Evaluating non-detection risk associated with metabarcoding approaches for rare metabarcoding approaches

EPA Science Inventory

Early detection of non-indigenous species (NIS), newly introduced species at low abundance in the monitoring area, can strengthen current management strategies including NIS control and eradication. A practical early detection strategy requires achieving balance between efficient...

Formation Flying in Earth, Libration, and Distant Retrograde Orbits

NASA Technical Reports Server (NTRS)

Folta, David C.

2004-01-01

This slide presentation examines the current and future state of formation flying, LEO formations, control strategies for flight in the vicinity of the libration points, and distant retrograde orbit formations. This discussion of LEO formations includes background on perturbation theory/accelerations and LEO formation flying. The discussion of strategies for formation flight in the vicinity of the libration points includes libration missions and natural and controlled libration orbit formations. A reference list is included.

An Assessment of EU 2020 Strategy: Too Far to Reach?

ERIC Educational Resources Information Center

Colak, Mehmet Selman; Ege, Aylin

2013-01-01

In 2010, EU adopted a new growth strategy which includes three growth priorities and five headline targets to be reached by 2020. The aim of this paper is to investigate the current performance of the EU member and candidate states in achieving these growth priorities and the overall strategy target by allocating the headline targets into the…

A fault-tolerant strategy based on SMC for current-controlled converters

NASA Astrophysics Data System (ADS)

Azer, Peter M.; Marei, Mostafa I.; Sattar, Ahmed A.

2018-05-01

The sliding mode control (SMC) is used to control variable structure systems such as power electronics converters. This paper presents a fault-tolerant strategy based on the SMC for current-controlled AC-DC converters. The proposed SMC is based on three sliding surfaces for the three legs of the AC-DC converter. Two sliding surfaces are assigned to control the phase currents since the input three-phase currents are balanced. Hence, the third sliding surface is considered as an extra degree of freedom which is utilised to control the neutral voltage. This action is utilised to enhance the performance of the converter during open-switch faults. The proposed fault-tolerant strategy is based on allocating the sliding surface of the faulty leg to control the neutral voltage. Consequently, the current waveform is improved. The behaviour of the current-controlled converter during different types of open-switch faults is analysed. Double switch faults include three cases: two upper switch fault; upper and lower switch fault at different legs; and two switches of the same leg. The dynamic performance of the proposed system is evaluated during healthy and open-switch fault operations. Simulation results exhibit the various merits of the proposed SMC-based fault-tolerant strategy.

Help! Our Camp Enrollment Is Down.

ERIC Educational Resources Information Center

Post, Peter

1993-01-01

Describes a marketing plan to increase enrollment in summer camps. Includes analyzing enrollment statistics, implementing marketing strategies that focus on retaining current campers, establishing a ranking system to concentrate efforts on inquiries most likely to enroll, and analyzing the effectiveness of marketing strategies. (LP)

Potential strategies for the eradication of multidrug-resistant Gram-negative bacterial infections.

PubMed

Huwaitat, Rawan; McCloskey, Alice P; Gilmore, Brendan F; Laverty, Garry

2016-07-01

Antimicrobial resistance is one of the leading threats to society. The increasing burden of multidrug-resistant Gram-negative infection is particularly concerning as such bacteria are demonstrating resistance to nearly all currently licensed therapies. Various strategies have been hypothesized to treat multidrug-resistant Gram-negative infections including: targeting the Gram-negative outer membrane; neutralization of lipopolysaccharide; inhibition of bacterial efflux pumps and prevention of protein folding. Silver and silver nanoparticles, fusogenic liposomes and nanotubes are potential strategies for extending the activity of licensed, Gram-positive selective, antibiotics to Gram-negatives. This may serve as a strategy to fill the current void in pharmaceutical development in the short term. This review outlines the most promising strategies that could be implemented to solve the threat of multidrug-resistant Gram-negative infections.

Setting-based interventions to promote mental health at the university: a systematic review.

PubMed

Fernandez, A; Howse, E; Rubio-Valera, M; Thorncraft, K; Noone, J; Luu, X; Veness, B; Leech, M; Llewellyn, G; Salvador-Carulla, L

2016-09-01

Universities are dynamic environments. But university life presents challenges that may affect the mental health of its community. Higher education institutions provide opportunities to promote public health. Our objective is to summarise the current evidence on strategies to promote mental health at the university, following a setting-based model. We conducted a systematic literature review following standard methods. Published literature that evaluated structural and organizations strategies to promote mental health at the university was selected. 19 papers were included. The majority of the studies were targeting the students, with only four aiming to promote employees' mental health. The most promising strategies to promote mental wellbeing included changes in the way students are taught and assessed. On the other hand, social marketing strategies had not impact on mental health. There is inconclusive evidence related to the effectiveness of policies to promote mental health. Universities should invest in creating supportive physical, social and academic environments that promote student and staff mental wellbeing. However, the current body of evidence is scarce and more research is needed to recommend what are the best strategies.

Exploring perceptions of community health policy in Kenya and identifying implications for policy change.

PubMed

McCollum, Rosalind; Otiso, Lilian; Mireku, Maryline; Theobald, Sally; de Koning, Korrie; Hussein, Salim; Taegtmeyer, Miriam

2016-02-01

Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change. We conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives, including those who will influence or be influenced by CHS policy change in Kenya (policymakers, sub-county health management teams, facility managers, community health extension worker (CHEW), community health workers (CHWs), clients and community members) in two purposively selected counties: Nairobi and Kitui. Qualitative data were digitally recorded, transcribed, translated and coded before framework analysis. There is widespread community appreciation for the existing strategy. High attrition, lack of accountability for voluntary CHWs and lack of funds to pay CHW salaries, combined with high CHEW workload were seen as main drivers for strategy change. Areas for change identified include: lack of clear supervisory structure including provision of adequate travel resources, current uneven coverage and equity of community health services, limited community knowledge about the strategy revision and demand for home-based HIV testing and counselling. This in-depth analysis which captures multiple perspectives results in robust recommendations for strategy revision informed by the Five Wonders of Change Framework. These recommendations point towards a more people-centred health system for improved equity and effectiveness and indicate priority areas for action if success of policy change through the roll-out of the revised strategy is to be realized. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

[Global brain metastases management strategy: a multidisciplinary-based approach].

PubMed

Métellus, P; Tallet, A; Dhermain, F; Reyns, N; Carpentier, A; Spano, J-P; Azria, D; Noël, G; Barlési, F; Taillibert, S; Le Rhun, É

2015-02-01

Brain metastases management has evolved over the last fifteen years and may use varying strategies, including more or less aggressive treatments, sometimes combined, leading to an improvement in patient's survival and quality of life. The therapeutic decision is subject to a multidisciplinary analysis, taking into account established prognostic factors including patient's general condition, extracerebral disease status and clinical and radiological presentation of lesions. In this article, we propose a management strategy based on the state of current knowledge and available therapeutic resources. Copyright © 2015. Published by Elsevier SAS.

Emerging Drugs for Uveitis

PubMed Central

Larson, Theresa; Nussenblatt, Robert B.; Sen, H. Nida

2010-01-01

Importance of the Field Uveitis is a challenging disease covering both infectious and noninfectious conditions. The current treatment strategies are hampered by the paucity of randomized controlled trials (RCTs) and few trials comparing efficacy of different agents. Areas Covered in this Review This review describes the current and future treatments of uveitis. A literature search was performed in PUBMED from 1965 to 2010 on drugs treating ocular inflammation with emphasis placed on more recent, larger studies. What the Reader Will Gain Readers should gain a basic understanding of current treatment strategies beginning with corticosteroids and transitioning to steroid sparing agents. Steroid sparing agents include the antimetabolites which include methotrexate, azathioprine, and mycophenolate mofetil; the calcineurin inhibitors which include cyclosporine, tacrolimus; alkylating agents which include cyclophosphamide and chlorambucil; and biologics which include the TNF-α inhibitors infliximab, adalimumab, and etanercept; daclizumab, interferon α2a, and rituximab. Take Home Message Newer agents are typically formulated from existing drugs or developed based on new advances in immunology. Future treatment will require a better understanding of the mechanisms involved in autoimmune diseases and better delivery systems in order to provide targeted treatment with minimal side effects. PMID:21210752

Extensively Drug-resistant Tuberculosis (XDR-TB): A daunting challenge to the current End TB Strategy and policy recommendations.

PubMed

Rahman, Md Arifur; Sarkar, Atanu

2017-07-01

Extensively Drug-resistant Tuberculosis (XDR-TB) has emerged as one of the most formidable challenges to the End TB Strategy that has targeted a 95% reduction in TB deaths and 90% reduction in cases by 2035. Globally, there were an estimated 55,100 new XDR-TB cases in 2015 in 117 countries. However, only one in 30 XDR-TB cases had been reported so far. Drug susceptibility test (DST) is the mainstay for diagnosing XDR-TB, but the lack of laboratory facilities in the resource-limited endemic countries limit its uses. A few new drugs including bedaquiline and delamanid, have the potential to improve the efficiency of XDR-TB treatment, but the drugs have been included in 39 countries only. The costs of XDR-TB treatment are several folds higher than that of the MDR-TB. Despite the financing from the donors, there is an urgent need to fill the current funding gap of US$ 2 billion to ensure effective treatment and robust surveillance. In the review article we have addressed current update on XDR-TB, including surveillance, diagnosis and the interventions needed to treat and limit its spread, emphasis on extensive financial support for implementing of current recommendations to meet the goals of End TB Strategy. Copyright © 2017 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Model For Marketing Strategy Decision Based On Multicriteria Decicion Making: A Case Study In Batik Madura Industry

NASA Astrophysics Data System (ADS)

Anna, I. D.; Cahyadi, I.; Yakin, A.

2018-01-01

Selection of marketing strategy is a prominent competitive advantage for small and medium enterprises business development. The selection process is is a multiple criteria decision-making problem, which includes evaluation of various attributes or criteria in a process of strategy formulation. The objective of this paper is to develop a model for the selection of a marketing strategy in Batik Madura industry. The current study proposes an integrated approach based on analytic network process (ANP) and technique for order preference by similarity to ideal solution (TOPSIS) to determine the best strategy for Batik Madura marketing problems. Based on the results of group decision-making technique, this study selected fourteen criteria, including consistency, cost, trend following, customer loyalty, business volume, uniqueness manpower, customer numbers, promotion, branding, bussiness network, outlet location, credibility and the inovation as Batik Madura marketing strategy evaluation criteria. A survey questionnaire developed from literature review was distributed to a sample frame of Batik Madura SMEs in Pamekasan. In the decision procedure step, expert evaluators were asked to establish the decision matrix by comparing the marketing strategy alternatives under each of the individual criteria. Then, considerations obtained from ANP and TOPSIS methods were applied to build the specific criteria constraints and range of the launch strategy in the model. The model in this study demonstrates that, under current business situation, Straight-focus marketing strategy is the best marketing strategy for Batik Madura SMEs in Pamekasan.

A Brief Overview of Tauopathy: Causes, Consequences, and Therapeutic Strategies.

PubMed

Orr, Miranda E; Sullivan, A Campbell; Frost, Bess

2017-07-01

There are currently no disease-modifying therapies for the treatment of tauopathies, a group of progressive neurodegenerative disorders that are pathologically defined by the presence of tau protein aggregates in the brain. Current challenges for the treatment of tauopathies include the inability to diagnose early and to confidently discriminate between distinct tauopathies in patients, alongside an incomplete understanding of the cellular mechanisms involved in pathogenic tau-induced neuronal death and dysfunction. In this review, we describe current diagnostic and therapeutic strategies, known drivers of pathogenic tau formation, recent contributions to our current mechanistic understanding of how pathogenic tau induces neuronal death, and potential diagnostic and therapeutic approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

Implementing Advanced Technologies in the Republic of China Air Force Officer Training System

DTIC Science & Technology

1994-03-01

Strategy Political Radar Systems Emergency Education Medicine Maneuvers Entertainment & Systems Design Primary Care Welfare Telegraph Systems I1 The...Planning area includes the career fields of Organization, Aircraft, Weapons, Air Strategy , and Maneuvers. In the Political area of occupational...materials to be considered. The current strategy is to maintain massive inventories of written testing materials for use in officer evaluations

Update on stress fractures in female athletes: epidemiology, treatment, and prevention.

PubMed

Chen, Yin-Ting; Tenforde, Adam S; Fredericson, Michael

2013-06-01

Stress fractures are a common type of overuse injury in athletes. Females have unique risk factors such as the female athlete triad that contribute to stress fracture injuries. We review the current literature on risk factors for stress fractures, including the role of sports participation and nutrition factors. Discussion of the management of stress fractures is focused on radiographic criteria and anatomic location and how these contribute to return to play guidelines. We outline the current recommendations for evaluating and treatment of female athlete triad. Technologies that may aid in recovery from a stress fracture including use of anti-gravity treadmills are discussed. Prevention strategies may include early screening of female athlete triad, promoting early participation in activities that improve bone health, nutritional strategies, gait modification, and orthotics.

Current and emerging formulation strategies for the effective transdermal delivery of HIV inhibitors.

PubMed

Ham, Anthony S; Buckheit, Robert W

2015-02-01

Current and emerging formulation strategies for skin permeation are poised to open the transdermal drug delivery to a broader range of small molecule compounds that do not fit the traditional requirements for successful transdermal drug delivery, allowing the development of new patch technologies to deliver antiretroviral drugs that were previously incapable of being delivered through transdermal means. Transdermal drug delivery offers several distinct advantages over traditional dosage forms. Current antiretroviral drugs used for the treatment of HIV infection include a variety of highly active small molecule compounds with significantly limited skin permeability, and thus new and novel means of enhancing transport through the skin are needed. Current and emerging formulation strategies are poised to open the transdermal drug delivery to a broader range of compounds that do not fit the traditional requirements for successful transdermal drug delivery, allowing the development of new patch technologies to deliver antiretroviral drugs that were previously incapable of being delivered through transdermal means. Thus, with continuing research into skin permeability and patch formulation strategies, there is a large potential for antiretroviral transdermal drug delivery.

Current and emerging formulation strategies for the effective transdermal delivery of HIV inhibitors

PubMed Central

Ham, Anthony S; Buckheit, Robert W

2015-01-01

Current and emerging formulation strategies for skin permeation are poised to open the transdermal drug delivery to a broader range of small molecule compounds that do not fit the traditional requirements for successful transdermal drug delivery, allowing the development of new patch technologies to deliver antiretroviral drugs that were previously incapable of being delivered through transdermal means. Transdermal drug delivery offers several distinct advantages over traditional dosage forms. Current antiretroviral drugs used for the treatment of HIV infection include a variety of highly active small molecule compounds with significantly limited skin permeability, and thus new and novel means of enhancing transport through the skin are needed. Current and emerging formulation strategies are poised to open the transdermal drug delivery to a broader range of compounds that do not fit the traditional requirements for successful transdermal drug delivery, allowing the development of new patch technologies to deliver antiretroviral drugs that were previously incapable of being delivered through transdermal means. Thus, with continuing research into skin permeability and patch formulation strategies, there is a large potential for antiretroviral transdermal drug delivery. PMID:25690088

Hot Topics on the Web: Strategies for Research.

ERIC Educational Resources Information Center

Diaz, Karen R.; O'Hanlon, Nancy

2001-01-01

Presents strategies for researching topics on the Web that are controversial or current in nature. Discusses topic selection and overviews, including the use of online encyclopedias; search engines; finding laws and pending legislation; advocacy groups; proprietary databases; Web site evaluation; and the continuing usefulness of print materials.…

Ethics and Distance Education: Strategies for Minimizing Academic Dishonesty in Online Assessment.

ERIC Educational Resources Information Center

Olt, Melissa R.

2002-01-01

Discusses ethics and student assessment in distance education, focusing on strategies for minimizing academic dishonesty in online student assessment. Topics include acknowledging the disadvantages of online assessment and overcoming them; designing an effective, cheat-proof online assessment; keeping online courses current; and providing students…

Recruiting and Retaining Respite Providers. ARCH Factsheet Number 44.

ERIC Educational Resources Information Center

Workman, Susan; Bates, Kerri

This fact sheet offers suggestions for developing recruitment plans and retention strategies to entice and support providers of respite care services for individuals with disabilities and their families. Recruitment strategies include: tapping the program's current providers for referrals; focusing on reaching the greatest number of people in the…

Institutional Advancement Strategies in Hard Times. AAHE-ERIC/Higher Education Research Report No. 2.

ERIC Educational Resources Information Center

Richards, Michael D.; Sherratt, Gerald R.

The historical role of institutional advancement and the specific activities and trends currently affecting it are reviewed, and four strategies for advancement programs are suggested. Institutional advancement includes alumni relations, fund-raising, public relations, internal and external communications, and government relations, and its…

Exercise as an adjunct treatment for opiate agonist treatment: review of the current research and implementation strategies.

PubMed

Weinstock, Jeremiah; Wadeson, Heather K; VanHeest, Jaci L

2012-01-01

Opiate dependence is a significant public health concern linked to poor quality of life, comorbid psychiatric disorders, and high costs to society. Current opiate agonist treatments are an effective but limited intervention. Adjunctive interventions could improve and augment opiate agonist treatment outcomes, including drug abstinence, quality of life, and physical health. This article reviews exercise as an adjunctive intervention for opiate agonist treatment, especially in regards to improving mood and overall quality of life, while reducing other substance use. Poor adherence and dropout frequently prevent many individuals from garnering the many physical and mental health benefits of exercise. Strategies for implementing an exercise intervention, including safety considerations, are discussed.

Low Cost Ways to Keep Software Current.

ERIC Educational Resources Information Center

Schultheis, Robert A.

1992-01-01

Discusses strategies for providing students with current computer software technology including acquiring previous versions of software, obtaining demonstration software, using student versions, getting examination software, buying from mail order firms, buying few copies, exploring site licenses, acquiring shareware or freeware, and applying for…

Maritime strategy and the nuclear age: Second edition

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

Till, G.

1984-01-01

This book offers an examination of the issues and theories that underlie contemporary maritime strategy. The author provides a description of the historical evolution of maritime strategy including an analysis of the works of Mahan, Columb and Corbett; assesses the impact that current political, technological and legal developments will have on the world's navies; and discusses contemporary American and Soviet maritime theory citing practical examples from recent naval events world-wide.

Recurrent urinary tract infections in women.

