg Balance Scale (45.0%), and the Timed “Up & Go” Test (27.6%). There was considerable variation in the components of balance assessed and measures used by respondents treating individuals in the orthopedic, neurologic, geriatric, and general rehabilitation populations. Limitations The survey provides quantitative data about what is done to assess balance, but does not explain the factors influencing current practice. Conclusions Many important components of balance and standardized measures are regularly used by physical therapists to assess balance. Further research, however, is needed to understand the factors contributing to the relatively lower rates of assessing reactive control, the component of balance most directly responsible for avoiding a fall. PMID:21868613

Setting a national minimum standard for health benefits: how do state benefit mandates compare with benefits in large-group plans?

PubMed

Frey, Allison; Mika, Stephanie; Nuzum, Rachel; Schoen, Cathy

2009-06-01

Many proposed health insurance reforms would establish a federal minimum benefit standard--a baseline set of benefits to ensure that people have adequate coverage and financial protection when they purchase insurance. Currently, benefit mandates are set at the state level; these vary greatly across states and generally target specific areas rather than set an overall standard for what qualifies as health insurance. This issue brief considers what a broad federal minimum standard might look like by comparing existing state benefit mandates with the services and providers covered under the Federal Employees Health Benefits Program (FEHBP) Blue Cross and Blue Shield standard benefit package, an example of minimum creditable coverage that reflects current standard practice among employer-sponsored health plans. With few exceptions, benefits in the FEHBP standard option either meet or exceed those that state mandates require-indicating that a broad-based national benefit standard would include most existing state benefit mandates.

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2018-02-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2017-10-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

Reading in NZ Schools: A Survey of Our Theory and Practice. Set Research Information for Teachers, Number Two, Item 2.

ERIC Educational Resources Information Center

Penton, John

Designed to provide information about reading in New Zealand, this report offers an overview of theory and practice in that area. Among the topics discussed are: the current concern about reading standards; developmental reading; effective methods of reading instruction; research into the nature of the reading process; preparation of teachers of…

Mentoring as the Core Element of New Teacher Induction in the USA: Policies and Practices

ERIC Educational Resources Information Center

Zembytska, Maryna

2016-01-01

The paper focuses on mentoring as the key strategy of novice teacher induction in the USA. The study reviews current mentoring/induction policies and trends in the U.S. system of in-service teacher training and support. The findings suggest that the conceptual framework, standards and practices of new teacher mentoring in the United States conform…

Desensitization to Mycofenolate Mofetil: a novel 12 step protocol.

PubMed

Smith, M; Gonzalez-Estrada, A; Fernandez, J; Subramanian, A

2016-07-01

The use of MMF has become standard practice in many solid organ transplant recipients due its efficacy and favorable risk profile compared to other immunosuppressants. There has been a single case report of successful MMF desensitization. However, this protocol did not follow current Drug practice parameters. We report a successful desensitization to MMF in a double heart-kidney transplant recipient.

Providing Test Performance Feedback That Bridges Assessment and Instruction: The Case of Two Standardized English Language Tests in Japan

ERIC Educational Resources Information Center

Sawaki, Yasuyo; Koizumi, Rie

2017-01-01

This small-scale qualitative study considers feedback and results reported for two major large-scale English language tests administered in Japan: the Global Test of English Communication for Students (GTECfS) and the Eiken Test in Practical English Proficiency (Eiken). Specifically, it examines current score-reporting practices in student and…

Understanding the use of standardized nursing terminology and classification systems in published research: A case study using the International Classification for Nursing Practice(®).

PubMed

Strudwick, Gillian; Hardiker, Nicholas R

2016-10-01

In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown. This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study. A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Coordination of care by primary care practices: strategies, lessons and implications.

PubMed

O'Malley, Ann S; Tynan, Ann; Cohen, Genna R; Kemper, Nicole; Davis, Matthew M

2009-04-01

Despite calls from numerous organizations and payers to improve coordination of care, there are few published accounts of how care is coordinated in real-world primary care practices. This study by the Center for Studying Health System Change (HSC) documents strategies that a range of physician practices use to coordinate care for their patients. While there was no single recipe for coordination given the variety of patient, physician, practice and market factors, some cross-cutting lessons were identified, such as the value of a commitment to interpersonal continuity of care as a foundation for coordination. Respondents also identified the importance of system support for the standardization of office processes to foster care coordination. While larger practices may have more resources to invest, many of the innovations described could be scaled to smaller practices. Some coordination strategies resulted in improved efficiency over time for practices, but by and large, physician practices currently pursue these efforts at their own expense. In addition to sharing information on effective strategies among practices, the findings also provide policy makers with a snapshot of the current care coordination landscape and implications for initiatives to improve coordination. Efforts to provide technical support to practices to improve coordination, for example, through medical-home initiatives, need to consider the baseline more typical practices may be starting from and tailor their support to practices ranging widely in size, resources and presence of standardized care processes. If aligned with payment incentives, some of these strategies have the potential to increase quality and satisfaction among patients and providers by helping to move the health care delivery system toward better coordinated care.

Standard Chinese: A Modular Approach. Resource Modules: Pronunciation and Romanization, Numbers, Classroom Expressions, Time and Dates.

ERIC Educational Resources Information Center

Defense Language Inst., Monterey, CA.

Texts in spoken Standard Chinese were developed to improve and update Chinese materials to reflect current usage in Beijing and Taipei. The focus is on communicating in Chinese in practical situations. The overall course is organized into 10 situational modules, student workbooks for each module, and resource modules. This text contains resource…

The uses and implications of standards in general practice consultations.

PubMed

Lippert, Maria Laura; Reventlow, Susanne; Kousgaard, Marius Brostrøm

2017-01-01

Quality standards play an increasingly important role in primary care through their inscription in various technologies for improving professional practice. While 'hard' biomedical standards have been the most common and debated, current quality development initiatives increasingly seek to include standards for the 'softer' aspects of care. This article explores the consequences of both kinds of quality standards for chronic care consultations. The article presents findings from an explorative qualitative field study in Danish general practice where a standardized technology for quality development has been introduced. Data from semi-structured interviews and observations among 17 general practitioners were analysed using an iterative analytical approach, which served to identify important variations in the uses and impacts of the technology. The most pronounced impact of the technology was observed among general practitioners who strictly adhered to the procedural standards on the interactional aspects of care. Thus, when allowed to function as an overall frame for consultations, those standards supported adherence to general recommendations regarding which elements to be included in chronic disease consultations. However, at the same time, adherence to those standards was observed to narrow the focus of doctor-patient dialogues and to divert general practitioners' attention from patients' personal concerns. Similar consequences of quality standards have previously been framed as manifestations of an inherent conflict between principles of patient-centredness and formal biomedical quality standards. However, this study suggests that standards on the 'softer' aspects of care may just as well interfere with a clinical approach relying on situated and attentive interactions with patients.

Ecological models supporting environmental decision making: a strategy for the future

USGS Publications Warehouse

Schmolke, Amelie; Thorbek, Pernille; DeAngelis, Donald L.; Grimm, Volker

2010-01-01

Ecological models are important for environmental decision support because they allow the consequences of alternative policies and management scenarios to be explored. However, current modeling practice is unsatisfactory. A literature review shows that the elements of good modeling practice have long been identified but are widely ignored. The reasons for this might include lack of involvement of decision makers, lack of incentives for modelers to follow good practice, and the use of inconsistent terminologies. As a strategy for the future, we propose a standard format for documenting models and their analyses: transparent and comprehensive ecological modeling (TRACE) documentation. This standard format will disclose all parts of the modeling process to scrutiny and make modeling itself more efficient and coherent.

Quality management in European screening laboratories in blood establishments: A view of current approaches and trends.

PubMed

Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda

2015-04-01

The screening laboratory has a critical role in the post-transfusion safety. The success of its targets and efficiency depends on the management system used. Even though the European Union directive 2002/98/EC requires a quality management system in blood establishments, its requirements for screening laboratories are generic. Complementary approaches are needed to implement a quality management system focused on screening laboratories. This article briefly discusses the current good manufacturing practices and good laboratory practices, as well as the trends in quality management system standards. ISO 9001 is widely accepted in some European Union blood establishments as the quality management standard, however this is not synonymous of its successful application. The ISO "risk-based thinking" is interrelated with the quality risk-management process of the EuBIS "Standards and criteria for the inspection of blood establishments". ISO 15189 should be the next step on the quality assurance of a screening laboratory, since it is focused on medical laboratory. To standardize the quality management systems in blood establishments' screening laboratories, new national and European claims focused on technical requirements following ISO 15189 is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

From the Margins to the Spotlight: Diverse Deaf and Hard of Hearing Student Populations and Standardized Assessment Accessibility.

PubMed

Cawthon, Stephanie

2015-01-01

Designing assessments and tests is one of the more challenging aspects of creating an accessible learning environment for students who are deaf or hard of hearing (DHH), particularly for deaf students with a disability (DWD). Standardized assessments are a key mechanism by which the educational system in the United States measures student progress, teacher effectiveness, and the impact of school reform. The diversity of student characteristics within DHH and DWD populations is only now becoming visible in the research literature relating to standardized assessments and their use in large-scale accountability reforms. The purpose of this article is to explore the theoretical frameworks surrounding assessment policy and practice, current research related to standardized assessment and students who are DHH and DWD, and potential implications for practice within both the assessment and instruction contexts.

Laboratory Diagnosis and Characterization of Fungal Disease in Patients with Cystic Fibrosis (CF): A Survey of Current UK Practice in a Cohort of Clinical Microbiology Laboratories.

PubMed

Boyle, Maeve; Moore, John E; Whitehouse, Joanna L; Bilton, Diana; Downey, Damian G

2018-03-02

There is much uncertainty as to how fungal disease is diagnosed and characterized in patients with cystic fibrosis (CF). A 19-question anonymous electronic questionnaire was developed and distributed to ascertain current practice in clinical microbiology laboratories providing a fungal laboratory service to CF centres in the UK. Analyses of responses identified the following: (1) current UK laboratory practice, in general, follows the current guidelines, but the scope and diversity of what is currently being delivered by laboratories far exceeds what is detailed in the guidelines; (2) there is a lack of standardization of fungal tests amongst laboratories, outside of the current guidelines; (3) both the UK CF Trust Laboratory Standards for Processing Microbiological Samples from People with Cystic Fibrosis and the US Cumulative Techniques and Procedures in Clinical Microbiology (Cumitech) Guidelines 43 Cystic Fibrosis Microbiology need to be updated to reflect both new methodological innovations, as well as better knowledge of fungal disease pathophysiology in CF; (4) there is a need for clinical medicine to decide upon a stratification strategy for the provision of new fungal assays that will add value to the physician in the optimal management of CF patients; (5) there is also a need to rationale what assays should be performed at local laboratory level and those which are best served at National Mycology Reference Laboratory level; and (6) further research is required in developing laboratory assays, which will help ascertain the clinical importance of 'old' fungal pathogens, as well as 'emerging' fungal pathogens.

30 CFR 75.902-4 - Attachment of ground conductors and ground check wires to equipment frames; use of separate...

Code of Federal Regulations, 2014 CFR

2014-07-01

... SAFETY STANDARDS-UNDERGROUND COAL MINES Underground Low- and Medium-Voltage Alternating Current Circuits... from resistance grounded systems separate connections shall be used when practicable. ...

30 CFR 75.902-4 - Attachment of ground conductors and ground check wires to equipment frames; use of separate...

Code of Federal Regulations, 2013 CFR

2013-07-01

... SAFETY STANDARDS-UNDERGROUND COAL MINES Underground Low- and Medium-Voltage Alternating Current Circuits... from resistance grounded systems separate connections shall be used when practicable. ...

30 CFR 75.902-4 - Attachment of ground conductors and ground check wires to equipment frames; use of separate...

Code of Federal Regulations, 2012 CFR

2012-07-01

... SAFETY STANDARDS-UNDERGROUND COAL MINES Underground Low- and Medium-Voltage Alternating Current Circuits... from resistance grounded systems separate connections shall be used when practicable. ...

Teaching Students to Correspond Effectively Electronically.

ERIC Educational Resources Information Center

Extejt, Marian M.

1998-01-01

Discusses current standards for formatting and etiquette of electronic mail in the business setting. Discusses privacy and appropriate content. Notes that class assignments involving electronic mail provide practical opportunities to develop ease with this form. (SR)

Experiences and Attitudes Among Psychiatric Mental Health Advanced Practice Nurses in the Use of Telemental Health: Results of an Online Survey.

PubMed

Baird, Martha B; Whitney, Lucinda; Caedo, Cassie E

Telemental health (TMH) growth is driven by recent trends in health delivery systems and disparities in access to mental health services. There are currently no standard educational guidelines to prepare psychiatric mental health advanced practice nurses (PMH-APRNs) in TMH delivery. To survey practicing PMH-APRNs across the United States about their experiences and attitudes about use of TMH. Eighty-three participants from the American Psychiatric Nurses Association online discussion board completed a nine-item survey. Length of time practicing as a PMH-APRN, TMH use in practice, populations served, and TMH background. A majority had been practicing as a PMH-APRN for less than a decade and had used TMH, although most reported no prior education or training in this delivery method. Participants did indicate a desire for TMH education. This survey affirms the prevalence of TMH use among PMH-APRN providers, lack of formal training, and necessity for standardized educational guidelines in TMH delivery.

GASB proposes new standards for financial reporting of postemployment benefits by state and local governments.

PubMed

Johnson, Karl D

2003-03-01

GASB has proposed new standards that will affect the way in which governments report postemployment health care benefits in audited external financial statements, resulting in more complete and transparent reporting by employers and plans and more relevant and useful information for the users of governmental financial reports. This article provides an overview of current financial reporting standards and practice, the financial reporting objectives of the project, the proposed measurement approach, noteworthy specific proposals, and the projected timetable for completion of the project and implementation of the new standards.

Standard NIM Instrumentation System

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

Costrell, Louis; Lenkszus, Frank R.; Rudnick, Stanley J.

NIM is a standard modular instrumentation system that is in wide use throughout the world. As the NIM system developed and accommodations were made to a dynamic instrumentation field and a rapidly advancing technology, additions, revisions and clarifications were made. These were incorporated into the standard in the form of addenda and errata. This standard is a revision of the NIM document, AEC Report TID-20893 (Rev 4) dated July 1974. It includes all the addenda and errata items that were previously issued as well as numerous additional items to make the standard current with modern technology and manufacturing practice.

Resistance factors for 100% dynamic testing, with and without static load tests.

DOT National Transportation Integrated Search

2011-05-01

Current department of transportation (DOT) and Federal Highway Administration (FHWA) practice has highly : variable load and resistance factor design (LRFD) resistance factors, , for driven piles from design (e.g., Standard : Penetration Tests (SPT...

Commercial Motor Vehicle Driver Obstructive Sleep Apnea Screening and Treatment in the United States: An Update and Recommendation Overview.

PubMed

Colvin, Loretta J; Collop, Nancy A

2016-01-01

No regulatory mandate exists in the United States (U.S.) for comprehensive obstructive sleep apnea (OSA) risk assessment and stratification for commercial motor vehicle (CMV) drivers. Current Federal Motor Carrier Safety Administration (FMCSA) requirements are outdated and depend largely on subjective report, a less reliable strategy in an occupational setting. Without FMCSA standards, sleep specialists, occupational medical examiners and employers rely on a collection of medical consensus recommendations to establish standards of care. These recommendations advise OSA risk assessment through a combination of focused medical history, physical examination, questionnaires, and accident history, which increase OSA detection compared to current FMCSA standards. For those diagnosed with OSA, consensus-based risk stratification helps identify CMV drivers who may benefit from OSA treatment and establish minimum standards for assessing treatment efficacy and adherence. Unfortunately no consolidated recommendation exists; rather, publications span medical and governmental literature in a patchwork fashion that no longer fully reflect current practice due to subsequent advances in OSA diagnosis, treatment, and technology. Based on searches of medical literature, internet materials, and reference lists from existing publications, an overview and discussion of key published recommendations regarding OSA assessment and treatment in CMV operators is provided. Suggestions for incorporating these recommendations into clinical sleep medicine practice in the U.S. are presented. The challenge for sleep specialists is maintaining the delicate balance between recommendations impacting standard of care and associated medico-legal impact with stakeholder interests from medical, regulatory, industry and public perspectives while providing high quality and efficient care. © 2016 American Academy of Sleep Medicine.

Animal Health and Welfare Issues Facing Organic Production Systems.

PubMed

Sutherland, Mhairi A; Webster, Jim; Sutherland, Ian

2013-10-31

The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare.

National Practice Patterns of Obtaining Informed Consent for Stroke Thrombolysis.

PubMed

Mendelson, Scott J; Courtney, D Mark; Gordon, Elisa J; Thomas, Leena F; Holl, Jane L; Prabhakaran, Shyam

2018-03-01

No standard approach to obtaining informed consent for stroke thrombolysis with tPA (tissue-type plasminogen activator) currently exists. We aimed to assess current nationwide practice patterns of obtaining informed consent for tPA. An online survey was developed and distributed by e-mail to clinicians involved in acute stroke care. Multivariable logistic regression analyses were performed to determine independent factors contributing to always obtaining informed consent for tPA. Among 268 respondents, 36.7% reported always obtaining informed consent and 51.8% reported the informed consent process caused treatment delays. Being an emergency medicine physician (odds ratio, 5.8; 95% confidence interval, 2.9-11.5) and practicing at a nonacademic medical center (odds ratio, 2.1; 95% confidence interval, 1.0-4.3) were independently associated with always requiring informed consent. The most commonly cited cause of delay was waiting for a patient's family to reach consensus about treatment. Most clinicians always or often require informed consent for stroke thrombolysis. Future research should focus on standardizing content and delivery of tPA information to reduce delays. © 2018 American Heart Association, Inc.

Same organization, same electronic health records (EHRs) system, different use: exploring the linkage between practice member communication patterns and EHR use patterns in an ambulatory care setting

PubMed Central

Leykum, Luci K; McDaniel, Reuben R

2011-01-01

Objective Despite efforts made by ambulatory care organizations to standardize the use of electronic health records (EHRs), practices often incorporate these systems into their work differently from each other. One potential factor contributing to these differences is within-practice communication patterns. The authors explore the linkage between within-practice communication patterns and practice-level EHR use patterns. Design Qualitative study of six practices operating within the same multi-specialty ambulatory care organization using the same EHR system. Semistructured interviews and direct observation were conducted with all physicians, nurses, medical assistants, practice managers, and non-clinical staff from each practice. Measurements An existing model of practice relationships was used to analyze communication patterns within the practices. Practice-level EHR use was defined and analyzed as the ways in which a practice uses an EHR as a collective or a group—including the degree of feature use, level of EHR-enabled communication, and frequency that EHR use changes in a practice. Interview and observation data were analyzed for themes. Based on these themes, within-practice communication patterns were categorized as fragmented or cohesive, and practice-level EHR use patterns were categorized as heterogeneous or homogeneous. Practices where EHR use was uniformly high across all users were further categorized as having standardized EHR use. Communication patterns and EHR use patterns were compared across the six practices. Results Within-practice communication patterns were associated with practice-level EHR use patterns. In practices where communication patterns were fragmented, EHR use was heterogeneous. In practices where communication patterns were cohesive, EHR use was homogeneous. Additional analysis revealed that practices that had achieved standardized EHR use (uniformly high EHR use across all users) exhibited high levels of mindfulness and respectful interaction, whereas practices that were furthest from achieving standardized EHR use exhibited low levels of mindfulness and respectful interaction. Conclusion Within-practice communication patterns provide a unique perspective for exploring the issue of standardization in EHR use. A major fallacy of setting homogeneous EHR use as the goal for practice-level EHR use is that practices with uniformly low EHR use could be considered successful. Achieving uniformly high EHR use across all users in a practice is more consistent with the goals of current EHR adoption and use efforts. It was found that some communication patterns among practice members may enable more standardized EHR use than others. Understanding the linkage between communication patterns and EHR use can inform understanding of the human element in EHR use and may provide key lessons for the implementation of EHRs and other health information technologies. PMID:21846780

Same organization, same electronic health records (EHRs) system, different use: exploring the linkage between practice member communication patterns and EHR use patterns in an ambulatory care setting.

PubMed

Lanham, Holly Jordan; Leykum, Luci K; McDaniel, Reuben R

2012-01-01

Despite efforts made by ambulatory care organizations to standardize the use of electronic health records (EHRs), practices often incorporate these systems into their work differently from each other. One potential factor contributing to these differences is within-practice communication patterns. The authors explore the linkage between within-practice communication patterns and practice-level EHR use patterns. Qualitative study of six practices operating within the same multi-specialty ambulatory care organization using the same EHR system. Semistructured interviews and direct observation were conducted with all physicians, nurses, medical assistants, practice managers, and non-clinical staff from each practice. An existing model of practice relationships was used to analyze communication patterns within the practices. Practice-level EHR use was defined and analyzed as the ways in which a practice uses an EHR as a collective or a group-including the degree of feature use, level of EHR-enabled communication, and frequency that EHR use changes in a practice. Interview and observation data were analyzed for themes. Based on these themes, within-practice communication patterns were categorized as fragmented or cohesive, and practice-level EHR use patterns were categorized as heterogeneous or homogeneous. Practices where EHR use was uniformly high across all users were further categorized as having standardized EHR use. Communication patterns and EHR use patterns were compared across the six practices. Within-practice communication patterns were associated with practice-level EHR use patterns. In practices where communication patterns were fragmented, EHR use was heterogeneous. In practices where communication patterns were cohesive, EHR use was homogeneous. Additional analysis revealed that practices that had achieved standardized EHR use (uniformly high EHR use across all users) exhibited high levels of mindfulness and respectful interaction, whereas practices that were furthest from achieving standardized EHR use exhibited low levels of mindfulness and respectful interaction. Within-practice communication patterns provide a unique perspective for exploring the issue of standardization in EHR use. A major fallacy of setting homogeneous EHR use as the goal for practice-level EHR use is that practices with uniformly low EHR use could be considered successful. Achieving uniformly high EHR use across all users in a practice is more consistent with the goals of current EHR adoption and use efforts. It was found that some communication patterns among practice members may enable more standardized EHR use than others. Understanding the linkage between communication patterns and EHR use can inform understanding of the human element in EHR use and may provide key lessons for the implementation of EHRs and other health information technologies.

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

PubMed

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

2017-10-01

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

Opinions of practitioners and program directors concerning accreditation standards for postdoctoral pediatric dentistry training programs.

PubMed

Casamassimo, P S; Wilson, S

1999-01-01

This study was performed to assess opinions of program directors and practitioners about the importance and necessary numbers of experiences required by current accreditation standards for training of pediatric dentists. A 32-item questionnaire was sent to all program directors of ADA-accredited postdoctoral pediatric dentistry training programs and to a random sample of 10% of the fellow/active membership of the American Academy of Pediatric Dentistry. An overall response rate of 56% was obtained from the single mailing. Practitioners and program directors differed significantly (P < or = 0.05) only in their opinions about the number of submucosal and intravenous sedation cases required for proficiency of eight experiences surveyed. The two groups differed significantly in 3 of 12 areas in terms of importance attributed for practice of contemporary pediatric dentistry: initiating and completing a research paper, biostatistics/epidemiology, and practice management. Program directors had little difficulty obtaining required experiences, and program dependence on Medicaid did not negatively affect quality of education. Practitioners and program directors agreed on the importance of most experiences and activities required by current accreditation standards.

Implementing clinical process management of vascular wounds in a tertiary facility: impact evaluation of a performance improvement project.

PubMed

Avruscio, Giampiero; Tocco-Tussardi, Ilaria; Bordignon, Greta; Vindigni, Vincenzo

2017-01-01

Chronic vascular wounds have a significant economic and social impact on our society calling for allocation of a great deal of attention and resources. Efforts should be oriented toward the achievement of the most effective and efficient clinical management. The Angiology Unit at the University Hospital of Padova, Italy, developed a performance improvement project to enhance the quality of practice for vascular ulcers. The project consisted in a multistep process comprising a critical revision of the previous clinical process management, staff education, tightening connections between operators and services, and creation of a position for a wound care nurse. The previous standard of practice was modified according to the results of revision and the current evidence-based practice. The new standard of practice reached its full application in September 2015. The number of patients treated and the number of visits in 2015 remained almost unvaried from 2014. However, the total annual expenditure for treating vascular ulcers was reduced by ~60% from the previous year. Standardization of guidelines and practice is effective in creating an efficient clinical management and in reducing the economic burden of vascular ulcers.

Setting performance standards for medical practice: a theoretical framework.

PubMed

Southgate, L; Hays, R B; Norcini, J; Mulholland, H; Ayers, B; Woolliscroft, J; Cusimano, M; McAvoy, P; Ainsworth, M; Haist, S; Campbell, M

2001-05-01

The assessment of performance in the real world of medical practice is now widely accepted as the goal of assessment at the postgraduate level. This is largely a validity issue, as it is recognised that tests of knowledge and in clinical simulations cannot on their own really measure how medical practitioners function in the broader health care system. However, the development of standards for performance-based assessment is not as well understood as in competency assessment, where simulations can more readily reflect narrower issues of knowledge and skills. This paper proposes a theoretical framework for the development of standards that reflect the more complex world in which experienced medical practitioners work. The paper reflects the combined experiences of a group of education researchers and the results of literature searches that included identifying current health system data sources that might contribute information to the measurement of standards. Standards that reflect the complexity of medical practice may best be developed through an "expert systems" analysis of clinical conditions for which desired health care outcomes reflect the contribution of several health professionals within a complex, three-dimensional, contextual model. Examples of the model are provided, but further work is needed to test validity and measurability.

(Un)Intended Outcomes of the Common Core English Language Arts Standards: A Narrative Inquiry into the Learning Experiences of English Learners' Teachers

ERIC Educational Resources Information Center

Mooney, Angela Jean

2015-01-01

The Common Core State Standards (CCSS) are a key piece of current reform efforts to reshape the U.S. educational system. Critics contend that the related Revised Publishers' Criteria (RPC), coupled with the authoritative power of the CCSS, will de-professionalize teachers, directing their practice from a distance. The purpose of this qualitative…

Measuring Teachers' Knowledge and Use of Data and Assessments: Creating a Measure as a First Step toward Effective Professional Development

ERIC Educational Resources Information Center

Vidacovich, Courtney

2015-01-01

Current teaching standards and practices are dictated, at least in part, by state- and district-mandated standardized tests. Yet, despite being surrounded by data, teachers receive only basic trainings on how to use assessments. In reality, teachers use data and assessments daily--even minute by minute--through the assessment process, which uses…

French Neo-Colonial Influence on Moroccan Language Education Policy: A Study of Current Status of Standard Arabic in Science Disciplines

ERIC Educational Resources Information Center

Zakhir, Marouane; O'Brien, Jason L.

2017-01-01

This paper reports the findings of a study on the attitudes of teachers and students regarding the language policy of the Moroccan educational system. Its primary goal is to explain the gap existing between the policy of Arabisation (i.e., the official adoption and utilization of Standard Arabic) and its practical implementation in science…

The Elements of an Effective Software Development Plan - Software Development Process Guidebook

DTIC Science & Technology

2011-11-11

standards and practices required for all XMPL software development. This SDP implements the <corporate> Standard Software Process (SSP). as tailored...Developing and integrating reusable software products • Approach to managing COTS/Reuse software implementation • COTS/Reuse software selection...final selection and submit to change board for approval MAINTENANCE Monitor current products for obsolescence or end of support Track new

Engaging Teenagers in Astronomy Using the Lens of Next Generation Science Standards and Common Core State Standards (Abstract)

NASA Astrophysics Data System (ADS)

Gillette, S.; Wolf, D.; Harrison, J.

2017-12-01

(Abstract only) The Vanguard Double Star Workshop has been developed to teach eighth graders the technique of measuring position angle and separation of double stars. Through this program, the students follow in the footsteps of a professional scientist by researching the topic, performing the experiment, writing a scientific article, publishing a scientific article, and finally presenting the material to peers. An examination of current educational standards grounds this program in educational practice and philosophy.

Engaging Teenagers in Astronomy Using the Lens of Next Generation Science Standards and Common Core State Standards

NASA Astrophysics Data System (ADS)

Gillette, Sean; Wolf, Debbie; Harrison, Jeremiah

2017-06-01

The Vanguard Double Star Workshop has been developed to teach eighth graders the technique of measuring position angle and separation of double stars. Through this program, the students follow in the footsteps of a professional scientist by researching the topic, performing the experiment, writing a scientific article, publishing a scientific article, and finally presenting the material to peers. An examination of current educational standards grounds this program in educational practice and philosophy.

A strategy for translating evidence into policy and practice to close the gap - developing essential service standards for Aboriginal and Torres Strait Islander cardiovascular care.

PubMed

Brown, Alex; O'Shea, Rebekah L; Mott, Kathy; McBride, Katharine F; Lawson, Tony; Jennings, Garry L R

2015-02-01

The development and application of essential standards for cardiovascular care for Aboriginal and Torres Strait Islander people creates a strategic platform on which to systematically close the gap in the health outcomes and life expectancy between Aboriginal and Torres Strait Islander and non-Indigenous people in Australia. We outline six developmental stages that can be used to enhance the effective translation of evidence into practice that reduces life expectancy differentials. Focussing efforts where the biggest gain can be made; considering how to make a policy-relevant difference with an emphasis on translation into policy and practice; establishing a foundation for action by engaging with stakeholders throughout the process; developing a framework to guide action; drafting policy-relevant and framework-appropriate essential service standards; and defining standards that help policy decision makers achieve current priority policy targets. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

A Comprehensive Guide to Readers Theatre: Enhancing Fluency and Comprehension in Middle School and Beyond

ERIC Educational Resources Information Center

Black, Alison; Stave, Anna M.

2007-01-01

With the current education climate so focused on accountability, teachers need to ensure that their teaching practices are supported by today's content-specific standards. To meet this need, "A Comprehensive Guide to Readers Theatre" shows not only how to implement Readers Theatre in the classroom but also how to use it to meet current literacy…

A mixed-methods study exploring sign-off mentorship practices in relation to the Nursing and Midwifery Council standards.

PubMed

Newton, Joanna; Taylor, Rachel M; Crighton, Liz

2017-10-01

To investigate the current practice and experience of sign-off mentors in one NHS trust. In the UK, sign-off mentors support nursing students in their last clinical placement and are accountable for the final assessment of fitness to practice as a registered nurse. Mixed-methods study. The focus was on two key Nursing and Midwifery Council standards: the requirement for students to work at least 40% of their time on clinical placement with a sign-off mentor/mentor; the sign-off mentor had one-hour-per-week protected time to meet the final placement student. Data were collected through two audits of clinical and university documents and an experience survey administered to all sign-off mentors in one trust. The audits showed that only 22/42 (52%) of students were supervised by their sign-off mentor/mentor at least 40% of the time, whilst 10/42 (24%) students never worked a shift with their sign-off mentor. Only one student met their sign-off mentor every week. Complete data were available in 31/64 (47%) sign-off mentors, of whom 21/30 (70%) rarely/never had reduced clinical commitment to mentor final placement students. Furthermore, 19/28 (68%) met their student after their shift had ended with 24/30 (80%) reporting not getting any protected time. Sign-off mentors have inadequate time and resources to undertake their role, yet are accountable for confirming the student has the required knowledge and skills to practise safely. The current model needs urgent review to improve mentoring standards. Understanding how the role of the sign-off mentor is working in practice is critical to ensuring that the Nursing and Midwifery Council standards are met, ensuring students are well supported and appropriately assessed in practice, and mentoring is given the high profile it deserves to guarantee high-quality care and protecting the public. © 2016 John Wiley & Sons Ltd.