PubMed

Aydin, Abdullatif; Ahmed, Kamran; Zaman, Iftikhar; Khan, Muhammad Shamim; Dasgupta, Prokar

2015-06-01

Recurrent urinary tract infections (UTIs) are more common in women and are frequently defined as ≥2 episodes in the last 6 months or ≥3 episodes in the last 12 months. In a primary care setting, 53 % of women above the age of 55 years and 36 % of younger women report a recurrence within 1 year. Thus, management and prevention of recurrent UTI is of utmost significance. This review aims to highlight the latest research in prevention strategies and suggest a management pathway. A search was conducted on MEDLINE, Embase and the Cochrane Database of Systematic Reviews databases for the latest systematic reviews and high-quality randomized controlled trials. Special emphasis was placed on the remit "recurrent" and strongly adhered to. Furthermore, a Google search was conducted for current guidelines on the management of UTIs. Current prevention strategies include eliminating risk factors that increase the risk of acquiring recurrent UTI and continuous, post-coital and self-initiated antimicrobial prophylaxis. Other prospective preventative strategies, currently under trial, include use of vaccinations, D-mannose and lactobacillus (probiotics). Although risk factors should be identified and addressed accordingly, individualized antibiotic prophylaxis remains the most effective method of management. Non-antibiotic prevention strategies such as cranberry, vitamin C and methenamine salts lack strong evidence to be introduced as routine management options and as alternatives to antibiotics. Based on current evidence and guidelines, a management pathway is recommended. Emerging therapies require further evaluation before they can be recommended.

ABS-FishCount: An Agent-Based Simulator of Underwater Sensors for Measuring the Amount of Fish.

PubMed

García-Magariño, Iván; Lacuesta, Raquel; Lloret, Jaime

2017-11-13

Underwater sensors provide one of the possibilities to explore oceans, seas, rivers, fish farms and dams, which all together cover most of our planet's area. Simulators can be helpful to test and discover some possible strategies before implementing these in real underwater sensors. This speeds up the development of research theories so that these can be implemented later. In this context, the current work presents an agent-based simulator for defining and testing strategies for measuring the amount of fish by means of underwater sensors. The current approach is illustrated with the definition and assessment of two strategies for measuring fish. One of these two corresponds to a simple control mechanism, while the other is an experimental strategy and includes an implicit coordination mechanism. The experimental strategy showed a statistically significant improvement over the control one in the reduction of errors with a large Cohen's d effect size of 2.55.

Clustering, climate and dengue transmission.

PubMed

Junxiong, Pang; Yee-Sin, Leo

2015-06-01

Dengue is currently the most rapidly spreading vector-borne disease, with an increasing burden over recent decades. Currently, neither a licensed vaccine nor an effective anti-viral therapy is available, and treatment largely remains supportive. Current vector control strategies to prevent and reduce dengue transmission are neither efficient nor sustainable as long-term interventions. Increased globalization and climate change have been reported to influence dengue transmission. In this article, we reviewed the non-climatic and climatic risk factors which facilitate dengue transmission. Sustainable and effective interventions to reduce the increasing threat from dengue would require the integration of these risk factors into current and future prevention strategies, including dengue vaccination, as well as the continuous support and commitment from the political and environmental stakeholders.

Current Controversies in Diagnosis and Management of Cleft Palate and Velopharyngeal Insufficiency

PubMed Central

Ysunza, Pablo Antonio; Repetto, Gabriela M.; Pamplona, Maria Carmen; Calderon, Juan F.; Shaheen, Kenneth; Chaiyasate, Konkgrit; Rontal, Matthew

2015-01-01

Background. One of the most controversial topics concerning cleft palate is the diagnosis and treatment of velopharyngeal insufficiency (VPI). Objective. This paper reviews current genetic aspects of cleft palate, imaging diagnosis of VPI, the planning of operations for restoring velopharyngeal function during speech, and strategies for speech pathology treatment of articulation disorders in patients with cleft palate. Materials and Methods. An updated review of the scientific literature concerning genetic aspects of cleft palate was carried out. Current strategies for assessing and treating articulation disorders associated with cleft palate were analyzed. Imaging procedures for assessing velopharyngeal closure during speech were reviewed, including a recent method for performing intraoperative videonasopharyngoscopy. Results. Conclusions from the analysis of genetic aspects of syndromic and nonsyndromic cleft palate and their use in its diagnosis and management are presented. Strategies for classifying and treating articulation disorders in patients with cleft palate are presented. Preliminary results of the use of multiplanar videofluoroscopy as an outpatient procedure and intraoperative endoscopy for the planning of operations which aimed to correct VPI are presented. Conclusion. This paper presents current aspects of the diagnosis and management of patients with cleft palate and VPI including 3 main aspects: genetics and genomics, speech pathology and imaging diagnosis, and surgical management. PMID:26273595

Targeting microbial biofilms: current and prospective therapeutic strategies

PubMed Central

Koo, Hyun; Allan, Raymond N; Howlin, Robert P; Hall-Stoodley, Luanne; Stoodley, Paul

2017-01-01

Biofilm formation is a key virulence factor for a wide range of microorganisms that cause chronic infections. The multifactorial nature of biofilm development and drug tolerance imposes great challenges for the use of conventional antimicrobials, and indicates the need for multi-targeted or combinatorial therapies. In this review, we focus on current therapeutic strategies and those that are under development that target vital structural and functional traits of microbial biofilms and drug tolerance mechanisms, including the extracellular matrix and dormant cells. We emphasize strategies that are supported by in vivo or ex vivo studies, highlight emerging biofilm-targeting technologies, and provide a rationale for multi-targeted therapies that are aimed at disrupting the complex biofilm microenvironment. PMID:28944770

Hemostatic strategies for traumatic and surgical bleeding

PubMed Central

Behrens, Adam M.; Sikorski, Michael J.; Kofinas, Peter

2017-01-01

Wide interest in new hemostatic approaches has stemmed from unmet needs in the hospital and on the battlefield. Many current commercial hemostatic agents fail to fulfill the design requirements of safety, efficacy, cost, and storage. Academic focus has led to the improvement of existing strategies as well as new developments. This review will identify and discuss the three major classes of hemostatic approaches: biologically derived materials, synthetically derived materials, and intravenously administered hemostatic agents. The general class is first discussed, then specific approaches discussed in detail, including the hemostatic mechanisms and the advancement of the method. As hemostatic strategies evolve and synthetic-biologic interactions are more fully understood, current clinical methodologies will be replaced. PMID:24307256

Application of an integrated strategy for monitoring of contaminants, including endocrine active chemicals, in Great Lakes Areas of Concern

EPA Science Inventory

Chemical monitoring strategies are most effective for those chemicals whose hazards are well understood and for which sensitive and cost effective analytical methods are available. Unfortunately, such chemicals represent a minor fraction of those that may currently occur in the e...

School Nurse Book Clubs: An Innovative Strategy for Lifelong Learning

ERIC Educational Resources Information Center

Greenawald, Deborah A.; Adams, Theresa M.

2008-01-01

Recognizing the ongoing need for continuing education for school nurses, the authors discuss the use of school nurse book clubs as an innovative lifelong-learning strategy. Current research supports the use of literature in nursing education. This article discusses the benefits of book club participation for school nurses and includes suggested…

Using Comparison of Multiple Strategies in the Mathematics Classroom: Lessons Learned and Next Steps

ERIC Educational Resources Information Center

Durkin, Kelley; Star, Jon R.; Rittle-Johnson, Bethany

2017-01-01

Comparison is a fundamental cognitive process that can support learning in a variety of domains, including mathematics. The current paper aims to summarize empirical findings that support recommendations on using comparison of multiple strategies in mathematics classrooms. We report the results of our classroom-based research on using comparison…

Strategies to Reduce Indoor Tanning

PubMed Central

Holman, Dawn M.; Fox, Kathleen A.; Glenn, Jeffrey D.; Guy, Gery P.; Watson, Meg; Baker, Katie; Cokkinides, Vilma; Gottlieb, Mark; Lazovich, DeAnn; Perna, Frank M.; Sampson, Blake P.; Seidenberg, Andrew B.; Sinclair, Craig; Geller, Alan C.

2015-01-01

Exposure to ultraviolet radiation from indoor tanning device use is associated with an increased risk of skin cancer, including risk of malignant melanoma, and is an urgent public health problem. By reducing indoor tanning, future cases of skin cancer could be prevented, along with the associated morbidity, mortality, and healthcare costs. On August 20, 2012, the CDC hosted a meeting to discuss the current body of evidence on strategies to reduce indoor tanning as well as research gaps. Using the Action Model to Achieve Healthy People 2020 Overarching Goals as a framework, the current paper provides highlights on the topics that were discussed, including (1) the state of the evidence on strategies to reduce indoor tanning; (2) the tools necessary to effectively assess, monitor, and evaluate the short- and long-term impact of interventions designed to reduce indoor tanning; and (3) strategies to align efforts at the national, state, and local levels through transdisciplinary collaboration and coordination across multiple sectors. Although many challenges and barriers exist, a coordinated, multilevel, transdisciplinary approach has the potential to reduce indoor tanning and prevent future cases of skin cancer. PMID:23683986

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

Code of Federal Regulations, 2010 CFR

2010-07-01

..., materials, support vessels, and strategies listed are suitable, within the limits of current technology, for... equipment. Examples of acceptable terms include those defined in American Society for Testing of Materials...

Hydrogen Storage Materials for Mobile and Stationary Applications: Current State of the Art.

PubMed

Lai, Qiwen; Paskevicius, Mark; Sheppard, Drew A; Buckley, Craig E; Thornton, Aaron W; Hill, Matthew R; Gu, Qinfen; Mao, Jianfeng; Huang, Zhenguo; Liu, Hua Kun; Guo, Zaiping; Banerjee, Amitava; Chakraborty, Sudip; Ahuja, Rajeev; Aguey-Zinsou, Kondo-Francois

2015-09-07

One of the limitations to the widespread use of hydrogen as an energy carrier is its storage in a safe and compact form. Herein, recent developments in effective high-capacity hydrogen storage materials are reviewed, with a special emphasis on light compounds, including those based on organic porous structures, boron, nitrogen, and aluminum. These elements and their related compounds hold the promise of high, reversible, and practical hydrogen storage capacity for mobile applications, including vehicles and portable power equipment, but also for the large scale and distributed storage of energy for stationary applications. Current understanding of the fundamental principles that govern the interaction of hydrogen with these light compounds is summarized, as well as basic strategies to meet practical targets of hydrogen uptake and release. The limitation of these strategies and current understanding is also discussed and new directions proposed. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Current status of Marek's disease in the united states and worldwide

USDA-ARS?s Scientific Manuscript database

A questionnaire was widely distributed in 2011 to estimate the global prevalence of Marek’s disease and gain a better understanding of current control strategies and future concerns. A total of 104 questionnaires were returned representing 108 countries from sources including national branch secret...

The Obesity, Metabolic Syndrome, and Type 2 Diabetes Mellitus Pandemic: II. Therapeutic Management of Atherogenic Dyslipidemia

PubMed Central

Ginsberg, Henry N.; MacCallum, Paul R.

2010-01-01

Strategies for the effective management of cardiovascular risk factors in patients with the metabolic syndrome (MS) or type 2 diabetes mellitus (T2DM) are essential to help reduce cardiovascular morbidity and mortality. Treatment strategies should be multi-factorial and include the promotion of therapeutic lifestyle changes, as well as pharmacologic therapies to treat individual risk factors according to current guidelines. In an accompanying article, the importance of atherogenic dyslipidemia as a risk factor for the development of cardiovascular disease in patients with the MS or T2DM was highlighted. Current treatment options for managing this characteristic form of atherogenic dyslipidemia are limited and tend to be only moderately effective. The focus of this review is the current pharmacotherapies available for the management of atherogenic dyslipidemia in patients with the MS or T2DM, highlighting the rationale for combining available treatments. Novel strategies currently in clinical development are also discussed. PMID:19751468

Budget impact analysis of rivaroxaban vs. warfarin anticoagulation strategy for direct current cardioversion in non-valvular atrial fibrillation patients: the MonaldiVert Economic Study.

PubMed

Russo, Vincenzo; Rago, Anna; Papa, Andrea A; Bianchi, Valter; Tavoletta, Vincenzo; DE Vivo, Stefano; Cavallaro, Ciro; Nigro, Gerardo; D'Onofrio, Antonio

2018-02-01

Rivaroxaban is the first novel oral anticoagulant to receive regulatory approval for non-valvular atrial fibrillation (NVAF) patients who require cardioversion. The MonaldiVert real life experience showed positive benefit-risk profile of short term rivaroxaban administration for transesophageal echocardiogram guided cardioversion in patients who had not achieved adequate pre-procedural vitamin K antagonist (VKA) anticoagulation. Aim of our study was to perform a budget impact analysis of MonaldiVert anticoagulation strategy for direct current cardioversion in NVAF patients and to compare the following costs borne by the Regional Healthcare System (RHS) with those for a hypothetical cohort of identical patients underwent from the beginning to early rivaroxaban treatment before direct current cardioversion. The mean costs per each NVAF patient treated with VKA strategy and rivaroxaban rescue strategy were € 134.53 and € 189.83, respectively. Considering a hypothetical scenario in which all study population would be treated from the beginning with rivaroxaban (rivaroxaban early strategy), the mean cost per patient would have been € 81.11. The total cost borne by the RHS, including the cost of the cardioversion procedure, for the two therapeutic strategies carried out at Monaldi Hospital (VKA strategy and Rivaroxaban rescue strategy) was € 88,458.53. The total cost would be borne by the RHS for rivaroxaban early strategy, if applied to all study population, would have been € 69,989.15 with a saving of € 18,469.38 compared to the actually applied strategy. Rivaroxaban rescue strategy for transesophageal echocardiography guided direct current cardioversion in NVAF patients, who had not achieved adequate pre-procedural VKA anticoagulation, is an effective and safe strategy, which allows to not delay the procedure, reducing times and wastage of cardioversion slots, without substantial costs increase.

Which therapeutic strategy will achieve a cure for HIV-1?

PubMed

Cillo, Anthony R; Mellors, John W

2016-06-01

Strategies to achieve a cure for HIV-1 infection can be broadly classified into three categories: eradication cure (elimination of all viral reservoirs), functional cure (immune control without reservoir eradication), or a hybrid cure (reservoir reduction with improved immune control). The many HIV-1 cure strategies being investigated include modification of host cells to resist HIV-1, engineered T cells to eliminate HIV-infected cells, broadly HIV-1 neutralizing monoclonal antibodies, and therapeutic vaccination, but the 'kick and kill' strategy to expose latent HIV-1 with latency reversing agents (LRAs) and kill the exposed cells through immune effector functions is currently the most actively pursued. It is unknown, however, whether LRAs can deplete viral reservoirs in vivo or whether current LRAs are sufficiently safe for clinical use. Copyright © 2016. Published by Elsevier B.V.

Clinical proteomics-driven precision medicine for targeted cancer therapy: current overview and future perspectives.

PubMed

Zhou, Li; Wang, Kui; Li, Qifu; Nice, Edouard C; Zhang, Haiyuan; Huang, Canhua

2016-01-01

Cancer is a common disease that is a leading cause of death worldwide. Currently, early detection and novel therapeutic strategies are urgently needed for more effective management of cancer. Importantly, protein profiling using clinical proteomic strategies, with spectacular sensitivity and precision, offer excellent promise for the identification of potential biomarkers that would direct the development of targeted therapeutic anticancer drugs for precision medicine. In particular, clinical sample sources, including tumor tissues and body fluids (blood, feces, urine and saliva), have been widely investigated using modern high-throughput mass spectrometry-based proteomic approaches combined with bioinformatic analysis, to pursue the possibilities of precision medicine for targeted cancer therapy. Discussed in this review are the current advantages and limitations of clinical proteomics, the available strategies of clinical proteomics for the management of precision medicine, as well as the challenges and future perspectives of clinical proteomics-driven precision medicine for targeted cancer therapy.

Marketing Means Business. Interchange No. 28.

ERIC Educational Resources Information Center

Macleod, Ann; And Others

A project examined information currently made available by colleges of further education in Scotland to users and the marketing strategies used. Thirty-eight of 45 colleges completed a questionnaire on current marketing practice. Other activities included focus groups and interviews with students and members of the general public and a postal…

Marketing Practices of Vapor Store Owners

PubMed Central

Gowin, Mary; Wann, Taylor Franklin

2015-01-01

Objectives. We examined the marketing strategies for local vapor stores in a large metropolitan area in Oklahoma. Methods. Vapor store owners or managers (n = 33) participated in individual interviews regarding marketing practices in 2014. We asked owners about their marketing strategies and the groups they targeted. We transcribed the interviews and analyzed them for themes. Results. Store owners used a variety of marketing strategies to bring new customers to their stores and keep current customers coming back. These marketing strategies showed many parallels to tobacco industry strategies. Most owners engaged in some form of traditional marketing practices (e.g., print media), but only a few used radio or television advertising because of budget constraints. Owners used social media and other forms of electronic communication, pricing discounts and specials, and loyalty programs. Owners also had booths at local events, sponsored community events, and hosted them in their stores. Owners attempted to target different groups of users, such as college students and long-term smokers. Conclusions. Local vapor store marketing practices closely resemble current and former tobacco industry marketing strategies. Surveillance of marketing practices should include local and Web-based strategies. PMID:25880960

Marketing practices of vapor store owners.

PubMed

Cheney, Marshall; Gowin, Mary; Wann, Taylor Franklin

2015-06-01

We examined the marketing strategies for local vapor stores in a large metropolitan area in Oklahoma. Vapor store owners or managers (n = 33) participated in individual interviews regarding marketing practices in 2014. We asked owners about their marketing strategies and the groups they targeted. We transcribed the interviews and analyzed them for themes. Store owners used a variety of marketing strategies to bring new customers to their stores and keep current customers coming back. These marketing strategies showed many parallels to tobacco industry strategies. Most owners engaged in some form of traditional marketing practices (e.g., print media), but only a few used radio or television advertising because of budget constraints. Owners used social media and other forms of electronic communication, pricing discounts and specials, and loyalty programs. Owners also had booths at local events, sponsored community events, and hosted them in their stores. Owners attempted to target different groups of users, such as college students and long-term smokers. Local vapor store marketing practices closely resemble current and former tobacco industry marketing strategies. Surveillance of marketing practices should include local and Web-based strategies.

Sustained Attention Development during the Toddlerhood to Preschool Period: Associations with Toddlers' Emotion Regulation Strategies and Maternal Behaviour

ERIC Educational Resources Information Center

Graziano, Paulo A.; Calkins, Susan D.; Keane, Susan P.

2011-01-01

The current study examined the role of maternal behaviour and toddlers' emotion regulation strategies in the development of children's sustained attention abilities. Participants for this study included 447 children (232 girls) obtained from three different cohorts participating in a larger ongoing longitudinal study. When the children were 2…

The Differences between Iranian Male and Female Students in Using Language Learning Strategies

ERIC Educational Resources Information Center

Sherafat, Zahra; Kabiri, Pantea; Soori, Afshin

2014-01-01

The current study aimed at investigating the differences between male and female Iranian students in using different learning strategies. The participants of the study included 60 Iranian EFL students (30 male and 30 female) in Islamic Azad University in Larestan branch. The results of this study revealed that the frequency of using different…

Work related musculoskeletal disorders amongst therapists in physically demanding roles: qualitative analysis of risk factors and strategies for prevention.