Medical Home Implementation: A Sensemaking Taxonomy of Hard and Soft Best Practices

PubMed Central

Hoff, Timothy

2013-01-01

Context The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. Methods I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. Findings I found two distinct taxonomies of implementation best practices, which I labeled “hard” and “soft” because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. Conclusions The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. PMID:24320169

Consensus on best practice standards for Fracture Liaison Service in the Asia-Pacific region.

PubMed

Chan, Ding-Cheng Derrick; Chang, Lo-Yu; Akesson, Kristina E; Mitchell, Paul; Chen, Chung-Hwan; Michael Lewiecki, E; Lee, Joon Kiong; Lau, Tang Ching; Songpatanasilp, Thawee; Lee, Kin Bong; Kim, Kwang Joon; Chen, Jung-Fu; Huang, Ko-En; Gau, Yih-Lan; Chang, Yin-Fan; Ebeling, Peter; Xia, Weibo; Yu, Wei; Suzuki, Atsushi; Hew, Fen Lee; Mercado-Asis, Leilani B; Chung, Yoon-Sok; Tsai, Keh-Sung; Lin, Gau-Tyan; Yang, Rong-Sen; Wu, Chih-Hsing

2018-05-12

The Fracture Liaison Service (FLS) Consensus Meeting endorsed by the International Osteoporosis Foundation (IOF), Asian Federation of Osteoporosis Societies (AFOS), and Asia Pacific Osteoporosis Foundation (APOF) was hosted by the Taiwanese Osteoporosis Association on October 14, 2017. International and domestic experts reviewed the 13 Best Practice Framework (BPF) standards and concluded that all standards were generally applicable in the Asia-Pacific region and needed only minor modifications to fit the healthcare settings in the region. To review and generate consensus on best practices of fracture liaison service (FLS) in the Asia-Pacific (AP) region. In October 2017, the Taiwanese Osteoporosis Association (TOA) invited experts from the AP region (n = 23), the Capture the Fracture Steering Committee (n = 2), and the USA (n = 1) to join the AP region FLS Consensus Meeting in Taipei. After two rounds of consensus generation, the recommendations on the 13 Best Practice Framework (BPF) standards were reported and reviewed by the attendees. Experts unable to attend the on-site meeting reviewed the draft, made suggestions, and approved the final version. Because the number of FLSs in the region is rapidly increasing, experts agreed that it was timely to establish consensus on benchmark quality standards for FLSs in the region. They also agreed that the 13 BPF standards and the 3 levels of standards were generally applicable, but that some clarifications were necessary. They suggested, for example, that patient and family education be incorporated into the current standards and that communication with the public to promote FLSs be increased. The consensus on the 13 BPF standards reviewed in this meeting was that they were generally applicable and required only a few advanced clarifications to increase the quality of FLSs in the region.

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

Landsat for practical forest type mapping - A test case

NASA Technical Reports Server (NTRS)

Bryant, E.; Dodge, A. G., Jr.; Warren, S. D.

1980-01-01

Computer classified Landsat maps are compared with a recent conventional inventory of forest lands in northern Maine. Over the 196,000 hectare area mapped, estimates of the areas of softwood, mixed wood and hardwood forest obtained by a supervised classification of the Landsat data and a standard inventory based on aerial photointerpretation, probability proportional to prediction, field sampling and a standard forest measurement program are found to agree to within 5%. The cost of the Landsat maps is estimated to be $0.065/hectare. It is concluded that satellite techniques are worth developing for forest inventories, although they are not yet refined enough to be incorporated into current practical inventories.

Efficacy vs. effectiveness research in psychotherapy: implications for clinical hypnosis.

PubMed

Amundson, Jon K; Alladin, Assen; Eamon, Gill

2003-07-01

Empirically supported therapy (EST) has become a major focus and trend for mental health practice. When hypnosis is involved, this may mean satisfying a standard that is entirely too narrow in its emphasis. In this article "efficacy"-based research in clinical practice is contrasted with "effectiveness" -focused research, and they are discussed from the perspective of hypnosis. When clinicians can consider trans-theoretical factors as well as those that are treatment-enhancing, possibilities for improved treatment outcome increase. The "effectiveness" perspective also serves as a counter point for hypnosis in contrast with the dubious efficacy-based gold standard currently proposed for therapy in general, and hypnosis in particular.

Accuracy of alternate oven drying procedures

USDA-ARS?s Scientific Manuscript database

Cotton post-harvest processing research frequently requires moisture content determination for seed cotton, cotton seed, and cotton lint. Standard procedures as documented in 1972 and as currently practiced were analyzed to estimate measurement uncertainty. Understanding the source and magnitude o...

Concrete testing device provides substantial savings : fact sheet.

DOT National Transportation Integrated Search

2011-11-01

Current practices require a permeability test, ASTM C1202: "Standard Test Method for Electrical Indication of Concrete's Ability to resist Chloride Ion Penetration," for structures with potential salt water intrusion. The test is run at 56 days of ag...

Behavioral Screening for Toxicology

EPA Science Inventory

Screening for behavioral toxicity, or neurotoxicity, has been in use for decades; however, only in the past 20 years has this become a standard practice in toxicology. Current screening batteries, such as the functional observational battery (FOB), are derived from protocols use...

30 CFR 254.26 - What information must I include in the “Worst case discharge scenario” appendix?

Code of Federal Regulations, 2011 CFR

2011-07-01

... limits of current technology, for the range of environmental conditions anticipated at your facility; and... Society for Testing of Materials (ASTM) publication F625-94, Standard Practice for Describing...

Center/TRACON Automation System: Development and Evaluation in the Field

DOT National Transportation Integrated Search

1993-10-01

Technological advances are changing the way that advanced air traffic control : automation should be developed and assessed. Current standards and practices of : system development place field testing at the end of the development process. : While su...

Tax-exempt hospitals and community benefit: new directions in policy and practice.

PubMed

Rubin, Daniel B; Singh, Simone R; Young, Gary J

2015-03-18

The current community benefit standard for nonprofit hospital tax exemption has been the subject of mounting criticism. Many different constituencies have advanced the view that in its present form it fails to ensure that nonprofit hospitals provide adequate benefits to their communities in exchange for their tax exemption. In contrast, hospitals have often expressed the concern that the community benefit standard in its current form is vague and therefore difficult to comply with. Various suggestions have been made regarding how the existing community benefit standard could be improved or even replaced. In this article, we first discuss the historical and legal development of the community benefit standard. We then present the key controversies that have emerged in recent years and the policy responses attempted thus far. Finally, we evaluate possible future policy directions, which reform efforts could follow.

Safety and predictability of conscious sedation in dentistry -- a multi-centre regional audit: South and West Wales experience.

PubMed

Muthukrishnan, A; McGregor, J; Thompson, S

2013-10-01

There are no previously published reports of audits in conscious sedation from a group comprising the general dental services (GDS), community dental services (CDS) and hospital dental services (HDS). The main aim of this audit was to assess current practice within the group in relation to the safety and predictability of dental treatment undertaken with the aid of conscious sedation. A total of nine centres collected data prospectively on 1,037 sedation episodes over the course of one year. Audit standards were locally agreed based on current evidence and local experience. They were set at a completion rate of 90% and an adverse incident rate of 2% or less. Based on the data collected, a completion rate of 92% and a minor adverse incident rate of 2.6% were recorded. The participating centres met the standards set locally for this audit. Current practice in the participating centres was found to be safe and predictable. The audit tool is being refined to improve the quality of data collection. Further research and service evaluation is recommended.

Renal biopsies in children: current practice and audit of outcomes.

PubMed

Hussain, Farida; Mallik, Meeta; Marks, Stephen D; Watson, Alan R

2010-02-01

There is considerable variation in the way that children are prepared for and the techniques employed in a renal biopsy. There was national agreement between UK paediatric renal centres to review current practice and audit outcomes An initial questionnaire survey was undertaken and a 12-month prospective audit performed of renal biopsies against agreed standards for the number of needle passes, adequacy of biopsy material and complication rates. Eleven of 13 centres participated. Information leaflets are sent pre-biopsy in five centres with only one using play preparation. Six of 11 routinely perform biopsies as day-case (DC) procedures and 6 use general anaesthesia (GA). Real-time ultrasound is the favoured method in eight centres. Biopsies are performed by nephrologists only in four centres, nephrologists with radiologists in five and radiology alone in two. Of 531 biopsies (352 native), 31% were performed as a DC with 49% being done under GA. The standard for the number of passes of native kidneys (95%). The major complication rate was higher than the standard of

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.

Conflict of Interest Policies for Organizations Producing a Large Number of Clinical Practice Guidelines

PubMed Central

Norris, Susan L.; Holmer, Haley K.; Burda, Brittany U.; Ogden, Lauren A.; Fu, Rongwei

2012-01-01

Background Conflict of interest (COI) of clinical practice guideline (CPG) sponsors and authors is an important potential source of bias in CPG development. The objectives of this study were to describe the COI policies for organizations currently producing a significant number of CPGs, and to determine if these policies meet 2011 Institute of Medicine (IOM) standards. Methodology/Principal Findings We identified organizations with five or more guidelines listed in the National Guideline Clearinghouse between January 1, 2009 and November 5, 2010. We obtained the COI policy for each organization from publicly accessible sources, most often the organization's website, and compared those polices to IOM standards related to COI. 37 organizations fulfilled our inclusion criteria, of which 17 (46%) had a COI policy directly related to CPGs. These COI policies varied widely with respect to types of COI addressed, from whom disclosures were collected, monetary thresholds for disclosure, approaches to management, and updating requirements. Not one organization's policy adhered to all seven of the IOM standards that were examined, and nine organizations did not meet a single one of the standards. Conclusions/Significance COI policies among organizations producing a large number of CPGs currently do not measure up to IOM standards related to COI disclosure and management. CPG developers need to make significant improvements in these policies and their implementation in order to optimize the quality and credibility of their guidelines. PMID:22629391

Development of a Hospital Outcome Measure Intended for Use With Electronic Health Records: 30-Day Risk-standardized Mortality After Acute Myocardial Infarction.

PubMed

McNamara, Robert L; Wang, Yongfei; Partovian, Chohreh; Montague, Julia; Mody, Purav; Eddy, Elizabeth; Krumholz, Harlan M; Bernheim, Susannah M

2015-09-01

Electronic health records (EHRs) offer the opportunity to transform quality improvement by using clinical data for comparing hospital performance without the burden of chart abstraction. However, current performance measures using EHRs are lacking. With support from the Centers for Medicare & Medicaid Services (CMS), we developed an outcome measure of hospital risk-standardized 30-day mortality rates for patients with acute myocardial infarction for use with EHR data. As no appropriate source of EHR data are currently available, we merged clinical registry data from the Action Registry-Get With The Guidelines with claims data from CMS to develop the risk model (2009 data for development, 2010 data for validation). We selected candidate variables that could be feasibly extracted from current EHRs and do not require changes to standard clinical practice or data collection. We used logistic regression with stepwise selection and bootstrapping simulation for model development. The final risk model included 5 variables available on presentation: age, heart rate, systolic blood pressure, troponin ratio, and creatinine level. The area under the receiver operating characteristic curve was 0.78. Hospital risk-standardized mortality rates ranged from 9.6% to 13.1%, with a median of 10.7%. The odds of mortality for a high-mortality hospital (+1 SD) were 1.37 times those for a low-mortality hospital (-1 SD). This measure represents the first outcome measure endorsed by the National Quality Forum for public reporting of hospital quality based on clinical data in the EHR. By being compatible with current clinical practice and existing EHR systems, this measure is a model for future quality improvement measures.

Administrative Support Occupations Skill Standards.

ERIC Educational Resources Information Center

Professional Secretaries International, Kansas City, MO.

This document establishes a set of performance expectations based on current practices in administrative support occupations. It is designed to assist individuals, training providers, employers, management personnel, and professional organizations in matching knowledge, abilities, and interests to knowledge and skills required for success in…

Functional Observational Battery Testing for Nervous System Effects of Drugs and Other Chemicals

EPA Science Inventory

Screening for behavioral toxicity, or neurotoxicity, has become standard practice in preclinical safety pharmacology and toxicology. Behavior represents the integrated sum of activities mediated by the nervous system. Current screening batteries, such as the functional observat...

Meaningful Written Communication by Administrators

ERIC Educational Resources Information Center

Keil, Virginia L.; McConnahan, Wendell R.

2006-01-01

Fifty-eight principals participated in this pilot study designed to examine the nature of school administrators' current practices in written communication. Work samples were examined against ISLLC standards that call for competency in facilitating vision, communicating culture and instruction, managing the organization, developing collaboration…

Behavioral screening for toxicology and safety pharmacology

EPA Science Inventory

Screening for behavioral toxicity, or neurotoxicity, has been in use for many decades; however, only in the past 20 years has this become a standard practice in toxicology and safety pharmacology. Current screening batteries, such as the functional observational battery (FOB) and...

Effectiveness study of UNL's crack routing device (CRD) - phase II.

DOT National Transportation Integrated Search

2016-12-31

This project evaluated the crack routing device (CRD) for effectiveness in improving current crack-cutting : practices and for possible adoption as a standard in the Nebraska Department of Roads (NDOR). To enact these : evaluations of CRD, the resear...

Effectiveness study of UNL's pneumatic crack/joint preparation device.

DOT National Transportation Integrated Search

2014-03-01

The aim of this project was to evaluate the effectiveness of the crack cleaning device (CCD) for improving the current crack/joint preparation practices and for possible adoption as a standard in Nebraska Department of Roads (NDOR). Through the colla...

Robotics in otolaryngology and head and neck surgery: Recommendations for training and credentialing

PubMed Central

Gross, Neil D.; Holsinger, F. Christopher; Magnuson, J. Scott; Duvvuri, Umamaheswar; Genden, Eric M.; Ghanem, Tamer AH.; Yaremchuk, Kathleen L.; Goldenberg, David; Miller, Matthew C.; Moore, Eric J.; Morris, Luc GT.; Netterville, James; Weinstein, Gregory S.; Richmon, Jeremy

2016-01-01

Training and credentialing for robotic surgery in otolaryngology - head and neck surgery is currently not standardized, but rather relies heavily on industry guidance. This manuscript represents a comprehensive review of this increasingly important topic and outlines clear recommendations to better standardize the practice. The recommendations provided can be used as a reference by individuals and institutions alike, and are expected to evolve over time. PMID:26950771

PS1-10: How Can the Same Practice Be Classified as Having 2 and 900 MDs? NAMCS Data Collection in a Changing Ambulatory Care Environment

PubMed Central

Halley, Meghan; Gillespie, Katherine; Rendle, Katharine; Luft, Harold

2014-01-01

Background/Aims Since 1973, the National Ambulatory Medical Care Survey (NAMCS), administered by the National Center for Health Statistics (NCHS) has been widely used in studies of ambulatory care. With the growth in large multispecialty practices – including many members of the HMORN – there is a need to understand how NAMCS data are collected and whether current processes yield accurate and reliable data. NAMCS collects data from physicians about their practices and abstracts a sample of patient visit records. This study reports on the physician component. Methods In collaboration with NCHS, nine physicians were randomly sampled from a multispecialty clinic using standard NAMCS recruitment procedures; eight physicians were eligible and agreed to participate. Using their standard protocols, three Field Representatives (FRs) conducted NAMCS physician interviews while a trained ethnographer (MH, KR) observed and audio-recorded each interview. Transcripts and field notes were analyzed using a grounded theory approach to identify key themes. Results Data have been collected and analyzed. They are currently undergoing standard confidentiality review by NCHS. However, this process has been delayed due to the government shutdown. We fully anticipate that results will be released in time for presentation at the HMORN conference. Conclusions Though we are precluded from disseminating results at this time, we will provide a full report of our results in our HMORN conference presentation.

Electrical, Electronic, and Electromechanical (EEE) Parts Management and Control Requirements for Space Flight Hardware and Critical Ground Support Equipment...aka... The NASA EEE Parts Standard, NASA-STD 8739.10

NASA Technical Reports Server (NTRS)

Majewicz, Peter; Sampson, Michael

2016-01-01

Describes development and content of a new NASA Standard for Electrical Electronic and Electromechanical (EEE) parts. This Standard reflects current practices, instead of changing them. Most NASA Centers utilize local documents, but there is minimal consistency across the Agency. A gap analysis clearly shows the differences that exist among the different centers and with respect to the NASA Parts Policy. Once approved, the new standard can be referenced in contracts and agreements with organizations outside of NASA.

The Current Status of Modular Coordination. A Research Correlation Conference of Building Research Institute, Division of Engineering and Industrial Research (Fall 1959).

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC.

Publication of conference presentations include--(1) a brief review of current modular standard development, (2) the statistical status of modular practice, (3) availability of modular products, and (4) educational programs on modular coordination. Included are--(1) explanatory diagrams, (2) text of an open panel discussion, and (3) a list of…

Reading the Small Print – Labelling Recommendations for Orthopaedic Implants

PubMed Central

Haene, Roger A; Sandhu, Ranbir S; Baxandall, Richard

2009-01-01

INTRODUCTION There exist, currently, no clear guidelines regarding standards for surgical implant labelling. Dimensions of the laminar flow canopies in orthopaedic use fixes the distance at which implant labels can be read. Mistakes when reading the label on an implant box can pose health risks for patients, and financial consequences for medical institutions. SUBJECTS AND METHODS Using scientifically validated tools such as the Snellen Chart Formula, a theoretical minimum standard for text on implant labels was reached. This theoretical standard was then tested under real operating conditions. After discovering a minimum practical standard for implant labels, the authors then audited current labels in use on a wide range of orthopaedic implant packages. Furthermore, other non-text-related labelling problems were also noted. RESULTS There is a definite minimum standard which should be observed when implant labels are manufactured. Implants in current use bear labels on the packaging that are of an insufficient standard to ensure patient safety in theatre. CONCLUSIONS The authors have established text parameters that will increase the legibility of implant labels. In the interests of improving risk management in theatre, therefore, the authors propose a standard for orthopaedic implant labelling, and believe this will provide a useful foundation for further discussion between the orthopaedic community and implant manufacturers. PMID:19686615

ESIP Information Quality Cluster (IQC)

NASA Technical Reports Server (NTRS)

Ramapriyan, H. K.; Peng, Ge; Moroni, David F.

2016-01-01

The Information Quality Cluster (IQC) within the Federation of Earth Science Information Partners (ESIP) was initially formed in 2011 and has evolved significantly over time. The current objectives of the IQC are to: 1. Actively evaluate community data quality best practices and standards; 2. Improve capture, description, discovery, and usability of information about data quality in Earth science data products; 3. Ensure producers of data products are aware of standards and best practices for conveying data quality, and data providers distributors intermediaries establish, improve and evolve mechanisms to assist users in discovering and understanding data quality information; and 4. Consistently provide guidance to data managers and stewards on how best to implement data quality standards and best practices to ensure and improve maturity of their data products. The activities of the IQC include: 1. Identification of additional needs for consistently capturing, describing, and conveying quality information through use case studies with broad and diverse applications; 2. Establishing and providing community-wide guidance on roles and responsibilities of key players and stakeholders including users and management; 3. Prototyping of conveying quality information to users in a more consistent, transparent, and digestible manner; 4. Establishing a baseline of standards and best practices for data quality; 5. Evaluating recommendations from NASA's DQWG in a broader context and proposing possible implementations; and 6. Engaging data providers, data managers, and data user communities as resources to improve our standards and best practices. Following the principles of openness of the ESIP Federation, IQC invites all individuals interested in improving capture, description, discovery, and usability of information about data quality in Earth science data products to participate in its activities.

Embryo transfer techniques: an American Society for Reproductive Medicine survey of current Society for Assisted Reproductive Technology practices.

PubMed

Toth, Thomas L; Lee, Malinda S; Bendikson, Kristin A; Reindollar, Richard H

2017-04-01

To better understand practice patterns and opportunities for standardization of ET. Cross-sectional survey. Not applicable. Not applicable. An anonymous 82-question survey was emailed to the medical directors of 286 Society for Assisted Reproductive Technology member IVF practices. A follow-up survey composed of three questions specific to ET technique was emailed to the same medical directors. Descriptive statistics of the results were compiled. The survey assessed policies, protocols, restrictions, and specifics pertinent to the technique of ET. There were 117 (41%) responses; 32% practice in academic settings and 68% in private practice. Responders were experienced clinicians, half of whom had performed <10 procedures during training. Ninety-eight percent of practices allowed all practitioners to perform ET; half did not follow a standardized ET technique. Multiple steps in the ET process were identified as "highly conserved;" others demonstrated discordance. ET technique is divided among [1] trial transfer followed immediately with ET (40%); [2] afterload transfer (30%); and [3] direct transfer without prior trial or afterload (27%). Embryos are discharged in the upper (66%) and middle thirds (29%) of the endometrial cavity and not closer than 1-1.5 cm from fundus (87%). Details of each step were reported and allowed the development of a "common" practice ET procedure. ET training and practices vary widely. Improved training and standardization based on outcomes data and best practices are warranted. A common practice procedure is suggested for validation by a systematic literature review. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Commercial Motor Vehicle Driver Obstructive Sleep Apnea Screening and Treatment in the United States: An Update and Recommendation Overview

PubMed Central

Colvin, Loretta J.; Collop, Nancy A.

2016-01-01

No regulatory mandate exists in the United States (U.S.) for comprehensive obstructive sleep apnea (OSA) risk assessment and stratification for commercial motor vehicle (CMV) drivers. Current Federal Motor Carrier Safety Administration (FMCSA) requirements are outdated and depend largely on subjective report, a less reliable strategy in an occupational setting. Without FMCSA standards, sleep specialists, occupational medical examiners and employers rely on a collection of medical consensus recommendations to establish standards of care. These recommendations advise OSA risk assessment through a combination of focused medical history, physical examination, questionnaires, and accident history, which increase OSA detection compared to current FMCSA standards. For those diagnosed with OSA, consensus-based risk stratification helps identify CMV drivers who may benefit from OSA treatment and establish minimum standards for assessing treatment efficacy and adherence. Unfortunately no consolidated recommendation exists; rather, publications span medical and governmental literature in a patchwork fashion that no longer fully reflect current practice due to subsequent advances in OSA diagnosis, treatment, and technology. Based on searches of medical literature, internet materials, and reference lists from existing publications, an overview and discussion of key published recommendations regarding OSA assessment and treatment in CMV operators is provided. Suggestions for incorporating these recommendations into clinical sleep medicine practice in the U.S. are presented. The challenge for sleep specialists is maintaining the delicate balance between recommendations impacting standard of care and associated medico-legal impact with stakeholder interests from medical, regulatory, industry and public perspectives while providing high quality and efficient care. Citation: Colvin LJ, Collop NA. Commercial motor vehicle driver obstructive sleep apnea screening and treatment in the United States: an update and recommendation overview. J Clin Sleep Med 2016;12(1):113–125. PMID:26094916

Guide of good practices for occupational radiological protection in plutonium facilities

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

NONE

1998-06-01

This Technical Standard (TS) does not contain any new requirements. Its purpose is to provide guides to good practice, update existing reference material, and discuss practical lessons learned relevant to the safe handling of plutonium. the technical rationale is given to allow US Department of Energy (DOE) health physicists to adapt the recommendations to similar situations throughout the DOE complex. Generally, DOE contractor health physicists will be responsible to implement radiation protection activities at DOE facilities and DOE health physicists will be responsible for oversight of those activities. This guidance is meant to be useful for both efforts. This TSmore » replaces PNL-6534, Health Physics Manual of Good Practices for Plutonium Facilities, by providing more complete and current information and by emphasizing the situations that are typical of DOE`s current plutonium operations; safe storage, decontamination, and decommissioning (environmental restoration); and weapons disassembly.« less

40 CFR 63.11155 - What are the standards and compliance requirements for new sources?

Code of Federal Regulations, 2013 CFR

2013-07-01

... practicable, the amount of oil and plastics in the scrap that is charged to the smelting furnace. Your plan... compliance with the requirements of your plan. You must keep a current copy of your pollution prevention plan...

48 CFR 30.202-7 - Determinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 30.202-7 Determinations. (a...) Conduct a review of the Disclosure Statement to ascertain whether it is current, accurate, and complete... adequately describes the contractor's cost accounting practices. Also, the CFAO shall— (i) If the Disclosure...

40 CFR 430.01 - General definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... that are representative of the application of the best practicable control technology currently available, the best conventional pollutant control technology, or new source performance standards in lieu... production at unbleached kraft mills including linerboard or bag paper and other mixed products, and to pulp...

40 CFR 430.01 - General definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... that are representative of the application of the best practicable control technology currently available, the best conventional pollutant control technology, or new source performance standards in lieu... production at unbleached kraft mills including linerboard or bag paper and other mixed products, and to pulp...

A review of the current management of impacted foreign bodies in the oesophagus in adults.

PubMed

Balasubramaniam, Senthil K; Bray, Dominic; Black, Myles I; Salama, N Y; Mitchell, David B

2008-08-01

Patients with acute oesophageal obstruction, either due to a foreign body or food bolus, present to any of the specialties of Otorhinolaryngology, General Surgery, Cardiothoracic Surgery or Gastroenterology. To review current routine management of this condition, we conducted a postal survey of all the consultants in the aforementioned specialties in the South Thames region. The aims of the survey were to assess current practice and to produce a standardized management plan for these patients.

Current Trends in Heparin Use During Arterial Vascular Interventional Radiology

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

Durran, Alexandra C., E-mail: durranjobs@hotmail.com; Watts, Christopher, E-mail: Christopher.watts@salisbury.nhs.uk

2012-12-15

Purpose: This study was designed to assess the current use of heparinized saline and bolus doses of heparin in non-neurological interventional radiology and to determine whether consensus could be reached to produce guidance for heparin use during arterial vascular intervention. Methods: An interactive electronic questionnaire was distributed to members of the British Society of Interventional Radiology regarding their current practice in the use, dosage, and timing of heparin boluses and heparinized flushing solutions.ResultsA total of 108 completed questionnaires were received. More than 80% of respondents used heparinized saline with varying concentrations; the most prevalent was 1,000 IU/l (international units ofmore » heparin per liter) and 5,000 IU/l. Fifty-one percent of interventionalists use 3,000 IU as their standard bolus dose; however, the respondents were split regarding the timing of bolus dose with {approx}60% administering it after arterial access is obtained and 40% after crossing the lesion. There was no consensus on altering dose according to body weight, and only 4% monitored clotting parameters. Conclusions: There seems to be some coherence among practicing interventionalists regarding heparin administration. We hypothesize that heparinized saline should be used at a recognized standard concentration of 1,000 IU/l as a flushing concentration in all arterial vascular interventions and that 3,000 IU bolus is considered the standard dose for straightforward therapeutic procedures and 5000 IU for complex, crural, and endovascular aneurysm repair work. The bolus should be given after arterial access is obtained to allow time for optimal anticoagulation to be achieved by the time of active intervention and stenting. Further research into clotting abnormalities following such interventional procedures would be an interesting quantifiable follow-up to this initial survey of opinions and practice.« less

An update on dental imaging.

PubMed

Whaites, E; Brown, J

1998-08-22

This paper reviews recent advances and current trends in dental radiology. Developments in the design of dental x-ray equipment which improve both radiation hygiene and image quality are described. Also discussed are new features which broaden the scope of intra-oral and panoramic radiological diagnosis in the general dental practice setting. The article concludes with the main recommendations from the latest guidelines on quality standards for radiography, selection criteria and quality assurance in general practice.

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.

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.

EBMT transplant centers with FACT-JACIE accreditation have significantly better compliance with related donor care standards

PubMed Central

Anthias, Chloe; O'Donnell, Paul V; Kiefer, Deidre M; Yared, Jean; Norkin, Maxim; Anderlini, Paolo; Savani, Bipin N; Diaz, Miguel A; Bitan, Menachem; Halter, Joerg P; Logan, Brent R; Switzer, Galen E; Pulsipher, Michael A; Confer, Dennis L; Shaw, Bronwen E

2016-01-01

Previous studies have identified healthcare practices that may place undue pressure on related donors (RDs) of hematopoietic cell products, and an increase in serious adverse events associated with morbidities in this population. As a result, specific requirements to safeguard RD health have been introduced to FACT-JACIE Standards, but the impact of accreditation on RD care has not previously been evaluated. A survey of transplant program directors of EBMT member centers was conducted by the Donor Health and Safety Working Committee of the Center for International Blood and Marrow Transplant Research (CIBMTR) to test the hypothesis that RD care in FACT-JACIE accredited centers is more closely aligned with international consensus donor care recommendations than RD care delivered in centers without accreditation. Responses were received from 39% of 304 centers. Our results show that practice in accredited centers was much closer to recommended standards as compared to non-accredited centers. Specifically, a higher percentage of accredited centers use eligibility criteria to assess RDs (93% versus 78%; P=0.02) and a lower percentage have a single physician simultaneously responsible for a RD and their recipient (14% versus 35%; P=0.008). In contrast, where regulatory standards do not exist, both accredited and non-accredited centers fell short of accepted best practice. These results raise concerns that despite improvements in care, current practice can place undue pressure on donors, and may increase the risk of donation-associated adverse events. We recommend measures to address these issues through enhancement of regulatory standards as well as national initiatives to standardize RD care. PMID:26597079

People with insomnia: experiences with sedative hypnotics and risk perception.

PubMed

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Ellis, Jason G; Saini, Bandana

2016-08-01

Sedative hypnotics form an important part of managing insomnia and are recommended for short-term use. It is standard practice for clinicians to inform the patient to use medications only 'when required', but the use of these medications is often chronic. Little is known about the impact of standard labelling/instructions on promoting appropriate medication use for managing insomnia. To explore patient medication-taking beliefs, experiences and behavioural practices relating to the use of pharmacological/complementary sleep aids for insomnia. Specialist sleep/psychology clinics and the general community in Sydney, Australia. Semi-structured interviews were conducted with 51 people with insomnia using a schedule of questions to gauge their experiences, beliefs and current practices relating to insomnia medication use. Interviews were audio-recorded, transcribed verbatim and subjected to Framework Analysis to identify emergent themes. Participants held distinctive views about the safety and efficacy of complementary and pharmacological agents but do not intuitively turn to medications to resolve their sleep complaint. Medication use was affirmed through tangible medication-taking cues due to the ambivalence in current instructions and labelling. Practices such as dosage modification, medication substitution and delaying medication use might be important drivers for psychological dependence. Current labelling and instructions do not necessarily promote the quality use of sedative hypnotics due to the variability in patient interpretations. Clarifying the timing, quantity and frequency of medication administration as well as insomnia symptom recognition would play a significant role in optimizing the role of pharmacotherapy in the management of insomnia. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Decreasing Catheter-Associated Urinary Tract Infections in the Neurological Intensive Care Unit: One Unit's Success.