PubMed

Passier, Leanne; McPhail, Steven

2011-01-25

Physiotherapy and occupational therapy are two professions at high risk of work related musculoskeletal disorders (WRMD). This investigation aimed to identify risk factors for WRMD as perceived by the health professionals working in these roles (Aim 1), as well as current and future strategies they perceive will allow them to continue to work in physically demanding clinical roles (Aim 2). A two phase exploratory investigation was undertaken. The first phase included a survey administered via a web based platform with qualitative open response items. The second phase involved four focus group sessions which explored topics obtained from the survey. Thematic analysis of qualitative data from the survey and focus groups was undertaken. Overall 112 (34.3%) of invited health professionals completed the survey; 66 (58.9%) were physiotherapists and 46 (41.1%) were occupational therapists. Twenty-four health professionals participated in one of four focus groups. The risk factors most frequently perceived by health professionals included: work postures and movements, lifting or carrying, patient related factors and repetitive tasks. The six primary themes for strategies to allow therapists to continue to work in physically demanding clinical roles included: organisational strategies, workload or work allocation, work practices, work environment and equipment, physical condition and capacity, and education and training. Risk factors as well as current and potential strategies for reducing WRMD amongst these health professionals working in clinically demanding roles have been identified and discussed. Further investigation regarding the relative effectiveness of these strategies is warranted.

Antifouling membranes for sustainable water purification: strategies and mechanisms.

PubMed

Zhang, Runnan; Liu, Yanan; He, Mingrui; Su, Yanlei; Zhao, Xueting; Elimelech, Menachem; Jiang, Zhongyi

2016-10-24

One of the greatest challenges to the sustainability of modern society is an inadequate supply of clean water. Due to its energy-saving and cost-effective features, membrane technology has become an indispensable platform technology for water purification, including seawater and brackish water desalination as well as municipal or industrial wastewater treatment. However, membrane fouling, which arises from the nonspecific interaction between membrane surface and foulants, significantly impedes the efficient application of membrane technology. Preparing antifouling membranes is a fundamental strategy to deal with pervasive fouling problems from a variety of foulants. In recent years, major advancements have been made in membrane preparation techniques and in elucidating the antifouling mechanisms of membrane processes, including ultrafiltration, nanofiltration, reverse osmosis and forward osmosis. This review will first introduce the major foulants and the principal mechanisms of membrane fouling, and then highlight the development, current status and future prospects of antifouling membranes, including antifouling strategies, preparation techniques and practical applications. In particular, the strategies and mechanisms for antifouling membranes, including passive fouling resistance and fouling release, active off-surface and on-surface strategies, will be proposed and discussed extensively.

A molecular insight into papaya leaf curl-a severe viral disease.

PubMed

Varun, Priyanka; Ranade, S A; Saxena, Sangeeta

2017-11-01

Papaya leaf curl disease (PaLCuD) caused by papaya leaf curl virus (PaLCuV) not only affects yield but also plant growth and fruit size and quality of papaya and is one of the most damaging and economically important disease. Management of PaLCuV is a challenging task due to diversity of viral strains, the alternate hosts, and the genomic complexities of the viruses. Several management strategies currently used by plant virologists to broadly control or eliminate the viruses have been discussed. In the absence of such strategies in the case of PaLCuV at present, the few available options to control the disease include methods like removal of affected plants from the field, insecticide treatments against the insect vector (Bemisia tabaci), and gene-specific control through transgenic constructs. This review presents the current understanding of papaya leaf curl disease, genomic components including satellite DNA associated with the virus, wide host and vector range, and management of the disease and suggests possible generic resistance strategies.

State-Specific Prevalence of Tobacco Product Use Among Adults - United States, 2014-2015.

PubMed

Odani, Satomi; Armour, Brian S; Graffunder, Corinne M; Willis, Gordon; Hartman, Anne M; Agaku, Israel T

2018-01-26

Despite recent declines in cigarette smoking prevalence, the tobacco product landscape has shifted to include emerging tobacco products* (1,2). Previous research has documented adult use of smokeless tobacco and cigarettes by state (3); however, state-specific data on other tobacco products are limited. To assess tobacco product use in the 50 U.S. states and the District of Columbia (DC), CDC and the National Cancer Institute analyzed self-reported use of six tobacco product types: cigarettes, cigars, regular pipes, water pipes, electronic cigarettes (e-cigarettes), and smokeless tobacco products among adults aged ≥18 years using data from the 2014-2015 Tobacco Use Supplement to the Current Population Survey (TUS-CPS). Prevalence of ever-use of any tobacco product ranged from 27.0% (Utah) to 55.4% (Wyoming). Current (every day or some days) use of any tobacco product ranged from 10.2% (California) to 27.7% (Wyoming). Cigarettes were the most common currently used tobacco product in all states and DC. Among current cigarette smokers, the proportion who currently used one or more other tobacco products ranged from 11.5% (Delaware) to 32.3% (Oregon). Differences in tobacco product use across states underscore the importance of implementing proven population-level strategies to reduce tobacco use and expanding these strategies to cover all forms of tobacco marketed in the United States. Such strategies could include comprehensive smoke-free policies, tobacco product price increases, anti-tobacco mass media campaigns, and barrier-free access to clinical smoking cessation resources (1,4).

Achieving competitive advantage through strategic human resource management.

PubMed

Fottler, M D; Phillips, R L; Blair, J D; Duran, C A

1990-01-01

The framework presented here challenges health care executives to manage human resources strategically as an integral part of the strategic planning process. Health care executives should consciously formulate human resource strategies and practices that are linked to and reinforce the broader strategic posture of the organization. This article provides a framework for (1) determining and focusing on desired strategic outcomes, (2) identifying and implementing essential human resource management actions, and (3) maintaining or enhancing competitive advantage. The strategic approach to human resource management includes assessing the organization's environment and mission; formulating the organization's business strategy; assessing the human resources requirements based on the intended strategy; comparing the current inventory of human resources in terms of numbers, characteristics, and human resource management practices with respect to the strategic requirements of the organization and its services or product lines; formulating the human resource strategy based on the differences between the assessed requirements and the current inventory; and implementing the appropriate human resource practices to reinforce the strategy and attain competitive advantage.

ABS-FishCount: An Agent-Based Simulator of Underwater Sensors for Measuring the Amount of Fish

PubMed Central

2017-01-01

Underwater sensors provide one of the possibilities to explore oceans, seas, rivers, fish farms and dams, which all together cover most of our planet’s area. Simulators can be helpful to test and discover some possible strategies before implementing these in real underwater sensors. This speeds up the development of research theories so that these can be implemented later. In this context, the current work presents an agent-based simulator for defining and testing strategies for measuring the amount of fish by means of underwater sensors. The current approach is illustrated with the definition and assessment of two strategies for measuring fish. One of these two corresponds to a simple control mechanism, while the other is an experimental strategy and includes an implicit coordination mechanism. The experimental strategy showed a statistically significant improvement over the control one in the reduction of errors with a large Cohen’s d effect size of 2.55. PMID:29137165

Current status of Marek’s disease in the United States & worldwide based on a questionnaire survey

USDA-ARS?s Scientific Manuscript database

A questionnaire was widely distributed in 2011 to estimate the global prevalence of Marek’s disease (MD) and gain a better understanding of current control strategies and future concerns. A total of 112 questionnaires were returned representing 116 countries from sources including national branch s...

Sex and hemisphere differences when mentally rotating meaningful and meaningless stimuli.

PubMed

Rilea, Stacy L

2008-05-01

The purpose of the current study was to investigate the influence of stimulus type and sex on strategy use and hemispheric processing during the mental rotation task. Participants included 67 right-handed men and women who completed three mental rotation tasks, all presented bilaterally. Participants rotated human stick figures, alphanumeric stimuli, and a two-dimensional (2D) meaningless object. No hemispheric differences were observed when rotating human stick figures, suggesting that men and women may rely on the same strategy. A left hemisphere advantage was observed in women when rotating alphanumeric stimuli, suggesting they may be relying on a verbal strategy, whereas no hemispheric differences were observed for men. Finally, inconsistent with predictions, no hemisphere differences were observed when rotating two-dimensional objects. The findings from the current study suggest that both the meaningfulness and the type of stimulus presented may influence strategy use differently for men and women.

New developments in the treatment of hypoplastic left heart syndrome.

PubMed

Alsoufi, Bahaaldin; Bennetts, Jayme; Verma, Subodh; Caldarone, Christopher A

2007-01-01

In the current decade, the prognosis of newborns with hypoplastic left heart syndrome, previously considered a uniformly fatal condition, has dramatically improved through refinement of rapidly evolving treatment strategies. These strategies include various modifications of staged surgical reconstruction, orthotopic heart transplantation, and hybrid palliation using ductal stenting and bilateral pulmonary artery banding. The variety of treatment approaches are based on different surgical philosophies, and each approach has its unique advantages and disadvantages. Nonetheless, multiple experienced centers have reported improved outcomes in each one of those modalities. The purpose of this review is to outline recent developments in the array of currently available management strategies for neonates with hypoplastic left heart syndrome. Because the vast majority of deaths in this patient population occur within the first months of life, the focus of the review will be evaluation of the impact of these management strategies on survival in the neonatal and infant periods.

Applications of nanotechnology in gastric cancer: detection and prevention by nutrition.

PubMed

Elingarami, Sauli; Liu, Ming; Fan, Jing; He, Nongyue

2014-01-01

New and emerging technologies, such as nanotechnology, have the potential to advance nutrition science by assisting in the discovery, development, and delivery of several intervention strategies to improve health and reduce the risk and complications of several diseases, including gastric cancer. This article reviews gastric cancer in relation to nutrition, discussing gastric carcinogenesis in-depth in relation to prevention of the disease by nutrition, as well as current detection approaches using nanotechnology. The current status of molecular nutritional biomarkers for gastric cancer is also discussed, as well as future strategies for the tailored management of gastric cancer.

On Convergence Acceleration Techniques for Unstructured Meshes

NASA Technical Reports Server (NTRS)

Mavriplis, Dimitri J.

1998-01-01

A discussion of convergence acceleration techniques as they relate to computational fluid dynamics problems on unstructured meshes is given. Rather than providing a detailed description of particular methods, the various different building blocks of current solution techniques are discussed and examples of solution strategies using one or several of these ideas are given. Issues relating to unstructured grid CFD problems are given additional consideration, including suitability of algorithms to current hardware trends, memory and cpu tradeoffs, treatment of non-linearities, and the development of efficient strategies for handling anisotropy-induced stiffness. The outlook for future potential improvements is also discussed.

Strategies and Performance in Elementary Students' Three-Digit Mental Addition

ERIC Educational Resources Information Center

Csíkos, Csaba

2016-01-01

The focus of this study is the relationship between students' performance in mental calculation and the strategies they use when solving three-digit mental addition problems. The sample comprises 78 4th grade students (40 boys and 38 girls). Their mean age was 10 years and 4 months. The main novelties of the current research include (1)…

Maternal Attachment and Depressive Symptoms in Urban Adolescents: The Influence of Coping Strategies and Gender

ERIC Educational Resources Information Center

Gaylord-Harden, Noni K.; Taylor, Jeremy J.; Campbell, Cynthya L.; Kesselring, Christine M.; Grant, Kathryn E.

2009-01-01

The current study examined coping strategies as mediators of the relation between maternal attachment and depressive symptoms in a sample of urban youth. Participants included 393 adolescents (M age = 12.03, SD = 0.85) participating in a larger study of the impact of stressful life experiences on low-income urban youth. Participants completed…

Understanding carbohydrate-carbohydrate interactions by means of glyconanotechnology.

PubMed

de la Fuente, Jesus M; Penadés, Soledad

2004-01-01

Carbohydrate-carbohydrate interaction is a reliable and versatile mechanism for cell adhesion and recognition. Glycosphingolipid (GSL) clusters at the cell membrane are mainly involved in this interaction. To investigate carbohydrate-carbohydrate interaction an integrated strategy (Glyconanotechnology) was developed. This strategy includes polyvalent tools (gold glyconanoparticles) mimicking GSL clustering at the cell membrane as well as analytical techniques such as AFM, TEM, and SPR to evaluate the interactions. The results obtained by means of this strategy and current status are presented.

[Economic evaluation on different two-dose-vaccination-strategies related to Measles, Mumps and Rubella Combined Attenuated Live Vaccine].

PubMed

He, H Q; Zhang, B; Yan, R; Li, Q; Fu, J; Tang, X W; Zhou, Y; Deng, X; Xie, S Y

2016-08-10

To evaluate the economic effect of Measles, Mumps and Rubella Combined Attenuated Live Vaccine (MMR) under different two-dose vaccination programs. A hypothetical birth cohort of 750 000 infants over their lifetime, was followed up from birth through death in Zhejiang province. The current MMR vaccination strategie would include three different ones: 1) Childlern were vaccinated with Measles-Rubella Combined Attenuated Live Vaccine and MMR, respectively at the age of 8 months and 18 months. 2) Children receive MMR at 8 months and 18 months, 3) Strategy 1 plus an additional vaccination of MMR at 4 years of age. Incremental cost-effectiveness ratio (ICER), incremental cost-benefit ratio (ICBR) and incremental net benefit (INB) were applied to calculate the health economic difference for Strategy 2 and Strategy 3 as compared to Strategy 1. Univariate sensitivity analysis was used to assess the robustness of results with main parameters, including the rate of immunization coverage, effectiveness of the vaccines, incidence and burdens of the related diseases, cost of vaccines and the vaccination program itself. ICER, ICBR and INB for Strategy 2 and Strategy 3 appeared as 2 012.51∶1 RMB Yuan per case and 4 238.72∶1 RMB Yuan per case, 1∶3.14 and 1∶1.58, 21 277 800 RMB Yuan and 9 276 500 RMB Yuan, respectively. Only slight changes (<20%) were found under the univariate sensitivity analysis, with varied values on main parameters. Based on the current national immunization program, infants vaccinated with MMR at 8 months of age, generated more health economic effects than the Strategy 3.

Definition and insertion of the GSPC in the political context of Mexico.

PubMed

Dávila, Patricia; Benítez, Hesiquio; Barrios, Yolanda; Cruz-Angón, Ndrea; Álvarez-Girard, Norma

2011-01-01

Mexico as a megadiverse country houses between 6 and 8% of the world's flora. However, the Mexican flora is facing challenges, including the presence of at least 981 threatened plant species and 618 exotic plant species, habitat loss, pollution, overexploitation of natural resources and the adverse effects of climate change, which are compromising its conservation and sustainable use. Mexico has been actively involved in the development and update of the Global Strategy for Plant Conservation (GSPC) adopted by the Convention on Biological Diversity (CBD). As a party to CBD, Mexico has established a Coordinating Committee for the Mexican Strategy for Plant Conservation (MSPC), which has adapted the GSPC to fit national needs and drafted a number of projects, indicators, means of verification and actors to ensure that the MSPC, as a public policy tool, really drives conservation and sustainable use actions among all sectors and lasts beyond the current administration. An agenda is being developed with activities that include the following: approaching Congress, identifying the relevance of the MSPC in the National Development Plan and the Mexican Biodiversity Strategy, making use of current environmental policies and an aggressive awareness programme. The MSPC includes simultaneous programmes of technical and political work.

34 CFR 410.10 - What must an application contain?

Code of Federal Regulations, 2010 CFR

2010-07-01

... to the current and projected labor market needs in its geographic area, including the institution's... number of students to be served, enrollment trends, and economic factors that could affect the... statement must include information on allowable expenses listed in § 410.30. (12) Strategies and resources...

State Assessment and Persuasive Writing in the Social Studies Instruction.

ERIC Educational Resources Information Center

Hunter, Barbara

1990-01-01

Examines current Illinois statewide assessment of social studies education. Argues conceptual knowledge assessment in the social studies should use essay tests. Includes guidelines and activities for teaching students to write persuasively. Explains various strategies to teach reading, writing, and thinking skills, including the "RAFT"…

Emerging Trends in "Smart Probiotics": Functional Consideration for the Development of Novel Health and Industrial Applications.

PubMed

El Hage, Racha; Hernandez-Sanabria, Emma; Van de Wiele, Tom

2017-01-01

The link between gut microbiota and human health is well-recognized and described. This ultimate impact on the host has contributed to explain the mutual dependence between humans and their gut bacteria. Gut microbiota can be manipulated through passive or active strategies. The former includes diet, lifestyle, and environment, while the latter comprise antibiotics, pre- and probiotics. Historically, conventional probiotic strategies included a phylogenetically limited diversity of bacteria and some yeast strains. However, biotherapeutic strategies evolved in the last years with the advent of fecal microbiota transplant (FMT), successfully applied for treating CDI, IBD, and other diseases. Despite the positive outcomes, long-term effects resulting from the uncharacterized nature of FMT are not sufficiently studied. Thus, developing strategies to simulate the FMT, using characterized gut colonizers with identified phylogenetic diversity, may be a promising alternative. As the definition of probiotics states that the microorganism should have beneficial effects on the host, several bacterial species with proven efficacy have been considered next generation probiotics. Non-conventional candidate strains include Akkermansia muciniphila, Faecalibacterium prausnitzii, Bacteroides fragilis , and members of the Clostridia clusters IV, XIVa, and XVIII. However, viable intestinal delivery is one of the current challenges, due to their stringent survival conditions. In this review, we will cover current perspectives on the development and assessment of next generation probiotics and the approaches that industry and stakeholders must consider for a successful outcome.

Multidisciplinary approaches to stimulate wound healing.

PubMed

Businaro, Rita; Corsi, Mariangela; Di Raimo, Tania; Marasco, Sergio; Laskin, Debra L; Salvati, Bruno; Capoano, Raffaele; Ricci, Serafino; Siciliano, Camilla; Frati, Giacomo; De Falco, Elena

2016-08-01

New civil wars and waves of terrorism are causing crucial social changes, with consequences in all fields, including health care. In particular, skin injuries are evolving as an epidemic issue. From a physiological standpoint, although wound repair takes place more rapidly in the skin than in other tissues, it is still a complex organ to reconstruct. Genetic and clinical variables, such as diabetes, smoking, and inflammatory/immunological pathologies, are also important risk factors limiting the regenerative potential of many therapeutic applications. Therefore, optimization of current clinical strategies is critical. Here, we summarize the current state of the field by focusing on stem cell therapy applications in wound healing, with an emphasis on current clinical approaches being developed. These involve protocols for the ex vivo expansion of adipose tissue-derived mesenchymal stem cells by means of a patented Good Manufacturing Practice-compliant platelet lysate. Combinations of multiple strategies, including genetic modifications and stem cells, biomimetic scaffolds, and novel vehicles, such as nanoparticles, are also discussed as future approaches. © 2016 New York Academy of Sciences.

Surveillance strategies for Classical Swine Fever in wild boar – a comprehensive evaluation study to ensure powerful surveillance

PubMed Central

Schulz, Katja; Peyre, Marisa; Staubach, Christoph; Schauer, Birgit; Schulz, Jana; Calba, Clémentine; Häsler, Barbara; Conraths, Franz J.