PubMed

Richards, Brenda; Sebastian, Bindhu; Sullivan, Hillary; Reyes, Rosemarie; D'Agostino, John F; Hagerty, Thomas

2017-06-01

Catheter-associated urinary tract infections are preventable adverse outcomes that increase hospital morbidity, mortality, and costs. These infections are particularly prevalent in intensive care units. To describe the success of an 18-bed neurological intensive care unit in using several nurse-implemented strategies that reduced the number of catheter-associated urinary tract infections. A prospective, interventional design with application of evidence-based practices to reduce catheter-associated urinary tract infections was used. Before implementation of the strategies, 40 catheter-associated urinary tract infections were reported for 2012 and 38 for 2013. The standardized infection ratio was 2.04 for 2012 (95% CI, 1.456-2.775) and 2.34 (95% CI, 1.522-3.312) for 2013. After implementation of the strategies, significantly fewer catheter-associated urinary tract infections were reported. In 2014, a total of 15 infections were reported, and the standardized infection ratio was less than 1.0 (95% CI, 0.685-1.900). Application of current evidence-based practices resulted in a substantial decrease in the number of catheter-associated urinary tract infections and a lower standardized infection ratio. These findings support current recommendations for "bundling" to maximize outcomes. ©2017 American Association of Critical-Care Nurses.

The Health Care Financing Administration's new examination documentation criteria: minimum auditing standards for the neurologic examination to be used by Medicare and other payors. Report from the American Academy of Neurology Medical Economics and Management Subcommittee.

PubMed

Nuwer, M R; Sigsbee, B

1998-02-01

Medicare recently announced the adoption of minimum documentation criteria for the neurologic examination. These criteria are added to existing standards for the history and medical decision-making. These criteria will be used in compliance audits by Medicare and other payors. Given the current federal initiative to eliminate fraud in the Medicare program, all neurologists need to comply with these standards. These criteria are for documentation only. Neurologic standards of care require a more complex and diverse examination pertinent to the problem(s) under consideration. Further guidance as to the content of a neurologic evaluation is outlined in the article "Practice guidelines: Neurologic evaluation" (Neurology 1990; 40: 871). The level of history and examination required for specific services is defined in the American Medical Association current procedural terminology book. Documentation standards for examination of children are not yet defined.

Cultural Competence Revisited

ERIC Educational Resources Information Center

Garran, Ann Marie; Werkmeister Rozas, Lisa

2013-01-01

In 2001, the National Association of Social Workers (NASW) adopted 10 discrete standards of culturally competent practice which undergird our commitment to diversity and social justice. The concept of intersectionality is newly emerging in social work, though, causing us to reflect on our current conceptualizations of cultural competence.…

Research on Professional Development Schools. Teacher Education Yearbook VII.

ERIC Educational Resources Information Center

Byrd, David M., Ed.; McIntyre, D. John, Ed.

This book examines the current standard practice of confining teacher preparation to 4 years of coursework, examining the growing interest in career-spanning teacher education. There are 12 chapters. Section 1, "Collaboration: Building Bridges to Transform Institutional Cultures," includes: "Overview and Framework" (Linda…

Professional Identity and the CORE Standards

ERIC Educational Resources Information Center

Benshoff, John J.; Robertson, Stacia; Davis, Sharon J.; Koch, D. Shane

2008-01-01

The historical evolution of the rehabilitation profession is addressed, and current issues facing rehabilitation educators and professionals are identified. Clearly, both our practice environments and our consumers are continuously evolving and becoming more diverse. Simultaneously, a need exists to be seen as a stable, unified profession.…

77 FR 15650 - Fisher House and Other Temporary Lodging

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... proposed rule generally reflects current VA policy and practice, and conforms to industry standards and... individuals from the medical care environment, Fisher House lodging is available only to accompanying... have an insignificant impact on small entities involved in the lodging industry. However, any effect...

77 FR 16213 - Proposed Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-20

... ensure that requested data can be provided in the desired format, reporting burden (time and financial... align with upcoming standard performance measure requirements. To separate the currently combined Grant... performance of the functions of the Corporation, including whether the information will have practical utility...

PHYTOTRANSFORMATION OF PERCHLORATE USING PARROT-FEATHER

EPA Science Inventory

Perchlorate is an oxvanion that has been extensively is a strong oxidizing
agent in solid rocket fuel. Contamination of groundwater has occurred as the result of Perchlorate use. Standard disposal practices during the 1950s through the 1970s did not reflect the current knowled...

The Future of Principal Evaluation

ERIC Educational Resources Information Center

Clifford, Matthew; Ross, Steven

2012-01-01

The need to improve the quality of principal evaluation systems is long overdue. Although states and districts generally require principal evaluations, research and experience tell that many state and district evaluations do not reflect current standards and practices for principals, and that evaluation is not systematically administered. When…

Integrating Sensor Monitoring Technology into the Current Air Pollution Regulatory Support Paradigm: Practical Considerations

EPA Science Inventory

The US Environmental Protection Agency (EPA) along with state, local, and tribal governments operate Federal Reference Method (FRM) and Federal Equivalent Method (FEM) instruments to assess compliance with US air pollution standards designed to protect human and ecosystem health....

Grading--Why Are School Policies Necessary? What Are the Issues?

ERIC Educational Resources Information Center

Thomas, William C.

1986-01-01

Argues that current grading practices in some schools lack consistency in several critical areas, including criteria for failure, absolute or relative standards, and motivation of slower students. Policies are suggested that will help educators develop fairer and more humane marking systems. (TE)

Current projects in Pre-analytics: where to go?

PubMed

Sapino, Anna; Annaratone, Laura; Marchiò, Caterina

2015-01-01

The current clinical practice of tissue handling and sample preparation is multifaceted and lacks strict standardisation: this scenario leads to significant variability in the quality of clinical samples. Poor tissue preservation has a detrimental effect thus leading to morphological artefacts, hampering the reproducibility of immunocytochemical and molecular diagnostic results (protein expression, DNA gene mutations, RNA gene expression) and affecting the research outcomes with irreproducible gene expression and post-transcriptional data. Altogether, this limits the opportunity to share and pool national databases into European common databases. At the European level, standardization of pre-analytical steps is just at the beginning and issues regarding bio-specimen collection and management are still debated. A joint (public-private) project entitled on standardization of tissue handling in pre-analytical procedures has been recently funded in Italy with the aim of proposing novel approaches to the neglected issue of pre-analytical procedures. In this chapter, we will show how investing in pre-analytics may impact both public health problems and practical innovation in solid tumour processing.

Still Human: A Call for Increased Focus on Ethical Standards in Cadaver Research.

PubMed

Bach, Michelle C

2016-12-01

Research on human cadavers is an important mechanism of scientific progress and comprises a large industry in the United States. However, despite its importance and influence, there is little ethical or regulatory oversight of cadaver-based research. This lack of transparency raises important ethical questions. Thus, this paper serves as a call for ethicists and regulators to pay increased attention to cadaver research. I argue that cadaver research ought to be considered a subset of human subjects research and held accountable to higher ethical standards. After describing current practices, I argue that oversight of cadaver research as a form of human subjects research is appropriate because cadaver research is similar to other types of human research, participants in cadaver research incur risks of harm, and a current lack of oversight has allowed the cadaver industry to entice research participation through ethically questionable practices. This paper urges greater dialogue among human subjects research ethicists and regulators about what constitutes appropriate protections for participants in cadaver research.

IEEE 1547 Standards Advancing Grid Modernization

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

Basso, Thomas; Chakraborty, Sudipta; Hoke, Andy

Technology advances including development of advanced distributed energy resources (DER) and grid-integrated operations and controls functionalities have surpassed the requirements in current standards and codes for DER interconnection with the distribution grid. The full revision of IEEE Standards 1547 (requirements for DER-grid interconnection and interoperability) and 1547.1 (test procedures for conformance to 1547) are establishing requirements and best practices for state-of-the-art DER including variable renewable energy sources. The revised standards will also address challenges associated with interoperability and transmission-level effects, in addition to strictly addressing the distribution grid needs. This paper provides the status and future direction of the ongoingmore » development focus for the 1547 standards.« less

Content-oriented Approach to Organization of Theories and Its Utilization

NASA Astrophysics Data System (ADS)

Hayashi, Yusuke; Bourdeau, Jacqueline; Mizoguch, Riichiro

In spite of the fact that the relation between theory and practice is a foundation of scientific and technological development, the trend of increasing the gap between theory and practice accelerates in these years. The gap embraces a risk of distrust of science and technology. Ontological engineering as the content-oriented research is expected to contribute to the resolution of the gap. This paper presents the feasibility of organization of theoretical knowledge on ontological engineering and new-generation intelligent systems based on it through an application of ontological engineering in the area of learning/instruction support. This area also has the problem of the gap between theory and practice, and its resolution is strongly required. So far we proposed OMNIBUS ontology, which is a comprehensive ontology that covers different learning/instructional theories and paradigms, and SMARTIES, which is a theory-aware and standard-compliant authoring system for making learning/instructional scenarios based on OMNIBUS ontology. We believe the theory-awareness and standard-compliance bridge the gap between theory and practice because it links theories to practical use of standard technologies and enables practitioners to easily enjoy theoretical support while using standard technologies in practice. The following goals are set in order to achieve it; computers (1) understand a variety of learning/instructional theories based on the organization of them, (2) utilize the understanding for helping authors' learning/instructional scenario making and (3) make such theoretically sound scenarios interoperable within the framework of standard technologies. This paper suggests an ontological engineering solution to the achievement of these three goals. Although the evaluation is far from complete in terms of practical use, we believe that the results of this study address high-level technical challenges from the viewpoint of the current state of the art in the research area of artificial intelligence not only in education but also in general, and therefore we hope that constitute a substantial contribution for organization of theoretical knowledge in many other areas.

Reflection: moving from a mandatory ritual to meaningful professional development.

PubMed

Murdoch-Eaton, Deborah; Sandars, John

2014-03-01

Reflection has become established as a key principle underpinning maintenance of standards within professional education and practice. A requirement to evidence reflection within performance review is intended to develop a transformative approach to practice, identify developmental goals, and ultimately, improve healthcare. However, some applications have taken an excessively instrumental approach to the evidencing of reflection, and while they have provided useful templates or framing devices for recording individualistic reflective practice, they potentially have distorted the original intentions. This article revisits the educational theory underpinning the importance of reflection for enhancing performance and considers how to enhance its value within current paediatric practice.

CPD Aligned to Competency Standards to Support Quality Practice

PubMed Central

Nash, Rose; Thompson, Wendy; Stupans, Ieva; Lau, Esther T. L.; Santos, Jose Manuel Serrano; Brown, Natalie; Nissen, Lisa M.; Chalmers, Leanne

2017-01-01

As medication experts, pharmacists are key members of the patient’s healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their professional development. Results of two separately administered surveys (2012 and 2013) were compared to examine the reported continued professional development (CPD) practices of Australian pharmacists. Examination of results from both studies enabled a focus on how the competency standards inform CPD practice. In the survey administered in 2012, 91% (n = 253/278) pharmacists reported that they knew their current registration requirements. However, in the survey administered in 2013, only 43% (n = 46/107) reported utilization of the National Competency Standards Framework for Pharmacists in Australia (NCS) to self-asses their practice as part of their annual re-registration requirements. Fewer, 23% (n = 25/107), used the NCS to plan their CPD. This may be symptomatic of poor familiarity with the NCS, uncertainty around undertaking self-directed learning as part of a structured learning plan and/or misunderstandings around what CPD should include. This is supported by thematic analysis of pharmacists’ social media comments. Initial and ongoing competence training to support meaningful CPD requires urgent attention in Australia. The competence (knowledge, skills and attributes) required to engage in meaningful CPD practice should be introduced and developed prior to entry into practice; other countries may find they are in a similar position. PMID:28970424

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.
.

CPD Aligned to Competency Standards to Support Quality Practice.

PubMed

Nash, Rose; Thompson, Wendy; Stupans, Ieva; Lau, Esther T L; Santos, Jose Manuel Serrano; Brown, Natalie; Nissen, Lisa M; Chalmers, Leanne

2017-02-25

As medication experts, pharmacists are key members of the patient's healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their professional development. Results of two separately administered surveys (2012 and 2013) were compared to examine the reported continued professional development (CPD) practices of Australian pharmacists. Examination of results from both studies enabled a focus on how the competency standards inform CPD practice.In the survey administered in 2012, 91% ( n = 253/278) pharmacists reported that they knew their current registration requirements. However, in the survey administered in 2013, only 43% ( n = 46/107) reported utilization of the National Competency Standards Framework for Pharmacists in Australia (NCS) to self-asses their practice as part of their annual re-registration requirements. Fewer, 23% ( n = 25/107), used the NCS to plan their CPD. This may be symptomatic of poor familiarity with the NCS, uncertainty around undertaking self-directed learning as part of a structured learning plan and/or misunderstandings around what CPD should include. This is supported by thematic analysis of pharmacists' social media comments. Initial and ongoing competence training to support meaningful CPD requires urgent attention in Australia. The competence (knowledge, skills and attributes) required to engage in meaningful CPD practice should be introduced and developed prior to entry into practice; other countries may find they are in a similar position.

Practice nurse health checks for adults with intellectual disabilities: a cluster-design, randomised controlled trial.

PubMed

Cooper, Sally-Ann; Morrison, Jill; Allan, Linda M; McConnachie, Alex; Greenlaw, Nicola; Melville, Craig A; Baltzer, Marion C; McArthur, Laura A; Lammie, Claire; Martin, Gordon; Grieve, Eleanor A D; Fenwick, Elisabeth

2014-12-01

Adults with intellectual disabilities have substantial health inequalities and poor access to health care. We assessed whether practice nurse-delivered health checks could improve the health of adults with intellectual disabilities compared with standard care. In this cluster-design, single-blind, randomised controlled trial, we included general practices in Scotland, UK. From June to December, 2011, we randomly assigned (1:1) these general practices to either health checks plus standard care (health-checks group), or standard care only (control group), and we recruited the patients from these practices. Randomisation was done with stratification by number of GPs per practice and number of registered patients with intellectual disabilities (<20 or ≥20). Two research assistants were masked to allocation, and undertook the review of 9 month medical records and interviews. Participants and carers were not masked. The intervention was one health check designed especially for people with intellectual disabilities delivered by a practice nurse. The objective was improvement in health and health care 9 months after randomisation, and the primary outcome was the incidence of newly detected health needs being met by this timepoint. Whether needs were met was established by the investigators being masked to group allocation. The analysis was by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN43324841. Between June 26 and Dec 20, 2011, we recruited 38 practices. 85 participants (from 16 practices) were randomly assigned to intervention and 67 (from 17 practices) to standard care; five of the identified practices did not supply any participants. 83 intervention and 66 standard care participants completed the trial. More newly detected health needs were met in the intervention group than in the control standard care group (median 1 [range 0-8], 76·4% met [SD 36·5] vs 2 [0-11], 72·6% met [35·4]; odds ratio [OR] 1·73 [95% CI 0·93-3·22], p=0·085), although this difference was not significant. Significantly more health monitoring needs were met in the intervention group than standard care (median 2 [0-20], 69·9% [SD 34·2] vs 2 [0-22], 56·8% [29·4], OR 2·38 [95% CI 1·31-4·32, p=0·0053]). The probability that health checks are cost effective was between 0·6 and 0·8, irrespective of the cost-effectiveness threshold level. Costs per patient were -£71·48 for health checks and -£20·56 for standard care. The difference (-£50·92) was not significant [95% CI -434 to 362]. No adverse events were attributable to the intervention. Health checks given by practice nurses to adults with intellectual disabilities produced health-care improvements that were more conducive to longer-term health than standard care given to this population. The intervention dominated standard care, being both cheaper and more effective. Health-check programmes might therefore be indicated for adults with intellectual disabilities. Scottish Government Change Fund, NHS Greater Glasgow and Clyde Research and Development. Copyright © 2014 Elsevier Ltd. All rights reserved.

Standard methods for sampling freshwater fishes: Opportunities for international collaboration

USGS Publications Warehouse

Bonar, Scott A.; Mercado-Silva, Norman; Hubert, Wayne A.; Beard, Douglas; Dave, Göran; Kubečka, Jan; Graeb, Brian D. S.; Lester, Nigel P.; Porath, Mark T.; Winfield, Ian J.

2017-01-01

With publication of Standard Methods for Sampling North American Freshwater Fishes in 2009, the American Fisheries Society (AFS) recommended standard procedures for North America. To explore interest in standardizing at intercontinental scales, a symposium attended by international specialists in freshwater fish sampling was convened at the 145th Annual AFS Meeting in Portland, Oregon, in August 2015. Participants represented all continents except Australia and Antarctica and were employed by state and federal agencies, universities, nongovernmental organizations, and consulting businesses. Currently, standardization is practiced mostly in North America and Europe. Participants described how standardization has been important for management of long-term data sets, promoting fundamental scientific understanding, and assessing efficacy of large spatial scale management strategies. Academics indicated that standardization has been useful in fisheries education because time previously used to teach how sampling methods are developed is now more devoted to diagnosis and treatment of problem fish communities. Researchers reported that standardization allowed increased sample size for method validation and calibration. Group consensus was to retain continental standards where they currently exist but to further explore international and intercontinental standardization, specifically identifying where synergies and bridges exist, and identify means to collaborate with scientists where standardization is limited but interest and need occur.

Radiology practice in Latin America: a literature review.

PubMed

Teague, Jordan

2013-01-01

To discover the status and structure of radiology in Latin America with respect to the health care systems it is part of, the effects of socioeconomics, the equipment and technology used, technologists and their training, accreditation, and professional organizations. Health-related databases and Google Scholar were searched for articles concerning radiology practice in Latin America. Articles were selected based on relevance to the research scope. Many regions in Latin America offer little to no access to radiology. Where there is access, the equipment often is old or not functioning, with limited and costly service and maintenance. Most trained technologists live in urban areas. There are no standardized accreditation practices in Latin America. However, forming professional organizations would help promote the practice of radiology and accreditation standards. International cooperative organizations enhance radiology by providing resources and opportunities for cooperation between countries. The current status of radiology in Latin America must be determined. This knowledge will help us discover opportunities for cooperation and ways to improve radiology practice. The main need in Latin America is to extend coverage to the underserved population.

Problem Solvers: Problem--Jesse's Train

ERIC Educational Resources Information Center

James, Julie; Steimle, Alice

2014-01-01

Persevering in problem solving and constructing and critiquing mathematical arguments are some of the mathematical practices included in the Common Core State Standards for Mathematics (CCSSI 2010). To solve unfamiliar problems, students must make sense of the situation and apply current knowledge. Teachers can present such opportunities by…

Rewards and Supports

ERIC Educational Resources Information Center

Hershberg, Theodore; Robertson-Kraft, Claire

2010-01-01

Pay-for-performance systems in public schools have long been burdened with controversy. Critics of performance pay systems contend that because teachers' impact cannot be measured without error, it is impossible to create fair and accurate systems for evaluating and rewarding performance. By this standard, however, current practice fails on both…

(De)constructing Student Engagement for Pre-Service Teacher Learning

ERIC Educational Resources Information Center

Beasley, Jennifer G.; Gist, Conra D.; Imbeau, Marcia B.

2014-01-01

Learning to teach is a complex intellectual and adaptive performance act. Student engagement is the cornerstone of effective instruction. Current education reform policies, such as Common Core State Standards (National Governors Association Center for Best Practices & Council of Chief State School Officers, 2010) and Teacher Effectiveness…

12 CFR 560.101 - Real estate lending standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... estate lending policies adopted pursuant to this section must: (i) Be consistent with safe and sound... institution's policies must be comprehensive, and consistent with safe and sound lending practices, and must..., construction, and absorption rates. • Current and projected lease terms, rental rates, and sales prices...

Challenges to laboratory hematology practice: Egypt perspective.

PubMed

Rizk, S H

2018-05-01

Laboratory hematology is an integral part of all clinical laboratories along the extensive healthcare facilities in Egypt. The aim of this review is to portrait the laboratory hematology practice in Egypt including its unique socioeconomic background, blood disease pattern, education and training, regulatory oversight, and the related challenges. Current practice varies widely between different parts of the healthcare system in terms of the range of tests, applied techniques, workforce experience, and quality of service. The national transfusion service (NBTS) in Egypt has been recently upgraded and standardized according to the World Health Organization (WHO) guidelines. Formal postgraduate education roughly follows the British system. Laboratory hematology specialization is achieved through 2-3 years masters' degree followed by 2-4 years doctorate degree in clinical pathology with training and research in hematology. Improvement of laboratory hematology education is recently undergoing a reform as a part of the modernization of higher education policy and following the standards developed by the National Quality Assurance and Accreditation Agency (NQAAA). Accreditation of medical laboratories is recently progressing with the development of the "Egyptian Accreditation Council" (EGAC) as the sole accreditation body system and training of assessors. Current laboratory system has many challenges, some are related to the inadequate system performance, and others are unique to laboratory hematology issues. The rapid technological advances and therapeutic innovations in hematology practice call for an adapting laboratory system with continuous upgrading. © 2018 John Wiley & Sons Ltd.

Mapping Perinatal Nursing Process Measurement Concepts to Standard Terminologies.

PubMed

Ivory, Catherine H

2016-07-01

The use of standard terminologies is an essential component for using data to inform practice and conduct research; perinatal nursing data standardization is needed. This study explored whether 76 distinct process elements important for perinatal nursing were present in four American Nurses Association-recognized standard terminologies. The 76 process elements were taken from a valid paper-based perinatal nursing process measurement tool. Using terminology-supported browsers, the elements were manually mapped to the selected terminologies by the researcher. A five-member expert panel validated 100% of the mapping findings. The majority of the process elements (n = 63, 83%) were present in SNOMED-CT, 28% (n = 21) in LOINC, 34% (n = 26) in ICNP, and 15% (n = 11) in CCC. SNOMED-CT and LOINC are terminologies currently recommended for use to facilitate interoperability in the capture of assessment and problem data in certified electronic medical records. Study results suggest that SNOMED-CT and LOINC contain perinatal nursing process elements and are useful standard terminologies to support perinatal nursing practice in electronic health records. Terminology mapping is the first step toward incorporating traditional paper-based tools into electronic systems.

Solar PV O&M Standards and Best Practices – Existing Gaps and Improvement Efforts

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

Klise, Geoffrey Taylor; Balfour, John R.; Keating, T. J.

2014-11-01

As greater numbers of photovoltaic (PV) systems are being installed, operations & maintenance (O&M) activities will need to be performed to ensure the PV system is operating as designed over its useful lifetime. To mitigate risks to PV system availability and performance, standardized procedures for O&M activities are needed to ensure high reliability and long-term system bankability. Efforts are just getting underway to address the need for standard O&M procedures as PV gains a larger share of U.S. generation capacity. Due to the existing landscape of how and where PV is installed, including distributed generation from small and medium PVmore » systems, as well as large, centralized utility-scale PV, O&M activities will require different levels of expertise and reporting, making standards even more important. This report summarizes recent efforts made by solar industry stakeholders to identify the existing standards and best practices applied to solar PV O&M activities, and determine the gaps that have yet to be, or are currently being addressed by industry.« less

Solar PV O&M Standards and Best Practices - Existing Gaps and Improvement Efforts

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

Klise, Geoffrey Taylor; Balfour, John R.; Keating, T. J.

2014-11-01

As greater numbers of photovoltaic (PV) systems are being installed, operations & maintenance (O&M) activities will need to be performed to ensure the PV system is operating as designed over its useful lifetime. To mitigate risks to PV system availability and performance, standardized procedures for O&M activities are needed to ensure high reliability and long-term system bankability. Efforts are just getting underway to address the need for standard O&M procedures as PV gains a larger share of U.S. generation capacity. Due to the existing landscape of how and where PV is installed, including distributed generation from small and medium PVmore » systems, as well as large, centralized utility-scale PV, O&M activities will require different levels of expertise and reporting, making standards even more important. This report summarizes recent efforts made by solar industry stakeholders to identify the existing standards and best practices applied to solar PV O&M activities, and determine the gaps that have yet to be, or are currently being addressed by industry.« less

Current issues on a standard for surrogate pregnancy procedures

PubMed Central

2012-01-01

While Korea does not have any legal statement on surrogacy, treatments are carried out in practice. As a result, every Institutional Review Board (IRB) of each fertility clinic faces an ethical predicament in reviewing each case. There is a need to arrange the institutions' own standards of surrogate pregnancy procedures before the establishment of national or professional regulation. This article examines the legal, social, and medical issues of surrogacy to help IRBs to judge their cases. PMID:23346523

Current issues on a standard for surrogate pregnancy procedures.

PubMed

Ha, Jung-Ok

2012-12-01

While Korea does not have any legal statement on surrogacy, treatments are carried out in practice. As a result, every Institutional Review Board (IRB) of each fertility clinic faces an ethical predicament in reviewing each case. There is a need to arrange the institutions' own standards of surrogate pregnancy procedures before the establishment of national or professional regulation. This article examines the legal, social, and medical issues of surrogacy to help IRBs to judge their cases.

Hydrologic and chemical-quality data from four rural basins in Guilford County, North Carolina, 1985-88

USGS Publications Warehouse

Hill, C.L.

1989-01-01

An investigation was begun in 1984 in Guilford County, North Carolina, to monitor water quality and soil erosion in basins with various land-management practices. Hydrologic and chemical-quality data were collected from four rural drainage basins, including two agricultural basins (7.4 and 4.8 acres) cultivated in tobacco and small grains, a mixed rural land-use basin (665 acres) currently under standard land-management practices, and a forested control basin (44 acres) characterizing background conditions. Mean concentrations of total nitrite plus nitrate were 1.0 milligrams per liter from the agricultural basin under standard land-management practices. This was nearly 10 times greater than concentrations from the forested basin. Records of streamflow discharge, chemical quality, ground-water levels, precipitation, and farming activities collected from October 1984 through September 1988 at one or more of the basins are also presented in this report.

From Index Catalogue to Gopher space: changes in our profession as reflected in the Handbook and CPHSL.

PubMed Central

Bunting, A

1994-01-01

A fifty-year review of the history of health sciences librarianship, as reflected in four editions of the Handbook of Medical Library Practice and its successor, Current Practice in Health Sciences Librarianship, illustrates the significant changes our profession has undergone. Publication in 1943 of the first edition of the Handbook marked an important milestone in the development of the Medical Library Association, as a group of dedicated volunteers documented standard practice and recorded useful data. Administration of health sciences libraries has moved from art to science. Responsibility for the development of collections is now the sole purview of professional librarians. Automation and bibliographic standards have revolutionized the methods for controlling and providing access to information resources. And, the means by which assistance is provided to library users, through the use of computer and telecommunications technology, has changed dramatically. PMID:8136754

The state of cell block variation and satisfaction in the era of molecular diagnostics and personalized medicine

PubMed Central

Crapanzano, John P.; Heymann, Jonas J.; Monaco, Sara; Nassar, Aziza; Saqi, Anjali

2014-01-01

Background: In the recent past, algorithms and recommendations to standardize the morphological, immunohistochemical and molecular classification of lung cancers on cytology specimens have been proposed, and several organizations have recommended cell blocks (CBs) as the preferred modality for molecular testing. Based on the literature, there are several different techniques available for CB preparation-suggesting that there is no standard. The aim of this study was to conduct a survey of CB preparation techniques utilized in various practice settings and analyze current issues, if any. Materials and Methods: A single E-mail with a link to an electronic survey was distributed to members of the American Society of Cytopathology and other pathologists. Questions pertaining to the participants’ practice setting and CBs-volume, method, quality and satisfaction-were included. Results: Of 95 respondents, 90/95 (94%) completed the survey and comprise the study group. Most participants practice in a community hospital/private practice (44%) or academic center (41%). On average, 14 CBs (range 0-50; median 10) are prepared by a laboratory daily. Over 10 methods are utilized: Plasma thrombin (33%), HistoGel (27%), Cellient automated cell block system (8%) and others (31%) respectively. Forty of 90 (44%) respondents are either unsatisfied or sometimes satisfied with their CB quality, with low-cellular yield being the leading cause of dissatisfaction. There was no statistical significance between the three most common CB preparation methods and satisfaction with quality. Discussion: Many are dissatisfied with their current method of CB preparation, and there is no consistent method to prepare CBs. In today's era of personalized medicine with an increasing array of molecular tests being applied to cytological specimens, there is a need for a standardized protocol for CB optimization to enhance cellularity. PMID:24799951

The state of cell block variation and satisfaction in the era of molecular diagnostics and personalized medicine.

PubMed

Crapanzano, John P; Heymann, Jonas J; Monaco, Sara; Nassar, Aziza; Saqi, Anjali

2014-01-01

In the recent past, algorithms and recommendations to standardize the morphological, immunohistochemical and molecular classification of lung cancers on cytology specimens have been proposed, and several organizations have recommended cell blocks (CBs) as the preferred modality for molecular testing. Based on the literature, there are several different techniques available for CB preparation-suggesting that there is no standard. The aim of this study was to conduct a survey of CB preparation techniques utilized in various practice settings and analyze current issues, if any. A single E-mail with a link to an electronic survey was distributed to members of the American Society of Cytopathology and other pathologists. Questions pertaining to the participants' practice setting and CBs-volume, method, quality and satisfaction-were included. Of 95 respondents, 90/95 (94%) completed the survey and comprise the study group. Most participants practice in a community hospital/private practice (44%) or academic center (41%). On average, 14 CBs (range 0-50; median 10) are prepared by a laboratory daily. Over 10 methods are utilized: Plasma thrombin (33%), HistoGel (27%), Cellient automated cell block system (8%) and others (31%) respectively. Forty of 90 (44%) respondents are either unsatisfied or sometimes satisfied with their CB quality, with low-cellular yield being the leading cause of dissatisfaction. There was no statistical significance between the three most common CB preparation methods and satisfaction with quality. Many are dissatisfied with their current method of CB preparation, and there is no consistent method to prepare CBs. In today's era of personalized medicine with an increasing array of molecular tests being applied to cytological specimens, there is a need for a standardized protocol for CB optimization to enhance cellularity.

Best Practice Guidelines for Pre-Launch Characterization and Calibration of Instruments for Passive Optical Remote Sensing1

PubMed Central

Datla, R. U.; Rice, J. P.; Lykke, K. R.; Johnson, B. C.; Butler, J. J.; Xiong, X.

2011-01-01

The pre-launch characterization and calibration of remote sensing instruments should be planned and carried out in conjunction with their design and development to meet the mission requirements. The onboard calibrators such as blackbodies and the sensors such as spectral radiometers should be characterized and calibrated using SI traceable standards. In the case of earth remote sensing, this allows inter-comparison and intercalibration of different sensors in space to create global time series of climate records of high accuracy where some inevitable data gaps can be easily bridged. The recommended best practice guidelines for this pre-launch effort is presented based on experience gained at National Institute of Standards and Technology (NIST), National Aeronautics and Space Administration (NASA) and National Oceanic and Atmospheric Administration (NOAA) programs over the past two decades. The currently available radiometric standards and calibration facilities at NIST serving the remote sensing community are described. Examples of best practice calibrations and intercomparisons to build SI (international System of Units) traceable uncertainty budget in the instrumentation used for preflight satellite sensor calibration and validation are presented. PMID:26989588

Coding of DNA samples and data in the pharmaceutical industry: current practices and future directions--perspective of the I-PWG.

PubMed

Franc, M A; Cohen, N; Warner, A W; Shaw, P M; Groenen, P; Snapir, A

2011-04-01

DNA samples collected in clinical trials and stored for future research are valuable to pharmaceutical drug development. Given the perceived higher risk associated with genetic research, industry has implemented complex coding methods for DNA. Following years of experience with these methods and with addressing questions from institutional review boards (IRBs), ethics committees (ECs) and health authorities, the industry has started reexamining the extent of the added value offered by these methods. With the goal of harmonization, the Industry Pharmacogenomics Working Group (I-PWG) conducted a survey to gain an understanding of company practices for DNA coding and to solicit opinions on their effectiveness at protecting privacy. The results of the survey and the limitations of the coding methods are described. The I-PWG recommends dialogue with key stakeholders regarding coding practices such that equal standards are applied to DNA and non-DNA samples. The I-PWG believes that industry standards for privacy protection should provide adequate safeguards for DNA and non-DNA samples/data and suggests a need for more universal standards for samples stored for future research.

Best Practice Guidelines for Pre-Launch Characterization and Calibration of Instruments for Passive Optical Remote Sensing.

PubMed

Datla, R U; Rice, J P; Lykke, K R; Johnson, B C; Butler, J J; Xiong, X

2011-01-01

The pre-launch characterization and calibration of remote sensing instruments should be planned and carried out in conjunction with their design and development to meet the mission requirements. The onboard calibrators such as blackbodies and the sensors such as spectral radiometers should be characterized and calibrated using SI traceable standards. In the case of earth remote sensing, this allows inter-comparison and intercalibration of different sensors in space to create global time series of climate records of high accuracy where some inevitable data gaps can be easily bridged. The recommended best practice guidelines for this pre-launch effort is presented based on experience gained at National Institute of Standards and Technology (NIST), National Aeronautics and Space Administration (NASA) and National Oceanic and Atmospheric Administration (NOAA) programs over the past two decades. The currently available radiometric standards and calibration facilities at NIST serving the remote sensing community are described. Examples of best practice calibrations and intercomparisons to build SI (international System of Units) traceable uncertainty budget in the instrumentation used for preflight satellite sensor calibration and validation are presented.

Creating Next Generation Teacher Preparation Programs to Support Implementation of the Next Generation Science Standards and Common Core State Standards in K-12 Schools: An Opportunity for the Earth and Space Sciences

NASA Astrophysics Data System (ADS)

Geary, E. E.; Egger, A. E.; Julin, S.; Ronca, R.; Vokos, S.; Ebert, E.; Clark-Blickenstaff, J.; Nollmeyer, G.

2015-12-01

A consortium of two and four year Washington State Colleges and Universities in partnership with Washington's Office of the Superintendent of Public Instruction (OSPI), the Teachers of Teachers of Science, and Teachers of Teachers of Mathematics, and other key stakeholders, is currently working to improve science and mathematics learning for all Washington State students by creating a new vision for STEM teacher preparation in Washington State aligned with the Next Generation Science Standards (NGSS) and the Common Core State Standards (CCSS) in Mathematics and Language Arts. Specific objectives include: (1) strengthening elementary and secondary STEM Teacher Preparation courses and curricula, (2) alignment of STEM teacher preparation programs across Washington State with the NGSS and CCSS, (3) development of action plans to support implementation of STEM Teacher Preparation program improvement at Higher Education Institutions (HEIs) across the state, (4) stronger collaborations between HEIs, K-12 schools, government agencies, Non-Governmental Organizations, and STEM businesses, involved in the preparation of preservice STEM teachers, (5) new teacher endorsements in Computer Science and Engineering, and (6) development of a proto-type model for rapid, adaptable, and continuous improvement of STEM teacher preparation programs. A 2015 NGSS gap analysis of teacher preparation programs across Washington State indicates relatively good alignment of courses and curricula with NGSS Disciplinary Core Ideas and Scientific practices, but minimal alignment with NGSS Engineering practices and Cross Cutting Concepts. Likewise, Computer Science and Sustainability ideas and practices are not well represented in current courses and curricula. During the coming year teams of STEM faculty, education faculty and administrators will work collaboratively to develop unique action plans for aligning and improving STEM teacher preparation courses and curricula at their institutions.

Meeting the measurement uncertainty and traceability requirements of ISO/AEC standard 17025 in chemical analysis.

PubMed

King, B

2001-11-01

The new laboratory accreditation standard, ISO/IEC 17025, reflects current thinking on good measurement practice by requiring more explicit and more demanding attention to a number of activities. These include client interactions, method validation, traceability, and measurement uncertainty. Since the publication of the standard in 1999 there has been extensive debate about its interpretation. It is the author's view that if good quality practices are already in place and if the new requirements are introduced in a manner that is fit for purpose, the additional work required to comply with the new requirements can be expected to be modest. The paper argues that the rigour required in addressing the issues should be driven by customer requirements and the factors that need to be considered in this regard are discussed. The issues addressed include the benefits, interim arrangements, specifying the analytical requirement, establishing traceability, evaluating the uncertainty and reporting the information.

Wheelchair transportation safety on school buses: stakeholder recommendations for priority issues and actions.

PubMed

Buning, Mary Ellen; Karg, Patricia E

2011-01-01

This paper presents results from and provides discussion of a state-of-the-science workshop in which highly informed stakeholders in wheelchair transportation safety for students on school buses were participants. The Nominal Group Technique was used to create a process in which the main issues preventing safe transportation of wheelchair-seated students and key strategies to overcome these issues were identified and ranked. These results, along with a synthesis of group discussion and recommendations for action, are presented along with consideration of current policies, regulations, and political realities. Critical safety shortcomings exist in this highly specialized enterprise that varies from state to state. Recommended strategies include implementing wheelchair requirements in federal transportation safety standards, creation of a clearinghouse for wheelchair transportation best practices and education, creation of national standards for training, practices, and monitoring, and increased "buy-in" to voluntary wheelchair standards by wheelchair manufacturers.

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.

Practice Parameters for the Use of Autotitrating Continuous Positive Airway Pressure Devices for Titrating Pressures and Treating Adult Patients with Obstructive Sleep Apnea Syndrome: An Update for 2007

PubMed Central

Morgenthaler, Timothy I.; Aurora, R. Nisha; Brown, Terry; Zak, Rochelle; Alessi, Cathy; Boehlecke, Brian; Chesson, Andrew L.; Friedman, Leah; Kapur, Vishesh; Maganti, Rama; Owens, Judith; Pancer, Jeffrey; Swick, Todd J.

2008-01-01

These practice parameters are an update of the previously published recommendations regarding the use of autotitrating positive airway pressure (APAP) devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome. Continuous positive airway pressure (CPAP) at an effective setting verified by attended polysomnography is a standard treatment for obstructive sleep apnea (OSA). APAP devices change the treatment pressure based on feedback from various patient measures such as airflow, pressure fluctuations, or measures of airway resistance. These devices may aid in the pressure titration process, address possible changes in pressure requirements throughout a given night and from night to night, aid in treatment of OSA when attended CPAP titration has not or cannot be accomplished, or improve patient comfort. A task force of the Standards of Practice Committee of the American Academy of Sleep Medicine has reviewed the literature published since the 2002 practice parameter on the use of APAP. Current recommendations follow: (1) APAP devices are not recommended to diagnose OSA; (2) patients with congestive heart failure, patients with significant lung disease such as chronic obstructive pulmonary disease; patients expected to have nocturnal arterial oxyhemoglobin desaturation due to conditions other than OSA (e.g., obesity hypoventilation syndrome); patients who do not snore (either naturally or as a result of palate surgery); and patients who have central sleep apnea syndromes are not currently candidates for APAP titration or treatment; (3) APAP devices are not currently recommended for split-night titration; (4) certain APAP devices may be used during attended titration with polysomnography to identify a single pressure for use with standard CPAP for treatment of moderate to severe OSA; (5) certain APAP devices may be initiated and used in the self-adjusting mode for unattended treatment of patients with moderate to severe OSA without significant comorbidities (CHF, COPD, central sleep apnea syndromes, or hypoventilation syndromes); (6) certain APAP devices may be used in an unattended way to determine a fixed CPAP treatment pressure for patients with moderate to severe OSA without significant comorbidities (CHF, COPD, central sleep apnea syndromes, or hypoventilation syndromes); (7) patients being treated with fixed CPAP on the basis of APAP titration or being treated with APAP must have close clinical follow-up to determine treatment effectiveness and safety; and (8) a reevaluation and, if necessary, a standard attended CPAP titration should be performed if symptoms do not resolve or the APAP treatment otherwise appears to lack efficacy. Citation: Morgenthaler TI; Aurora RN; Brown T; Zak R; Alessi C; Boehlecke B; Chesson AL; Friedman L; Kapur V; Maganti R; Owens J; Pancer J; Swick TJ; Standards of Practice Committee of the AASM. Practice parameters for the use of autotitrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome: An update for 2007. SLEEP 2008;31(1):141-147. PMID:18220088

The Next Generation Science Standards: An Historic Opportunity for K-12 Earth and Space Science Education

NASA Astrophysics Data System (ADS)

Johnson, R. M.; Passow, M. J.; Holzer, M. A.; Moore, J.

2014-12-01

The Next Generation Science Standards (NGSS) provide an historic opportunity to significantly improve Earth and space science (ESS) education nationally at the K-12 level. The increased emphasis on ESS related topics in the NGSS relative to previous standards provides a real opportunity for ensuring all K-12 students in adopting states learn about the ESS - allowing us to reach many more students than are currently are exposed to our discipline. The new standards are also exciting in that they explicitly couple science and engineering practice, cross-cutting concepts, and disciplinary core ideas in such a way that student must actively demonstrate their understanding through actions rather than through mere regurgitation of memorized responses. Achieving mastery of NGSS Performance Expectations will require practice with higher-order learning skills - with students engaging in the practices of scientists and engineers. Preparing students for this mastery will be a challenging task for teachers, since in many states professional development support is limited at best for the current curriculum - let alone the curricula that will be developed to address the NGSS. As adoption of the NGSS expands across the country, states will be at various levels of implementation of the new standards over the next several years - and there is real concern that teachers must have sufficient professional development to be able to be successful in preparing their students - particularly in view of likely coupled assessments and teacher evaluations. NESTA strongly supports implementation of the NGSS, and the rigorous and compelling ESS education it will engender, when coupled with a strong emphasis nationwide on teacher professional development. For the past two years, the National Earth Science Teachers Association (NESTA) has continued our leadership in K-12 ESS education through workshops, web seminars, events and publications that emphasize implementation of the NGSS in ESS-related courses. Our recent survey of K-12 Earth and space science educators confirms widespread enthusiasm about the potential offered by the new standards, as well as concern about the urgent need for professional development to support teacher implementation of the standards.

The best choice of equipment to obtain high quality standardised results in intra-oral photography - a comparison between the common practice in the UK and the gold standard set by the literature.

PubMed

Marcato, Laura; Sandler, Jonathan

2018-04-01

Since digital technology made dental photography widely available, photographers have been trying to establish the 'gold standard' when obtaining intra-oral photographs. A basic knowledge of photographic principles, familiarity with particular dental techniques and a correct choice and use of equipment contribute significantly both to the standardisation and quality of photographs. A recent survey between members of the Institute of Medical Illustrators shed a light on the current practice in the UK. Medical photographers do not always have access to the full range of suitable equipment. A better selection of retractors and occlusal mirrors would undoubtedly contribute to higher quality images.

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.

[Error prevention through management of complications in urology: standard operating procedures from commercial aviation as a model].

PubMed

Kranz, J; Sommer, K-J; Steffens, J

2014-05-01

Patient safety and risk/complication management rank among the current megatrends in modern medicine, which has undoubtedly become more complex. In time-critical, error-prone and difficult situations, which often occur repeatedly in everyday clinical practice, guidelines are inappropriate for acting rapidly and intelligently. With the establishment and consistent use of standard operating procedures like in commercial aviation, a possible strategic approach is available. These medical aids to decision-making - quick reference cards - are short, optimized instructions that enable a standardized procedure in case of medical claims.

Plastics processing: statistics, current practices, and evaluation.

PubMed

Cooke, F

1993-11-01

The health care industry uses a huge quantity of plastic materials each year. Much of the machinery currently used, or supplied, for plastics processing is unsuitable for use in a clean environment. In this article, the author outlines the reasons for the current situation and urges companies to re-examine their plastic-processing methods, whether performed in-house or subcontracted out. Some of the factors that should be considered when evaluating plastics-processing equipment are outlined to assist companies in remaining competitive and complying with impending EC regulations on clean room standards for manufacturing areas.

Ethical Considerations for Cognitive-Behavioral Therapists in Psychotherapy Research Trials

ERIC Educational Resources Information Center

Haman, Kirsten L.; Hollon, Steven D.

2009-01-01

Psychotherapy research studies, which balance the pursuit of knowledge with the provision of treatment, can place unique demands on clinicians, patients, and research staff. However, the literature on ethical considerations in psychotherapy trials is minimal. The current paper depicts CBT community standards of practice in the context of two…

On Present State of Teaching Russian Language in Russia

ERIC Educational Resources Information Center

Tekucheva, Irina V.; Gromova, Liliya Y.

2016-01-01

The article discusses the current state of teaching Russian language, discovers the nature of philological education, outlines the main problems of the implementation of the standard in school practice, analyzes the problems of formation of universal educational actions within the context of the implementation of cognitive-communicative approach,…

Technologies for Education: A Practical Guide. Fourth Edition.

ERIC Educational Resources Information Center

Barron, Ann E.; Orwig, Gary W.; Ivers, Karen S.; Lilavois, Nick

This book offers an updated look at the technologies that are impacting education. Designed for educators who are interested in the instructional applications of technology, the book provides information about current technology standards for students and teachers, as well as research related to the effectiveness of technology in education. It…

Strengthening Science Departments

ERIC Educational Resources Information Center

Campbell, Todd; Melville, Wayne; Bartley, Anthony

2012-01-01

Teachers do not work in a vacuum. They are, in most cases, part of a science department in which teachers and the chairperson have important roles in science education reform. Current reform is shaped by national standards documents that emphasize the pedagogical and conceptual importance of best practices framed by constructivism and focused on…

Help Seeking in Academic Settings: Goals, Groups, and Contexts

ERIC Educational Resources Information Center

Karabenick, Stuart A., Ed.; Newman, Richard S., Ed.

2006-01-01

Building on Karabenick's earlier volume on this topic and maintaining its high standards of scholarship and intellectual rigor, this book brings together contemporary work that is theoretically as well as practically important. It highlights current trends in the area and gives expanded attention to applications to teaching and learning. The…

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

Strategies for Career-Long Teacher Education. Teacher Education Yearbook VI.

ERIC Educational Resources Information Center

McIntyre, D. John, Ed.; Byrd, David M., Ed.

This collection of papers examines the current standard practice of confining teacher preparation to 4 years of coursework, discussing the growing interest in career-spanning teacher education. Section 1, "Teacher Cognition, Constructivist Teacher Education, and the Ethical and Social Implications of Schooling: Overview and Framework"…

16 CFR 1611.4 - Flammability test.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Flammability test. 1611.4 Section 1611.4... FLAMMABILITY OF VINYL PLASTIC FILM The Standard § 1611.4 Flammability test. (a) Apparatus and materials. The... protect the igniter flame and specimen from air currents during tests, yet contain a suitable door or...

Personality Types as an Indicator of Online Student Success and Retention

ERIC Educational Resources Information Center

Meredith, Ben P.

2011-01-01

With online education courses within public institutions realizing lower than average retention and success rates for students, current retention practices and models are falling woefully short of providing workable, viable answers to keeping students and helping them be successful without lowering academic standards. While a relationship between…

Ethical Issues in the Research of Group Work

ERIC Educational Resources Information Center

Goodrich, Kristopher M.; Luke, Melissa

2017-01-01

This article provides a primer for researchers exploring ethical issues in the research of group work. The article begins with an exploration of relevant ethical issues through the research process and current standards guiding its practice. Next, the authors identify resources that group work researchers can consult prior to constructing their…

The Forgotten: Formal Assessment of the Adult Writer

ERIC Educational Resources Information Center

McNair, Daniel J.; Curry, Toi L.

2013-01-01

This review of current writing assessment practices focuses upon the adult population, an area significantly underrepresented within psychoeducational literature. As compared to other populations, such as K-12 students, there are few options for the practitioner wishing to evaluate adult writers by means of standardized assessment instruments.…

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

40 CFR 409.32 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS SUGAR PROCESSING POINT SOURCE CATEGORY Liquid Cane Sugar Refining Subcategory § 409.32 Effluent limitations guidelines representing the degree of effluent... application of the best practicable control technology currently available (BPT): (a) Any liquid cane sugar...

Effectiveness of Existing Eye Safety Legislation in Arizona.

ERIC Educational Resources Information Center

Gillaspy, Roy Eugene

This study was designed to ascertain the current practices of eye safety in Arizona high school industrial education laboratories, including the enforcement of eye safety legislation, use of eye protection devices, how the eye ware meets the American National Standards Institute specifications, and the teachers' interpretations of the existing eye…

Censorship and the Media.

ERIC Educational Resources Information Center

Rohrer, Daniel Morgan

This review of current legal practices with respect to censorship in the areas of obscenity and pornography contains a history of anti-obscenity legislation; a review of the efforts of the United States Supreme Court and lower courts to define obscenity; a discussion of publisher Larry Flynt's battle against the "community standards"…

Reclamation: what about trees

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

Kolar, C.A.; Ashby, W.C.

A five-year research programme was started in 1978 in the Botany Department of Southern Illinois University to evaluate the effect of reclamation practices on tree survival and growth. The project was initiated as a direct result of reports from Illinois and Indiana of tree-planting failures on mined lands reclaimed to current regulation standards.

ARTISTIC Critique: A Practical Approach to Viewing Dance

ERIC Educational Resources Information Center

Harris, Typhani

2013-01-01

Content Literacy, 21st Century Skills, and Common Core Standards are quickly becoming the buzz of current public education initiatives. As these new policies dictate educational reform, public schools are hustling to find meaning, definition, and accountability for these future expectations. Content literacy goes beyond the ability to read and…

Report from AmSECT's International Consortium for Evidence-Based Perfusion: American Society of Extracorporeal Technology Standards and Guidelines for Perfusion Practice: 2013.

PubMed

Baker, Robert A; Bronson, Shahna L; Dickinson, Timothy A; Fitzgerald, David C; Likosky, Donald S; Mellas, Nicholas B; Shann, Kenneth G

2013-09-01

One of the roles of a professional society is to develop standards and guidelines of practice as an instrument to guide safe and effective patient care. The American Society of Extracorporeal Technology (AmSECT) first published its Essentials for Perfusion Practice, Clinical Function: Conduct of Extracorporeal Circulation in 1993. The International Consortium for Evidence-Based Perfusion (ICEBP), a committee within AmSECT, was tasked with updating this document in 2010. The aim of this report is to describe the method of development and content of AmSECT's new professional standards and guidelines. The ICEBP committee independently evaluated and provided input regarding the current "Essentials and Guidelines." Structural changes were made to the entire document, and a draft document was developed, presented, and circulated to the AmSECT Board of Directors and broader membership for comment. Informed by these reviews, a revised document was then presented to the Society for a membership vote. The final document consists of 15 areas of practice covered by 50 Standards and 38 Guidelines (see Appendix 1) with the first standard focusing on the development of institutional protocols to support their implementation and use. A majority of the membership voted to accept the document (81.2% of the voting membership accepting, 18.8% rejecting). After an audit of the balloting process by AmSECT's Ethics Committee, the results were reported to the membership and the document was officially adopted on July 24, 2013. The Standards and Guidelines will serve as a useful guide for cardiac surgical teams that wish to develop institution-specific standards and guidelines to improve the reliability, safety, and effectiveness of adult cardiopulmonary bypass. The ICEBP recognizes that the development of a Standards and Guidelines statement alone will not change care. Safe, reliable, and effective care will be best served through the development and implementation of institutional protocols based on these standards. AmSECT's Standards and Guidelines for Perfusion Practice reflect the changing landscape of our profession as we work toward a safer and optimal provision of cardiopulmonary bypass for all our patients as well as a work environment that is supportive of delivering this care. standards, guidelines, cardiopulmonary bypass, perfusion, cardiac surgery.

Potential facilitators and barriers to adopting standard treatment guidelines in clinical practice.

PubMed

Sharma, Sangeeta; Pandit, Ajay; Tabassum, Fauzia

2017-04-18

Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality/value This survey among clinicians, despite limitations, gives helpful insights. While favourable attitudes may be helpful, clinical adoption could be improved more effectively by targeting barriers.

Surgical treatment of Bell's palsy: current attitudes.

PubMed

Smouha, Eric; Toh, Elizabeth; Schaitkin, Barry M

2011-09-01

To learn the current management of Bell's palsy among practicing otologists and neurotologists and to better define the role of surgical decompression of the facial nerve in the treatment of Bell's palsy. Survey questionnaire. We conducted a survey of members of the American Otological Society and the American Neurotology Society to learn their current practices in the treatment of Bell's palsy. Eighty-six neurotologists responded out of 334 surveys (26%). The majority of respondents obtain magnetic resonance imaging and electrical testing for new patients and treat with a combination of steroids and antiviral agents. More than two thirds of respondents would recommend surgery to patients who met the established electrophysiologic criteria (electroneuronography <10% normal, no spontaneous motor unit action potentials on electromyography within 10 days of onset of complete paralysis). However, only half believe that surgical decompression should be the standard of care, and only half would use a standard middle fossa approach. Lack of evidence was the most commonly cited reason for not recommending surgery. Several respondents wrote that they would leave the option of surgery to the patient. Most important, one third of neurotologists have not performed a surgical decompression for Bell's palsy in the last 10 years, and 95% perform less than one procedure per year. Disagreement persists among practicing otologists about the role of surgical decompression for Bell's palsy. More convincing clinical evidence will be needed before there is widespread consensus regarding the surgical treatment of this condition. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Current Status of and Recommendations for Nutrition Education in Gastroenterology Fellowship Training in Canada.

PubMed

Hu, Jing; Raman, Maitreyi; Gramlich, Leah

2018-04-01

Knowledge and skill in the area of nutrition are a key competency for the gastroenterologist. However, standards for nutrition education for gastroenterology fellows in Canada do not exist, and gastroenterologists in training and in practice do not feel confident in their knowledge or skill as it relates to nutrition. This study was undertaken to identify the current status of nutrition education in gastroenterology (GI) fellowship training programs in Canada and to provide insight into the development of nutrition educational goals, processes, and evaluation. Using mixed methods, we did a survey of current and recent graduates and program directors of GI fellowship programs in Canada. We undertook a focus group with program directors and fellows to corroborate findings of the survey and to identify strategies to advance nutrition education, knowledge, and skill of trainees. In total, 89.3% of the respondents perceived that the nutrition education was important for GI training, and 82.1% of the respondents perceived nutrition care would be part of their practice. However, only 50% of respondents had a formal rotation in their program, and it was mandatory only 36% of the time. Of the respondents, 95% felt that nutrition education should be standardized within GI fellowship training. Significant gaps in nutrition education exist with GI fellowship programs in Canada. The creation of standards for nutrition education would be valued by training programs, and such a nutrition curriculum for GI fellowship training in Canada is proposed. © 2017 American Society for Parenteral and Enteral Nutrition.

Leadership in Nursing Homes: Directors of Nursing Aligning Practice With Regulations.

PubMed

Siegel, Elena O; Bettega, Kristen; Bakerjian, Debra; Sikma, Suzanne

2018-06-01

Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.]. Copyright 2018, SLACK Incorporated.

Variability in recording and scoring of respiratory events during sleep in Europe: a need for uniform standards.

PubMed

Arnardottir, Erna S; Verbraecken, Johan; Gonçalves, Marta; Gjerstad, Michaela D; Grote, Ludger; Puertas, Francisco Javier; Mihaicuta, Stefan; McNicholas, Walter T; Parrino, Liborio

2016-04-01

Uniform standards for the recording and scoring of respiratory events during sleep are lacking in Europe, although many centres follow the published recommendations of the American Academy of Sleep Medicine. The aim of this study was to assess the practice for the diagnosis of sleep-disordered breathing throughout Europe. A specially developed questionnaire was sent to representatives of the 31 national sleep societies in the Assembly of National Sleep Societies of the European Sleep Research Society, and a total of 29 countries completed the questionnaire. Polysomnography was considered the primary diagnostic method for sleep apnea diagnosis in 10 (34.5%), whereas polygraphy was used primarily in six (20.7%) European countries. In the remaining 13 countries (44.8%), no preferred methodology was used. Fifteen countries (51.7%) had developed some type of national uniform standards, but these standards varied significantly in terms of scoring criteria, device specifications and quality assurance procedures between countries. Only five countries (17.2%) had published these standards. Most respondents supported the development of uniform recording and scoring criteria for Europe, which might be based partly on the existing American Academy of Sleep Medicine rules, but also take into account differences in European practice when compared to North America. This survey highlights the current varying approaches to the assessment of patients with sleep-disordered breathing throughout Europe and supports the need for the development of practice parameters in the assessment of such patients that would be suited to European clinical practice. © 2015 European Sleep Research Society.

StaR Child Health: improving global standards for child health research.

PubMed

Offringa, Martin; Needham, Allison C; Chan, Winnie W Y

2013-11-01

Standards for Research (StaR) in Child Health, founded in 2009, addresses the current scarcity of and deficiencies in pediatric clinical trials. StaR Child Health brings together leading international experts devoted to developing practical, evidence-based standards to enrich the reliability and relevance of pediatric clinical research. Through a systematic "knowledge to action" plan, StaR Child Health creates opportunities to improve the evidence base for child health across the world. To date, six standards have been published and four more are under development. It is now time to use these standards. Improving the design, conduct and reporting of pediatric clinical trials will ultimately advance the quality of health care provided to children across the globe. Crown Copyright © 2013. All rights reserved.

"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.

Practice patterns of image guided particle therapy in Europe: A 2016 survey of the European Particle Therapy Network (EPTN).

PubMed

Bolsi, Alessandra; Peroni, Marta; Amelio, Dante; Dasu, Alexandru; Stock, Markus; Toma-Dasu, Iuliana; Nyström, Petra Witt; Hoffmann, Aswin

2018-03-28

Image guidance is critical in achieving accurate and precise radiation delivery in particle therapy, even more than in photon therapy. However, equipment, quality assurance procedures and clinical workflows for image-guided particle therapy (IGPT) may vary substantially between centres due to a lack of standardization. A survey was conducted to evaluate the current practice of IGPT in European particle therapy centres. In 2016, a questionnaire was distributed among 19 particle therapy centres in 12 European countries. The questionnaire consisted of 30 open and 37 closed questions related to image guidance in the general clinical workflow, for moving targets, current research activities and future perspectives of IGPT. All centres completed the questionnaire. The IGPT methods used by the 10 treating centres varied substantially. The 9 non-treating centres were in the process to introduce IGPT. Most centres have developed their own IGPT strategies, being tightly connected to their specific technical implementation and dose delivery methods. Insight into the current clinical practice of IGPT in European particle therapy centres was obtained. A variety in IGPT practices and procedures was confirmed, which underlines the need for harmonisation of practice parameters and consensus guidelines. Copyright © 2018 Elsevier B.V. All rights reserved.

Mission Success and Environmental Protection: Orbital Debris Considerations

NASA Technical Reports Server (NTRS)

Johnson, Nicholas

2007-01-01

The current U.S. National Space Policy specifically calls on U.S. Government entities "to follow the United States Government Orbital Debris Mitigation Standard Practices, consistent with mission requirements and cost effectiveness, in the procurement and operation of spacecraft, launch services, and the operation of tests and experiments in space. Early assessment (pre-PDR) of orbital debris mitigation compliance is essential to minimize development impacts. Orbital debris mitigation practices today are the most effective means to protect the near-Earth space environment for future missions.

CrossTalk, The Journal of Defense Software Engineering. Volume 26, Number 2. March/April 2013

DTIC Science & Technology

2013-04-01

standards and best practices. “Software and hardware are at risk of being tam - pered with even before they are linked together in an operational system...because of their role in national and global security and the variety of valuable lessons learned and best practices they can provide because they are...Management. GAO said DoD’s efforts to implement SCRM can be a learning tool for others in the Federal government. DoD is currently imple- CrossTalk

Improving care standards for patients with spinal trauma combining a modified e-Delphi process and stakeholder interviews: a study protocol.

PubMed

Sharwood, Lisa N; Stanford, Ralph; Middleton, James W; Burns, Brian; Joseph, Anthony; Flower, Oliver; Rigby, Oran; Ball, Jonathon; Dhaliwal, Shelly

2017-01-19

Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients. A modified e-Delphi process will be used to gain consensus for best practice across specific clinical early care areas for the patient with TSCI; invited participants will include clinicians across Australia with relevant and significant expertise. A rapid literature review will identify available evidence, including any current guidelines from 2005 to 2015. Level and strength of evidence identified, including areas of contention, will be used to formulate the first round survey questions and statements. Participants will undertake 2-3 online survey rounds, responding anonymously to questionnaires regarding care practices and indicating their agreement or otherwise with practice standard statements. Relevant key stakeholders, including patients, will also be interviewed face to face. Ethics approval for this study was obtained by the NSW Population & Health Services Research Ethics Committee on 14 January 2016 (HREC/12/CIPHS/74). Seeking comprehensive understanding of how the variation in early care pathways and treatment can be addressed to achieve optimal patient outcomes and economic costs; the overall aim is the agreement to a consistent approach to the triage, treatment, transport and definitive care of acute TSCI victims. The agreed practice standards of care will inform the development of a Clinical Pathway with practice change strategies for implementation. These standards will offer a benchmark for state-wide and potentially national policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A survey of current ostrich handling and transport practices in North America with reference to ostrich welfare and transportation guidelines set up in other countries.