2017-01-01

Surveillance of Classical Swine Fever (CSF) should not only focus on livestock, but must also include wild boar. To prevent disease transmission into commercial pig herds, it is therefore vital to have knowledge about the disease status in wild boar. In the present study, we performed a comprehensive evaluation of alternative surveillance strategies for Classical Swine Fever (CSF) in wild boar and compared them with the currently implemented conventional approach. The evaluation protocol was designed using the EVA tool, a decision support tool to help in the development of an economic and epidemiological evaluation protocol for surveillance. To evaluate the effectiveness of the surveillance strategies, we investigated their sensitivity and timeliness. Acceptability was analysed and finally, the cost-effectiveness of the surveillance strategies was determined. We developed 69 surveillance strategies for comparative evaluation between the existing approach and the novel proposed strategies. Sampling only within sub-adults resulted in a better acceptability and timeliness than the currently implemented strategy. Strategies that were completely based on passive surveillance performance did not achieve the desired detection probability of 95%. In conclusion, the results of the study suggest that risk-based approaches can be an option to design more effective CSF surveillance strategies in wild boar. PMID:28266576

Surveillance strategies for Classical Swine Fever in wild boar - a comprehensive evaluation study to ensure powerful surveillance.

PubMed

Schulz, Katja; Peyre, Marisa; Staubach, Christoph; Schauer, Birgit; Schulz, Jana; Calba, Clémentine; Häsler, Barbara; Conraths, Franz J

2017-03-07

Surveillance of Classical Swine Fever (CSF) should not only focus on livestock, but must also include wild boar. To prevent disease transmission into commercial pig herds, it is therefore vital to have knowledge about the disease status in wild boar. In the present study, we performed a comprehensive evaluation of alternative surveillance strategies for Classical Swine Fever (CSF) in wild boar and compared them with the currently implemented conventional approach. The evaluation protocol was designed using the EVA tool, a decision support tool to help in the development of an economic and epidemiological evaluation protocol for surveillance. To evaluate the effectiveness of the surveillance strategies, we investigated their sensitivity and timeliness. Acceptability was analysed and finally, the cost-effectiveness of the surveillance strategies was determined. We developed 69 surveillance strategies for comparative evaluation between the existing approach and the novel proposed strategies. Sampling only within sub-adults resulted in a better acceptability and timeliness than the currently implemented strategy. Strategies that were completely based on passive surveillance performance did not achieve the desired detection probability of 95%. In conclusion, the results of the study suggest that risk-based approaches can be an option to design more effective CSF surveillance strategies in wild boar.

Cost-effectiveness analysis of acute kidney injury biomarkers in pediatric cardiac surgery.

PubMed

Petrovic, Stanislava; Bogavac-Stanojevic, Natasa; Lakic, Dragana; Peco-Antic, Amira; Vulicevic, Irena; Ivanisevic, Ivana; Kotur-Stevuljevic, Jelena; Jelic-Ivanovic, Zorana

2015-01-01

Acute kidney injury (AKI) is significant problem in children with congenital heart disease (CHD) who undergo cardiac surgery. The economic impact of a biomarker-based diagnostic strategy for AKI in pediatric populations undergoing CHD surgery is unknown. The aim of this study was to perform the cost effectiveness analysis of using serum cystatin C (sCysC), urine neutrophil gelatinase-associated lipocalin (uNGAL) and urine liver fatty acid-binding protein (uL-FABP) for the diagnosis of AKI in children after cardiac surgery compared with current diagnostic method (monitoring of serum creatinine (sCr) level). We developed a decision analytical model to estimate incremental cost-effectiveness of different biomarker-based diagnostic strategies compared to current diagnostic strategy. The Markov model was created to compare the lifetime cost associated with using of sCysC, uNGAL, uL-FABP with monitoring of sCr level for the diagnosis of AKI. The utility measurement included in the analysis was quality-adjusted life years (QALY). The results of the analysis are presented as the incremental cost-effectiveness ratio (ICER). Analysed biomarker-based diagnostic strategies for AKI were cost-effective compared to current diagnostic method. However, uNGAL and sCys C strategies yielded higher costs and lower effectiveness compared to uL-FABP strategy. uL-FABP added 1.43 QALY compared to current diagnostic method at an additional cost of $8521.87 per patient. Therefore, ICER for uL-FABP compared to sCr was $5959.35/QALY. Our results suggest that the use of uL-FABP would represent cost effective strategy for early diagnosis of AKI in children after cardiac surgery.

Alternative Strategies to Achieve Cardiovascular Mortality Goals in China and India: A Microsimulation of Target- Versus Risk-Based Blood Pressure Treatment.

PubMed

Basu, Sanjay; Yudkin, John S; Sussman, Jeremy B; Millett, Christopher; Hayward, Rodney A

2016-03-01

The World Health Organization aims to reduce mortality from chronic diseases including cardiovascular disease (CVD) by 25% by 2025. High blood pressure is a leading CVD risk factor. We sought to compare 3 strategies for treating blood pressure in China and India: a treat-to-target (TTT) strategy emphasizing lowering blood pressure to a target, a benefit-based tailored treatment (BTT) strategy emphasizing lowering CVD risk, or a hybrid strategy currently recommended by the World Health Organization. We developed a microsimulation model of adults aged 30 to 70 years in China and in India to compare the 2 treatment approaches across a 10-year policy-planning horizon. In the model, a BTT strategy treating adults with a 10-year CVD event risk of ≥ 10% used similar financial resources but averted ≈ 5 million more disability-adjusted life-years in both China and India than a TTT approach based on current US guidelines. The hybrid strategy in the current World Health Organization guidelines produced no substantial benefits over TTT. BTT was more cost-effective at $205 to $272/disability-adjusted life-year averted, which was $142 to $182 less per disability-adjusted life-year than TTT or hybrid strategies. The comparative effectiveness of BTT was robust to uncertainties in CVD risk estimation and to variations in the age range analyzed, the BTT treatment threshold, or rates of treatment access, adherence, or concurrent statin therapy. In model-based analyses, a simple BTT strategy was more effective and cost-effective than TTT or hybrid strategies in reducing mortality. © 2016 American Heart Association, Inc.

Reconceptualizing cancer immunotherapy based on plant production systems

PubMed Central

Hefferon, Kathleen

2017-01-01

Plants can be used as inexpensive and facile production platforms for vaccines and other biopharmaceuticals. More recently, plant-based biologics have expanded to include cancer immunotherapy agents. The following review describes the current state of the art for plant-derived strategies to prevent or reduce cancers. The review discusses avenues taken to prevent infection by oncogenic viruses, solid tumors and lymphomas. Strategies including cancer vaccines, monoclonal antibodies and virus nanoparticles are described, and examples are provided. The review ends with a discussion of the implications of plant-based cancer immunotherapy for developing countries. PMID:28884013

New Immunotherapy Strategies in Breast Cancer

PubMed Central

Yu, Lin-Yu; Tang, Jie; Zhang, Cong-Min; Zeng, Wen-Jing; Yan, Han; Li, Mu-Peng; Chen, Xiao-Ping

2017-01-01

Breast cancer is the most commonly diagnosed cancer among women. Therapeutic treatments for breast cancer generally include surgery, chemotherapy, radiotherapy, endocrinotherapy and molecular targeted therapy. With the development of molecular biology, immunology and pharmacogenomics, immunotherapy becomes a promising new field in breast cancer therapies. In this review, we discussed recent progress in breast cancer immunotherapy, including cancer vaccines, bispecific antibodies, and immune checkpoint inhibitors. Several additional immunotherapy modalities in early stages of development are also highlighted. It is believed that these new immunotherapeutic strategies will ultimately change the current status of breast cancer therapies. PMID:28085094

From the Margins to the Center: Recommendations for Current and Aspiring Educational Leaders

ERIC Educational Resources Information Center

Nolan, Tina R.

2009-01-01

Tina Nolan presents a call to action for current and future leaders to assume a new role as change leaders for the museum education profession. This article puts forth a series of recommendations and strategies for repositioning museum educators from the margins of their institutions to the center. Included among these recommendations are…

Landscape review of current HIV 'kick and kill' cure research - some kicking, not enough killing.

PubMed

Thorlund, Kristian; Horwitz, Marc S; Fife, Brian T; Lester, Richard; Cameron, D William

2017-08-29

Current antiretroviral therapy (ART) used to treat human immunodeficiency virus (HIV) patients is life-long because it only suppresses de novo infections. Recent efforts to eliminate HIV have tested the ability of a number of agents to reactivate ('Kick') the well-known latent reservoir. This approach is rooted in the assumption that once these cells are reactivated the host's immune system itself will eliminate ('Kill') the virus. While many agents have been shown to reactivate large quantities of the latent reservoir, the impact on the size of the latent reservoir has been negligible. This suggests that the immune system is not sufficient to eliminate reactivated reservoirs. Thus, there is a need for more emphasis on 'kill' strategies in HIV cure research, and how these might work in combination with current or future kick strategies. We conducted a landscape review of HIV 'cure' clinical trials using 'kick and kill' approaches. We identified and reviewed current available clinical trial results in human participants as well as ongoing and planned clinical trials. We dichotomized trials by whether they did not include or include a 'kill' agent. We extracted potential reasons why the 'kill' is missing from current 'kick and kill' strategies. We subsequently summarized and reviewed current 'kill' strategies have entered the phase of clinical trial testing in human participants and highlighted those with the greatest promise. The identified 'kick' trials only showed promise on surrogate measures activating latent T-cells, but did not show any positive effects on clinical 'cure' measures. Of the 'kill' agents currently being tested in clinical trials, early results have shown small but meaningful proportions of participants remaining off ART for several months with broadly neutralizing antibodies, as well as agents for regulating immune cell responses. A similar result was also recently observed in a trial combining a conventional 'kick' with a vaccine immune booster ('kill'). While an understanding of the efficacy of each individual component is crucial, no single 'kick' or 'kill' agent is likely to be a fully effective cure. Rather, the solution is likely found in a combination of multiple 'kick and kill' interventions.

Environmental Activities for Teaching Critical Thinking. [Environmental Education Information Report.

ERIC Educational Resources Information Center

Howe, Robert W.; Disinger, John F.

The ability to think critically is essential if individuals are to live, work, and function effectively in our current and changing society. The activities included in this publication were selected to identify a variety of effective strategies for teaching critical thinking skills through environmental education. Activities include library…

Current status of gene therapy for brain tumors

PubMed Central

MURPHY, ANDREA M.; RABKIN, SAMUEL D.

2013-01-01

Glioblastoma (GBM) is the most common and deadliest primary brain tumor in adults, with current treatments having limited impact on disease progression. Therefore the development of alternative treatment options is greatly needed. Gene therapy is a treatment strategy that relies on the delivery of genetic material, usually transgenes or viruses, into cells for therapeutic purposes, and has been applied to GBM with increasing promise. We have included selectively replication-competent oncolytic viruses within this strategy, although the virus acts directly as a complex biologic anti-tumor agent rather than as a classic gene delivery vehicle. GBM is a good candidate for gene therapy because tumors remain locally within the brain and only rarely metastasize to other tissues; the majority of cells in the brain are post-mitotic, which allows for specific targeting of dividing tumor cells; and tumors can often be accessed neurosurgically for administration of therapy. Delivery vehicles used for brain tumors include nonreplicating viral vectors, normal adult stem/progenitor cells, and oncolytic viruses. The therapeutic transgenes or viruses are typically cytotoxic or express prodrug activating suicide genes to kill glioma cells, immunostimulatory to induce or amplify anti-tumor immune responses, and/or modify the tumor microenvironment such as blocking angiogenesis. This review describes current preclinical and clinical gene therapy strategies for the treatment of glioma. PMID:23246627

Clinical Interventions for Hyperacusis in Adults: A Scoping Review to Assess the Current Position and Determine Priorities for Research

PubMed Central

Potgieter, Iskra; Baguley, David M.

2017-01-01

Background There is no universally accepted definition for hyperacusis, but in general it is characterised by decreased sound tolerance to ordinary environmental sounds. Despite hyperacusis being prevalent and having significant clinical implications, much remains unknown about current management strategies. Purpose To establish the current position of research on hyperacusis and identify research gaps to direct future research. Design and Sample Using an established methodological framework, electronic and manual searches of databases and journals identified 43 records that met our inclusion criteria. Incorporating content and thematic analysis approaches, the definitions of hyperacusis, management strategies, and outcome measures were catalogued. Results Only 67% of the studies provided a definition of hyperacusis, such as “reduced tolerance” or “oversensitivity to sound.” Assessments and outcome measures included Loudness Discomfort Levels, the Hyperacusis Questionnaire, and Tinnitus Retraining Therapy (TRT) interview. Management strategies reported were Cognitive Behavioural Therapy, TRT, devices, pharmacological therapy, and surgery. Conclusions Management strategies were typically evaluated in patients reporting hyperacusis as a secondary complaint or as part of a symptom set. As such the outcomes reported only provided an indication of their effectiveness for hyperacusis. Randomised Controlled Trials are needed to evaluate the effectiveness of management strategies for patients experiencing hyperacusis. PMID:29312994

A Non-Heroic Strategy for the Management of Decline: An Examination of the American Approach to Educational Retrenchment.

ERIC Educational Resources Information Center

Peruniak, W. S.

Since Canada and the U.S. share the common problem of declining enrollment, this paper studies the current situation in the States and assesses the merits and shortcomings of the nonheroic strategy being pursued there. The author credits the failure to develop a comprehensive, coherent plan in even one state to several factors, including the…

Load Balancing Strategies for Multiphase Flows on Structured Grids

NASA Astrophysics Data System (ADS)

Olshefski, Kristopher; Owkes, Mark

2017-11-01

The computation time required to perform large simulations of complex systems is currently one of the leading bottlenecks of computational research. Parallelization allows multiple processing cores to perform calculations simultaneously and reduces computational times. However, load imbalances between processors waste computing resources as processors wait for others to complete imbalanced tasks. In multiphase flows, these imbalances arise due to the additional computational effort required at the gas-liquid interface. However, many current load balancing schemes are only designed for unstructured grid applications. The purpose of this research is to develop a load balancing strategy while maintaining the simplicity of a structured grid. Several approaches are investigated including brute force oversubscription, node oversubscription through Message Passing Interface (MPI) commands, and shared memory load balancing using OpenMP. Each of these strategies are tested with a simple one-dimensional model prior to implementation into the three-dimensional NGA code. Current results show load balancing will reduce computational time by at least 30%.

Developing a Web-Based Advisory Expert System for Implementing Traffic Calming Strategies

PubMed Central

Falamarzi, Amir; Borhan, Muhamad Nazri; Rahmat, Riza Atiq O. K.

2014-01-01

Lack of traffic safety has become a serious issue in residential areas. In this paper, a web-based advisory expert system for the purpose of applying traffic calming strategies on residential streets is described because there currently lacks a structured framework for the implementation of such strategies. Developing an expert system can assist and advise engineers for dealing with traffic safety problems. This expert system is developed to fill the gap between the traffic safety experts and people who seek to employ traffic calming strategies including decision makers, engineers, and students. In order to build the expert system, examining sources related to traffic calming studies as well as interviewing with domain experts have been carried out. The system includes above 150 rules and 200 images for different types of measures. The system has three main functions including classifying traffic calming measures, prioritizing traffic calming strategies, and presenting solutions for different traffic safety problems. Verifying, validating processes, and comparing the system with similar works have shown that the system is consistent and acceptable for practical uses. Finally, some recommendations for improving the system are presented. PMID:25276861

Developing a web-based advisory expert system for implementing traffic calming strategies.

PubMed

Falamarzi, Amir; Borhan, Muhamad Nazri; Rahmat, Riza Atiq O K

2014-01-01

Lack of traffic safety has become a serious issue in residential areas. In this paper, a web-based advisory expert system for the purpose of applying traffic calming strategies on residential streets is described because there currently lacks a structured framework for the implementation of such strategies. Developing an expert system can assist and advise engineers for dealing with traffic safety problems. This expert system is developed to fill the gap between the traffic safety experts and people who seek to employ traffic calming strategies including decision makers, engineers, and students. In order to build the expert system, examining sources related to traffic calming studies as well as interviewing with domain experts have been carried out. The system includes above 150 rules and 200 images for different types of measures. The system has three main functions including classifying traffic calming measures, prioritizing traffic calming strategies, and presenting solutions for different traffic safety problems. Verifying, validating processes, and comparing the system with similar works have shown that the system is consistent and acceptable for practical uses. Finally, some recommendations for improving the system are presented.

Bridging the gap between science and policy: an international survey of scientists and policy makers in China and Canada.

PubMed

Choi, Bernard C K; Li, Liping; Lu, Yaogui; Zhang, Li R; Zhu, Yao; Pak, Anita W P; Chen, Yue; Little, Julian

2016-02-06

Bridging the gap between science and policy is an important task in evidence-informed policy making. The objective of this study is to prioritize ways to bridge the gap. The study was based on an online survey of high-ranking scientists and policy makers who have a senior position in universities and governments in the health sector in China and Canada. The sampling frame comprised of universities with schools of public health and medicine and various levels of government in health and public health. Participants included university presidents and professors, and government deputy ministers, directors general and directors working in the health field. Fourteen strategies were presented to the participants for ranking as current ways and ideal ways in the future to bridge the gap between science and policy. Over a 3-month survey period, there were 121 participants in China and 86 in Canada with response rates of 30.0 and 15.9 %, respectively. The top strategies selected by respondents included focus on policy (conducting research that focuses on policy questions), science-policy forums, and policy briefs, both as current ways and ideal ways to bridge the gap between science and policy. Conferences were considered a priority strategy as a current way, but not an ideal way in the future. Canadian participants were more in favor of using information technology (web-based portals and email updates) than their Chinese counterparts. Among Canadian participants, two strategies that were ranked low as current ways (collaboration in study design and collaboration in analysis) became a priority as ideal ways. This could signal a change in thinking in shifting the focus from the "back end" or "downstream" (knowledge dissemination) of the knowledge transfer process to the "front end" or "upstream" (knowledge generation). Our international study has confirmed a number of previously reported priority strategies to bridge the gap between science and policy. More importantly, our study has contributed to the future work on evidence-based policy making by comparing the responses from China and Canada and the current and ideal way for the future. Our study shows that the concept and strategies of bridging the gap between science and policy are not static but varying in space and evolving over time.

Stress and coping in Australian nurses: a systematic review.

PubMed

Lim, J; Bogossian, F; Ahern, K

2010-03-01

To identify factors that contribute to stress in Australian nurses, consider the coping strategies they use and examine the effects of stressors on nurses' health and well-being. Stress is a major concern in the nursing profession with work overload, nurse shortages and high turnover rates as the common stressors. Although nursing stress has been studied extensively, there is a lack of clarity on the nursing situation in Australia. A systematic review of the current literature was conducted on stress and coping strategies within the Australian nursing population. Stressors included work overload, role conflicts and experiences of aggression. Coping strategies included seeking support, problem solving and self-control. The majority of the studies reported detrimental effects on nurses' physical and mental well-being with little consideration given to the spillover effects of nursing work stress to their family and social relationships. Recommendations included factoring in personal and work stresses, promoting the use of effective coping strategies and maintaining supportive social relationships.