PubMed

Bejaei, M; Cheng, K M

2014-02-01

Appropriate management of an ostrich's exposure to stressors during preslaughter handling and transport practices can improve its well-being and product quality. Because of the lack of information about ostrich farming and transportation in North America and lack of developed Codes of Practice for ratite transport in Canada and the United States, the first objective of our research was to identify current preslaughter handling and transport practices of the ostrich industry in Canada and the United States, and to identify potential welfare issues based on the current practices. The second objective of this research was to review ostrich transport welfare standards and guidelines from Australia, European Union, New Zealand, and South Africa to investigate if those guidelines are applicable to Canadian and American ostrich production systems. Preliminary producer interviews, on-farm visits, and literature review information sources were used to design a producer questionnaire that was used to survey producers by Internet and mail surveying methods to identify existing ostrich transport norms in Canada and the United States. Based on the results of our producer survey and review of the transport standards and guidelines, we conclude that following factors are potential ostrich handling and transport welfare issues in Canada and the United States: lack of scientific information about welfare of ostriches during handling and transport; unfamiliarity of handlers and birds with handling and transport practices; not considering birds' social bounds, sex, behavior, and physical state in mixing them during handling and transport process; lack of an established specific maximum water and feed withdrawal duration for ostrich transport in Canada and the United States; lack of a specific vehicle designed for ratite transportation in Canada and the United States considering different physical body characteristics of ostriches compared with other species; exposure of birds to natural light during transport inside the trailer; overcrowding; and long transportation in Canada and the United States. Results of this research will contribute toward developing Codes of Practice for preslaughter handling, transportation, and slaughter of ostriches in Canada and the United States.

Site Characterization at a Tidal Energy Site in the East River, NY (usa)

NASA Astrophysics Data System (ADS)

Gunawan, B.; Neary, V. S.; Colby, J.

2012-12-01

A comprehensive tidal energy site characterization is performed using ADV measurements of instantaneous horizontal current magnitude and direction at the planned hub centerline of a tidal turbine over a two month period, and contributes to the growing data base of tidal energy site hydrodynamic conditions. The temporal variation, mean current statistics, and turbulence of the key tidal hydrodynamic parameters are examined in detail, and compared to estimates from two tidal energy sites in Puget Sound. Tidal hydrodynamic conditions, including mean annual current (at hub height), the speed of extreme gusts (instantaneous horizontal currents acting normal to the rotor plane), and turbulence intensity (as proposed here, relative to a mean current of 2 m s-1) can vary greatly among tidal energy sites. Comparison of hydrodynamic conditions measured in the East River tidal straight in New York City with those reported for two tidal energy sites in Puget Sound indicate differences of mean annual current speeds, difference in the instantaneous current speeds of extreme gusts, and differences in turbulence intensities. Significant differences in these parameters among the tidal energy sites, and with the tidal resource assessment map, highlight the importance of conducting site resource characterization with ADV measurements at the machine scale. As with the wind industry, which adopted an International Electrotechnical Commission (IEC) wind class standard to aid in the selection of wind turbines for a particular site, it is recommended that the tidal energy industry adopt an appropriate standard for tidal current classes. Such a standard requires a comprehensive field campaign at multiple tidal energy sites that can identify the key hydrodynamic parameters for tidal current site classification, select a list of tidal energy sites that exhibit the range of hydrodynamic conditions that will be encountered, and adopt consistent measurement practices (standards) for site classification.

Standardization and Implementation of a Standard Emergency Code Call System within Estern Region Medical Command

DTIC Science & Technology

2009-03-01

currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 21-04-2009 2. REPORT TYPE...morph with the advent of the personal computer. Instead, they went out of business . A similar situation exists with the Ford, Chrysler and GM, where...This dissent needs a constructive forum or outlet so outside-the-box solutions and better business practices have a nurturing environment for

Endoscopic management of benign bile duct strictures.

PubMed

Baron, Todd H; Davee, Tomas

2013-04-01

The use of endoscopic retrograde cholangiopancreatography for treating benign biliary strictures has become the standard of practice, with surgery and percutaneous therapy reserved for selected patients. The gold-standard endoscopic therapy is dilation of the stricture followed by placing and exchanging progressively larger and more numerable plastic stents over a 1-year period. Newer modalities, including the use of fully covered metal stents, are currently under investigation in an effort to improve the treatment of benign biliary strictures. Copyright © 2013 Elsevier Inc. All rights reserved.

Accounting principles, revenue recognition, and the profitability of pharmacy benefit managers.

PubMed

McLean, Robert A; Garis, Robert I

2005-03-01

To contrast pharmacy benefit management (PBM) companies' measured profitability by using two accounting standards. The first accounting standard is that which, under Generally Accepted Accounting Principles (GAAP), PBMs are currently allowed to employ. The second accounting standard, seemingly more congruent with the PBM business model, treats the PBM as an agent of the plan sponsor. Financial Accounting Standards Board (FASB) Emerging Issues Task Force Issue 99-19, U.S. Securities and Exchange 10-K filings and financial accounting literature. Under GAAP record keeping, the PBM industry profitability appears modest. Using currently applied GAAP, the PBM treats all payment from the plan sponsor as revenue and all payment to the pharmacy as revenue. However, the PBM functions, in practice, as an entity that passes-through money collected from one party (the sponsor) to other parties (dispensing pharmacies). Therefore, it would seem that the nature of PBM cash flows would be more accurately recorded as a pass-through entity. When the PBM is evaluated using an accounting method that recognizes the pass-through nature of its business, the PBM profit margin increases dramatically. Current GAAP standards make traditional financial statement analysis of PBMs unrevealing, and may hide genuinely outstanding financial performance. Investors, regulators, pharmacies, and the FASB all have an interest in moving to clarify this accounting anomaly.

Laboratory and Field Evaluation of Rapid Setting Cementitious Materials for Large Crater Repair

DTIC Science & Technology

2010-05-01

frame used within which to complete the repair was the current NATO standard of 4 hr. A total of 6 simulated craters were prepared, with each repair...Combat Command 129 Andrews Street Langley Air Force Base, VA 23665 ERDC TR-10-4 ii Abstract: Current practice for expedient runway repair...penalty. Numerous commercial products are available. A full-scale field test was conducted using rapid setting materials to repair simulated bomb craters

Hysteroscopic Sterilization: History and Current Methods

PubMed Central

Greenberg, James A

2008-01-01

For many practicing obstetrician-gynecologists, tubal ligation was the gold standard by which female sterilization techniques were measured. Yet gynecologic surgeons have simultaneously sought to occlude the fallopian tubes transcervically to avoid discomfort and complications associated with transabdominal approaches. In this review, the history of transcervical sterilization is discussed. Past, current, and upcoming techniques are reviewed. This article focuses on interval sterilization techniques, thus removing post-vaginal and post-cesarean delivery tubal ligations from the discussion. PMID:19015762

Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review.

PubMed

Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F

2014-07-01

Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs.

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

PubMed

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

2016-04-01

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

Advanced Practice Registered Nurses and Physician Assistants in Sleep Centers and Clinics: A Survey of Current Roles and Educational Background

PubMed Central

Colvin, Loretta; Cartwright, Ann; Collop, Nancy; Freedman, Neil; McLeod, Don; Weaver, Terri E.; Rogers, Ann E.

2014-01-01

Study Objectives: To survey Advanced Practice Registered Nurse (APRN) and Physician Assistant (PA) utilization, roles and educational background within the field of sleep medicine. Methods: Electronic surveys distributed to American Academy of Sleep Medicine (AASM) member centers and APRNs and PAs working within sleep centers and clinics. Results: Approximately 40% of responding AASM sleep centers reported utilizing APRNs or PAs in predominantly clinical roles. Of the APRNs and PAs surveyed, 95% reported responsibilities in sleep disordered breathing and more than 50% in insomnia and movement disorders. Most APRNs and PAs were prepared at the graduate level (89%), with sleep-specific education primarily through “on the job” training (86%). All APRNs surveyed were Nurse Practitioners (NPs), with approximately double the number of NPs compared to PAs. Conclusions: APRNs and PAs were reported in sleep centers at proportions similar to national estimates of NPs and PAs in physicians' offices. They report predominantly clinical roles, involving common sleep disorders. Given current predictions that the outpatient healthcare structure will change and the number of APRNs and PAs will increase, understanding the role and utilization of these professionals is necessary to plan for the future care of patients with sleep disorders. Surveyed APRNs and PAs reported a significant deficiency in formal and standardized sleep-specific education. Efforts to provide formal and standardized educational opportunities for APRNs and PAs that focus on their clinical roles within sleep centers could help fill a current educational gap. Citation: Colvin L, Cartwright Ann, Collop N, Freedman N, McLeod D, Weaver TE, Rogers AE. Advanced practice registered nurses and physician assistants in sleep centers and clinics: a survey of current roles and educational background. J Clin Sleep Med 2014;10(5):581-587. PMID:24812545

Redefining Quality Measurement in Cancer Care.

PubMed

Nardi, Elizabeth A; McCanney, James; Winckworth-Prejsnar, Katy; Schatz, Alyssa A; Adelson, Kerin; Neubauer, Marcus; Smith, Mary Lou; Walters, Ronald; Carlson, Robert W

2018-05-01

Quality measurement in oncology is increasing in significance as payment schemes shift from volume to value. As demand for quality measures increases, challenges in the development of quality measures, standardization across measures, and the limitations of health information technology have become apparent. Moreover, the time and financial burden associated with developing, tracking, and reporting quality measures are substantial. Despite these challenges, best practices and leaders in the field of quality measurement in oncology have emerged. To understand the current challenges and promising practices in quality measurement and to explore future considerations for measure development and measure reporting in oncology, NCCN convened the NCCN Policy Summit: Redefining Quality Measurement in Oncology. The summit included discussion of the current quality landscape and efforts to develop quality measures, use of quality measures in various programs, patient perspective of quality, and challenges and best practices for quality reporting. Copyright © 2018 by the National Comprehensive Cancer Network.

Laboratory practice guidelines for detecting and reporting JAK2 and MPL mutations in myeloproliferative neoplasms: a report of the Association for Molecular Pathology.

PubMed

Gong, Jerald Z; Cook, James R; Greiner, Timothy C; Hedvat, Cyrus; Hill, Charles E; Lim, Megan S; Longtine, Janina A; Sabath, Daniel; Wang, Y Lynn

2013-11-01

Recurrent mutations in JAK2 and MPL genes are genetic hallmarks of BCR-ABL1-negative myeloproliferative neoplasms. Detection of JAK2 and MPL mutations has been incorporated into routine diagnostic algorithms for these diseases. This Special Article summarizes results from a nationwide laboratory survey of JAK2 and MPL mutation analysis. Based on the current practice pattern and the literature, this Special Article provides recommendations and guidelines for laboratory practice for detection of mutations in the JAK2 and MPL genes, including clinical manifestations for prompting the mutation analysis, current and recommended methodologies for testing the mutations, and standardization for reporting the test results. This Special Article also points to future directions for genomic testing in BCR-ABL1-negative myeloproliferative neoplasms. Copyright © 2013 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

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.

From distress guidelines to developing models of psychosocial care: current best practices.

PubMed

Clark, Paul G; Bolte, Sage; Buzaglo, Joanne; Golant, Mitch; Daratsos, Louisa; Loscalzo, Matthew

2012-01-01

Psychological distress has been recognized as having a significant effect upon cognitive and emotional functioning, quality of life, and in some populations increased costs of care. Screening for distress and provision of psychosocial care in oncology treatment settings has been identified as a future accreditation standard by the American College of Surgeons Commission on Cancer (CoC). Because there are few available models of programs of distress screening and referral to inform oncology social workers and other members of the psychosocial support team with planning their own programs, this article seeks to provide exemplars of best practices that are currently in place in four different settings where psychosocial support is provided to people living with cancer and their families. Each program will provide an overview of how it was successfully established and its contribution toward evolving evidence-informed best practices.

Electronic decision support in general practice. What's the hold up?

PubMed

Liaw, S T; Schattner, P

2003-11-01

The uptake of computers in Australian general practice has been for administrative use and prescribing, but the development of electronic decision support (EDS) has been particularly slow. Therefore, computers are not being used to their full potential in assisting general practitioners to care for their patients. This article examines current barriers to EDS in general practice and possible strategies to increase its uptake. Barriers to the uptake of EDS include a lack of a business case, shifting of costs for data collection and management to the clinician, uncertainty about the optimal level of decision support, lack of technical and semantic standards, and resistance to EDS use by the time conscious GP. There is a need for a more strategic and attractive incentives program, greater national coordination, and more effective collaboration between government, the computer industry and the medical profession if current inertia is to be overcome.

Evaluating quality and its determinants in lipid control for secondary prevention of heart disease and stroke in primary care: a study in an inner London Borough.

PubMed

Dodhia, Hiten; Kun, Liu; Logan Ellis, Hugh; Crompton, James; Wierzbicki, Anthony S; Williams, Helen; Hodgkinson, Anna; Balazs, John

2015-12-09

To assess quality of management and determinants in lipid control for secondary prevention of cardiovascular disease (CVD) using multilevel regression models. Cross-sectional study. Inner London borough, with a primary care registered population of 378,000 (2013). 48/49 participating general practices with 7869 patients on heart disease/stroke registers were included. (1) Recording of current total cholesterol levels and lipid control according to national evidence-based standards. (2) Assessment of quality by age, sex, ethnicity, deprivation, presence of other risks or comorbidity in meeting both lipid measurement and control standards. Some process standards were not met. Patients with a current cholesterol measurement >5 mmol/L were less likely to have a current statin prescription (adjusted OR=3.10; 95% CI 2.70 to 3.56). They were more likely to have clustering of other CVD risk factors. Women were significantly more likely to have raised cholesterol after adjustment for other factors (adjusted OR=1.74; 95% CI 1.53 to 1.98). In this study, the key factor that explained poor lipid control in people with CVD was having no current prescription record of a statin. Women were more likely to have poorly controlled cholesterol (independent of comorbid risk factors and after adjusting for age, ethnicity, deprivation index and practice-level variation). Women with CVD should be offered statin prescription and may require higher statin dosage for improved control. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Patch testing custom isocyanate materials from the workplace.

PubMed

Burrows, Dianne; Houle, Marie-Claude; Holness, D Linn; DeKoven, Joel; Skotnicki, Sandy

2015-01-01

Patch testing with standard trays of commercially available allergens is the current practice for investigating suspected cases of isocyanate-induced allergic contact dermatitis (ACD). In some facilities, these standard trays are further supplemented with custom preparations of isocyanate-containing materials. The aim was to determine whether added value exists in patch testing patients to custom isocyanate preparations in suspected cases of ACD. We performed a retrospective analysis of 11 patients referred to our specialty clinic between January 2003 and March 2011 for suspected patients of ACD who had custom testing with isocyanate materials from their workplace. In addition to standard trays of allergens, all patients were patch tested with custom isocyanate materials from their workplaces. Three (27%) of 11 patients showed an added value in testing to custom isocyanate allergens. Of these 3 patients, one had a reaction that reinforced positive reactions to the standard isocyanate tray, but the other 2 (18%) had no reactions to any of the commercially available allergens. Because of the high proportion of reactions (27%), we recommend the use of custom testing to workplace isocyanate products as a supplement to current standard patch testing procedures.

Direct Field Acoustic Testing

NASA Technical Reports Server (NTRS)

Larkin, Paul; Goldstein, Bob

2008-01-01

This paper presents an update to the methods and procedures used in Direct Field Acoustic Testing (DFAT). The paper will discuss some of the recent techniques and developments that are currently being used and the future publication of a reference standard. Acoustic testing using commercial sound system components is becoming a popular and cost effective way of generating a required acoustic test environment both in and out of a reverberant chamber. This paper will present the DFAT test method, the usual setup and procedure and the development and use of a closed-loop, narrow-band control system. Narrow-band control of the acoustic PSD allows all standard techniques and procedures currently used in random control to be applied to acoustics and some examples are given. The paper will conclude with a summary of the development of a standard practice guideline that is hoped to be available in the first quarter of next year.

Systematic review of emergency medicine clinical practice guidelines: Implications for research and policy.

PubMed

Venkatesh, Arjun K; Savage, Dan; Sandefur, Benjamin; Bernard, Kenneth R; Rothenberg, Craig; Schuur, Jeremiah D

2017-01-01

Over 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence. Systematic review of clinical practice guidelines (Clinical Policies) published by the American College of Emergency Physicians from January 1990 to January 2016. Standardized data were abstracted from each Clinical Policy including the number and level of recommendations as well as the reported class of evidence. Primary outcomes were the proportion of Level C equivalent recommendations and Class III equivalent evidence. The primary analysis was limited to current Clinical Policies, while secondary analysis included all Clinical Policies. A total of 54 Clinical Policies including 421 recommendations and 2801 cited references, with an average of 7.8 recommendations and 52 references per guideline were included. Of 19 current Clinical Policies, 13 of 141 (9.2%) recommendations were Level A, 57 (40.4%) Level B, and 71 (50.4%) Level C. Of 845 references in current Clinical Policies, 67 (7.9%) were Class I, 272 (32.3%) Class II, and 506 (59.9%) Class III equivalent. Among all Clinical Policies, 200 (47.5%) recommendations were Level C equivalent, and 1371 (48.9%) of references were Class III equivalent. Emergency medicine clinical practice guidelines are largely based on lower classes of evidence and a majority of recommendations are expert opinion based. Emergency medicine appears to suffer from an evidence gap that should be prioritized in the national research agenda and considered by policymakers prior to developing future quality standards.

Looking for Skeletons in the Data Centre `Cupboard': How Repository Certification Can Help

NASA Astrophysics Data System (ADS)

Sorvari, S.; Glaves, H.

2017-12-01

There has been a national geoscience repository at the British Geological Survey (or one of its previous incarnations) almost since its inception in 1835. This longevity has resulted in vast amounts of analogue material and, more recently, digital data some of which has been collected by our scientists but much more has been acquired either through various legislative obligations or donated from various sources. However, the role and operation of the UK National Geoscience Data Centre (NGDC) in the 21st Century is very different to that of the past, with new systems and procedures dealing with predominantly digital data. A web-based ingestion portal allows users to submit their data directly to the NGDC while online services provide discovery and access to data and derived products. Increasingly we are also required to implement an array of standards e.g. ISO, OGC, W3C, best practices e.g. FAIR and legislation e.g. EU INSPIRE Directive; whilst at the same time needing to justifying our very existence to our funding agency and hosting organisation. External pressures to demonstrate that we can be recognised as a trusted repository by researchers, various funding agencies, publishers and other related entities have forced us to look at how we function, and to benchmark our operations against those of other organisations and current relevant standards such as those laid down by different repository certification processes. Following an assessment of the various options, the WDS/DSA certification process was selected as the most appropriate route for accreditation of NGDC as a trustworthy repository. It provided a suitable framework for reviewing the current systems, procedures and best practices. Undertaking this process allowed us to identify where the NGDC already has robust systems in place and where there were gaps and deficiencies in current practices. The WDS/DSA assessment process also helped to reinforce best practice throughout the NGDC and demonstrated that many of the recognised and required procedures and standards for recognition as a trusted repository were already in place, even if they were not always followed!

The trials and tribulations of a practitioner-researcher: challenges and lessons learned through testing a feminist-cognitive-relational social work model of practice.

PubMed

Dombo, Eileen A; Bass, Ami P

2014-01-01

In practice with adult women who survived childhood sexual abuse, the field of social work currently lacks an evidence-based intervention. The current interventions, from the 1990s, come primarily from psychologists. The hypothesis that the Feminist-Cognitive-Relational Social Work Model and Intervention will be more effective in decreasing cognitive distortions, and increasing intimacy and relational health when compared to the standard agency intervention was tested in a quasi-experimental study. The challenges in carrying out the study in small, non-profit organizations are explored to highlight the difficulties in developing evidence-based interventions. Changes to implementation that resulted from the research findings are discussed.

Exogenous and endogenous hormones and breast cancer

PubMed Central

ChenMD, Wendy Y.

2008-01-01

Exposure to higher levels of both exogenous and endogenous hormone is associated with breast cancer risk. Because of the association between breast cancer and HRT, only the minimal duration of HRT use is recommended for symptom control, and it is not recommended for chronic disease management. Current research issues include the role of progestins, other types of HRT, duration of unopposed estrogen use, and characteristics of cancers that develop on HRT. Circulating sex steroid levels are associated with breast cancer risk, but multiple issues need to be addressed before they are used routinely in clinical practice. Current research issues include measurement of levels for routine clinical practice, integration with standard breast cancer risk models and genetic polymorphism data, and applicability to estrogen-receptor-negative cancers. PMID:18971119

Improvement in the management of gout is vital and overdue: an audit from a UK primary care medical practice

PubMed Central

2013-01-01

Background Gout is estimated to affect 1.4% of adults in the UK. Appropriate and timely management is essential to reduce the risk of further flares, complications, and to reduce cardiovascular disease risk. The British Society for Rheumatology and British Health Professionals in Rheumatology (BSR/BHPR) and the European League Against Rheumatism (EULAR) have published guidance regarding the management of gout, thereby providing standards against which performance can be measured. This audit was designed to assess the extent to which patients diagnosed with gout in one primary care medical practice in North Staffordshire, UK, are managed in accordance with current best practice guidelines, and to identify strategies for improvement where appropriate. Methods Audit criteria were derived from the EULAR and BSR/BHPR guidelines; standards were set arbitrarily, but with consideration of patient comorbidity and other factors which may influence concordance. An electronic search of the practice records was performed to identify adults with a diagnosis of gout. Medical record review with a descriptive analysis was undertaken to assess the extent to which medical management adhered to the predefined standards. Results Of the total ≥18 year-old practice population (n = 8686), 305 (3%) patient records included a diagnosis of gout. Of these, 74% (n = 226) had an electronic record of serum uric acid (SUA), and 11% (n = 34) and 53% (n = 162) a measure of estimated glomerular filtration rate (eGFR) ever and serum glucose since diagnosis respectively. 34% (n = 105) of patients had ever taken urate-lowering therapy with 25% (n = 77) currently prescribed this at the time of data extraction. Dose adjustment and monitoring of treatment according to SUA was found to be inadequate. Provision of lifestyle advice and consideration of comorbidities was also lacking. Conclusions The primary care management of gout in this practice was not concordant with national and international guidance, a finding consistent with previous studies. This demonstrates that the provision of guidelines alone is not sufficient to improve the quality of gout management and we identify possible strategies to increase guideline adherence. PMID:24225170

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.

7 CFR 28.105 - Practical forms of cotton standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Practical forms of cotton standards. 28.105 Section 28... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.105 Practical forms of cotton standards. (a) Practical forms of the...

7 CFR 28.105 - Practical forms of cotton standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 2 2013-01-01 2013-01-01 false Practical forms of cotton standards. 28.105 Section 28... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.105 Practical forms of cotton standards. (a) Practical forms of the...

7 CFR 28.105 - Practical forms of cotton standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Practical forms of cotton standards. 28.105 Section 28... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.105 Practical forms of cotton standards. (a) Practical forms of the...

7 CFR 28.105 - Practical forms of cotton standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 2 2014-01-01 2014-01-01 false Practical forms of cotton standards. 28.105 Section 28... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.105 Practical forms of cotton standards. (a) Practical forms of the...

7 CFR 28.105 - Practical forms of cotton standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Practical forms of cotton standards. 28.105 Section 28... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Practical Forms of Cotton Standards § 28.105 Practical forms of cotton standards. (a) Practical forms of the...

Access to Intersectionality, Content to Competence: Deconstructing Social Work Education Diversity Standards

ERIC Educational Resources Information Center

Jani, Jayshree S.; Pierce, Dean; Ortiz, Larry; Sowbel, Lynda

2011-01-01

This article provides an assessment of the current situation in social work education regarding the teaching of content on diversity, with a focus on implications for social work theory, practice, and education. The article provides a critical analysis of the historical development of approaches to teaching diversity content in social work…

Microbeads and Engineering Design in Chemistry: No Small Educational Investigation

ERIC Educational Resources Information Center

Hoffman, Adam; Turner, Ken

2015-01-01

A multipart laboratory activity introducing microbeads was created to meet engineering and engineering design practices consistent with new Next Generation Science Standards (NGSS). Microbeads are a current topic of concern as they have been found to cause adverse impacts in both marine and freshwater systems resulting in multiple states proposing…

Perceived Uncertainty Sources in Wind Power Plant Design

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

Damiani, Rick R

This presentation for the Fourth Wind Energy Systems Engineering Workshop covers some of the uncertainties that still impact turbulent wind operation and how these affect design and structural reliability; identifies key sources and prioritization for R and D; and summarizes an analysis of current procedures, industry best practice, standards, and expert opinions.

Managing Courses Defining Learning: What Faculty, Students, and Administrators Want

ERIC Educational Resources Information Center

Jafari, Ali; McGee, Patricia; Carmean, Colleen

2006-01-01

The use of Learning/Course Management Systems (L/CMSs) has exploded in higher education. Recently, these authors served as editors for a book, "Course Management Systems for Learning," which explored current L/CMS design and usage by documenting best practices, research, standards, and implementations. Although the final section of the book…

Synthetic biology R&D risks: Social-institutional contexts matter!

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

Wolfe, Amy K.; Bjornstad, David J.; Shumpert, Barry L.

Social and institutional analyses currently are missing from considerations of synthetic biology R&D-related biosafety, which instead have bioethics, governance, or technical orientations. Social and institutional context shapes standard practice. Here, analyzing context helps identify circumstances that create, amplify, or diminish risk, thereby revealing new opportunities for avoiding or managing those risks.

Synthetic biology R&D risks: Social-institutional contexts matter!

DOE PAGES

Wolfe, Amy K.; Bjornstad, David J.; Shumpert, Barry L.; ...

2016-02-15

Social and institutional analyses currently are missing from considerations of synthetic biology R&D-related biosafety, which instead have bioethics, governance, or technical orientations. Social and institutional context shapes standard practice. Here, analyzing context helps identify circumstances that create, amplify, or diminish risk, thereby revealing new opportunities for avoiding or managing those risks.

Potential means of cost reduction in grade crossing automatic gate systems. volume II : improved gate arm concepts for railroad/highway grade crossings gate systems

DOT National Transportation Integrated Search

1977-02-28

This report, Volume II of a two-volume study, examines the potential for reduction of the cost of installing and maintaining automatic gates at railroad-highway grade crossings. It includes a review of current practices, equipment, and standards; con...

Health Education Teacher Resource Handbook: A Practical Guide for K-12 Health Education.

ERIC Educational Resources Information Center

Mahoney, Beverly Saxton, Ed.; Olsen, Larry K., Ed.

This handbook provides background information on the health curriculum, as well as current, comprehensive information on publications, standards, and special materials for K-12 health education. The manual begins with an introduction, by P. Bruce Uhrmacher, which provides an overview of the ideologies and philosophies that have affected curriculum…

Professional Competence of Teachers in the Age of Globalization

ERIC Educational Resources Information Center

Orazbayeva, Kuldarkhan O.

2016-01-01

Current challenges of globalization in a democratic post-industrial information society make the competency-based approach a standard in the creation of the global educational environment. This study describes the special aspects of the integration of the competency-based approach into the educational theory and practice of post-Soviet countries,…

THE PRACTICE OF CHEMISTRY AND ENGINEERING IN THE CONTEXT OF SUSTAINABILITY

EPA Science Inventory

It is generally recognized that the current rate of resource use to maintain our standard of living is not sustainable for the long term. This idea calls for satisfying our needs by finding resources that are renewable. The question remains as to how we ascertain that the means a...

Stories in Our Classrooms: Diverse Human Lives, as Narrated by Standardizing Policies

ERIC Educational Resources Information Center

Bomer, Randy

2006-01-01

Bomer challenges the logic and effectiveness of current educational policy, noting that just as educational practice was becoming interdisciplinary and promoting holistic growth, philanthropic organizations pulled away from the effort with the expectation that government and other funding entities would pick up the responsibility. They didn't.…

General and Specific Outcomes for Grades One to Five Music.

ERIC Educational Resources Information Center

Morin, Francine

This guide was developed in response to a mandate for music teachers in Transcona-Springfield School Division No. 12 (Manitoba, Canada) to generate a set of music learning outcomes to guide and standardize assessment and evaluation practices across the division. The currently legislated K-6 music curriculum (Manitoba Department of Education, 1978)…

Student Interest in Engineering Design-Based Science

ERIC Educational Resources Information Center

Selcen Guzey, S.; Moore, Tamara J.; Morse, Gillian

2016-01-01

Current reform efforts in science education around the world call on teachers to use integrated approaches to teach science. As a part of such reform efforts in the United States, engineering practices and engineering design have been identified in K-12 science education standards. However, there is relatively little is known about effective ways…

The U.S. Department of Agriculture Automated Multiple-Pass Method accurately assesses sodium intakes

USDA-ARS?s Scientific Manuscript database

Accurate and practical methods to monitor sodium intake of the U.S. population are critical given current sodium reduction strategies. While the gold standard for estimating sodium intake is the 24 hour urine collection, few studies have used this biomarker to evaluate the accuracy of a dietary ins...

Exploring the Perceived Effectiveness of the School Administration: Studying the Enhancement of Organizational Practices

ERIC Educational Resources Information Center

Urrutia-Campos, Carlos Lenin

2016-01-01

Principals are facing complex educational scenarios such as an increasing diversity of minority groups in schools, adjustments in regulations, and higher academic standards that press school leaders to update or obtain professional skills. Administrators should be aware that current professional skills may not be sufficient to comply with new…

Observations of Academic Instruction for Students with Significant Intellectual Disability: Three States, Thirty-Nine Classrooms, One View

ERIC Educational Resources Information Center

Restorff, Diane E.; Abery, Brian H.

2013-01-01

As part of the validation process for alternate assessments, 39 classroom observations were conducted to gather data about current practices in providing academic instruction to students with significant intellectual disability. Using a standardized protocol, data were gathered using direct instructional observation, an Individualized Education…

Pragmatic Language Impairment: Case Studies of Social and Pragmatic Language Therapy

ERIC Educational Resources Information Center

Adams, Catherine; Baxendale, Janet; Lloyd, Julian; Aldred, Catherine

2005-01-01

The current position on speech and language intervention for children who have pragmatic language impairment (PLI) is limited by a lack of evidence to support practice. Two intervention outcome case studies of children with PLI, aimed at establishing efficacy, are presented in this paper. Standardized language tests and conversational sampling…

Discrepancies between Ideal Characteristics of a Property Tax System and Current Practice in New York.

ERIC Educational Resources Information Center

Netzer, Dick; Berne, Robert

1995-01-01

Ideally, voters' and state legislatures' policy choices should underlie a property tax system that is straightforward, comprehensible, systematic, and reasonably related to policy objectives. Administration should be uniform and fair. New York State's property tax system lacks a uniform valuation standard and "circuit breaker" and has…

Establishment of northern red oak genetic tests with nursery-graded seedlings

Treesearch

S. A. Lay; M. A. Remaley; S. E. Schlarbaum; P. P. Kormanik; T. Tibbs; R. A. Cox; T. LaFarge; A. M. Saxton

1997-01-01

Artificial regeneration of northern red oak (Quercus rubra L.) has had variable success over time. Current nursery practices generally involve the growth of seedlings to a standardized height and form with little regard to seed source, seedling quality, or subsequent field performance. Additionally, there is not an accepted culling criteria for...

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…

Use of Outcome Measurement by Paediatric AHPs in Northern Ireland

ERIC Educational Resources Information Center

Harron, Anita; Titterington, Jill

2016-01-01

Background: Professional standards advocate routine use of outcome measurement (OM) in the practice of allied health professionals (AHPs). Historically, OM has focused on impairment and its immediate constraints on activity, while current policy encourages the development and addition of impact-based OM. There appears to be an assumption at this…

James Madison's Practical Ideals for the 1990s.

ERIC Educational Resources Information Center

Delattre, Edwin J.

This paper examines recent behavior of public officials at various levels of government in the United States, finds a systemic failure to meet ethical standards, and concludes that the wisdom of James Madison has much applicability to current times. Given his keen perception of human nature, Madison would not be too surprised at today's poor…

Navigating the legal and ethical foundations of informed consent and confidentiality in integrated primary care.

PubMed

Hudgins, Cathy; Rose, Sandra; Fifield, Peter Y; Arnault, Steve

2013-03-01

This article describes findings from ongoing research and analysis of current literature in addition to discussions with leaders in the field, communications with lawyers and administrators of advocacy and government agencies pertaining to integrated primary care (IPC). Standards of care are established based on a myriad of factors, including professional codes of ethics, case law, state and federal laws, professional standards, existing best practices, current professional guidelines, administrative rules and regulations, and licensing board regulations. Regulations may differ for behavioral health and medical providers, posing challenges in IPC settings. This article provides a review of these regulations, particularly 42CFR Part 2, a federal law governing confidentiality for substance abuse programs, Health Insurance Portability and Accountability Act (HIPAA), and state laws relevant to patient care in IPC settings. On the basis of findings from the study, the authors make recommendations related to patient care practices concerning informed consent and release of information procedures, treatment and warm hand-off protocols, documentation and electronic record keeping, agreements with other providers, and billing. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Treating an Established Episode of Delirium in Palliative Care: Expert Opinion and Review of the Current Evidence Base With Recommendations for Future Development

PubMed Central

Pereira, José L.; Davis, Daniel H.J.; Currow, David C.; Meagher, David; Rabheru, Kiran; Wright, David; Bruera, Eduardo; Hartwick, Michael; Gagnon, Pierre R.; Gagnon, Bruno; Breitbart, William; Regnier, Laura; Lawlor, Peter G.

2014-01-01

Context Delirium is a highly prevalent complication in patients in palliative care settings, especially in the end-of-life context. Objectives To review the current evidence base for treating episodes of delirium in palliative care settings and propose a framework for future development. Methods We combined multidisciplinary input from delirium researchers and other purposely selected stakeholders at an international delirium study planning meeting. This was supplemented by a literature search of multiple databases and relevant reference lists to identify studies regarding therapeutic interventions for delirium. Results The context of delirium management in palliative care is highly variable. The standard management of a delirium episode includes the investigation of precipitating and aggravating factors followed by symptomatic treatment with drug therapy. However, the intensity of this management depends on illness trajectory and goals of care in addition to the local availability of both investigative modalities and therapeutic interventions. Pharmacologically, haloperidol remains the practice standard by consensus for symptomatic control. Dosing schedules are derived from expert opinion and various clinical practice guidelines as evidence-based data from palliative care settings are limited. The commonly used pharmacologic interventions for delirium in this population warrant evaluation in clinical trials to examine dosing and titration regimens, different routes of administration, and safety and efficacy compared with placebo. Conclusion Delirium treatment is multidimensional and includes the identification of precipitating and aggravating factors. For symptomatic management, haloperidol remains the practice standard. Further high-quality collaborative research investigating the appropriate treatment of this complex syndrome is needed. PMID:24480529

A lack of standardization: the basis for the ethical issues surrounding quality and performance reports.

PubMed

Suchy, Kirsten

2010-01-01

Consumers in the United States are taking advantage of the proliferation of publicly available, internet-based performance reports and quality appraisals of health plans, healthcare organizations, hospitals, and physicians to aid in their healthcare decision making. However, these appraisal practices have given rise to controversy and debate over certain distinctive ethical issues. This article advocates a standardized ethical framework to guide current and future development and implementation of performance reports. This framework, which would resolve a number of the major issues, includes the following ethical principles to guide the practice of public reporting on the Internet and facilitate enhanced quality improvement in the healthcare industry: legitimacy, data integrity and quality, transparency, informed understanding, equity, privacy and confidentiality, collaboration, accountability, and evaluation and continuous improvement.

Prospects for the use of animal cell cultures in screening of pharmaceutical substances

NASA Astrophysics Data System (ADS)

Kolesnikova, S. G.; Moiseeva, I. Y.

2017-01-01

Currently, there is a tendency to reduce the use of animals in conducting safety tests of chemical substances. Therefore, in vitro methods are a good alternative or adjunct to in vivo safety tests. This is especially important at the stage of pre-clinical drug trial. In 2004, the international standard for the principles of good laboratory practice (GLP) [1] was adopted which regulates chemicals trials in cell cultures. However, in Russia, until recently, this issue has been neglected. Research works have been scarce. In 2013, the standard for GLP principles and compliance monitoring was adopted in Russia [2]. The feasibility of using animal cell cultures as drug testing system has been proved by the experimental base and is now being introduced into practice [3].

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

Science in the schoolhouse: an uninvited guest.

PubMed

Landrum, Timothy J; Tankersley, Melody

2004-01-01

Science and scientific thinking have not made a substantial impact on educational practice. In this discussion, we examine the relationship between science and education and delineate four reasons for characterizing science as an uninvited guest in schools: (a) Science is not highly regarded in society; (b) good science and bad science are often mistaken for one another; (c) the amount of current data is overwhelming; and (d) science is not easy for those who practice it (researchers), those who translate it (teacher educators), or those who consume it (teachers). We suggest several strategies to improve this relationship, including promoting standards of educational practice, emphasizing the role of teacher educators as translators of the research base into classroom practice, and linking student outcomes with the use of effective instructional practices.

Gusts and shear within hurricane eyewalls can exceed offshore wind turbine design standards

NASA Astrophysics Data System (ADS)

Worsnop, Rochelle P.; Lundquist, Julie K.; Bryan, George H.; Damiani, Rick; Musial, Walt

2017-06-01

Offshore wind energy development is underway in the U.S., with proposed sites located in hurricane-prone regions. Turbine design criteria outlined by the International Electrotechnical Commission do not encompass the extreme wind speeds and directional shifts of hurricanes stronger than category 2. We examine a hurricane's turbulent eyewall using large-eddy simulations with Cloud Model 1. Gusts and mean wind speeds near the eyewall of a category 5 hurricane exceed the current Class I turbine design threshold of 50 m s-1 mean wind and 70 m s-1 gusts. Largest gust factors occur at the eye-eyewall interface. Further, shifts in wind direction suggest that turbines must rotate or yaw faster than current practice. Although current design standards omit mention of wind direction change across the rotor layer, large values (15-50°) suggest that veer should be considered.

Cost effectiveness of the U.S. Geological Survey's stream-gaging program in Illinois

USGS Publications Warehouse

Mades, D.M.; Oberg, K.A.

1984-01-01

Data uses and funding sources were identified for 138 continuous-record discharge-gaging stations currently (1983) operated as part of the stream-gaging program in Illinois. Streamflow data from five of those stations are used only for regional hydrology studies. Most streamflow data are used for defining regional hydrology, defining rainfall-runoff relations, flood forecasting, regulating navigation systems, and water-quality sampling. Based on the evaluations of data use and of alternative methods for determining streamflow in place of stream gaging, no stations in the 1983 stream-gaging program should be deactivated. The current budget (in 1983 dollars) for operating the 138-station program is $768,000 per year. The average standard error of instantaneous discharge for the current practice for visiting the gaging stations is 36.5 percent. Missing stage record accounts for one-third of the 36.5 percent average standard error. (USGS)

Gusts and shear within hurricane eyewalls can exceed offshore wind turbine design standards

DOE PAGES

Worsnop, Rochelle P.; Lundquist, Julie K.; Bryan, George H.; ...

2017-05-30

Here, offshore wind energy development is underway in the U.S., with proposed sites located in hurricane-prone regions. Turbine design criteria outlined by the International Electrotechnical Commission do not encompass the extreme wind speeds and directional shifts of hurricanes stronger than category 2. We examine a hurricane's turbulent eyewall using large-eddy simulations with Cloud Model 1. Gusts and mean wind speeds near the eyewall of a category 5 hurricane exceed the current Class I turbine design threshold of 50 m s –1 mean wind and 70 m s –1 gusts. Largest gust factors occur at the eye-eyewall interface. Further, shifts inmore » wind direction suggest that turbines must rotate or yaw faster than current practice. Although current design standards omit mention of wind direction change across the rotor layer, large values (15–50°) suggest that veer should be considered.« less

Gusts and shear within hurricane eyewalls can exceed offshore wind turbine design standards

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

Worsnop, Rochelle P.; Lundquist, Julie K.; Bryan, George H.

Here, offshore wind energy development is underway in the U.S., with proposed sites located in hurricane-prone regions. Turbine design criteria outlined by the International Electrotechnical Commission do not encompass the extreme wind speeds and directional shifts of hurricanes stronger than category 2. We examine a hurricane's turbulent eyewall using large-eddy simulations with Cloud Model 1. Gusts and mean wind speeds near the eyewall of a category 5 hurricane exceed the current Class I turbine design threshold of 50 m s –1 mean wind and 70 m s –1 gusts. Largest gust factors occur at the eye-eyewall interface. Further, shifts inmore » wind direction suggest that turbines must rotate or yaw faster than current practice. Although current design standards omit mention of wind direction change across the rotor layer, large values (15–50°) suggest that veer should be considered.« less

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

Proposed Robust Entanglement-Based Magnetic Field Sensor Beyond the Standard Quantum Limit.

PubMed

Tanaka, Tohru; Knott, Paul; Matsuzaki, Yuichiro; Dooley, Shane; Yamaguchi, Hiroshi; Munro, William J; Saito, Shiro

2015-10-23

Recently, there have been significant developments in entanglement-based quantum metrology. However, entanglement is fragile against experimental imperfections, and quantum sensing to beat the standard quantum limit in scaling has not yet been achieved in realistic systems. Here, we show that it is possible to overcome such restrictions so that one can sense a magnetic field with an accuracy beyond the standard quantum limit even under the effect of decoherence, by using a realistic entangled state that can be easily created even with current technology. Our scheme could pave the way for the realizations of practical entanglement-based magnetic field sensors.

Advanced endoscopic imaging in gastric neoplasia and preneoplasia

PubMed Central

Lee, Jonathan W J; Lim, Lee Guan; Yeoh, Khay Guan

2017-01-01

Conventional white light endoscopy remains the current standard in routine clinical practice for early detection of gastric cancer. However, it may not accurately diagnose preneoplastic gastric lesions. The technological advancements in the field of endoscopic imaging for gastric lesions are fast growing. This article reviews currently available advanced endoscopic imaging modalities, in particular chromoendoscopy, narrow band imaging and confocal laser endomicroscopy, and their corresponding evidence shown to improve diagnosis of preneoplastic gastric lesions. Raman spectrometry and polarimetry are also introduced as promising emerging technologies. PMID:28176895

Development of job standards for clinical nutrition therapy for dyslipidemia patients.

PubMed

Kang, Min-Jae; Seo, Jung-Sook; Kim, Eun-Mi; Park, Mi-Sun; Woo, Mi-Hye; Ju, Dal-Lae; Wie, Gyung-Ah; Lee, Song-Mi; Cha, Jin-A; Sohn, Cheong-Min

2015-04-01

Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals.

Standardizing practices: a socio-history of experimental systems in classical genetic and virological cancer research, ca. 1920-1978.

PubMed

Fujimura, J H

1996-01-01

This paper presents a narrative history of technologies in cancer research circa 1920-1978 and a theoretical perspective on the complex, intertwined relationships between scientific problems, material practices and technologies, concepts and theories, and other historical circumstances. The history presents several active lines of research and technology development in the genetics of cancer in the United States which were constitutive of proto-oncogene work in its current form. I write this history from the perspective of technology development. Scientists participating in cancer research created tools with which to study their problems of interest, but the development of the tools also influenced the questions asked and answered in the form of concepts and theories developed. These tools included genetic ideas of the 1920s, inbred mouse colonies, chemicals and antibiotics developed during World War Two, tissue cultures and their technical procedures, and viruses. I examine these tools as standardized experimental systems that standardized materials as well as practices in laboratories. Inbred animals, tissue culture materials and methods, and tumor viruses as experimental systems gave materiality to "genes' and "cancer'. They are technical-natural objects that stand-in for nature in the laboratory.

Recording routine forensic mental health evaluations should be a standard of practice in the 21st century.

PubMed

Siegel, David M; Kinscherff, Robert

2018-04-25

The standard of practice for forensic interviews in criminal and delinquency cases, other than those conducted as part of brief preliminary screening evaluations or in emergency situations, should include a digital recording requirement. This standard should be adopted because of the greater availability of, and familiarity with, recording technology on the part of mental health professionals, the greater use and proven effectiveness of recording in other contexts of the criminal justice system, and the improvement in court presentation and accuracy of judicial determinations involving forensic assessments that recording will provide. The experience of practitioners with recording since professional associations last studied the issue should be taken into account, as informal data suggest it has been positive. Unfortunately, the legal system is unlikely to prompt this advance without its reconsideration by the forensic mental health professions, because current constitutional jurisprudence does not require recording and effectively makes it contingent upon request by examiners. Forensic evaluators thus have a valuable opportunity to educate the legal system on the utility and importance of this key reform, and so should adopt it as a best practice. Copyright © 2018 John Wiley & Sons, Ltd.

Are electronic medical records helpful for care coordination? Experiences of physician practices.

PubMed

O'Malley, Ann S; Grossman, Joy M; Cohen, Genna R; Kemper, Nicole M; Pham, Hoangmai H

2010-03-01

Policies promoting widespread adoption of electronic medical records (EMRs) are premised on the hope that they can improve the coordination of care. Yet little is known about whether and how physician practices use current EMRs to facilitate coordination. We examine whether and how practices use commercial EMRs to support coordination tasks and identify work-around practices have created to address new coordination challenges. Semi-structured telephone interviews in 12 randomly selected communities. Sixty respondents, including 52 physicians or staff from 26 practices with commercial ambulatory care EMRs in place for at least 2 years, chief medical officers at four EMR vendors, and four national thought leaders. Six major themes emerged: (1) EMRs facilitate within-office care coordination, chiefly by providing access to data during patient encounters and through electronic messaging; (2) EMRs are less able to support coordination between clinicians and settings, in part due to their design and a lack of standardization of key data elements required for information exchange; (3) managing information overflow from EMRs is a challenge for clinicians; (4) clinicians believe current EMRs cannot adequately capture the medical decision-making process and future care plans to support coordination; (5) realizing EMRs' potential for facilitating coordination requires evolution of practice operational processes; (6) current fee-for-service reimbursement encourages EMR use for documentation of billable events (office visits, procedures) and not of care coordination (which is not a billable activity). There is a gap between policy-makers' expectation of, and clinical practitioners' experience with, current electronic medical records' ability to support coordination of care. Policymakers could expand current health information technology policies to support assessment of how well the technology facilitates tasks necessary for coordination. By reforming payment policy to include care coordination, policymakers could encourage the evolution of EMR technology to include capabilities that support coordination, for example, allowing for inter-practice data exchange and multi-provider clinical decision support.

The UK Quality and Outcomes Framework pay-for-performance scheme and spirometry: rewarding quality or just quantity? A cross-sectional study in Rotherham, UK

PubMed Central

Strong, Mark; South, Gail; Carlisle, Robin

2009-01-01

Background Accurate spirometry is important in the management of COPD. The UK Quality and Outcomes Framework pay-for-performance scheme for general practitioners includes spirometry related indicators within its COPD domain. It is not known whether high achievement against QOF spirometry indicators is associated with spirometry to BTS standards. Methods Data were obtained from the records of 3,217 patients randomly sampled from 5,649 patients with COPD in 38 general practices in Rotherham, UK. Severity of airflow obstruction was categorised by FEV1 (% predicted) according to NICE guidelines. This was compared with clinician recorded COPD severity. The proportion of patients whose spirometry met BTS standards was calculated in each practice using a random sub-sample of 761 patients. The Spearman rank correlation between practice level QOF spirometry achievement and performance against BTS spirometry standards was calculated. Results Spirometry as assessed by clinical records was to BTS standards in 31% of cases (range at practice level 0% to 74%). The categorisation of airflow obstruction according to the most recent spirometry results did not agree well with the clinical categorisation of COPD recorded in the notes (Cohen's kappa = 0.34, 0.30 – 0.38). 12% of patients on COPD registers had FEV1 (% predicted) results recorded that did not support the diagnosis of COPD. There was no association between quality, as measured by adherence to BTS spirometry standards, and either QOF COPD9 achievement (Spearman's rho = -0.11), or QOF COPD10 achievement (rho = 0.01). Conclusion The UK Quality and Outcomes Framework currently assesses the quantity, but not the quality of spirometry. PMID:19558719

The UK Quality and Outcomes Framework pay-for-performance scheme and spirometry: rewarding quality or just quantity? A cross-sectional study in Rotherham, UK.

PubMed

Strong, Mark; South, Gail; Carlisle, Robin

2009-06-28

Accurate spirometry is important in the management of COPD. The UK Quality and Outcomes Framework pay-for-performance scheme for general practitioners includes spirometry related indicators within its COPD domain. It is not known whether high achievement against QOF spirometry indicators is associated with spirometry to BTS standards. Data were obtained from the records of 3,217 patients randomly sampled from 5,649 patients with COPD in 38 general practices in Rotherham, UK. Severity of airflow obstruction was categorised by FEV1 (% predicted) according to NICE guidelines. This was compared with clinician recorded COPD severity. The proportion of patients whose spirometry met BTS standards was calculated in each practice using a random sub-sample of 761 patients. The Spearman rank correlation between practice level QOF spirometry achievement and performance against BTS spirometry standards was calculated. Spirometry as assessed by clinical records was to BTS standards in 31% of cases (range at practice level 0% to 74%). The categorisation of airflow obstruction according to the most recent spirometry results did not agree well with the clinical categorisation of COPD recorded in the notes (Cohen's kappa = 0.34, 0.30 - 0.38). 12% of patients on COPD registers had FEV1 (% predicted) results recorded that did not support the diagnosis of COPD. There was no association between quality, as measured by adherence to BTS spirometry standards, and either QOF COPD9 achievement (Spearman's rho = -0.11), or QOF COPD10 achievement (rho = 0.01). The UK Quality and Outcomes Framework currently assesses the quantity, but not the quality of spirometry.

Deep Venous Thrombosis Prophylaxis in Anterior Cruciate Ligament Reconstructive Surgery: What Is the Current State of Practice?

PubMed

Keller, Robert A; Moutzouros, Vasilios; Dines, Joshua S; Bush-Joseph, Charles A; Limpisvasti, Orr

Venous thromboembolism (VTE) is a significant perioperative risk with many common orthopaedic procedures. Currently, there is no standardized recommendation for the use of VTE prophylaxis during anterior cruciate ligament (ACL) reconstruction. This study sought to evaluate the current prophylactic practices of fellowship-trained sports medicine orthopaedic surgeons in the United States. Very few surgeons use perioperative VTE prophylaxis for ACL reconstructive surgery. Survey. Surveys were emailed to the alumni networks of 4 large ACGME-accredited sports medicine fellowship programs. Questions were focused on their current use of chemical and nonchemical VTE prophylaxis. Surveys were completed by 142 surgeons in the United States, yielding a response rate of 32%. Of those who responded, 50.7% stated that they routinely use chemical prophylaxis, with 95.5% of those using aspirin (acetylsalicylic acid [ASA]). There was no standardized dosing protocol, with respondents using ASA 325 mg once (46%) or twice daily (26%) or ASA 81 mg once (18%) or twice (10%) daily. The most common reason for not including chemical prophylaxis within the reconstruction procedure was that it is unnecessary given the low risk of VTE. Physicians also based their prophylaxis regimen more on their own clinical experience than concern for litigation. Half of all sports medicine fellowship-trained surgeons surveyed routinely use chemical VTE prophylaxis after ACL reconstruction, with more than 90% of those using ASA. Of those using ASA, there was no prevailing dosing protocol. For those not using chemical prophylaxis, the most important reason was that it was felt to be unnecessary due to the risks outweighing the benefits. Those who do not regularly use chemical prophylaxis would be willing to, however, if a patient had a personal or family history of clotting disorder or is currently on birth control. Additionally, clinical experience was the primary driver for a current prophylaxis protocol. This survey study evaluating the use of VTE prophylaxis with ACL reconstruction lends clinical insight to the current practice of a large, geographically diverse group of fellowship-trained sports medicine orthopaedic surgeons in the United States.

A survey of current practices for genomic sequencing test interpretation and reporting processes in US laboratories.

PubMed

O'Daniel, Julianne M; McLaughlin, Heather M; Amendola, Laura M; Bale, Sherri J; Berg, Jonathan S; Bick, David; Bowling, Kevin M; Chao, Elizabeth C; Chung, Wendy K; Conlin, Laura K; Cooper, Gregory M; Das, Soma; Deignan, Joshua L; Dorschner, Michael O; Evans, James P; Ghazani, Arezou A; Goddard, Katrina A; Gornick, Michele; Farwell Hagman, Kelly D; Hambuch, Tina; Hegde, Madhuri; Hindorff, Lucia A; Holm, Ingrid A; Jarvik, Gail P; Knight Johnson, Amy; Mighion, Lindsey; Morra, Massimo; Plon, Sharon E; Punj, Sumit; Richards, C Sue; Santani, Avni; Shirts, Brian H; Spinner, Nancy B; Tang, Sha; Weck, Karen E; Wolf, Susan M; Yang, Yaping; Rehm, Heidi L

2017-05-01

While the diagnostic success of genomic sequencing expands, the complexity of this testing should not be overlooked. Numerous laboratory processes are required to support the identification, interpretation, and reporting of clinically significant variants. This study aimed to examine the workflow and reporting procedures among US laboratories to highlight shared practices and identify areas in need of standardization. Surveys and follow-up interviews were conducted with laboratories offering exome and/or genome sequencing to support a research program or for routine clinical services. The 73-item survey elicited multiple choice and free-text responses that were later clarified with phone interviews. Twenty-one laboratories participated. Practices highly concordant across all groups included consent documentation, multiperson case review, and enabling patient opt-out of incidental or secondary findings analysis. Noted divergence included use of phenotypic data to inform case analysis and interpretation and reporting of case-specific quality metrics and methods. Few laboratory policies detailed procedures for data reanalysis, data sharing, or patient access to data. This study provides an overview of practices and policies of experienced exome and genome sequencing laboratories. The results enable broader consideration of which practices are becoming standard approaches, where divergence remains, and areas of development in best practice guidelines that may be helpful.Genet Med advance online publication 03 Novemeber 2016.

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.

Collaborative Practice Model: Improving the Delivery of Bad News.

PubMed

Bowman, Pamela N; Slusser, Kim; Allen, Deborah

2018-02-01

Ideal bad news delivery requires skilled communication and team support. The literature has primarily focused on patient preferences, impact on care decisions, healthcare roles, and communication styles, without addressing systematic implementation. This article describes how an interdisciplinary team, led by advanced practice nurses, developed and implemented a collaborative practice model to deliver bad news on a unit that had struggled with inconsistencies. Using evidence-based practices, the authors explored current processes, role perceptions and expectations, and perceived barriers to developing the model, which is now the standard of care and an example of interprofessional team collaboration across the healthcare system. This model for delivering bad news can be easily adapted to meet the needs of other clinical units.
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EMCDDA Best Practice Promotion in Europe: an internet based dissemination tool.

PubMed

Ferri, Marica; Bo, Alessandra

2013-01-01

Best practice is the best application of available evidence to current activities in the drugs field. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) created a web-based tool aimed at bridging together scientific evidence and current practices in the drug addiction field. Beyond dissemination of evidence, the scope is to share best practice among the European countries. The synthesis of the evidence is based on the methods of the Cochrane collaboration (the Drugs and Alcohol Group) and the Grade working group. As of February 2013 the portal encompasses four modules on the effectiveness of demand reduction interventions, a collection of European projects on prevention, treatment, harm reduction and social reintegration and an inventory of European Guidelines and Standards including a bank of instruments to evaluate interventions (http://www.emcdda.europa.eu/bestpractice). The summaries of evidence are presented in a plain language format and include brief explanation of the measures of effect supporting the evidence, but do not provide specific recommendations. The main future challenge of EMCDDA's best practice promotion is to become a service for those willing to implement best practice. The Best Practice Portal should become a platform where to find all is needed for successful implementation (handbooks, training materials, guidelines for evaluation and contacts for mentoring).

Management of obstetric postpartum hemorrhage: a national service evaluation of current practice in the UK

PubMed Central

Al Wattar, Bassel H; Tamblyn, Jennifer A; Parry-Smith, William; Prior, Mathew; Van Der Nelson, Helen

2017-01-01

Background Postpartum hemorrhage (PPH) continues to be one of the major causes of maternal mortality and morbidity in obstetrics. Variations in practice often lead to adverse maternity outcomes following PPH. Our objective was to assess the current practice in managing PPH in the UK. Methods We performed a national multicenter prospective service evaluation study over one calendar month and compared the current performance to national standards for managing PPH. We used a standardized data collection tool and collected data on patients’ demographics, incidence of PPH, estimated blood loss (EBL), prophylactic and treatment measures, onset of labor, and mode of delivery. Results We collected data from 98 obstetric units, including 3663 cases of primary PPH. Fifty percent of cases were minor PPH (EBL 500–1000 mL, n=1900/3613, 52.6%) and the remaining were moderate PPH (EBL >1000 to <2000 mL, n=1424/3613, 39.4%) and severe PPH (EBL >2000 mL, n=289/3613, 8%). The majority of women received active management of the third stage of labor (3504/3613, 97%) most commonly with Syntometrine intramuscular (1479/3613, 40.9%). More than half required one additional uterotonic agent (2364/3613, 65.4%) most commonly with Syntocinon intravenous infusion (1155/2364, 48.8%). There was a poor involvement of consultant obstetricians and anesthetists in managing PPH cases, which was more prevalent when managing major PPH (p=0.0001). Conclusion There are still variations in managing PPH in the UK against national guidelines. More senior doctor involvement and regular service evaluation are needed to improve maternal outcomes following PPH. PMID:28176919

Good manufacturing practice (GMP) compliance in the biologics sector: plasma fractionation.

PubMed

Ways, J P; Preston, M S; Baker, D; Huxsoll, J; Bablak, J

1999-12-01

The U.S. blood supply is the safest it has ever been. Due to blood safety and the introduction of viral inactivation/clearance technologies, protein therapies derived from human blood have also in recent years had a history of product safety. Nevertheless, since 1995, the plasma-fractionation industry has experienced increased compliance-related actions by the Food and Drug Administration (FDA), as shown by a substantive increase in the number of FDA 483 inspectional observations, FDA warning letters and other FDA regulatory action. An evaluation of these trends shows that they reflect the implementation by the FDA of increased inspectional interest in the plasma-fractionation industry and an evolution of inspectional practices and standards of current good manufacturing practice (cGMP). Plasma fractionators have responded to FDA actions by carefully evaluating and addressing each inspectional observation, assessing impact to product and taking appropriate actions, including corrective actions to prevent future occurrence. They have made major investments in facilities, quality systems, personnel and training to meet the evolving standards of cGMP and in an effort to implement these standards systemically. Through industry associations, manufacturers have further enhanced product safety by adopting additional voluntary standards for plasma to prevent the entry of potentially unsuitable plasma into the production process. The industry remains committed to application of cGMP and to working with the FDA in further evolution of these standards while striving to assure a continued supply of safe, pure and effective plasma-derived therapies.

Integrated Pest Management Practices Reduce Insecticide Applications, Preserve Beneficial Insects, and Decrease Pesticide Residues in Flue-Cured Tobacco Production.

PubMed

Slone, Jeremy D; Burrack, Hannah J

2016-12-01

Integrated pest management (IPM) recommendations, including scouting and economic thresholds (ETs), are available for North Carolina flue-cured tobacco growers, although ETs for key pests have not been updated in several decades. Moreover, reported IPM adoption rates by flue-cured tobacco growers remain low, at < 40%, according to NC cooperative extension surveys conducted during the last four years. Previous research has suggested that timing insecticide treatments using currently available ETs can reduce the average number of applications to two or fewer per season. We conducted field-scale trials at nine commercial tobacco farms, three in 2104 and six in 2015, to quantify inputs associated with current scouting recommendations, to determine if current ETs were able to reduce insecticide applications as compared to grower standard practices, and to assess the impacts of reduced insecticide applications on end of season yield and pesticide residues. Two fields were identified at each farm and were scouted weekly for insects. One field was only treated with insecticides if pests reached ET (IPM), while the other field was managed per grower discretion (Grower Standard). IPM fields received an average of two fewer insecticide applications without compromising yield. More insecticide applications resulted in higher pesticide residues in cured leaf samples from Grower Standard fields than those from IPM fields. Reductions in insecticides and management intensity also resulted in larger beneficial insect populations in IPM fields. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Robust Engineering Designs for Infrastructure Adaptation to a Changing Climate

NASA Astrophysics Data System (ADS)

Samaras, C.; Cook, L.

2015-12-01

Infrastructure systems are expected to be functional, durable and safe over long service lives - 50 to over 100 years. Observations and models of climate science show that greenhouse gas emissions resulting from human activities have changed climate, weather and extreme events. Projections of future changes (albeit with uncertainties caused by inadequacies of current climate/weather models) can be made based on scenarios for future emissions, but actual future emissions are themselves uncertain. Most current engineering standards and practices for infrastructure assume that the probabilities of future extreme climate and weather events will match those of the past. Climate science shows that this assumption is invalid, but is unable, at present, to define these probabilities over the service lives of existing and new infrastructure systems. Engineering designs, plans, and institutions and regulations will need to be adaptable for a range of future conditions (conditions of climate, weather and extreme events, as well as changing societal demands for infrastructure services). For their current and future projects, engineers should: Involve all stakeholders (owners, financers, insurance, regulators, affected public, climate/weather scientists, etc.) in key decisions; Use low regret, adaptive strategies, such as robust decision making and the observational method, comply with relevant standards and regulations, and exceed their requirements where appropriate; Publish design studies and performance/failure investigations to extend the body of knowledge for advancement of practice. The engineering community should conduct observational and modeling research with climate/weather/social scientists and the concerned communities and account rationally for climate change in revised engineering standards and codes. This presentation presents initial research on decisionmaking under uncertainty for climate resilient infrastructure design.