Possible application of a nematophagous fungus as a biological control agent of parasitic nematodes on commercial sheep farms in South Africa.

PubMed

Faedo, M; Krecek, R C

2002-03-01

Biological control of parasitic nematodes of livestock is currently under development and represents another tool that may be integrated into helminth parasite control strategies. This paper presents a brief introduction to commercial sheep farming in South Africa and currently available nematode parasite control methods. These include the FAMACHA clinical assay, strategies of pasture management, dilution of resistant worm species by introduction of susceptible worms, breed resistant sheep and nutritional supplementation. The purpose of this paper is to outline the principles of biological control using nematophagous fungi and how it may be applied on sheep farms in South Africa.

Sophisticated Cloning, Fermentation, and Purification Technologies for an Enhanced Therapeutic Protein Production: A Review

PubMed Central

Gupta, Sanjeev K.; Shukla, Pratyoosh

2017-01-01

The protein productions strategies are crucial towards the development of application based research and elucidating the novel purification strategies for industrial production. Currently, there are few innovative avenues are studies for cloning, upstream, and purification through efficient bioprocess development. Such strategies are beneficial for industries as well as proven to be vital for effectual therapeutic protein development. Though, these techniques are well documented, but, there is scope of addition to current knowledge with novel and new approaches and it will pave new avenues in production of recombinant microbial and non-microbial proteins including secondary metabolites. In this review, we have focussed on the recent development in clone selection, various modern fermentation and purification technologies and future directions in these emerging areas. Moreover, we have also highlighted notable perspectives and challenges involved in the bioengineering of such proteins, including quality by design, gene editing and pioneering ideas. The biopharmaceutical industries continue to shift towards more flexible, automated platforms and economical product development, which in turn can help in developing the cost effective processes and affordable drug development for a large community. PMID:28725194

In vitro genotoxicity testing strategy for nanomaterials and the adaptation of current OECD guidelines

PubMed Central

Doak, S.H.; Manshian, B.; Jenkins, G.J.S.; Singh, N.

2012-01-01

There is a pressing requirement to define a hazard identification and risk management strategy for nanomaterials due to the rapid growth in the nanotechnology industry and their promise of life-style revolutions through the development of wide-ranging nano-containing consumer products. Consequently, a battery of well defined and appropriate in vitro assays to assess a number of genotoxicity endpoints is required to minimise extensive and costly in vivo testing. However, the validity of the established protocols in current OECD recognised genotoxicity assays for nanomaterials is currently being questioned. In this report, we therefore consider the in vitro OECD genotoxicity test battery including the Ames, micronucleus and HPRT forward mutation assays, and their potential role in the safety assessment of nanomaterial induced DNA damage in vitro. PMID:21971291

Advances in metabolome information retrieval: turning chemistry into biology. Part II: biological information recovery.

PubMed

Tebani, Abdellah; Afonso, Carlos; Bekri, Soumeya

2018-05-01

This work reports the second part of a review intending to give the state of the art of major metabolic phenotyping strategies. It particularly deals with inherent advantages and limits regarding data analysis issues and biological information retrieval tools along with translational challenges. This Part starts with introducing the main data preprocessing strategies of the different metabolomics data. Then, it describes the main data analysis techniques including univariate and multivariate aspects. It also addresses the challenges related to metabolite annotation and characterization. Finally, functional analysis including pathway and network strategies are discussed. The last section of this review is devoted to practical considerations and current challenges and pathways to bring metabolomics into clinical environments.

Simulation of networks of spiking neurons: A review of tools and strategies

PubMed Central

Brette, Romain; Rudolph, Michelle; Carnevale, Ted; Hines, Michael; Beeman, David; Bower, James M.; Diesmann, Markus; Morrison, Abigail; Goodman, Philip H.; Harris, Frederick C.; Zirpe, Milind; Natschläger, Thomas; Pecevski, Dejan; Ermentrout, Bard; Djurfeldt, Mikael; Lansner, Anders; Rochel, Olivier; Vieville, Thierry; Muller, Eilif; Davison, Andrew P.; El Boustani, Sami

2009-01-01

We review different aspects of the simulation of spiking neural networks. We start by reviewing the different types of simulation strategies and algorithms that are currently implemented. We next review the precision of those simulation strategies, in particular in cases where plasticity depends on the exact timing of the spikes. We overview different simulators and simulation environments presently available (restricted to those freely available, open source and documented). For each simulation tool, its advantages and pitfalls are reviewed, with an aim to allow the reader to identify which simulator is appropriate for a given task. Finally, we provide a series of benchmark simulations of different types of networks of spiking neurons, including Hodgkin–Huxley type, integrate-and-fire models, interacting with current-based or conductance-based synapses, using clock-driven or event-driven integration strategies. The same set of models are implemented on the different simulators, and the codes are made available. The ultimate goal of this review is to provide a resource to facilitate identifying the appropriate integration strategy and simulation tool to use for a given modeling problem related to spiking neural networks. PMID:17629781

Is there any value to arthroscopic debridement of ankle osteoarthritis and impingement?

PubMed

Phisitkul, Phinit; Tennant, Joshua N; Amendola, Annunziato

2013-09-01

This article summarizes the current literature regarding the use of arthroscopy for the various types of ankle osteoarthritis with impingement symptoms. Discussion includes the role of diagnostic arthroscopy and adjunctive use of arthroscopy with other modalities. The section on the authors' preferred technique describes our current operative and perioperative strategies in detail. Published by Elsevier Inc.

A cost-effectiveness analysis comparing different strategies to implement noninvasive prenatal testing into a Down syndrome screening program.

PubMed

Ayres, Alice C; Whitty, Jennifer A; Ellwood, David A

2014-10-01

Currently, noninvasive prenatal testing (NIPT) is only recommended in high-risk women following conventional Down syndrome (DS) screening, and it has not yet been included in the Australian DS screening program. To evaluate the cost-effectiveness of different strategies of NIPT for DS screening in comparison with current practice. A decision-analytic approach modelled a theoretical cohort of 300,000 singleton pregnancies. The strategies compared were the following: current practice, NIPT as a second-tier investigation, NIPT only in women >35 years, NIPT only in women >40 years and NIPT for all women. The direct costs (low and high estimates) were derived using both health system costs and patient out-of-pocket expenses. The number of DS cases detected and procedure-related losses (PRL) were compared between strategies. The incremental cost per case detected was the primary measure of cost-effectiveness. Universal NIPT costs an additional $134,636,832 compared with current practice, but detects 123 more DS cases (at an incremental cost of $1,094,608 per case) and avoids 90 PRL. NIPT for women >40 years was the most cost-effective strategy, costing an incremental $81,199 per additional DS case detected and avoiding 95 PRL. The cost of NIPT needs to decrease significantly if it is to replace current practice on a purely cost-effectiveness basis. However, it may be beneficial to use NIPT as first-line screening in selected high-risk patients. Further evaluation is needed to consider the longer-term costs and benefits of screening. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Determining the Ideal Strategy for Ventilator-associated Pneumonia Prevention. Cost-Benefit Analysis.

PubMed

Branch-Elliman, Westyn; Wright, Sharon B; Howell, Michael D

2015-07-01

Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection with high associated cost and poor patient outcomes. Many strategies for VAP reduction have been evaluated. However, the combination of strategies with the optimal cost-benefit ratio remains unknown. To determine the preferred VAP prevention strategy, both from the hospital and societal perspectives. A cost-benefit decision model with a Markov model was constructed. Baseline probability of VAP, death, reintubation, and discharge from the intensive care unit (ICU) alive were ascertained from clinical trial data. Model inputs were obtained from the medical literature and the U.S. Department of Labor; a device cost was obtained from the manufacturer. Sensitivity analyses were completed to test the robustness of model results. Overall least expensive strategy and the strategy with the best cost-benefit ratio, up to a willingness to pay threshold of $50,000-100,000 per case of VAP averted was sought. We examined a total of 120 unique combinations of VAP prevention strategies. The preferred strategy from the hospital perspective included subglottic suction endotracheal tubes, probiotics, and the Institute for Healthcare Improvement VAP Prevention Bundle. The preferred strategy from the point of view of society also included additional prevention measures (oral care with chlorhexidine and selective oral decontamination). No preferred strategies included silver endotracheal tubes or selective gut decontamination. Despite their infrequent use, current data suggest that the use of prophylactic probiotics and subglottic endotracheal tubes are cost-effective for preventing VAP from the societal and hospital perspectives.

Strategies to mitigate dissociative and psychotomimetic effects of ketamine in the treatment of major depressive episodes: a narrative review.

PubMed

Cooper, Matthew D; Rosenblat, Joshua D; Cha, Danielle S; Lee, Yena; Kakar, Ron; McIntyre, Roger S

2017-09-01

Objectives Replicated evidence has demonstrated that ketamine exerts rapid-acting and potent antidepressant effects. Notwithstanding, its promise to mitigate depressive symptoms and suicidality in antidepressant-resistant populations, several limitations and safety concerns accompany ketamine including, but not limited to, the potential for abuse and psychotomimetic/dissociative experiences. The focus of the current narrative review is to synthesise available evidence of strategies that may mitigate and fully prevent treatment-emergent psychotomimetic and dissociative effects associated with ketamine administration. Methods PubMed, Google Scholar and ClinicalTrials.gov were searched for relevant articles. Results Potential avenues investigated to minimise psychotomimetic effects associated with ketamine administration include the following: (1) altering dosing and infusion rates; (2) route of administration; (3) enantiomer choice; (4) co-administration with mood stabilisers of antipsychotics; and (5) use of alternative N-methyl-d-aspartate (NMDA)-modulating agents. Emerging evidence indicates that dissociative experiences can be significantly mitigated by using an intranasal route of administration, lower dosages, or use of alternative NMDA-modulating agents, namely lanicemine (AZD6765) and GLYX-13. Conclusions Currently, intranasal administration presents as the most promising strategy to mitigate dissociative and psychotomimetic effects; however, studies of strategies to mitigate the adverse events of ketamine are limited in number and quality and thus further investigation is still needed.

Neoadjuvant radiotherapeutic strategies in pancreatic cancer

PubMed Central

Roeder, Falk

2016-01-01

This review summarizes the current status of neoadjuvant radiation approaches in the treatment of pancreatic cancer, including a description of modern radiation techniques, and an overview on the literature regarding neoadjuvant radio- or radiochemotherapeutic strategies both for resectable and irresectable pancreatic cancer. Neoadjuvant chemoradiation for locally-advanced, primarily non- or borderline resectable pancreas cancer results in secondary resectability in a substantial proportion of patients with consecutively markedly improved overall prognosis and should be considered as possible alternative in pretreatment multidisciplinary evaluations. In resectable pancreatic cancer, outstanding results in terms of response, local control and overall survival have been observed with neoadjuvant radio- or radiochemotherapy in several phase I/II trials, which justify further evaluation of this strategy. Further investigation of neoadjuvant chemoradiation strategies should be performed preferentially in randomized trials in order to improve comparability of the current results with other treatment modalities. This should include the evaluation of optimal sequencing with newer and more potent systemic induction therapy approaches. Advances in patient selection based on new molecular markers might be of crucial interest in this context. Finally modern external beam radiation techniques (intensity-modulated radiation therapy, image-guided radiation therapy and stereotactic body radiation therapy), new radiation qualities (protons, heavy ions) or combinations with alternative boosting techniques widen the therapeutic window and contribute to the reduction of toxicity. PMID:26909133

The Effectiveness of Different Diet Strategies to Reduce Type 2 Diabetes Risk in Youth

PubMed Central

Gow, Megan L.; Garnett, Sarah P.; Baur, Louise A.; Lister, Natalie B.

2016-01-01

Type 2 diabetes in children and adolescents has become a prominent clinical issue in recent decades. Increasing numbers of young people have risk factors for type 2 diabetes, particularly obesity, indicating the need for effective type 2 diabetes prevention strategies. The aim of this review was to identify specific dietary strategies that optimize improvements in risk factors for type 2 diabetes in youth and hence reduce the risk of type 2 diabetes development. Our review of the current literature indicates that dietary interventions lead to weight loss when intervention adherence is high. However, in addition to weight loss, a diet that is reduced in carbohydrates may optimize improvements in other type 2 diabetes risk factors, including insulin resistance and hyperglycemia. While further research is needed to confirm this finding, reduced carbohydrate diets may include a very low-carbohydrate diet, a very low-energy diet, a lower-glycemic-index diet, and/or an intermittent fasting diet. This array of dietary strategies provides a suite of intervention options for clinicians to recommend to young people at risk of type 2 diabetes. However, these findings are in contrast to current guidelines for the prevention of type 2 diabetes in adults which recommends a low-fat, high-carbohydrate diet. PMID:27517953

The Management of Cephalic Arch Stenosis in Arteriovenous Fistulas for Hemodialysis: A Systematic Review

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

Vasanthamohan, Lakshman, E-mail: lakshman.vasanthamohan@medportal.ca; Gopee-Ramanan, Prasaanthan, E-mail: Prasa.gopee@medportal.ca; Athreya, Sriharsha, E-mail: sathreya@stjoes.ca

AimTo conduct a systematic review of management of current cephalic arch stenosis (CAS) and associated outcomes in the context of dysfunctional hemodialysis access.Materials and MethodsPubMed, Web of Science, and Cochrane Library were searched to retrieve literature on the management of CAS. Studies had to focus on management of access stenosis solely in the cephalic arch. Case reports and literature reviews were excluded. Studies were categorized by intervention, and primary and secondary patency data were compiled. Studies were aggregated, and meta-analyses were performed where possible.ResultsNine papers satisfied the aforementioned criteria: five were retrospective studies and four were prospective studies. CAS managementmore » strategies have included percutaneous transluminal balloon angioplasty (PTA), peripheral cutting balloons, surgical cephalic vein transpositions, bare stents, and stent grafts. Reporting strategies varied between studies. Meta-analyses showed that results were variable even within studies using the same modality, particularly for PTA.ConclusionNo singular, definitive management strategy exists for CAS. Current studies are limited by being primarily single-center retrospective trials featuring heterogenous patient populations, interventions, and endpoints. Priorities for future studies should include larger randomized trials, more uniform management strategies and endpoints, and a longer duration of follow-up.« less

Applying a Consumer Behavior Lens to Salt Reduction Initiatives.

PubMed

Regan, Áine; Kent, Monique Potvin; Raats, Monique M; McConnon, Áine; Wall, Patrick; Dubois, Lise

2017-08-18

Reformulation of food products to reduce salt content has been a central strategy for achieving population level salt reduction. In this paper, we reflect on current reformulation strategies and consider how consumer behavior determines the ultimate success of these strategies. We consider the merits of adopting a 'health by stealth', silent approach to reformulation compared to implementing a communications strategy which draws on labeling initiatives in tandem with reformulation efforts. We end this paper by calling for a multi-actor approach which utilizes co-design, participatory tools to facilitate the involvement of all stakeholders, including, and especially, consumers, in making decisions around how best to achieve population-level salt reduction.

Establishing a Safe School Culture: An Examination of Current Practices in K through 12 Leadership

ERIC Educational Resources Information Center

Kelly, Zanita V.

2016-01-01

School improvement plans and major reform initiatives most often target core academic competencies. They might include strategies to improve the physical safety of school campuses, but they rarely include discussions about creating psychologically safe environments. School safety has garnered national attention in the aftermath of violent high…

The gap between currently available evidence and awareness in clinical practice of wound care: It is the time to shower earlier.

PubMed

Yu, Ya-Hsuan; Chao, Sylvia; Lin, Yen-Kuang; Chou, Yun-Yun; Liao, Hsun-Hsiang; Loh, El-Wui; Wong, Chung-Shun; Tam, Ka-Wai

2018-03-01

A postoperative water-forbidden strategy has been used for many decades. However, evidence shows that early contact with water postoperatively does not increase the infection rate. Our study evaluated the gap between currently available evidence and awareness in clinical practice of postoperative wound care. We conducted a systematic review to compare the outcomes between postoperative water-contact and water-forbidden groups. PubMed, EMBASE, and Cochrane databases were searched. A meta-analysis was conducted to calculate a pooled effect size by using random-effects models. On the basis of pooling results, a questionnaire survey was conducted to evaluate the gap from systematic review to clinical practice by clinical staff and patients. We reviewed 12 trials including 4,086 patients. Incidence of infection and wound complications did not differ significantly between water-contact and water-forbidden groups. Satisfaction was significantly higher in water-contact group than in water-forbidden group (risk ratio: 17.33; 95% confidence interval, 11.11-27.03). A survey of clinicians showed that awareness, acceptance of the evidence, and the current water-contact strategy differed among departments. However, many clinicians showed no willingness to apply the water-contact strategy for various reasons. A survey of patients showed low awareness of the issue and variety in willingness to contact water. Water-forbidden strategy causes inconvenience to patients. However, a majority of patients and clinicians still hesitated to apply the early water-contact strategy, even after viewing the results of the current review. Establishment of local clinical practice guidelines, advocacy from authorities, and promotion by social media for this strategy are warranted. Copyright © 2018 Elsevier Inc. All rights reserved.

Emerging Trends in “Smart Probiotics”: Functional Consideration for the Development of Novel Health and Industrial Applications

PubMed Central

El Hage, Racha; Hernandez-Sanabria, Emma; Van de Wiele, Tom

2017-01-01

The link between gut microbiota and human health is well-recognized and described. This ultimate impact on the host has contributed to explain the mutual dependence between humans and their gut bacteria. Gut microbiota can be manipulated through passive or active strategies. The former includes diet, lifestyle, and environment, while the latter comprise antibiotics, pre- and probiotics. Historically, conventional probiotic strategies included a phylogenetically limited diversity of bacteria and some yeast strains. However, biotherapeutic strategies evolved in the last years with the advent of fecal microbiota transplant (FMT), successfully applied for treating CDI, IBD, and other diseases. Despite the positive outcomes, long-term effects resulting from the uncharacterized nature of FMT are not sufficiently studied. Thus, developing strategies to simulate the FMT, using characterized gut colonizers with identified phylogenetic diversity, may be a promising alternative. As the definition of probiotics states that the microorganism should have beneficial effects on the host, several bacterial species with proven efficacy have been considered next generation probiotics. Non-conventional candidate strains include Akkermansia muciniphila, Faecalibacterium prausnitzii, Bacteroides fragilis, and members of the Clostridia clusters IV, XIVa, and XVIII. However, viable intestinal delivery is one of the current challenges, due to their stringent survival conditions. In this review, we will cover current perspectives on the development and assessment of next generation probiotics and the approaches that industry and stakeholders must consider for a successful outcome. PMID:29033923

Pandemic influenza communication: views from a deliberative forum.