Quality beyond compliance.

PubMed

Centanni, N; Monroe, M; White, L; Larson, R

1999-01-01

The service sector within the biopharmaceutical industry has experienced phenomenal growth over the past decade. In the highly regulated Good Laboratory Practices environment, the need for timely, high-quality service, accurate results, and on-time deliverables becomes paramount for the success and profitability of biopharmaceutical companies. The quality assurance process is a vital component of this drug product-development cycle and ensures compliance to the highest domestic and international regulatory standards. Quality-assurance professionals historically have held the role of independent auditors of the processes, who certify that results meet current standards of practice. Covance, a contract research organization that includes Good Laboratory Practices laboratories, reorganized and expanded the functional responsibilities of its quality assurance team in 1997. Auditors and quality assurance professionals have assumed roles beyond traditional compliance auditing and are forging new leadership and mentoring roles as process-improvement specialists. The results have been tangible, measurable benefits for clients and the Covance organization. This article provides an overview of this cultural change and the processes put in place to improve efficiency, productivity, and customer and employee satisfaction.

WE-A-210-00: Educational: Diagnostic Ultrasound QA

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

NONE

This presentation will focus on the present role of ultrasound medical physics in clinical practices. The first part of the presentation will provide an overview of ultrasound QC methodologies and testing procedures. A brief review of ultrasound phantoms utilized in these testing procedures will be presented. The second part of the presentation will summarize ultrasound imaging technical standards and professional guidelines by American College of Radiology (ACR), American Institute of Ultrasound in Medicine (AIUM), American Association of Physicists in Medicine (AAPM) and International Electrotechnical Commission (IEC). The current accreditation requirements by ACR and AIUM for ultrasound practices will be describedmore » and the practical aspects of implementing QC programs to be compliant with these requirements will be discussed. Learning Objectives: Achieve familiarity with common ultrasound QC test methods and ultrasound phantoms. Understand the coverage of the existing testing standards and professional guidelines on diagnostic ultrasound imaging. Learn what a medical physicist needs to know about ultrasound program accreditation and be able to implement ultrasound QC programs accordingly.« less

Leo Spacecraft Charging Design Guidelines: A Proposed NASA Standard

NASA Technical Reports Server (NTRS)

Hillard, G. B.; Ferguson, D. C.

2004-01-01

Over the past decade, Low Earth Orbiting (LEO) spacecraft have gradually required ever-increasing power levels. As a rule, this has been accomplished through the use of high voltage systems. Recent failures and anomalies on such spacecraft have been traced to various design practices and materials choices related to the high voltage solar arrays. NASA Glenn has studied these anomalies including plasma chamber testing on arrays similar to those that experienced difficulties on orbit. Many others in the community have been involved in a comprehensive effort to understand the problems and to develop practices to avoid them. The NASA Space Environments and Effects program, recognizing the timeliness of this effort, commissioned and funded a design guidelines document intended to capture the current state of understanding. This document, which was completed in the spring of 2003, has been submitted as a proposed NASA standard. We present here an overview of this document and discuss the effort to develop it as a NASA standard.

Current issues of personnel and laboratory practices in genetic testing

PubMed Central

Mark, Hon Fong Louie; Kelly, Thaddeus; Watson, Michael S; Hoeltge, Gerald; Miller, Wayne A; Beauregard, Laurent

1995-01-01

As genetic testing is an area with implications extending far beyond that of the primary patient, it is appropriately an area that is under increased scrutiny. To ensure that high quality is maintained in the delivery of genetic services, several agencies have developed standards and guidelines. The present article summarises important recommendations made by the American College of Medical Genetics (ACMG), the College of American Pathologists (CAP), the US Health Care Financing Administration (HCFA), and the US Food and Drug Administration (FDA) as they relate to genetic testing. Some of the standards are based on voluntary compliance, whereas others have the force of regulation. They all address issues of personnel credentials, laboratory operations, and the most critical quality assurance and control measures for diagnostic laboratories from the perspective of various agencies. In most instances, the standards promulgated by these agencies are offered as minimum criteria. The exact impact of these regulations on the practice of medical genetics has yet to be established. Images PMID:8558555

Medical nutrition therapy in adults with chronic kidney disease: integrating evidence and consensus into practice for the generalist registered dietitian nutritionist.

PubMed

Beto, Judith A; Ramirez, Wendy E; Bansal, Vinod K

2014-07-01

Chronic kidney disease is classified in stages 1 to 5 by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative depending on the level of renal function by glomerular filtration rate and, more recently, using further categorization depending on the level of glomerular filtration rate and albuminuria by the Kidney Disease Improving Global Outcomes initiative. Registered dietitian nutritionists can be reimbursed for medical nutrition therapy in chronic kidney disease stages 3 to 4 for specific clients under Center for Medicare and Medicaid Services coverage. This predialysis medical nutrition therapy counseling has been shown to both potentially delay progression to stage 5 (renal replacement therapy) and decrease first-year mortality after initiation of hemodialysis. The Joint Standards Task Force of the American Dietetic Association (now the Academy of Nutrition and Dietetics), the Renal Nutrition Dietetic Practice Group, and the National Kidney Foundation Council on Renal Nutrition collaboratively published 2009 Standards of Practice and Standards of Professional Performance for generalist, specialty, and advanced practice registered dietitian nutritionists in nephrology care. The purpose of this article is to provide an update on current recommendations for screening, diagnosis, and treatment of adults with chronic kidney disease for application in clinical practice for the generalist registered dietitian nutritionist using the evidence-based library of the Academy of Nutrition and Dietetics, published clinical practice guidelines (ie, National Kidney Foundation Council on Renal Nutrition, Renal Nutrition Dietetic Practice Group, Kidney Disease Outcomes Quality Initiative, and Kidney Disease Improving Global Outcomes), the Nutrition Care Process model, and peer-reviewed literature. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Establishing Obstetric Anesthesiology Practice Guidelines in the Republic of Armenia: A Global Health Collaboration.

PubMed

Yuill, Gordon; Amroyan, Ashot; Millar, Simon; Vardapetyan, Emil; Habib, Ashraf S; Owen, Medge D

2017-08-01

Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of international collaborations and appropriate practice guidelines may help address clinical care deficiencies. This report's aim was to assess the impact of a multiyear collaboration on obstetric anesthesia practices in the Republic of Armenia. An invited multinational team of physicians conducted six visits to Armenia between 2006 and 2015 to observe current practice and establish standards of obstetric anesthesia care. The Armenian Society of Anaesthesiologists and Intensive Care specialists collected data on the numbers of vaginal delivery, cesarean delivery, and neuraxial anesthesia use in maternity units during the period. Data were analyzed with the Fisher exact or chi-square test, as appropriate. Neuraxial anesthesia use for cesarean delivery increased significantly (P < 0.0001) in all 10 maternity hospitals within the capital city of Yerevan. For epidural labor analgesia, there was sustained or increased use in only two hospitals. For hospitals located outside the capital city, there was a similar increase in the use of neuraxial anesthesia for cesarean delivery that was greater in hospitals that were visited by an external team (P < 0.0001); however, use of epidural labor analgesia was not increased significantly. Over the course of the collaboration, guidelines for obstetric anesthesia were drafted and approved by the Armenian Ministry of Health. Collaboration between Armenian anesthesiologists and dedicated visiting physicians to update and standardize obstetric anesthesia practices led to national practice guidelines and sustained improvements in clinical care in the Republic of Armenia.

Safe, Healthy Birth: What Every Pregnant Woman Needs to Know

PubMed Central

Lothian, Judith A.

2009-01-01

In spite of technology and medical science's ability to manage complex health problems, the current maternity care environment has increased risks for healthy women and their babies. It comes as a surprise to most women that standard maternity care does not reflect best scientific evidence. In this column, evidence-based maternity care practices are discussed with an emphasis on the practices that increase safety for mother and baby, and what pregnant women need to know in order to have safe, healthy births is described. PMID:19750214

The utility of Pro Forma Income Statements.

PubMed

Reiboldt, Max; Reiboldt, John

2002-01-01

Recent headlines surrounding the financial demise of the nation's seventh largest company, Enron, and its subsequent entanglements with its accounting and consulting firm, Arthur Andersen, have placed a cloud of suspicion upon many reasonable business practices that otherwise are considered standard procedure. The proforma income statement is one of those practices. An oft-used tool in financial management, pro formas play a useful role for projecting financial performance based on predictable forecasts or assumptions. Regardless of the current scrutiny, there is still a valid use for accurately prepared statements.

An introduction to best practices in free energy calculations.

PubMed

Shirts, Michael R; Mobley, David L

2013-01-01

Free energy calculations are extremely useful for investigating small-molecule biophysical properties such as protein-ligand binding affinities and partition coefficients. However, these calculations are also notoriously difficult to implement correctly. In this chapter, we review standard methods for computing free energy via simulation, discussing current best practices and examining potential pitfalls for computational researchers performing them for the first time. We include a variety of examples and tips for how to set up and conduct these calculations, including applications to relative binding affinities and small-molecule solvation free energies.

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.

Solutions for medical databases optimal exploitation.

PubMed

Branescu, I; Purcarea, V L; Dobrescu, R

2014-03-15

The paper discusses the methods to apply OLAP techniques for multidimensional databases that leverage the existing, performance-enhancing technique, known as practical pre-aggregation, by making this technique relevant to a much wider range of medical applications, as a logistic support to the data warehousing techniques. The transformations have practically low computational complexity and they may be implemented using standard relational database technology. The paper also describes how to integrate the transformed hierarchies in current OLAP systems, transparently to the user and proposes a flexible, "multimodel" federated system for extending OLAP querying to external object databases.

Laboratory techniques and rhythmometry

NASA Technical Reports Server (NTRS)

Halberg, F.

1973-01-01

Some of the procedures used for the analysis of rhythms are illustrated, notably as these apply to current medical and biological practice. For a quantitative approach to medical and broader socio-ecologic goals, the chronobiologist gathers numerical objective reference standards for rhythmic biophysical, biochemical, and behavioral variables. These biological reference standards can be derived by specialized computer analyses of largely self-measured (until eventually automatically recorded) time series (autorhythmometry). Objective numerical values for individual and population parameters of reproductive cycles can be obtained concomitantly with characteristics of about-yearly (circannual), about-daily (circadian) and other rhythms.

First-year university Physics students’ knowledge about direct current circuits: probing improvement in understanding as a function of teaching and learning interventions

NASA Astrophysics Data System (ADS)

Newman, Richard; van der Ventel, Brandon; Hanekom, Crischelle

2017-07-01

Probing university students’ understanding of direct-current (DC) resistive circuits is still a field of active physics education research. We report here on a study we conducted of this understanding, where the cohort consisted of students in a large-enrollment first-year physics module. This is a non-calculus based physics module for students in the life sciences stream. The study involved 366 students enrolled in the physics (bio) 154 module at Stellenbosch University in 2015. Students’ understanding of DC resistive circuits was probed by means of a standardized test instrument. The instrument comprises 29 multiple choice questions that students have to answer in ~40 min. Students were required to first complete the standardized test at the start of semester (July 2015). For ease of reference we call this test the pre-test. Students answered the pre-test having no university-level formal exposure to DC circuits in theory or practice. The pre-test therefore served to probe students’ school level knowledge of DC circuits. As the semester progressed students were exposed to a practical (E1), lectures, a prescribed textbook, a tutorial and online videos focusing on DC circuits. The E1 practical required students to solve DC circuit problems by means of physically constructing circuits, algebraically using Kirchhoff's Rules and Ohm’s Law, and by means of simulating circuits using the app iCircuit running on iPads (iOS platform). Each E1 practical involved ~50 students in a three hour session. The practical was repeated three afternoons per week over an eight week period. Twenty three iPads were distributed among students on a practical afternoon in order for them to do the circuit simulations in groups (of 4-5 students). At the end of the practical students were again required to do the standardized test on circuits and complete a survey on their experience of the use of the iPad and iCircuit app. For ease of reference we refer to this second test as the post-test. The students’ average score on the post-test was found to be ~25% higher than their pre-test score. The results of the iPad use survey show that the majority of students felt that the iCircuit app enhanced their learning of DC circuits.

Bridging Policy and Practice: A Study of EFL Teacher Talk in China

ERIC Educational Resources Information Center

Teo, Peter

2017-01-01

This study focuses on teacher talk in the context of English as a Foreign Language (EFL) teaching in China. Framed against China's current focus on "thinking, imagination and innovation" as stated in the National English Curriculum Standards (NECS), this paper reports the findings of a qualitative study aimed at understanding how the…

Investigating Mathematics Students' Use of Multiple Representations when Solving Linear Equations with One Unknown

ERIC Educational Resources Information Center

Beyranevand, Matthew L.

2010-01-01

Although it is difficult to find any current literature that does not encourage use of multiple representations in mathematics classrooms, there has been very limited research that compared such practice to student achievement level on standardized tests. This study examined the associations between students' achievement levels and their (a)…

State-Level Support for Comprehensive School Reform: Implications for Policy and Practice

ERIC Educational Resources Information Center

Lane, Brett; Gracia, Susan

2005-01-01

In the current context of standards-based reform and heightened accountability for school performance, state education agencies (SEAs) have an important, but not yet well-articulated, role to play in local school improvement efforts. This article starts to articulate such a role by examining the variety of approaches and strategies used by 7 SEAs…

Dialectical Behavior Therapy in College Counseling Centers: Current Literature and Implications for Practice

ERIC Educational Resources Information Center

Chugani, Carla D.

2015-01-01

This article examines the topic of Dialectical Behavior Therapy (DBT) applied in college counseling centers. Trends in mental health issues on college campuses are briefly reviewed in support of the increased need for evidence-based treatment of severe mental health issues. The article next presents an overview of the standard DBT model and…

5 CFR 5501.104 - Prohibited financial interests applicable to employees of the Food and Drug Administration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES SUPPLEMENTAL STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE... employee under 18 U.S.C. 208—whether by purchase, gift, bequest, marriage, or otherwise, except that with... prospective and current investors or participants, does not indicate the objective or practice of...

Serotypes of Salmonella enterica subspecies I isolated from mice caught on US poultry farms 1995 through 1998

USDA-ARS?s Scientific Manuscript database

Whole genome analysis of foodborne pathogens is standard practice for regulatory agencies in the US, and a goal of 1 million genomes for Salmonella enterica is currently 76% complete. Inclusion of a range of Salmonella enterica subspecies I serotypes is important because only 30 of approximately 150...

A review and evaluation of the Langley Research Center's Scientific and Technical Information Program: Results of phase 6: The technical report. A survey and analysis

NASA Technical Reports Server (NTRS)

Mccullough, R. A.; Pinelli, T. E.; Pilley, D. D.; Stohrer, F. F.

1982-01-01

Current practice and usage using selected technical reports; literature relative to the sequential, language, and presentation components of technical reports; and NASA technical report publications standards are discussed. The effctiveness of the technical report as a product for information dissemination is considered.

Integrated Practice in the Early Years in Australia: The Assumptions, Omissions and Contradictions of Policy Reform

ERIC Educational Resources Information Center

Macfarlane, Kym; Nolan, Andrea; Cartmel, Jennifer

2016-01-01

The aim of this article is to examine current national early years' policy reform, which emphasises the importance of service integration, national quality standards and a quality knowledge base for educators concerning the provision of early childhood education and care. Using Queensland, Australia, as an example, a policy discourse analysis…

The Common Sense Guide to the Common Core: Teacher-Tested Tools for Implementation

ERIC Educational Resources Information Center

McKnight, Katherine

2014-01-01

Based on the original source document for the Common Core State Standards and tested by 1,000 educators in diverse classrooms across the country, these research-based tools will help readers examine their current practices and adapt existing curriculum. Each of the 40 tools is clearly presented, explained, and exemplified, guiding educators…

Towards a Personal Best: A Case for Introducing Ipsative Assessment in Higher Education

ERIC Educational Resources Information Center

Hughes, Gwyneth

2011-01-01

The central role that assessment plays is recognised in higher education, in particular how formative feedback guides learning. A model for effective feedback practice is used to argue that, in current schemes, formative feedback is often not usable because it is strongly linked to external criteria and standards, rather than to the processes of…

Beyond Grade Retention and Social Promotion: Promoting the Social and Academic Competence of Students

ERIC Educational Resources Information Center

Jimerson, Shane R.; Pletcher, Sarah M. W.; Graydon, Kelly; Schnurr, Britton L.; Nickerson, Amanda B.; Kundert, Deborah K.

2006-01-01

During the past decade, amidst the current context emphasizing educational standards and accountability, the practice of grade retention has increased. The call for an end to social promotion has generated a variety of recommendations and legislation regarding promotion policies. This context has served as a catalyst for numerous debates regarding…

Distributed School Leadership and Its Influence on Teaching Capacity: A Case Study from Teachers' Perspective

ERIC Educational Resources Information Center

Crespo, Cecilia I.

2016-01-01

Current educational reforms call for higher student learning standards. The result is greater accountability for teaching and learning than ever before. School leadership mediates reform implementation so that the intent of the policy is transferred into teaching practice. I suggest that how teachers make sense of leadership reform activities…

The changing face of medical negligence law: from Bolam to Bolitho.

PubMed

Sooriakumaran, Prasanna

2008-06-01

The Bolam test was the standard by which medical negligence cases were judged. However, recently, the Bolitho case has resulted in a shift away from Bolam, with significant effects for all future negligence suits. Doctors need to have a thorough understanding of these issues in order to practice successfully in the current litiginous climate.

Teachers' Sensemaking about Implementation of an Innovative Science Curriculum across the Settings of Professional Development and Classroom Enactment

ERIC Educational Resources Information Center

de los Santos, Xeng

2017-01-01

Designing professional development that effectively supports teachers in learning new and often challenging practices remains a dilemma for teacher educators. Within the context of current reform efforts in science education, such as the "Next Generation Science Standards," teacher educators are faced with managing the dilemma of how to…

Research-Based Writing Practices and the Common Core: Meta-Analysis and Meta-Synthesis

ERIC Educational Resources Information Center

Graham, Steve; Harris, Karen R.; Santangelo, Tanya

2015-01-01

In order to meet writing objectives specified in the Common Core State Standards (CCSS), many teachers need to make significant changes in how writing is taught. While CCSS identified what students need to master, it did not provide guidance on how teachers are to meet these writing benchmarks. The current article presents research-supported…

[Centennial retrospective on the evolution and development of the nursing practice environment in Taiwan].

PubMed

Lin, Shou-Ju; Huang, Lain-Hua

2014-08-01

The practice environment for nurses has seen tremendous change over the past century due to the dedication and trailblazing work of nursing pioneers. This article describes how the nursing practice environment in Taiwan has evolved over this period. References used include nursing narratives, hospital accreditation standards, standard operating procedures, workplace safety standards, and worksite-related values and expectations. The efforts of the professional nursing community to realize a positive practice environment are further discussed. Over this century of change, the only thing that has remained unchanged is the commitment of nurses to "treat patients as one's own family". In the current as well as the previous periods of manpower shortages in nursing, the nursing community has managed to turn crisis into opportunity by using the situation to enhance pay and benefits. Nursing professionalism is widely respected and recognized throughout Taiwan society. The rapidly changing needs of the 21st century in aspects such as the advancement of high technology, the rapid growth of the elderly population, and the fast rate of social change seriously impact the development of the nursing profession. How to effectively apply high technology, simplify workflows, provide high quality and humanistic nursing care, build safe and quality workplaces, attract bright nursing students, and provide healthcare for the entire population will remain the responsibilities of nursing for generations to come.

Prevalence, Etiology and Treatment of Peri-Implant Mucositis and Peri-Implantitis: A Survey of Periodontists in the United States.

PubMed

Papathanasiou, Evangelos; Finkelman, Matthew; Hanley, James; Parashis, Andreas O

2016-05-01

Currently, information available on the exact prevalence and standard therapeutic protocol of peri-implant diseases is insufficient. The aim of this survey was to investigate the perceived prevalence, etiology, and management of peri-implant mucositis and peri-implantitis by periodontists in the United States. A twenty-question survey was developed. Periodontists currently practicing in the United States were contacted by an e-mail that contained a link to access the survey. Two hundred eighty periodontists (79.3% males; 62.9% with >10 years in practice, 75.7% in private practice) completed the survey. Most (96.1%) of the participants were placing implants (58.3% for >10 years and 32.4% >150 implants/year). The majority reported that the prevalence of peri-implant mucositis and peri-implantitis in their practices is up to 25% but is higher in the general US population and that up to 10% of implants must be removed due to peri-implantitis. There was agreement among contributing etiologic factors such as: 1) plaque; 2) smoking; 3) adverse loading; 4) oral hygiene; 5) use of antimicrobial gel/mouthrinse; 6) non-surgical debridement; 7) use of systemic antibiotics; and 8) 3-month supportive care for treatment of peri-implantitis. Significant heterogeneity was recorded in relation to the instruments used for debridement, use and type of surgical treatment, and materials used for regeneration. Only 5.1% believed that treatment is very effective. This survey indicates that peri-implant diseases are a frequently encountered problem in periodontal practices and that the absence of a standard therapeutic protocol results in significant empirical use of therapeutic modalities and a moderately effective treatment outcome.

Factors driving James Cook University Bachelor of Medicine, Bachelor of Surgery graduates' choice of internship location and beyond.

PubMed

Schauer, Anna; Woolley, Torres; Sen Gupta, Tarun

2014-04-01

To identify the main reason James Cook University (JCU) Bachelor of Medicine, Bachelor of Surgery graduates chose their internship location and first four practice relocations. This cross-sectional study invited 261 JCU medical graduates to participate in an email or telephone survey. Graduates' main reason for choosing internship location and up to four subsequent relocations, post-graduate specialty training undertaken and practice location (either metropolitan or non-metropolitan) for graduates' internship year and current practice year (2012). Respondents (n=175; response rate=67%) reported personal factors as the primary driver for choosing their internship location, with 33% returning to 'near their family/home town', and 21% staying in the town they were based in Years 5 and 6. Professional reasons dominated for subsequent relocations, particularly 'long-term career ambitions'. Fifty-nine of the 175 (34%) JCU graduates had undertaken their internship in a metropolitan location (Australian Standard Geographical Classification Remoteness Area 1), while 80 (46%) currently (in 2012) practised in a metropolitan location. Internship location was not associated with later specialty training, but current metropolitan practice was associated with Surgical or Paediatrics training (P=0.007 and P=0.063, respectively), while current non-metropolitan practice was associated with General Practice and Rural Generalist training (P=0.010 and P=0.001, respectively). Personal decisions take precedence over professional career decisions for why JCU medical graduates chose their internship location, but subsequent relocations are driven by career ambitions, usually around specialty training requirements. These findings support establishing more post-graduate training opportunities in non-metropolitan settings for Surgical and Paediatric specialties as a retention strategy for a rural medical career. © 2014 National Rural Health Alliance Inc.

Noneconomic factors influencing scrap metal disposition decisions at DOE and NRC-licensed nuclear facilities

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

Ewen, M.D.; Robinson, L.A.

1997-02-01

The U.S. Environmental Protection Agency (EPA) is currently developing radiation protection standards for scrap metal, which will establish criteria for the unconditional clearance of scrap from nuclear facilities. In support of this effort, Industrial Economics, Incorporated is assessing the costs and benefits attributable to the rulemaking. The first step in this analysis is to develop an in-depth understanding of the factors influencing scrap disposition decisions, so that one can predict current and future practices under existing requirements and compare them to the potential effects of EPA`s rulemaking. These baseline practices are difficult to predict due to a variety of factors.more » First, because decommissioning activities are just beginning at many sites, current practices do not necessarily provide an accurate indicator of how these practices may evolve as site managers gain experience with related decisions. Second, a number of different regulations and policies apply to these decisions, and the interactive effects of these requirements can be difficult to predict. Third, factors other than regulatory constraints and costs may have a significant effect on related decisions, such as concerns about public perceptions. In general, research suggests that these factors tend to discourage the unconditional clearance of scrap metal.« less

Randomization to Standard and Concise Informed Consent Forms: Development of Evidence-Based Consent Practices

PubMed Central

Enama, Mary E.; Hu, Zonghui; Gordon, Ingelise; Costner, Pamela; Ledgerwood, Julie E.; Grady, Christine

2012-01-01

Background Consent to participate in research is an important component of the conduct of ethical clinical trials. Current consent practices are largely policy-driven. This study was conducted to assess comprehension of study information and satisfaction with the consent form between subjects randomized to concise or to standard informed consent forms as one approach to developing evidence-based consent practices. Methods Participants (N=111) who enrolled into two Phase I investigational influenza vaccine protocols (VRC 306 and VRC 307) at the NIH Clinical Center were randomized to one of two IRB-approved consents; either a standard or concise form. Concise consents had an average of 63% fewer words. All other aspects of the consent process were the same. Questionnaires about the study and the consent process were completed at enrollment and at the last visit in both studies. Results Subjects using concise consent forms scored as well as those using standard length consents in measures of comprehension (7 versus 7, p=0.79 and 20 versus 21, p=0.13), however, the trend was for the concise consent group to report feeling better informed. Both groups thought the length and detail of the consent form was appropriate. Conclusions Randomization of study subjects to different length IRB-approved consents forms as one method for developing evidence-based consent practices, resulted in no differences in study comprehension or satisfaction with the consent form. A concise consent form may be used ethically in the context of a consent process conducted by well-trained staff with opportunities for discussion and education throughout the study. PMID:22542645

Evidence and resources to implement Pharmacogenetic Knowledge for Precision Medicine

PubMed Central

Caudle, Kelly E.; Gammal, Roseann S.; Whirl-Carrillo, Michelle; Hoffman, James M.; Relling, Mary V.; Klein, Teri E.

2016-01-01

Purpose Implementation of pharmacogenetics into clinical practice has been relatively slow despite substantial scientific progress over the last decade. One barrier that inhibits uptake of pharmacogenetics into routine clinical practice is the lack of knowledge of how to translate a genetic test into a clinical action based on current evidence. The purpose of this paper is to describe the current state of pharmacogenetic evidence and evidence-based resources that facilitate the uptake of pharmacogenetics into clinical practice. Summary Controversy exists over the required evidence threshold needed for routine clinical implementation of pharmacogenetics. Large randomized controlled trials are not clinically feasible or necessary for many pharmacogenetic applications. Online resources exist like the Clinical Pharmacogenetics Implementation Consortium (CPIC) and the Pharmacogenomics Knowledgebase (PharmGKB) that provide freely available, evidence-based resources that facilitate the translation of genetic laboratory test results into actionable prescribing recommendations for specific drugs. Conclusion Resources provided by organizations such as CPIC and PharmGKB that use standardized approaches to evaluate the literature and provide clinical guidance are essential for the implementation of pharmacogenetics into routine clinical practice. PMID:27864205

Practice parameters for the use of autotitrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome: an update for 2007. An American Academy of Sleep Medicine report.

PubMed

Morgenthaler, Timothy I; Aurora, R Nisha; Brown, Terry; Zak, Rochelle; Alessi, Cathy; Boehlecke, Brian; Chesson, Andrew L; Friedman, Leah; Kapur, Vishesh; Maganti, Rama; Owens, Judith; Pancer, Jeffrey; Swick, Todd J

2008-01-01

These practice parameters are an update of the previously published recommendations regarding the use of autotitrating positive airway pressure (APAP) devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome. Continuous positive airway pressure (CPAP) at an effective setting verified by attended polysomnography is a standard treatment for obstructive sleep apnea (OSA). APAP devices change the treatment pressure based on feedback from various patient measures such as airflow, pressure fluctuations, or measures of airway resistance. These devices may aid in the pressure titration process, address possible changes in pressure requirements throughout a given night and from night to night, aid in treatment of OSA when attended CPAP titration has not or cannot be accomplished, or improve patient comfort. A task force of the Standards of Practice Committee of the American Academy of Sleep Medicine has reviewed the literature published since the 2002 practice parameter on the use of APAP. Current recommendations follow: (1) APAP devices are not recommended to diagnose OSA; (2) patients with congestive heart failure, patients with significant lung disease such as chronic obstructive pulmonary disease; patients expected to have nocturnal arterial oxyhemoglobin desaturation due to conditions other than OSA (e.g., obesity hypoventilation syndrome); patients who do not snore (either naturally or as a result of palate surgery); and patients who have central sleep apnea syndromes are not currently candidates for APAP titration or treatment; (3) APAP devices are not currently recommended for split-night titration; (4) certain APAP devices may be used during attended titration with polysomnography to identify a single pressure for use with standard CPAP for treatment of moderate to severe OSA; (5) certain APAP devices may be initiated and used in the self-adjusting mode for unattended treatment of patients with moderate to severe OSA without significant comorbidities (CHF, COPD, central sleep apnea syndromes, or hypoventilation syndromes); (6) certain APAP devices may be used in an unattended way to determine a fixed CPAP treatment pressure for patients with moderate to severe OSA without significant comorbidities (CHF, COPD, central sleep apnea syndromes, or hypoventilation syndromes); (7) patients being treated with fixed CPAP on the basis of APAP titration or being treated with APAP must have close clinical follow-up to determine treatment effectiveness and safety; and (8) a reevaluation and, if necessary, a standard attended CPAP titration should be performed if symptoms do not resolve or the APAP treatment otherwise appears to lack efficacy.

Estimating the consequences of fire exclusion for food crop production, soil fertility, and fallow recovery in shifting cultivation landscapes in the humid tropics.

PubMed

Norgrove, Lindsey; Hauser, Stefan

2015-03-01

In the Congo Basin, smallholder farmers practice slash-and-burn shifting cultivation. Yet, deliberate burning might no longer be sustainable under reduced fallow scenarios. We synthesized data from the Forest Margins Benchmark Area (FMBA), comprising 1.54 million hectares (ha), in southern Cameroon and assessed the impact of fire exclusion on yield, labor inputs, soil fertility, ecosystem carbon stocks, and fallow recovery indicators in two common field types (plantain and maize) under both current and reduced fallow scenarios. While we could not distinguish between impacts of standard farmer burning practice and fire exclusion treatments for the current fallow scenario, we concluded that fire exclusion would lead to higher yields, higher ecosystem carbon stocks as well as potentially faster fallow recovery under the reduced fallow scenario. While its implementation would increase labor requirements, we estimated increased revenues of 421 and 388 US$ ha(-1) for plantain and maize, respectively. Applied to the FMBA, and assuming a 6-year reduced fallow scenario, fire exclusion in plantain fields would potentially retain 240,464 Mg more ecosystem carbon, comprising topsoil carbon plus tree biomass carbon, than standard farmer practice. Results demonstrate a potential "win-win scenario" where yield benefits, albeit modest, and conservation benefits can be obtained simultaneously. This could be considered as a transitional phase towards higher input use and thus higher yielding systems.