PubMed

Rogers, Wendy A; Street, Jackie M; Braunack-Mayer, Annette J; Hiller, Janet E

2009-09-01

To use a deliberative forum to elicit community perspectives on communication about pandemic influenza planning, and to compare these findings with the current Australian national communication strategy. Deliberative forum of 12 persons randomly selected from urban South Australia. Forum members were briefed by experts in infection control, virology, ethics and public policy before deliberating on four key questions: what, how and when should the community be told about pandemic influenza and by whom? The forum recommended provision of detailed and comprehensive information by credible experts, rather than politicians, using a variety of media including television and internet. Recommendations included cumulative communication to build expertise in the community, and specific strategies to include groups such as young people, people with physical or mental disabilities, and rural and remote communities. Information provided should be practical, accurate, and timely, with no 'holding back' about the seriousness of a pandemic. The forum expressed confidence in the expert witnesses, despite the acknowledged uncertainty of many of the predictions. The deliberative forum's recommendations were largely consistent with the Australian national pandemic influenza communication strategy and the relevant literature. However, the forum recommended: release of more detailed information than currently proposed in the national strategy; use of non-political spokespersons; and use of novel communication methods. Their acceptance of uncertainty suggests that policy makers should be open about the limits of knowledge in potentially threatening situations. Our findings show that deliberative forums can provide community perspectives on topics such as communication about pandemic influenza.

Understanding Current Safety Issues for Trajectory Based Operations

NASA Technical Reports Server (NTRS)

Feary, Michael; Stewart, Michael

2016-01-01

Increases in procedural complexity were investigated as a possible contributor to flight path deviations in airline operations. Understanding current operational issues and their causes must be embraced to maintain current safety standards while increasing future functionality. ASRS data and expert narratives were used to discover factors relating to pilot deviations. Our investigation pointed to ATC intervention, automation confusion, procedure design, and mixed equipment as primary issues. Future work will need to include objective data and mitigation strategies.

Invasive strategy and frailty in very elderly patients with acute coronary syndromes.

PubMed

Llaó, Isaac; Ariza-Solé, Albert; Sanchis, Juan; Alegre, Oriol; López-Palop, Ramon; Formiga, Francesc; Marín, Francisco; Vidán, María T; Martínez-Sellés, Manuel; Sionis, Alessandro; Vives-Borrás, Miguel; Gómez-Hospital, Joan Antoni; Gómez-Lara, Josep; Roura, Gerard; Díez-Villanueva, Pablo; Núñez-Gil, Iván; Maristany, Jaume; Asmarats, Lluis; Bueno, Héctor; Abu-Assi, Emad; Cequier, Àngel

2018-04-03

Current guidelines recommend an early invasive strategy in patients with non-ST segment elevation acute coronary syndromes (NSTEACS). The role of an invasive strategy in frail elderly patients remains controversial. The LONGEVO-SCA registry included unselected NSTEACS patients aged ≥80 years. A geriatric assessment was performed during hospitalization, including frailty. We evaluated the impact of an invasive strategy during the admission on the incidence of cardiac death, reinfarction or new revascularisation at 6-months. From 531 patients included, 145 (27.3%) were frail. Mean age was 84.3 years. Most patients underwent an invasive strategy (407/531, 76.6%). Patients undergoing an invasive strategy were younger and had lower proportion of frailty (23.3% vs 40.3%, p<0.001). The incidence of cardiac events was more common in patients managed conservatively, after adjusting for confounding factors (sub-Hazard ratio (sHR) 2.32, 95% confidence interval (CI) 1.26-4.29, p=0.007). This association remained significant in non-frail patients (sHR 3.85, 95% CI 2.13-6.95, p=0.001), but was not significant in patients with established frailty criteria (sHR 1.40, 95% CI 0.72-2.75, p=0.325). The interaction invasive strategy-frailty was significant (p=0.032) Conclusions: An invasive strategy was independently associated with better outcomes in very elderly patients with NSTEACS. This association was different according to frailty status.

Current trends in pharmacy benefit designs: a threat to disease management in chronic complex diseases.

PubMed

Owens, Gary; Emons, Matthew F; Christian-Herman, Jennifer; Lawless, Grant

2007-04-01

With a focus on those patients who are candidates for treatment with biologic agents, we review the impact that current pharmacy benefit trends have on patients with chronic complex diseases and how they affect opportunities for disease management in this unique patient population. Dramatic increases in health care costs have led to a variety of strategies to manage cost. Many of these strategies either limit access to care or increase the patient's responsibility for choosing and paying for care, especially for medications. These strategies have a disproportionate impact on patients with chronic complex diseases, particularly those who require the use of biologic medications. A fundamental prerequisite of disease management has been coverage of disease-modifying therapies. If current pharmacy benefit trends continue, unintended consequences will likely occur including lost opportunities for disease management. Current pharmacy benefit trends could adversely impact disease management, particularly for patients requiring the use of biologic agents. Health plans should consider innovative benefit designs that reflect an appropriate level of cost sharing across all key stake-holders, ensuring appropriate access to needed therapies. Additional research is needed to clarify the value of newer approaches to therapies or benefit design changes.

Management strategies in pancreatic cancer.

PubMed

Campen, Christopher J; Dragovich, Tomislav; Baker, Amanda F

2011-04-01

Current first-line and adjuvant chemotherapeutic strategies for management of patients with pancreatic cancer are reviewed. Pancreatic adenocarcinoma is the 10th most prevalent cancer and the fourth most common cause of cancer deaths in the United States. More than 80% of patients with pancreatic cancer are diagnosed with locally advanced or metastatic disease and are not candidates for surgery; these patients often require multimodal treatment. The most widely used chemotherapy for such patients, as well as patients requiring adjuvant therapy after surgery, is gemcitabine or gemcitabine-based chemotherapy. All current chemotherapies for pancreatic cancer are associated with dose-limiting hematologic toxicity and other adverse effects that require ongoing monitoring and dosage adjustment to balance the benefits and risks of treatment. Pharmacists can play an important role in monitoring and providing drug information and guidance to patients and oncologists. Current investigational strategies include efforts to improve chemotherapy response rates and outcomes through modulation of cell signaling pathways and use of nanotechnology to improve drug delivery. Current management of pancreatic cancer is multifaceted, involving anticancer therapy, supportive care, and toxicity management. Standard systemic therapy with gemcitabine as a single agent or in combination with other cytotoxic agents provides modest benefits in terms of response and symptom control.

Power Management Based Current Control Technique for Photovoltaic-Battery Assisted Wind-Hydro Hybrid System

NASA Astrophysics Data System (ADS)

Ram Prabhakar, J.; Ragavan, K.

2013-07-01

This article proposes new power management based current control strategy for integrated wind-solar-hydro system equipped with battery storage mechanism. In this control technique, an indirect estimation of load current is done, through energy balance model, DC-link voltage control and droop control. This system features simpler energy management strategy and necessitates few power electronic converters, thereby minimizing the cost of the system. The generation-demand (G-D) management diagram is formulated based on the stochastic weather conditions and demand, which would likely moderate the gap between both. The features of management strategy deploying energy balance model include (1) regulating DC-link voltage within specified tolerances, (2) isolated operation without relying on external electric power transmission network, (3) indirect current control of hydro turbine driven induction generator and (4) seamless transition between grid-connected and off-grid operation modes. Furthermore, structuring of the hybrid system with appropriate selection of control variables enables power sharing among each energy conversion systems and battery storage mechanism. By addressing these intricacies, it is viable to regulate the frequency and voltage of the remote network at load end. The performance of the proposed composite scheme is demonstrated through time-domain simulation in MATLAB/Simulink environment.

Remote Monitoring to Reduce Heart Failure Readmissions.

PubMed

Emani, Sitaramesh

2017-02-01

Rehospitalization for heart failure remains a challenge in the treatment of affected patients. The ability to remotely monitor patients for worsening heart failure may provide an avenue through which therapeutic interventions can be made to prevent a rehospitalization. Available data on remote monitoring to reduce heart failure rehospitalizations are reviewed within. Strategies to reduce readmissions include clinical telemonitoring, bioimpedance changes, biomarkers, and remote hemodynamic monitoring. Telemonitoring is readily available, but has low sensitivity and adherence. No data exist to demonstrate the efficacy of this strategy in reducing admissions. Bioimpedance offers improved sensitivity compared to telemonitoring, but has not demonstrated an ability to reduce hospitalizations and is currently limited to those patients who have separate indications for an implantable device. Biomarker levels have shown variable results in the ability to reduce hospitalizations and remain without definitive proof supporting their utilization. Remote hemodynamic monitoring has shown the strongest ability to reduce heart failure readmissions and is currently approved for this purpose. However, remote hemodynamic monitoring requires an invasive procedure and may not be cost-effective. All currently available strategies to reduce hospitalizations with remote monitoring have drawbacks and challenges. Remote hemodynamic monitoring is currently the most efficacious based on data, but is not without its own imperfections.

Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now?

PubMed Central

Themistoklis, Tzatzairis; Theodosia, Vogiatzaki; Konstantinos, Kazakos; Georgios, Drosos I

2017-01-01

Total knee replacement (TKR) is one of the most common surgeries over the last decade. Patients undergoing TKR are at high risk for postoperative anemia and furthermore for allogeneic blood transfusions (ABT). Complications associated with ABT including chills, rigor, fever, dyspnea, light-headedness should be early recognized in order to lead to a better prognosis. Therefore, perioperative blood management program should be adopted with main aim to reduce the risk of blood transfusion while maximizing hemoglobin simultaneously. Many blood conservation strategies have been attempted including preoperative autologous blood donation, acute normovolemic haemodilution, autologous blood transfusion, intraoperative cell saver, drain clamping, pneumatic tourniquet application, and the use of tranexamic acid. For practical and clinical reasons we will try to classify these strategies in three main stages/pillars: Pre-operative optimization, intra-operative and post-operative protocols. The aim of this work is review the strategies currently in use and reports our experience regarding the perioperative blood management strategies in TKR. PMID:28660135

Nanoparticle based tailoring of adjuvant function: the role in vaccine development.

PubMed

Prashant, Chandravilas Keshvan; Kumar, Manoj; Dinda, Amit Kumar

2014-09-01

Vaccination is one of the most powerful therapeutic tools for prevention and management of various infective and non-infective diseases including malignancy. Mass vaccination is a great strategy for eradicating major infectious diseases throughout the world like small pox. Application of nanotechnology for antigen delivery is a unique area of research and development which can change the vaccination strategy and policy in future. Nanocarriers can enhance antigen presentation including modulation of antigen processing pathways according to the specific need. The current review explores the pros and cons of application of different nanomaterials for antigen presentation and vaccine development.

Blood doping: risks to athletes' health and strategies for detection.

PubMed

Oliveira, Carolina Dizioli Rodrigues de; Bairros, André Valle de; Yonamine, Mauricio

2014-07-01

Blood doping has been defined as the misuse of substances or certain techniques to optimize oxygen delivery to muscles with the aim to increase performance in sports activities. It includes blood transfusion, administration of erythropoiesis-stimulating agents or blood substitutes, and gene manipulations. The main reasons for the widespread use of blood doping include: its availability for athletes (erythropoiesis-stimulating agents and blood transfusions), its efficiency in improving performance, and its difficult detection. This article reviews and discusses the blood doping substances and methods used for in sports, the adverse effects related to this practice, and current strategies for its detection.

State of the art of nanocrystals technology for delivery of poorly soluble drugs

NASA Astrophysics Data System (ADS)

Zhou, Yuqi; Du, Juan; Wang, Lulu; Wang, Yancai

2016-09-01

Formulation of nanocrystals is a distinctive approach which can effectively improve the delivery of poorly water-soluble drugs, thus enticing the development of the nanocrystals technology. The characteristics of nanocrystals resulted in an exceptional drug delivery conductance, including saturation solubility, dissolution velocity, adhesiveness, and affinity. Nanocrystals were treated as versatile pharmaceuticals that could be delivered through almost all routes of administration. In the current review, oral, pulmonary, and intravenous routes of administration were presented. Also, the targeting of drug nanocrystals, as well as issues of efficacy and safety, were also discussed. Several methods were applied for nanocrystals production including top-down production strategy (media milling, high-pressure homogenization), bottom-up production strategy (antisolvent precipitation, supercritical fluid process, and precipitation by removal of solvent), and the combination approaches. Moreover, this review also described the evaluation and characterization of the drug nanocrystals and summarized the current commercial pharmaceutical products utilizing nanocrystals technology.

How faculty learn about and implement research-based instructional strategies: The case of Peer Instruction

NASA Astrophysics Data System (ADS)

Dancy, Melissa; Henderson, Charles; Turpen, Chandra

2016-06-01

[This paper is part of the Focused Collection on Preparing and Supporting University Physics Educators.] The lack of knowledge about how to effectively spread and sustain the use of research-based instructional strategies is currently a significant barrier to the improvement of undergraduate physics education. In this paper we address this lack of knowledge by reporting on an interview study of 35 physics faculty, of varying institution types, who were self-reported users of, former users of, or knowledgeable nonusers of the research-based instructional strategy Peer Instruction. Interview questions included in this analysis focused on the faculty's experiences, knowledge, and use of Peer Instruction, along with general questions about current and past teaching methods used by the interviewee. The primary findings include the following: (i) Faculty self-reported user status is an unreliable measure of their actual practice. (ii) Faculty generally modify specific instructional strategies and may modify out essential components. (iii) Faculty are often unaware of the essential features of an instructional strategy they claim to know about or use. (iv) Informal social interactions provide a significant communication channel in the dissemination process, in contrast to the formal avenues of workshops, papers, websites, etc., often promoted by change agents, and (v) experience with research-based strategies as a graduate student or through curriculum development work may be highly impactful. These findings indicate that educational transformation can be better facilitated by improving communication with faculty, supporting effective modification by faculty during implementation, and acknowledging and understanding the large impact of informal social interactions as a mode of dissemination.

Nursing theory and concept development: a theoretical model of clinical nurses' intentions to stay in their current positions.

PubMed

Cowden, Tracy L; Cummings, Greta G

2012-07-01

We describe a theoretical model of staff nurses' intentions to stay in their current positions. The global nursing shortage and high nursing turnover rate demand evidence-based retention strategies. Inconsistent study outcomes indicate a need for testable theoretical models of intent to stay that build on previously published models, are reflective of current empirical research and identify causal relationships between model concepts. Two systematic reviews of electronic databases of English language published articles between 1985-2011. This complex, testable model expands on previous models and includes nurses' affective and cognitive responses to work and their effects on nurses' intent to stay. The concepts of desire to stay, job satisfaction, joy at work, and moral distress are included in the model to capture the emotional response of nurses to their work environments. The influence of leadership is integrated within the model. A causal understanding of clinical nurses' intent to stay and the effects of leadership on the development of that intention will facilitate the development of effective retention strategies internationally. Testing theoretical models is necessary to confirm previous research outcomes and to identify plausible sequences of the development of behavioral intentions. Increased understanding of the causal influences on nurses' intent to stay should lead to strategies that may result in higher retention rates and numbers of nurses willing to work in the health sector. © 2012 Blackwell Publishing Ltd.

Benefits and harms of lung cancer screening in HIV-infected individuals with CD4+ ≥ 500: a simulation study.

PubMed

Kong, Chung Yin; Sigel, Keith; Criss, Steven D; Sheehan, Deirdre F; Triplette, Matthew; Silverberg, Michael J; Henschke, Claudia I; Justice, Amy; Braithwaite, R Scott; Wisnivesky, Juan; Crothers, Kristina

2018-04-19

Lung cancer is the leading cause of non-AIDS-defining cancer deaths among HIV-infected individuals. Although lung cancer screening with low-dose computed tomography (LDCT) is endorsed by multiple national organizations, whether HIV-infected individuals would have similar benefit as uninfected individuals from lung cancer screening is unknown. Our objective was to determine the benefits and harms of lung cancer screening among HIV-infected individuals. We modified an existing simulation model, the Lung Cancer Policy Model, for HIV-infected patients. Veterans Aging Cohort Study, Kaiser Permanente Northern California HIV Cohort, and medical literature. Target population: HIV-infected current and former smokers. Lifetime. Population. Annual LDCT screening from ages 45, 50, or 55 until ages 72 or 77 years. Benefits assessed included lung cancer mortality reduction and life-years gained; harms assessed included numbers of LDCT examinations, false-positive results, and overdiagnosed cases. For HIV-infected patients with CD4 at least 500 and 100% antiretroviral therapy adherence, screening using the Centers for Medicare & Medicaid Services criteria (age 55-77, 30 pack-years of smoking, current smoker or quit within 15 years of screening) would reduce lung cancer mortality by 18.9%, similar to the mortality reduction of uninfected individuals. Alternative screening strategies utilizing lower screening age and/or pack-years criteria increase mortality reduction, but require more LDCT examinations. Strategies assumed 100% screening adherence. Lung cancer screening reduces mortality in HIV-infected patients with CD4 at least l500, with a number of efficient strategies for eligibility, including the current Centers for Medicare & Medicaid Services criteria.

Planning strategies for the avoidance of pitfalls in intervention research.

PubMed

Pruitt, R H; Privette, A B

2001-08-01

With the exception of large clinical trials, few studies in nursing and other social sciences test interventions. The discipline of nursing needs to maintain a full range of research designs for continued knowledge development. Intervention research presents unique opportunities and challenges for the novice as well as the seasoned researcher. Some of these methodological challenges include the complex nature of human subjects and interventions, including many factors that interfere with the study variables. Preliminary studies often reveal challenges that may not always be predicted or reflected in research texts. These challenges may be as important as the study results for success in future research efforts. Difficulties encountered in intervention research and suggested strategies for maintaining the integrity of the study are addressed. These challenges include maintaining an adequate sample size, intervention demands, measuring variables, timing issues, and experiencing unexpected events. Strategies presented include the importance of extensive planning, minimizing subject expectations and rewarding efforts, attention to control group members, incorporating retention strategies, expanding knowledge of variables and the study population, preliminary studies as well as anticipating unexpected events. The need for enhanced communication among nurse researchers, educators and clinicians is addressed. In the current health care arena, nurse researchers must understand organizational dynamics and marketing strategies. Collaborative research efforts can increase the visibility of nursing research as well as funding opportunities.

Health information exchange: persistent challenges and new strategies

PubMed Central

Gamm, Larry D

2010-01-01

Recent federal policies and actions support the adoption of health information exchange (HIE) in order to improve healthcare by addressing fragmented personal health information. However, concerted efforts at facilitating HIE have existed for over two decades in this country. The lessons of these experiences include a recurrence of barriers and challenges beyond those associated with technology. Without new strategies, the current support and methods of facilitating HIE may not address these barriers. PMID:20442146

Adoption of alternative financing strategies to increase the diffusion of picture archiving and communication systems into the radiology marketplace.

PubMed

Reiner, B; Siegel, E; McKay, P

2000-05-01

The objective of the study was to evaluate current marketplace conditions and strategies employed by major picture archiving and communication systems (PACS) vendors in the creation of alternative financing strategies, to enhance the diffusion of filmless imaging. Data were collected from the major PACS vendors in the forms of survey questionnaires and review of existing leases. Topics evaluated in the survey included current financing options available, foreseeable changes in PACS financing, role of third-party financiers, and creation of risk-sharing arrangements. Generic leases were also reviewed evaluating the presence or absence of several key variables including technology obsolescence protection, hardware/software upgrades, end-of-term options, determination of fair market value, functionality/acceptance testing, uptime guarantees, and workflow management consulting. Eight of the 10 PACS vendors surveyed participated in the data collection. The vast majority of current PACS implementations (60% to 90%) occur through direct purchase, with conventional leasing (operating or capital) accounting for only 5% to 30% of PACS installations. The majority of respondents view fee-for-lease arrangements and other forms of risk sharing as increasing importance for future PACS financing. The specific targets for such risk-sharing arrangements consist of small hospital and privately owned imaging centers. Leases currently offered range in duration from 3 to 5 years and frequently offer technology obsolescence protection with upgrades, multiple end-of-term options, and some form of acceptance testing. A number of important variables frequently omitted from leases include uptime guarantees, flexibility in changing financing or vendors, and incorporation of expected productivity/operational efficiency gains. As vendors strive to increase the penetration of PACS into the radiology marketplace, there will be a shift from conventional financing (loan or purchase) to leasing. Fee-for-use leasing and other forms of risk sharing have the greatest potential in smaller hospitals, which do not have the financial resources to pursue conventional financing options. Potential PACS customers must be cautious when entering into these alternative financing strategies, to ensure that appropriate safeguards are incorporated, in order to minimize downside risk.

Calorie postings in chain restaurants in a low-income urban neighborhood: measuring practical utility and policy compliance.

PubMed

Cohn, Elizabeth Gross; Larson, Elaine L; Araujo, Christina; Sawyer, Vanessa; Williams, Olajide

2012-08-01

Current strategies for combating obesity include recent federal legislation mandating calorie count postings in chain restaurants. This study describes the current practice of menu board calorie postings in a low-income urban neighborhood, identifies the extent to which current practice complies with existing policy, and evaluates the practical utility of menu boards to consumers. We conclude that although most postings were legally compliant, they did not demonstrate utility. Menu postings for individual servings are easily understood, but complex math skills are needed to interpret meals designed to serve more than one person. In some items, calories doubled depending on flavor and the calorie posting did not give enough information to make healthier selections. We identified specific strategies to improve practical utility and provide recommendations for policy implementation.

Treatment of early Parkinson's disease.

PubMed

Pahwa, Rajesh; Lyons, Kelly E

2014-08-01

This review summarizes currently available treatment options and treatment strategies, investigational treatments, and the importance of exercise for early Parkinson's disease. The available treatment options for early Parkinson's disease have changed little in the past decade and include carbidopa/levodopa, dopamine agonists, and monoamine oxidase type B (MAO-B) inhibitors. However, we discuss changes in treatment strategies, including dosing and the use of combination therapy used in an attempt to reduce or delay the appearance of motor complications and other adverse events. We will also review several investigational treatments that have shown promise for the treatment of early Parkinson's disease, including a new extended release formulation of carbidopa/levodopa (IPX066), safinamide which inhibits MAO-B, dopamine uptake and glutamate and pardoprunox which is a 5HT-1A agonist and a partial dopamine agonist. Finally, we discuss recent studies focusing on exercise as an important component in the management of early Parkinson's disease. Advances in the management of early Parkinson's disease include evolving treatment strategies, new investigational treatments, and earlier implementation of various forms of exercise.

Targeting α-synuclein for treating Parkinson’s disease: mechanistic and therapeutic considerations

PubMed Central

Gorry, Philippe; Przedborski, Serge; Vila, Miquel; Hunot, Stephane; Singleton, Andrew; Olanow, C. Warren; Merchant, Kalpana M.; Bezard, Erwan; Petsko, Gregory A.; Meissner, Wassilios G.

2016-01-01

Summary Progressive neuronal cell loss in a small subset of brainstem and mesencephalic nuclei and widespread aggregation of the α-synuclein protein in the form of Lewy bodies and Lewy neurites are neuropathological hallmarks of Parkinson’s disease. Most cases occur sporadically, but mutations in several genes, including α-synuclein, are associated with disease development. The mechanisms driving neurodegeneration remain unknown, hence limiting therapeutic strategies aimed at blocking neuronal death. This review describes current evidence for a predominant role of α-synuclein in the pathogenesis of PD, as well as some of the most promising α-synuclein-based strategies currently in development for this incurable neurodegenerative disorder. PMID:26050140

Cost-effectiveness of a novel blood-pool contrast agent in the setting of chest pain evaluation in an emergency department.

PubMed

Espinosa, Gabriela; Annapragada, Ananth

2013-10-01

We evaluated three diagnostic strategies with the objective of comparing the current standard of care for individuals presenting acute chest pain and no history of coronary artery disease (CAD) with a novel diagnostic strategy using an emerging technology (blood-pool contrast agent [BPCA]) to identify the potential benefits and cost reductions. A decision analytic model of diagnostic strategies and outcomes using a BPCA and a conventional agent for CT angiography (CTA) in patients with acute chest pain was built. The model was used to evaluate three diagnostic strategies: CTA using a BPCA followed by invasive coronary angiography (ICA), CTA using a conventional agent followed by ICA, and ICA alone. The use of the two CTA-based triage tests before ICA in a population with a CAD prevalence of less than 47% was predicted to be more cost-effective than ICA alone. Using the base-case values and a cost premium for BPCA over the conventional CT agent (cost of BPCA ≈ 5× that of a conventional agent) showed that CTA with a BPCA before ICA resulted in the most cost-effective strategy; the other strategies were ruled out by simple dominance. The model strongly depends on the rates of complications from the diagnostic tests included in the model. In a population with an elevated risk of contrast-induced nephropathy (CIN), a significant premium cost per BPCA dose still resulted in the alternative whereby CTA using BPCA was more cost-effective than CTA using a conventional agent. A similar effect was observed for potential complications resulting from the BPCA injection. Conversely, in the presence of a similar complication rate from BPCA, the diagnostic strategy of CTA using a conventional agent would be the optimal alternative. BPCAs could have a significant impact in the diagnosis of acute chest pain, in particular for populations with high incidences of CIN. In addition, a BPCA strategy could garner further savings if currently excluded phenomena including renal disease and incidental findings were included in the decision model.

Expert Systems: Tutors, Tools, and Tutees.

ERIC Educational Resources Information Center

Lippert, Renate C.

1989-01-01

Discusses the current status, research, and practical implications of artificial intelligence and expert systems in education. Topics discussed include computer-assisted instruction; intelligent computer-assisted instruction; intelligent tutoring systems; instructional strategies involving the creation of knowledge bases; decision aids;…

Current approaches for the assessment of in situ biodegradation.

PubMed

Bombach, Petra; Richnow, Hans H; Kästner, Matthias; Fischer, Anko

2010-04-01

Considering the high costs and technical difficulties associated with conventional remediation strategies, in situ biodegradation has become a promising approach for cleaning up contaminated aquifers. To verify if in situ biodegradation of organic contaminants is taking place at a contaminated site and to determine if these processes are efficient enough to replace conventional cleanup technologies, a comprehensive characterization of site-specific biodegradation processes is essential. In recent years, several strategies including geochemical analyses, microbial and molecular methods, tracer tests, metabolite analysis, compound-specific isotope analysis, and in situ microcosms have been developed to investigate the relevance of biodegradation processes for cleaning up contaminated aquifers. In this review, we outline current approaches for the assessment of in situ biodegradation and discuss their potential and limitations. We also discuss the benefits of research strategies combining complementary methods to gain a more comprehensive understanding of the complex hydrogeological and microbial interactions governing contaminant biodegradation in the field.

Perceived Discrimination, Coping Strategies, and Mexican Origin Adolescents' Internalizing and Externalizing Behaviors: Examining the Moderating Role of Gender and Cultural Orientation.

PubMed

Brittian, Aerika S; Toomey, Russell B; Gonzales, Nancy A; Dumka, Larry E

2013-01-01

The literature identifying effective coping strategies related to perceived discrimination has yielded mixed findings, suggesting that recommendations for effective coping may vary by individual and group differences. The current study examined the influence of perceived discrimination and coping strategies on Mexican origin adolescents' later internalizing symptoms and externalizing behaviors, and assessed the moderating roles of gender and cultural orientation. Participants included 189 adolescents (46% male, 54% female) interviewed at 7 th and 8 th grade. Results suggested that the associations between perceived discrimination and internalizing symptoms were buffered by distraction coping among youth that were low on Anglo orientation but not among youth high on Anglo orientation. In addition, the associations between perceived discrimination and externalizing behaviors were buffered by social support seeking, but only among youth that were low on Mexican orientation. Directions for future research and application of the current research are discussed.

School nurse book clubs: an innovative strategy for lifelong learning.

PubMed

Greenawald, Deborah A; Adams, Theresa M

2008-04-01

Recognizing the ongoing need for continuing education for school nurses, the authors discuss the use of school nurse book clubs as an innovative lifelong-learning strategy. Current research supports the use of literature in nursing education. This article discusses the benefits of book club participation for school nurses and includes suggested fiction and nonfiction books that can be used to enhance nursing knowledge and practice. Through reading and discussion, school nurses can increase their knowledge of nursing history and current health care issues, thus becoming better prepared to address challenging issues that arise in practice. In addition, the use of literature as a learning strategy allows school nurses to broaden their understanding of unique cultural factors that influence the health beliefs and practices of students and their families. Book club participation can also assist school nurses in honing leadership and communication skills and becoming energized to become better advocates for children and families.

Occupation emerges in the process of therapy.

PubMed

Price, Pollie; Miner, Stephanie

2007-01-01

The current literature offers no cohesive definition of occupation-based practice. Current definitions emphasize intervention forms and contexts, which do not reflect the complexity of practice. This article demonstrates that the therapeutic relationship and the meanings that are created in the therapy process are central aspects of occupation-based practice. Occupation, as an idea that emerges in the therapeutic process, has aspects of both doing and becoming. The authors conducted observation sessions and interviews with an occupational therapist, Nancy, who used multiple therapeutic strategies with one child, Hannah, as they worked toward Hannah's goals of going to preschool and becoming a friend. Strategies include changing therapeutic conditions, using cognitive strategies, bridging the person-task-social context, pushing participation, and engaging in narrative micronegotiations. Occupation emerged in the therapeutic processes as the occupational therapist and client co-created meaning about the client moving toward or away from who she wanted to become.

Advanced Sensors and Controls for Building Applications: Market Assessment and Potential R&D Pathways

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

Brambley, Michael R.; Haves, Philip; McDonald, Sean C.

2005-04-13

Significant energy savings can be achieved in commercial building operation, along with increased comfort and control for occupants, through the implementation of advanced technologies. This document provides a market assessment of existing building sensors and controls and presents a range of technology pathways (R&D options) for pursuing advanced sensors and building control strategies. This paper is actually a synthesis of five other white papers: the first describes the market assessment including estimates of market potential and energy savings for sensors and control strategies currently on the market as well as a discussion of market barriers to these technologies. The othermore » four cover technology pathways: (1) current applications and strategies for new applications, (2) sensors and controls, (3) networking, security, and protocols and standards, and (4) automated diagnostics, performance monitoring, commissioning, optimal control and tools. Each technology pathway chapter gives an overview of the technology or application. This is followed by a discussion of needs and the current status of the technology. Finally, a series of research topics is proposed.« less

Development of a tailored strategy to improve postpartum hemorrhage guideline adherence.

PubMed

de Visser, Suzan M; Woiski, Mallory D; Grol, Richard P; Vandenbussche, Frank P H A; Hulscher, Marlies E J L; Scheepers, Hubertina C J; Hermens, Rosella P M G

2018-02-08

Despite the introduction of evidence based guidelines and practical courses, the incidence of postpartum hemorrhage shows an increasing trend in developed countries. Substandard care is often found, which implies an inadequate implementation in high resource countries. We aimed to reduce the gap between evidence-based guidelines and clinical application, by developing a strategy, tailored to current barriers for implementation. The development of the implementation strategy consisted of three phases, supervised by a multidisciplinary expert panel. In the first phase a framework of the strategy was created, based on barriers to optimal adherence identified among professionals and patients together with evidence on effectiveness of strategies found in literature. In the second phase, the tools within the framework were developed, leading to a first draft. In the third phase the strategy was evaluated among professionals and patients. The professionals were asked to give written feedback on tool contents, clinical usability and inconsistencies with current evidence care. Patients evaluated the tools on content and usability. Based on the feedback of both professionals and patients the tools were adjusted. We developed a tailored strategy to improve guideline adherence, covering the trajectory of the third trimester of pregnancy till the end of the delivery. The strategy, directed at professionals, comprehending three stop moments includes a risk assessment checklist, care bundle and time-out procedure. As patient empowerment tools, a patient passport and a website with patient information was developed. The evaluation among the expert panel showed all professionals to be satisfied with the content and usability and no discrepancies or inconsistencies with current evidence was found. Patients' evaluation revealed that the information they received through the tools was incomplete. The tools were adjusted accordingly to the missing information. A usable, tailored strategy to implement PPH guidelines and practical courses was developed. The next step is the evaluation of the strategy in a feasibility trial. Clinical trial registration: The Fluxim study, registration number: NCT00928863 .

High-performance supercapacitors using a nanoporous current collector made from super-aligned carbon nanotubes.

PubMed

Zhou, Ruifeng; Meng, Chuizhou; Zhu, Feng; Li, Qunqing; Liu, Changhong; Fan, Shoushan; Jiang, Kaili

2010-08-27

Nanoporous current collectors for supercapacitors have been fabricated by cross-stacking super-aligned carbon nanotube (SACNT) films as a replacement for heavy conventional metallic current collectors. The CNT-film current collectors have good conductivity, extremely low density (27 microg cm(-2)), high specific surface area, excellent flexibility and good electrochemical stability. Nanosized active materials such as NiO, Co(3)O(4) or Mn(2)O(3) nanoparticles can be directly synthesized on the SACNT films by a straightforward one-step, in situ decomposition strategy that is both efficient and environmentally friendly. These composite films can be integrated into a pseudo-capacitor that does not use metallic current collectors, but nevertheless shows very good performance, including high specific capacitance (approximately 500 F g(-1), including the current collector mass), reliable electrochemical stability (<4.5% degradation in 2500 cycles) and a very high rate capability (245 F g(-1) at 155 A g(-1)).

High-performance supercapacitors using a nanoporous current collector made from super-aligned carbon nanotubes

NASA Astrophysics Data System (ADS)

Zhou, Ruifeng; Meng, Chuizhou; Zhu, Feng; Li, Qunqing; Liu, Changhong; Fan, Shoushan; Jiang, Kaili

2010-08-01

Nanoporous current collectors for supercapacitors have been fabricated by cross-stacking super-aligned carbon nanotube (SACNT) films as a replacement for heavy conventional metallic current collectors. The CNT-film current collectors have good conductivity, extremely low density (27 µg cm - 2), high specific surface area, excellent flexibility and good electrochemical stability. Nanosized active materials such as NiO, Co3O4 or Mn2O3 nanoparticles can be directly synthesized on the SACNT films by a straightforward one-step, in situ decomposition strategy that is both efficient and environmentally friendly. These composite films can be integrated into a pseudo-capacitor that does not use metallic current collectors, but nevertheless shows very good performance, including high specific capacitance (~500 F g - 1, including the current collector mass), reliable electrochemical stability (<4.5% degradation in 2500 cycles) and a very high rate capability (245 F g - 1 at 155 A g - 1).

Insights from the evaluation of a provincial healthy eating strategy in Nova Scotia, Canada.

PubMed

Sim, S Meaghan; Kirk, Sara F L

2013-10-01

Healthy Eating Nova Scotia represents the first provincial comprehensive healthy eating strategy in Canada and a strategy that is framed within a population-health model. Five years after strategy launch, our objective was to evaluate Healthy Eating Nova Scotia to determine perceptions of strategy implementation and strategy outputs. The focus of the current paper is on the findings of this evaluation. We conducted an evaluation of the strategy through three activities that included a document review, survey of key stakeholders and in-depth interviews with key strategy informants. The findings from each of the activities were integrated to determine what has worked well with strategy implementation, what could be improved and what outputs have resulted. The evaluation was conducted in the Canadian province of Nova Scotia. Participants for this evaluation included survey respondents (n 120) and key informants (n 16). A total of 156 documents were also reviewed. Significant investments have been made towards inter-sectoral partnerships and resourcing that has provided the necessary leadership and momentum for the strategy. Policy development has been leveraged through the strategy primarily in the health and education sectors and is perceived as a visible success. Clarity of human resource roles and funding within the context of a provincial strategy may be beneficial for continued strategy implementation, as is expansion of policy development. Known to be the first evaluation of its kind, these findings and related considerations will be of interest to policy makers developing and implementing similar strategies in their own jurisdictions.

Preparation for pain management during childbirth: the psychological aspects of coping strategy development in antenatal education.

PubMed

Escott, Diane; Slade, Pauline; Spiby, Helen

2009-11-01

During childbirth, in addition to or in place of analgesia, women manage pain using a range of coping strategies. Antenatal education provides an opportunity prior to birth to help women to prepare for an often painful event. However, this is usually carried out with little reference to the literature regarding psychological factors which influence the experience of pain. This review seeks to consider how recent developments in psychological knowledge could enhance care. Areas identified include range of coping strategies and factors influencing their efficacy and implementation. This draws on both the literature on management of acute pain in other scenarios and the limited literature related to childbirth related pain. The following recommendations for systematic evaluation in the context of antenatal education are made: (i) Increase the range of coping strategies currently utilized to include cognitive based strategies. (ii) Help women to identify and understand the nature of their own coping styles and preferences, including any unhelpful patterns of pain catastrophizing. (iii) Help women to develop their own unique set of coping strategies for labor. (iv) Strengthen feelings of coping self-efficacy by practice in class and reinforcement by the class teacher. (v) Develop implementation intentions which account for the changing context of childbirth and (vi) Actively develop prompting and reinforcement of use of identified coping strategies by birth partners.

Results of our national survey. Current formulary decision-making strategies and new factors influencing the process.

PubMed

1995-08-01

Formulary recently conducted a survey of 2,000 of its readers to uncover what forces are at play in their formulary decision-making processes. Topics included general philosophies toward formulary decision making, philosophies toward adding and deleting products, influences on the process, trends related to product reviews, formulary management strategies, drug information educational strategies, and new approaches to the formulary decision-making process. Some 295 surveys (14.75%) were returned. Highlights and analyses of the survey findings are presented for your review and comparison with your practice setting's approaches.