Estimating the Consequences of Fire Exclusion for Food Crop Production, Soil Fertility, and Fallow Recovery in Shifting Cultivation Landscapes in the Humid Tropics

NASA Astrophysics Data System (ADS)

Norgrove, Lindsey; Hauser, Stefan

2015-03-01

In the Congo Basin, smallholder farmers practice slash-and-burn shifting cultivation. Yet, deliberate burning might no longer be sustainable under reduced fallow scenarios. We synthesized data from the Forest Margins Benchmark Area (FMBA), comprising 1.54 million hectares (ha), in southern Cameroon and assessed the impact of fire exclusion on yield, labor inputs, soil fertility, ecosystem carbon stocks, and fallow recovery indicators in two common field types (plantain and maize) under both current and reduced fallow scenarios. While we could not distinguish between impacts of standard farmer burning practice and fire exclusion treatments for the current fallow scenario, we concluded that fire exclusion would lead to higher yields, higher ecosystem carbon stocks as well as potentially faster fallow recovery under the reduced fallow scenario. While its implementation would increase labor requirements, we estimated increased revenues of 421 and 388 US ha-1 for plantain and maize, respectively. Applied to the FMBA, and assuming a 6-year reduced fallow scenario, fire exclusion in plantain fields would potentially retain 240,464 Mg more ecosystem carbon, comprising topsoil carbon plus tree biomass carbon, than standard farmer practice. Results demonstrate a potential "win-win scenario" where yield benefits, albeit modest, and conservation benefits can be obtained simultaneously. This could be considered as a transitional phase towards higher input use and thus higher yielding systems.

Assessment of a Microsoft Kinect-based 3D scanning system for taking body segment girth measurements: a comparison to ISAK and ISO standards.

PubMed

Clarkson, Sean; Wheat, Jon; Heller, Ben; Choppin, Simon

2016-01-01

Use of anthropometric data to infer sporting performance is increasing in popularity, particularly within elite sport programmes. Measurement typically follows standards set by the International Society for the Advancement of Kinanthropometry (ISAK). However, such techniques are time consuming, which reduces their practicality. Schranz et al. recently suggested 3D body scanners could replace current measurement techniques; however, current systems are costly. Recent interest in natural user interaction has led to a range of low-cost depth cameras capable of producing 3D body scans, from which anthropometrics can be calculated. A scanning system comprising 4 depth cameras was used to scan 4 cylinders, representative of the body segments. Girth measurements were calculated from the 3D scans and compared to gold standard measurements. Requirements of a Level 1 ISAK practitioner were met in all 4 cylinders, and ISO standards for scan-derived girth measurements were met in the 2 larger cylinders only. A fixed measurement bias was identified that could be corrected with a simple offset factor. Further work is required to determine comparable performance across a wider range of measurements performed upon living participants. Nevertheless, findings of the study suggest such a system offers many advantages over current techniques, having a range of potential applications.

Multiparametric prostate MRI: technical conduct, standardized report and clinical use.

PubMed

Manfredi, Matteo; Mele, Fabrizio; Garrou, Diletta; Walz, Jochen; Fütterer, Jurgen J; Russo, Filippo; Vassallo, Lorenzo; Villers, Arnauld; Emberton, Mark; Valerio, Massimo

2018-02-01

Multiparametric prostate MRI (mp-MRI) is an emerging imaging modality for diagnosis, characterization, staging, and treatment planning of prostate cancer (PCa). The technique, results reporting, and its role in clinical practice have been the subject of significant development over the last decade. Although mp-MRI is not yet routinely used in the diagnostic pathway, almost all urological guidelines have emphasized the potential role of mp-MRI in several aspects of PCa management. Moreover, new MRI sequences and scanning techniques are currently under evaluation to improve the diagnostic accuracy of mp-MRI. This review presents an overview of mp-MRI, summarizing the technical applications, the standardized reporting systems used, and their current roles in various stages of PCa management. Finally, this critical review also reports the main limitations and future perspectives of the technique.

An Overview of the Challenges With and Proposed Solutions for the Ingest and Distribution Processes for Airborne Data Management

NASA Technical Reports Server (NTRS)

Beach, Aubrey; Northup, Emily; Early, Amanda; Wang, Dali; Kusterer, John; Quam, Brandi; Chen, Gao

2015-01-01

The current data management practices for NASA airborne field projects have successfully served science team data needs over the past 30 years to achieve project science objectives, however, users have discovered a number of issues in terms of data reporting and format. The ICARTT format, a NASA standard since 2010, is currently the most popular among the airborne measurement community. Although easy for humans to use, the format standard is not sufficiently rigorous to be machine-readable. This makes data use and management tedious and resource intensive, and also create problems in Distributed Active Archive Center (DAAC) data ingest procedures and distribution. Further, most DAACs use metadata models that concentrate on satellite data observations, making them less prepared to deal with airborne data.

[Research strategies in standard decoction of medicinal slices].

PubMed

Chen, Shi-Lin; Liu, An; Li, Qi; Toru, Sugita; Zhu, Guang-Wei; Sun, Yi; Dai, Yun-Tao; Zhang, Jun; Zhang, Tie-Jun; Takehisa, Tomoda; Liu, Chang-Xiao

2016-04-01

This paper discusses the research situation of the standard decoction of medicinal slices at home and abroad. Combined with the experimental data, the author proposes that the standard decoction of medicinal slices is made of single herb using standard process which should be guided by the theory of traditional Chinese medicine, based on clinical practice and referred to modern extraction method with a standard process. And the author also proposes the principles of establishing the specification of process parameters and quality standards and established the basis of drug efficacy material and biological reference. As a standard material and standard system, the standard decoction of medicinal slices can provide standards for clinical medication, standardize the use of the new type of medicinal slices especially for dispensing granules, which were widely used in clinical. It can ensure the accuracy of drugs and consistency of dose, and to solve current supervision difficulties. Moreover the study of standard decoction of medicinal slices will provide the research on dispensing granules, traditional Chinese medicine prescription standard decoction and couplet medicines standard decoction a useful reference. Copyright© by the Chinese Pharmaceutical Association.

Reading instruction in science: Teachers' practices, beliefs, & self-efficacy

NASA Astrophysics Data System (ADS)

Morales, Christina M.

The Common Core State Standards (CCSS, 2010) and the Next Generation Science Standards (NGSS, 2013) call on science teachers to play a stronger role in helping students learn from informational science texts. Curriculum implementation efforts aimed at addressing these new standards should build on what teachers are already doing to help students with reading in their classrooms and the pedagogical issues that they feel are important to science learning. However, few current studies have gathered these important insights from science teachers. Aiming to fill this gap in the literature, this study attempted to describe middle school science teachers' current practices, beliefs, and self-efficacy regarding reading and reading instruction in their classrooms. A conceptual model hypothesizing that self-efficacy mediates the relationship between teachers' beliefs about how important reading instruction is to science learning and how often they provide reading instruction in their science classes was also tested. Participants (N = 247) reported that students regularly engaged in reading-related tasks in science class. Somer's D correlation analyses highlighted positive associations between the frequency with which teachers reported that students engaged in various reading-related tasks and the frequency with which they reported providing reading instruction for those tasks, suggesting that students tended to receive explicit instruction or coaching for the reading-related tasks they engaged in most often. Middle school science teachers also expressed positive beliefs about the importance of reading-related tasks and explicit instruction or coaching for reading in science and tended to take on responsibility for helping students become better readers of science texts. Last, a path analysis confirmed that the association between teachers' beliefs and practices was mediated through teachers' self-efficacy (beta = .07, p < .001). This suggests that self-efficacy can influence teacher practice: even if teachers believe that reading instruction is important or even essential to science learning, they might avoid or resist providing reading instruction if they do not feel efficacious in helping students become stronger readers of science texts.

Design of experiments enhanced statistical process control for wind tunnel check standard testing

NASA Astrophysics Data System (ADS)

Phillips, Ben D.

The current wind tunnel check standard testing program at NASA Langley Research Center is focused on increasing data quality, uncertainty quantification and overall control and improvement of wind tunnel measurement processes. The statistical process control (SPC) methodology employed in the check standard testing program allows for the tracking of variations in measurements over time as well as an overall assessment of facility health. While the SPC approach can and does provide researchers with valuable information, it has certain limitations in the areas of process improvement and uncertainty quantification. It is thought by utilizing design of experiments methodology in conjunction with the current SPC practices that one can efficiently and more robustly characterize uncertainties and develop enhanced process improvement procedures. In this research, methodologies were developed to generate regression models for wind tunnel calibration coefficients, balance force coefficients and wind tunnel flow angularities. The coefficients of these regression models were then tracked in statistical process control charts, giving a higher level of understanding of the processes. The methodology outlined is sufficiently generic such that this research can be applicable to any wind tunnel check standard testing program.

Developing Carbon Nanotube Standards at NASA

NASA Technical Reports Server (NTRS)

Nikolaev, Pasha; Arepalli, Sivaram; Sosa, Edward; Gorelik, Olga; Yowell, Leonard

2007-01-01

Single wall carbon nanotubes (SWCNTs) are currently being produced and processed by several methods. Many researchers are continuously modifying existing methods and developing new methods to incorporate carbon nanotubes into other materials and utilize the phenomenal properties of SWCNTs. These applications require availability of SWCNTs with known properties and there is a need to characterize these materials in a consistent manner. In order to monitor such progress, it is critical to establish a means by which to define the quality of SWCNT material and develop characterization standards to evaluate of nanotube quality across the board. Such characterization standards should be applicable to as-produced materials as well as processed SWCNT materials. In order to address this issue, NASA Johnson Space Center has developed a protocol for purity and dispersion characterization of SWCNTs (Ref.1). The NASA JSC group is currently working with NIST, ANSI and ISO to establish purity and dispersion standards for SWCNT material. A practice guide for nanotube characterization is being developed in cooperation with NIST (Ref.2). Furthermore, work is in progress to incorporate additional characterization methods for electrical, mechanical, thermal, optical and other properties of SWCNTs.

Developing Carbon Nanotube Standards at NASA

NASA Technical Reports Server (NTRS)

Nikolaev, Pasha; Arepalli, Sivaram; Sosa, Edward; Gorelik, Olga; Yowell, Leonard

2007-01-01

Single wall carbon nanotubes (SWCNTs) are currently being produced and processed by several methods. Many researchers are continuously modifying existing methods and developing new methods to incorporate carbon nanotubes into other materials and utilize the phenomenal properties of SWCNTs. These applications require availability of SWCNTs with known properties and there is a need to characterize these materials in a consistent manner. In order to monitor such progress, it is critical to establish a means by which to define the quality of SWCNT material and develop characterization standards to evaluate of nanotube quality across the board. Such characterization standards should be applicable to as-produced materials as well as processed SWCNT materials. In order to address this issue, NASA Johnson Space Center has developed a protocol for purity and dispersion characterization of SWCNTs. The NASA JSC group is currently working with NIST, ANSI and ISO to establish purity and dispersion standards for SWCNT material. A practice guide for nanotube characterization is being developed in cooperation with NIST. Furthermore, work is in progress to incorporate additional characterization methods for electrical, mechanical, thermal, optical and other properties of SWCNTs.

Uncertainty and instream flow standards

USGS Publications Warehouse

Castleberry, D.; Cech, J.; Erman, D.; Hankin, D.; Healey, M.; Kondolf, M.; Mengel, M.; Mohr, M.; Moyle, P.; Nielsen, Jennifer L.; Speed, T.; Williams, J.

1996-01-01

Several years ago, Science published an important essay (Ludwig et al. 1993) on the need to confront the scientific uncertainty associated with managing natural resources. The essay did not discuss instream flow standards explicitly, but its arguments apply. At an April 1995 workshop in Davis, California, all 12 participants agreed that currently no scientifically defensible method exists for defining the instream flows needed to protect particular species of fish or aquatic ecosystems (Williams, in press). We also agreed that acknowledging this fact is an essential step in dealing rationally and effectively with the problem.Practical necessity and the protection of fishery resources require that new instream flow standards be established and that existing standards be revised. However, if standards cannot be defined scientifically, how can this be done? We join others in recommending the approach of adaptive management. Applied to instream flow standards, this approach involves at least three elements.

Bringing Standardized Processes in Atom-Probe Tomography: I Establishing Standardized Terminology

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

Anderson, Ian M; Danoix, F; Forbes, Richard

2011-01-01

Defining standardized methods requires careful consideration of the entire field and its applications. The International Field Emission Society (IFES) has elected a Standards Committee, whose task is to determine the needed steps to establish atom-probe tomography as an accepted metrology technique. Specific tasks include developing protocols or standards for: terminology and nomenclature; metrology and instrumentation, including specifications for reference materials; test methodologies; modeling and simulations; and science-based health, safety, and environmental practices. The Committee is currently working on defining terminology related to atom-probe tomography with the goal to include terms into a document published by the International Organization for Standardsmore » (ISO). A lot of terms also used in other disciplines have already been defined) and will be discussed for adoption in the context of atom-probe tomography.« less

Publishing 13C metabolic flux analysis studies: A review and future perspectives

PubMed Central

Crown, Scott B.; Antoniewicz, Maciek R.

2018-01-01

13C-Metabolic flux analysis (13C-MFA) is a powerful model-based analysis technique for determining intracellular metabolic fluxes in living cells. It has become a standard tool in many labs for quantifying cell physiology, e.g. in metabolic engineering, systems biology, biotechnology, and biomedical research. With the increasing number of 13C-MFA studies published each year, it is now ever more important to provide practical guidelines for performing and publishing 13C-MFA studies so that quality is not sacrificed as the number of publications increases. The main purpose of this paper is to provide an overview of good practices in 13C-MFA, which can eventually be used as minimum data standards for publishing 13C-MFA studies. The motivation for this work is two-fold: (1) currently, there is no general consensus among researchers and journal editors as to what minimum data standards should be required for publishing 13C-MFA studies; as a result, there are great discrepancies in terms of quality and consistency; and (2) there is a growing number of studies that cannot be reproduced or verified independently due to incomplete information provided in these publications. This creates confusion, e.g. when trying to reconcile conflicting results, and hinders progress in the field. Here, we review current status in the 13C-MFA field and highlight some of the shortcomings with regards to 13C-MFA publications. We then propose a checklist that encompasses good practices in 13C-MFA. We hope that these guidelines will be a valuable resource for the community and allow 13C-flux studies to be more easily reproduced and accessed by others in the future. PMID:24025367

Confidentiality and Privacy for Smartphone Applications in Child and Adolescent Psychiatry: Unmet Needs and Practical Solutions.

PubMed

Wu, Emily; Torous, John; Hardaway, Rashad; Gutheil, Thomas

2017-01-01

This article summarizes the current literature on clinical knowledge and practical gaps regarding the confidentiality and privacy for smartphone and connected devices in child and adolescent psychiatry and offers practical solutions and consideration for the next steps for the field. Important issues to consider include disclosure of information sharing, access privilege, privacy and trust, risk and benefit analysis, and the need for standardization. Through understanding the privacy and confidentiality concerns regarding digital devices, child and adolescent psychiatrists can guide patients and parents though informed decision-making and also help shape how the field creates the next generation of these tools. Copyright © 2016 Elsevier Inc. All rights reserved.

Relationship Between Past Food Deprivation and Current Dietary Practices and Weight Status Among Cambodian Refugee Women in Lowell, MA

PubMed Central

Wilde, Parke E.; Liang, Sidney; Bermudez, Odilia I.; Silka, Linda; Rogers, Beatrice Lorge

2010-01-01

Objectives. We investigated Cambodian refugee women's past food experiences and the relationship between those experiences and current food beliefs, dietary practices, and weight status. Methods. Focus group participants (n = 11) described past food experiences and current health-related food beliefs and behaviors. We randomly selected survey participants (n = 133) from a comprehensive list of Cambodian households in Lowell, Massachusetts. We collected height, weight, 24-hour dietary recall, food beliefs, past food experience, and demographic information. We constructed a measure of past food deprivation from focus group and survey responses. We analyzed data with multivariate logistic and linear regression models. Results. Participants experienced severe past food deprivation and insecurity. Those with higher past food-deprivation scores were more likely to currently report eating meat with fat (odds ratio [OR] = 1.14 for every point increase on the 9-to-27–point food-deprivation measure), and to be overweight or obese by Centers for Disease Control and Prevention (OR = 1.28) and World Health Organization (OR = 1.18) standards. Conclusions. Refugees who experienced extensive food deprivation or insecurity may be more likely to engage in unhealthful eating practices and to be overweight or obese than are those who experienced less-extreme food deprivation or insecurity. PMID:20724691

Relationship between past food deprivation and current dietary practices and weight status among Cambodian refugee women in Lowell, MA.

PubMed

Peterman, Jerusha Nelson; Wilde, Parke E; Liang, Sidney; Bermudez, Odilia I; Silka, Linda; Rogers, Beatrice Lorge

2010-10-01

We investigated Cambodian refugee women's past food experiences and the relationship between those experiences and current food beliefs, dietary practices, and weight status. Focus group participants (n = 11) described past food experiences and current health-related food beliefs and behaviors. We randomly selected survey participants (n = 133) from a comprehensive list of Cambodian households in Lowell, Massachusetts. We collected height, weight, 24-hour dietary recall, food beliefs, past food experience, and demographic information. We constructed a measure of past food deprivation from focus group and survey responses. We analyzed data with multivariate logistic and linear regression models. Participants experienced severe past food deprivation and insecurity. Those with higher past food-deprivation scores were more likely to currently report eating meat with fat (odds ratio [OR] = 1.14 for every point increase on the 9-to-27-point food-deprivation measure), and to be overweight or obese by Centers for Disease Control and Prevention (OR = 1.28) and World Health Organization (OR = 1.18) standards. Refugees who experienced extensive food deprivation or insecurity may be more likely to engage in unhealthful eating practices and to be overweight or obese than are those who experienced less-extreme food deprivation or insecurity.

The future of pharmacy practice research - Perspectives of academics and practitioners from Australia, NZ, United Kingdom, Canada and USA.

PubMed

Babar, Zaheer-Ud-Din; Scahill, Shane; Nagaria, Raveena Amee; Curley, Louise E

2018-01-11

Healthcare is under significant pressure with the explosion of long term conditions, shift in worldwide demographics and is evolving through advances in technology. Aligned with this is the changing role of pharmacy from the traditional dispenser of medicines to having (in addition) a more advanced clinical role. This study aimed to understand what the pharmacy practice research agenda might look like from the viewpoint of pharmacy academics and practitioners across five high-income countries. Qualitative methods were used, and thirty one-hour interviews were undertaken with practitioners and academics from five economically advanced countries. These nations have comparable socio-economic status but differing health systems and include; Australia, Canada, New Zealand, United Kingdom and United States of America. Six key informants were chosen from each country, three academics and three community pharmacists. A general inductive analysis was undertaken to analyse the most common and recurring themes. These themes of research were based around current community pharmacy practice issues and the enablers to changing the profession. Specific areas pharmacy practice could be more involved with included long term health conditions. Some community pharmacists also believed that research into the impact of professional standards and policy change would be beneficial. The findings of this research suggest that current pharmacy practice research methods are sufficient, but need to be used more effectively. Participants identified a wide range of issues within community pharmacy practice. Academics largely focused on how research can be utilised in the community and how to implement findings to ensure sustainability of pharmacy practice research. Issues that community pharmacists would like to research are related to the current practice model, such as allocating time to provide patient-focused services in addition to managing a business. Copyright © 2018 Elsevier Inc. All rights reserved.

Clinical practice guidelines in complementary and alternative medicine. An analysis of opportunities and obstacles. Practice and Policy Guidelines Panel, National Institutes of Health Office of Alternative Medicine.

PubMed

1997-01-01

An estimated 1 of 3 Americans uses some form of complementary and alternative medicine (CAM), such as acupuncture, homeopathy, or herbal medicine. In 1995, the National Institutes of Health Office of Alternative Medicine convened an expert panel to examine the role of clinical practice guidelines in CAM. The panel concluded that CAM practices currently are unsuitable for the development of evidence-based practice guidelines, in part because of the lack of relevant outcomes data from well-designed clinical trials. Moreover, the notions of standardization and appropriateness, inherent in guideline development, face challenging methodologic problems when applied to CAM, which considers many different treatment practices appropriate and encourages highly individualized care. Due to different belief systems and divergent theories about the nature of health and illness, CAM disciplines have fundamental differences in how they define target conditions, causes of disease, interventions, and outcome measures of effectiveness. These differences are even more striking when compared with those used by Western medicine. The panel made a series of recommendations on strategies to strengthen the evidence base for future guideline development in CAM and to meet better the current information needs of clinicians, patients, and guideline developers who seek information about CAM treatments.

Lost in transformation? Reviving ethics of care in hospital cultures of evidence-based healthcare.

PubMed

Norlyk, Annelise; Haahr, Anita; Dreyer, Pia; Martinsen, Bente

2017-07-01

Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients' individual perspectives in an evidence-based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence-based recommendations, which specify a set of rules that the patient must follow rigorously. The other is a course of democratization based on patients' involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence-based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence-based medicine are being lost in the transformation into the current evidence-based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as 'one best way'. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence-based practice and the ideals of patient participation thus preventing a practice of 'McNursing'. © 2017 John Wiley & Sons Ltd.

The Computerized Medical Record as a Tool for Clinical Governance in Australian Primary Care

PubMed Central

Phillips, Christine; Hall, Sally; Travaglia, Joanne

2013-01-01

Background Computerized medical records (CMR) are used in most Australian general practices. Although CMRs have the capacity to amalgamate and provide data to the clinician about their standard of care, there is little research on the way in which they may be used to support clinical governance: the process of ensuring quality and accountability that incorporates the obligation that patients are treated according to best evidence. Objective The objective of this study was to explore the capability, capacity, and acceptability of CMRs to support clinical governance. Methods We conducted a realist review of the role of seven CMR systems in implementing clinical governance, developing a four-level maturity model for the CMR. We took Australian primary care as the context, CMR to be the mechanism, and looked at outcomes for individual patients, localities, and for the population in terms of known evidence-based surrogates or true outcome measures. Results The lack of standardization of CMRs makes national and international benchmarking challenging. The use of the CMR was largely at level two of our maturity model, indicating a relatively simple system in which most of the process takes place outside of the CMR, and which has little capacity to support benchmarking, practice comparisons, and population-level activities. Although national standards for coding and projects for record access are proposed, they are not operationalized. Conclusions The current CMR systems can support clinical governance activities; however, unless the standardization and data quality issues are addressed, it will not be possible for current systems to work at higher levels. PMID:23939340

Assessing the readiness of precision medicine interoperabilty: An exploratory study of the National Institutes of Health genetic testing registry.

PubMed

Ronquillo, Jay G; Weng, Chunhua; Lester, William T

2017-11-17

  Precision medicine involves three major innovations currently taking place in healthcare:  electronic health records, genomics, and big data.  A major challenge for healthcare providers, however, is understanding the readiness for practical application of initiatives like precision medicine.   To better understand the current state and challenges of precision medicine interoperability using a national genetic testing registry as a starting point, placed in the context of established interoperability formats.   We performed an exploratory analysis of the National Institutes of Health Genetic Testing Registry.  Relevant standards included Health Level Seven International Version 3 Implementation Guide for Family History, the Human Genome Organization Gene Nomenclature Committee (HGNC) database, and Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT).  We analyzed the distribution of genetic testing laboratories, genetic test characteristics, and standardized genome/clinical code mappings, stratified by laboratory setting. There were a total of 25472 genetic tests from 240 laboratories testing for approximately 3632 distinct genes.  Most tests focused on diagnosis, mutation confirmation, and/or risk assessment of germline mutations that could be passed to offspring.  Genes were successfully mapped to all HGNC identifiers, but less than half of tests mapped to SNOMED CT codes, highlighting significant gaps when linking genetic tests to standardized clinical codes that explain the medical motivations behind test ordering.  Conclusion:  While precision medicine could potentially transform healthcare, successful practical and clinical application will first require the comprehensive and responsible adoption of interoperable standards, terminologies, and formats across all aspects of the precision medicine pipeline.

Improving practice in community-based settings: a randomized trial of supervision - study protocol.

PubMed

Dorsey, Shannon; Pullmann, Michael D; Deblinger, Esther; Berliner, Lucy; Kerns, Suzanne E; Thompson, Kelly; Unützer, Jürgen; Weisz, John R; Garland, Ann F

2013-08-10

Evidence-based treatments for child mental health problems are not consistently available in public mental health settings. Expanding availability requires workforce training. However, research has demonstrated that training alone is not sufficient for changing provider behavior, suggesting that ongoing intervention-specific supervision or consultation is required. Supervision is notably under-investigated, particularly as provided in public mental health. The degree to which supervision in this setting includes 'gold standard' supervision elements from efficacy trials (e.g., session review, model fidelity, outcome monitoring, skill-building) is unknown. The current federally-funded investigation leverages the Washington State Trauma-focused Cognitive Behavioral Therapy Initiative to describe usual supervision practices and test the impact of systematic implementation of gold standard supervision strategies on treatment fidelity and clinical outcomes. The study has two phases. We will conduct an initial descriptive study (Phase I) of supervision practices within public mental health in Washington State followed by a randomized controlled trial of gold standard supervision strategies (Phase II), with randomization at the clinician level (i.e., supervisors provide both conditions). Study participants will be 35 supervisors and 130 clinicians in community mental health centers. We will enroll one child per clinician in Phase I (N = 130) and three children per clinician in Phase II (N = 390). We use a multi-level mixed within- and between-subjects longitudinal design. Audio recordings of supervision and therapy sessions will be collected and coded throughout both phases. Child outcome data will be collected at the beginning of treatment and at three and six months into treatment. This study will provide insight into how supervisors can optimally support clinicians delivering evidence-based treatments. Phase I will provide descriptive information, currently unavailable in the literature, about commonly used supervision strategies in community mental health. The Phase II randomized controlled trial of gold standard supervision strategies is, to our knowledge, the first experimental study of gold standard supervision strategies in community mental health and will yield needed information about how to leverage supervision to improve clinician fidelity and client outcomes. ClinicalTrials.gov NCT01800266.

The law and the expanding nursing role.

PubMed Central

Bullough, B

1976-01-01

Nursing has moved through two major phases in licensure. From 1900 to 1938 basic registration acts were passed and amended. In 1938 the goal became mandatory licensure for all those who nursed for hire. This move was linked with the stratification of the nursing role to include both practical and registered nurses. The third and current phase in licensure began in 1971 with the Idaho revision of the nurse practice act; 30 states have now revised their nurse practice acts to facilitate role expansion for registered nurses. Several approaches are being used in these laws including mandating new board regulations, expanding the definitions of nursing; increasing the power of physicians to delegate, and mandating the use of standardized protocols to guide the practice of nurses who are accepting new responsibilities. PMID:769567

Future methods in pharmacy practice research.

PubMed

Almarsdottir, A B; Babar, Z U D

2016-06-01

This article describes the current and future practice of pharmacy scenario underpinning and guiding this research and then suggests future directions and strategies for such research. First, it sets the scene by discussing the key drivers which could influence the change in pharmacy practice research. These are demographics, technology and professional standards. Second, deriving from this, it seeks to predict and forecast the future shifts in use of methodologies. Third, new research areas and availability of data impacting on future methods are discussed. These include the impact of aging information technology users on healthcare, understanding and responding to cultural and social disparities, implementing multidisciplinary initiatives to improve health care, medicines optimization and predictive risk analysis, and pharmacy as business and health care institution. Finally, implications of the trends for pharmacy practice research methods are discussed.

Increasing Access to Dental and Medical Care by Allowing Greater Flexibility in Scope of Practice

PubMed Central

Hoffmann, Diane; Rowthorn, Virginia

2015-01-01

In recent years, advocates for increasing access to medical and oral health care have argued for expanding the scope of practice of dentists and physicians. Although this idea may have merit, significant legal and other barriers stand in the way of allowing dentists to do more primary health care, physicians to do more oral health care, and both professions to collaborate. State practice acts, standards of care, and professional school curricula all support the historical separation between the 2 professions. Current laws do not contemplate working across professional boundaries, leaving providers who try vulnerable to legal penalties. Here we examine the legal, regulatory, and training barriers to dental and medical professionals performing services outside their traditional scope of practice. PMID:26180970

The law and the expanding nursing role.

PubMed

Bullough, B

1976-03-01

Nursing has moved through two major phases in licensure. From 1900 to 1938 basic registration acts were passed and amended. In 1938 the goal became mandatory licensure for all those who nursed for hire. This move was linked with the stratification of the nursing role to include both practical and registered nurses. The third and current phase in licensure began in 1971 with the Idaho revision of the nurse practice act; 30 states have now revised their nurse practice acts to facilitate role expansion for registered nurses. Several approaches are being used in these laws including mandating new board regulations, expanding the definitions of nursing; increasing the power of physicians to delegate, and mandating the use of standardized protocols to guide the practice of nurses who are accepting new responsibilities.

Review of Virtual Reality Treatment in Psychiatry: Evidence Versus Current Diffusion and Use.

PubMed

Mishkind, Matthew C; Norr, Aaron M; Katz, Andrea C; Reger, Greg M

2017-09-18

This review provides an overview of the current evidence base for and clinical applications of the use of virtual reality (VR) in psychiatric practice, in context of recent technological developments. The use of VR in psychiatric practice shows promise with much of the research demonstrating clinical effectiveness for conditions including post-traumatic stress disorder, anxiety and phobias, chronic pain, rehabilitation, and addictions. However, more research is needed before the use of VR is considered a clinical standard of practice in some areas. The recent release of first generation consumer VR products signals a change in the viability of further developing VR systems and applications. As applications increase so will the need for good quality research to best understand what makes VR effective, and when VR is not appropriate for clinical services. As the field progresses, it is hopeful that the flexibility afforded by this technology will yield superior outcomes and a better understanding of the underlying mechanisms impacting those outcomes.

The evolution of social work education in England: a critical review of its connections and commonalities with nurse education.

PubMed

Manthorpe, Jill; Hussein, Shereen; Moriarty, Jo

2005-07-01

Social work education in England underwent significant change in its move to degree status in 2003. It is hoped that the result will be increased professional standing for social workers, an improvement in the current widespread problems with recruitment, and assurance that all newly qualified social workers meet the National Occupational Standards for Social Work (Available from: http://www.topssengland.net/files/cd/). This change has pre-occupied social work educators and debate within the profession has concentrated on the practicalities and expectations of reform. This paper suggests that those working in nurse education may observe a number of similarities with its own earlier reforms and with current debates on whether nursing should move to an all-graduate profession. It then highlights three aspects of the new requirements for social work training: service user involvement, the place of research-minded practice, and the primacy of practice--that may be of interest and relevance to nursing colleagues.