Preventing pressure ulcers in long-term care: a cost-effectiveness analysis.

PubMed

Pham, Ba'; Stern, Anita; Chen, Wendong; Sander, Beate; John-Baptiste, Ava; Thein, Hla-Hla; Gomes, Tara; Wodchis, Walter P; Bayoumi, Ahmed; Machado, Márcio; Carcone, Steven; Krahn, Murray

2011-11-14

Pressure ulcers are common in many care settings, with adverse health outcomes and high treatment costs. We evaluated the cost-effectiveness of evidence-based strategies to improve current prevention practice in long-term care facilities. We used a validated Markov model to compare current prevention practice with the following 4 quality improvement strategies: (1) pressure redistribution mattresses for all residents, (2) oral nutritional supplements for high-risk residents with recent weight loss, (3) skin emollients for high-risk residents with dry skin, and (4) foam cleansing for high-risk residents requiring incontinence care. Primary outcomes included lifetime risk of stage 2 to 4 pressure ulcers, quality-adjusted life-years (QALYs), and lifetime costs, calculated according to a single health care payer's perspective and expressed in 2009 Canadian dollars (Can$1 = US$0.84). Strategies cost on average $11.66 per resident per week. They reduced lifetime risk; the associated number needed to treat was 45 (strategy 1), 63 (strategy 4), 158 (strategy 3), and 333 (strategy 2). Strategy 1 and 4 minimally improved QALYs and reduced the mean lifetime cost by $115 and $179 per resident, respectively. The cost per QALY gained was approximately $78 000 for strategy 3 and $7.8 million for strategy 2. If decision makers are willing to pay up to $50 000 for 1 QALY gained, the probability that improving prevention is cost-effective is 94% (strategy 4), 82% (strategy 1), 43% (strategy 3), and 1% (strategy 2). The clinical and economic evidence supports pressure redistribution mattresses for all long-term care residents. Improving prevention with perineal foam cleansers and dry skin emollients appears to be cost-effective, but firm conclusions are limited by the available clinical evidence.

Treatment Strategy for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma.

PubMed

Nakamura, Shotaro; Matsumoto, Takayuki

2015-09-01

Recent trends and current knowledge on the diagnosis and treatment strategy for gastric mucosa-associated lymphoid tissue (MALT) lymphoma are reviewed. Helicobacter pylori infection plays the causative role in the pathogenesis, and H pylori eradication is the first-line treatment of this disease, which leads to complete remission in 60% to 90% of cases. A Japanese multicenter study confirmed that the long-term outcome of gastric MALT lymphoma after H pylori eradication is excellent. Treatment strategies for patients not responding to H pylori eradication including "watch and wait" strategy, radiotherapy, chemotherapy, rituximab immunotherapy, and combination of these should be tailored in consideration of the disease extent in each patient. Copyright © 2015 Elsevier Inc. All rights reserved.

Applying a Consumer Behavior Lens to Salt Reduction Initiatives

PubMed Central

Potvin Kent, Monique; Raats, Monique M.; McConnon, Áine; Wall, Patrick; Dubois, Lise

2017-01-01

Reformulation of food products to reduce salt content has been a central strategy for achieving population level salt reduction. In this paper, we reflect on current reformulation strategies and consider how consumer behavior determines the ultimate success of these strategies. We consider the merits of adopting a ‘health by stealth’, silent approach to reformulation compared to implementing a communications strategy which draws on labeling initiatives in tandem with reformulation efforts. We end this paper by calling for a multi-actor approach which utilizes co-design, participatory tools to facilitate the involvement of all stakeholders, including, and especially, consumers, in making decisions around how best to achieve population-level salt reduction. PMID:28820449

Diagnosis of viral hepatitis

PubMed Central

Easterbrook, Philippa J.; Roberts, Teri; Sands, Anita; Peeling, Rosanna

2017-01-01

Purpose of review Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and HIV–HBV and HCV coinfection are major causes of chronic liver disease worldwide. Testing and diagnosis is the gateway for access to both treatment and prevention services, but there remains a large burden of undiagnosed infection globally. We review the global epidemiology, key challenges in the current hepatitis testing response, new tools to support the hepatitis global response (2016–2020 Global Hepatitis Health Sector strategy, and 2017 WHO guidelines on hepatitis testing) and future directions and innovations in hepatitis diagnostics. Recent findings Key challenges in the current hepatitis testing response include lack of quality-assured serological and low-cost virological in-vitro diagnostics, limited facilities for testing, inadequate data to guide country-specific hepatitis testing approaches, stigmatization of those with or at risk of viral hepatitis and lack of guidelines on hepatitis testing for resource-limited settings. The new Global Hepatitis Health Sector strategy sets out goals for elimination of viral hepatitis as a public health threat by 2030 and gives outcome targets for reductions in new infections and mortality, as well as service delivery targets that include testing, diagnosis and treatment. The 2017 WHO hepatitis testing guidelines for adults, adolescents and children in low-income and middle-income countries outline the public health approach to strengthen and expand current testing practices for viral hepatitis and addresses who to test (testing approaches), which serological and virological assays to use (testing strategies) as well as interventions to promote linkage to prevention and care. Summary Future directions and innovations in hepatitis testing include strategies to improve access such as through use of existing facility and community-based testing opportunities for hepatitis testing, near-patient or point-of-care assays for virological markers (nucleic acid testing and HCV core antigen), dried blood spot specimens used with different serological and nucleic acid test assays, multiplex and multi-disease platforms to enable testing for multiple analytes/pathogens and potential self-testing for viral hepatitis. PMID:28306597

Control Strategy of Active Power Filter Based on Modular Multilevel Converter

NASA Astrophysics Data System (ADS)

Xie, Xifeng

2018-03-01

To improve the capacity, pressure resistance and the equivalent switching frequency of active power filter (APF), a control strategy of APF based on Modular Multilevel Converter (MMC) is presented. In this Control Strategy, the indirect current control method is used to achieve active current and reactive current decoupling control; Voltage Balance Control Strategy is to stabilize sub-module capacitor voltage, the predictive current control method is used to Track and control of harmonic currents. As a result, the harmonic current is restrained, and power quality is improved. Finally, the simulation model of active power filter controller based on MMC is established in Matlab/Simulink, the simulation proves that the proposed strategy is feasible and correct.

E-health: an overview of the uses of the Internet, social media, apps, and websites for mood disorders.

PubMed

Parikh, Sagar V; Huniewicz, Paulina

2015-01-01

The current article defines and surveys E-health: Internet and technology-guided interventions and tools useful for mood disorders. E-health encompasses many categories, including computerized self-help strategies, online psychotherapy, websites that provide information, social media approaches including Facebook, Internet forums for health discussions, personal blogs, and videogames. Multiple tools exist to assess and document symptoms, particularly mood charts. Although all of these approaches are popular, only online psychotherapy and videogames have actually been evaluated in studies to evaluate both validity and efficacy. The face validity of social communication strategies including social media and blogs is strong, with clear implications for stigma reduction and peer support. Informational websites continue to be primary sources of psychoeducation on mental disorders. Social media sites have widespread use by the public and a profusion of health discussions and tools, but without published research evaluation of efficacy. E-health strategies, particularly online psychotherapy and tools to document symptoms, are useful and likely effective. Social communication strategies show enormous popularity, but urgently require research evaluation for impact.

Strategies to induce broadly protective antibody responses to viral glycoproteins.

PubMed

Krammer, F

2017-05-01

Currently, several universal/broadly protective influenza virus vaccine candidates are under development. Many of these vaccines are based on strategies to induce protective antibody responses against the surface glycoproteins of antigenically and genetically diverse influenza viruses. These strategies might also be applicable to surface glycoproteins of a broad range of other important viral pathogens. Areas covered: Common strategies include sequential vaccination with divergent antigens, multivalent approaches, vaccination with glycan-modified antigens, vaccination with minimal antigens and vaccination with antigens that have centralized/optimized sequences. Here we review these strategies and the underlying concepts. Furthermore, challenges, feasibility and applicability to other viral pathogens are discussed. Expert commentary: Several broadly protective/universal influenza virus vaccine strategies will be tested in humans in the coming years. If successful in terms of safety and immunological readouts, they will move forward into efficacy trials. In the meantime, successful vaccine strategies might also be applied to other antigenically diverse viruses of concern.

Adding Fault Tolerance to NPB Benchmarks Using ULFM

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

Parchman, Zachary W; Vallee, Geoffroy R; Naughton III, Thomas J

2016-01-01

In the world of high-performance computing, fault tolerance and application resilience are becoming some of the primary concerns because of increasing hardware failures and memory corruptions. While the research community has been investigating various options, from system-level solutions to application-level solutions, standards such as the Message Passing Interface (MPI) are also starting to include such capabilities. The current proposal for MPI fault tolerant is centered around the User-Level Failure Mitigation (ULFM) concept, which provides means for fault detection and recovery of the MPI layer. This approach does not address application-level recovery, which is currently left to application developers. In thismore » work, we present a mod- ification of some of the benchmarks of the NAS parallel benchmark (NPB) to include support of the ULFM capabilities as well as application-level strategies and mechanisms for application-level failure recovery. As such, we present: (i) an application-level library to checkpoint and restore data, (ii) extensions of NPB benchmarks for fault tolerance based on different strategies, (iii) a fault injection tool, and (iv) some preliminary results that show the impact of such fault tolerant strategies on the application execution.« less

Sensor Acquisition for Water Utilities: A Survey and Technology List

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

Alai, M; Glascoe, L; Love, A

2005-03-07

The early detection of the deliberate biological and chemical contamination of water distribution systems is a necessary capability for securing the nation's water supply. Current and emerging early-detection technology capabilities and shortcomings need to be identified and assessed to provide government agencies and water utilities with an improved methodology for assessing the value of installing these technologies. The Department of Homeland Security (DHS) has tasked a multi-laboratory team to evaluate current and future needs to protect the nation's water distribution infrastructure by supporting an objective evaluation of current and new technologies. The primary deliverables from this Operational Technology Demonstration (OTD)more » are the following: (1) establishment of an advisory board for review and approval of testing protocols, technology acquisition processes and recommendations for technology test and evaluation in laboratory and field settings; (2) development of a technology acquisition process; (3) creation of laboratory and field testing and evaluation capability; and (4) testing of candidate technologies for insertion into a water early warning system. The initial phase of this study involves the development of two separate but complementary strategies to be reviewed by the advisory board: (1) a technology acquisition strategy, and (2) a technology evaluation strategy. Lawrence Livermore National Laboratory and Sandia National Laboratories are tasked with the first strategy, while Los Alamos, Pacific Northwest, and Oak Ridge National Laboratories are tasked with the second strategy. The first goal of the acquisition strategy is the development of a technology survey process that includes a review of previous sensor surveys and current test programs and then the development of a method to solicit and select existing and emerging sensor technologies for evaluation and testing. In this paper we discuss a survey of previous efforts by governmental agencies and private companies with the aim of facilitating a water sensor technology acquisition procedure. We provide a survey of previous sensor studies with regard to the use of Early Warning Systems (EWS) including earlier surveys, testing programs, and response studies. In the project we extend this earlier work by developing a list of important sensor specifications that are then used to help assemble a sensor selection criteria. A list of sensor technologies with their specifications is appended to this document. This list will assist the second goal of the project which is a recommendation of candidate technologies for laboratory and field testing.« less

Gastric adenocarcinoma screening and prevention in the era of new biomarker and endoscopic technologies: a cost-effectiveness analysis.

PubMed

Yeh, Jennifer M; Hur, Chin; Ward, Zachary; Schrag, Deborah; Goldie, Sue J

2016-04-01

To estimate the cost-effectiveness of noncardia gastric adenocarcinoma (NCGA) screening strategies based on new biomarker and endoscopic technologies. Using an intestinal-type NCGA microsimulation model, we evaluated the following one-time screening strategies for US men: (1) serum pepsinogen to detect gastric atrophy (with endoscopic follow-up of positive screen results), (2) endoscopic screening to detect dysplasia and asymptomatic cancer (with endoscopic mucosal resection (EMR) treatment for detected lesions) and (3) Helicobacter pylori screening and treatment. Screening performance, treatment effectiveness, cancer and cost data were based on published literature and databases. Subgroups included current, former and never smokers. Outcomes included lifetime cancer risk and incremental cost-effectiveness ratios (ICERs), expressed as cost per quality-adjusted-life-year (QALY) gained. Screening the general population at age 50 years reduced the lifetime intestinal-type NCGA risk (0.24%) by 26.4% with serum pepsinogen screening, 21.2% with endoscopy and EMR and 0.2% with H. pylori screening/treatment. Targeting current smokers reduced the lifetime risk (0.35%) by 30.8%, 25.5%, and 0.1%, respectively. For all subgroups, serum pepsinogen screening was more effective and more cost-effective than all other strategies, although its ICER varied from $76,000/QALY (current smokers) to $105,400/QALY (general population). Results were sensitive to H. pylori prevalence, screen age and serum pepsinogen test sensitivity. Probabilistic sensitivity analysis found that at a $100,000/QALY willingness-to-pay threshold, the probability that serum pepsinogen screening was preferred was 0.97 for current smokers. Although not warranted for the general population, targeting high-risk smokers for serum pepsinogen screening may be a cost-effective strategy to reduce intestinal-type NCGA mortality. 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/

The physicochemical process of bacterial attachment to abiotic surfaces: Challenges for mechanistic studies, predictability and the development of control strategies.

PubMed

Wang, Yi; Lee, Sui Mae; Dykes, Gary

2015-01-01

Bacterial attachment to abiotic surfaces can be explained as a physicochemical process. Mechanisms of the process have been widely studied but are not yet well understood due to their complexity. Physicochemical processes can be influenced by various interactions and factors in attachment systems, including, but not limited to, hydrophobic interactions, electrostatic interactions and substratum surface roughness. Mechanistic models and control strategies for bacterial attachment to abiotic surfaces have been established based on the current understanding of the attachment process and the interactions involved. Due to a lack of process control and standardization in the methodologies used to study the mechanisms of bacterial attachment, however, various challenges are apparent in the development of models and control strategies. In this review, the physicochemical mechanisms, interactions and factors affecting the process of bacterial attachment to abiotic surfaces are described. Mechanistic models established based on these parameters are discussed in terms of their limitations. Currently employed methods to study these parameters and bacterial attachment are critically compared. The roles of these parameters in the development of control strategies for bacterial attachment are reviewed, and the challenges that arise in developing mechanistic models and control strategies are assessed.

INSULIN RESISTANCE POST-BURN: UNDERLYING MECHANISMS AND CURRENT THERAPEUTIC STRATEGIES

PubMed Central

Gauglitz, Gerd G.; Herndon, David N.; Jeschke, Marc G.

2014-01-01

The profound hypermetabolic response to burn injury is associated with insulin resistance and hyperglycemia, significantly contributing to the incidence of morbidity and mortality in this patient population. These responses are present in all trauma, surgical, or critically ill patients, but the severity, length, and magnitude is unique for burn patients. Although advances in therapeutic strategies to attenuate the post-burn hypermetabolic response have significantly improved the clinical outcome of these patients over the past years, therapeutic approaches to overcome stress-induced hyperglycemia have remained challenging. Intensive insulin therapy has been shown to significantly reduce morbidity and mortality in critically ill patients. High incidence of hypoglycemic events and difficult blood glucose titrations have led to investigation of alternative strategies, including the use of metformin, a biguanide, or fenofibrate, a PPAR-γ agonist. Nevertheless, weaknesses and potential side affects of these drugs reinforces the need for better understanding of the molecular mechanisms underlying insulin resistance post-burn that may lead to novel therapeutic strategies further improving the prognosis of these patients. This review aims to discuss the mechanisms underlying insulin resistance induced hyperglycemia post-burn and outlines current therapeutic strategies that are being used to modulate hyperglycemia following thermal trauma. PMID:18695610

Strategies for recruiting additional African Americans into the NASA JSC summer faculty fellows program

NASA Technical Reports Server (NTRS)

Hyman, Ladelle M.

1993-01-01

African Americans have participated sporadically in the NASA JSC Summer Faculty Fellows Program--none in 1992 and four in 1993. There is a pool of African Americans who are both qualified to provide services and willing to participate in initiatives which support technologies required for future JSC programs. They can provide human support and handle mission operations, spacecraft systems, planet surface systems, and management tools. Most of these faculty teach at historically black colleges and universities (HBCU's). This research will document the current recruitment system, critique it, and develop a strategy which will facilitate the diversification of the NASA JSC Summer Faculty Fellows Program. While NASA currently mails notices to HBCU's, such notices have generated few applications from, and fewer selections of, targeted faculty. To increase the participation of African Americans in the NASA JSC Summer Faculty Fellows Program, this participant will prepare a strategy which includes a document which identifies HBCU-targeted faculty and enumerates more formally extensive and intensive communication procedures. A fifteen-minute panel discussion, which will include a video, will be delivered during the annual meeting of the American Society for Engineering Education (ASEE) to be held in Edmonton, Alberta, Canada, June 26-29, 1994. An announcement letter will be mailed to targeted faculty; follow-up telephone calls and personal visits will be made and a checklist flowchart will be completed by key NASA personnel or designee. Although initially limited to NASA JSC's recruitment of African Americans, this strategy may be broadened to include other NASA sites and other targeted minority groups.

Pandemic influenza communication: views from a deliberative forum

PubMed Central

Rogers, Wendy A.; Street, Jackie M.; Braunack‐Mayer, Annette J.; Hiller, Janet E.

2009-01-01

Abstract Objective  To use a deliberative forum to elicit community perspectives on communication about pandemic influenza planning, and to compare these findings with the current Australian national communication strategy. Design  Deliberative forum of 12 persons randomly selected from urban South Australia. Forum members were briefed by experts in infection control, virology, ethics and public policy before deliberating on four key questions: what, how and when should the community be told about pandemic influenza and by whom? Results  The forum recommended provision of detailed and comprehensive information by credible experts, rather than politicians, using a variety of media including television and internet. Recommendations included cumulative communication to build expertise in the community, and specific strategies to include groups such as young people, people with physical or mental disabilities, and rural and remote communities. Information provided should be practical, accurate, and timely, with no ‘holding back’ about the seriousness of a pandemic. The forum expressed confidence in the expert witnesses, despite the acknowledged uncertainty of many of the predictions. Discussion and Conclusion  The deliberative forum’s recommendations were largely consistent with the Australian national pandemic influenza communication strategy and the relevant literature. However, the forum recommended: release of more detailed information than currently proposed in the national strategy; use of non‐political spokespersons; and use of novel communication methods. Their acceptance of uncertainty suggests that policy makers should be open about the limits of knowledge in potentially threatening situations. Our findings show that deliberative forums can provide community perspectives on topics such as communication about pandemic influenza. PMID:19754694

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes

PubMed Central

Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

2017-01-01

Background: Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. Methods: The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. Results: The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. Conclusion: This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care) perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability. PMID:29179292

Economic optimization of a global strategy to address the pandemic threat.

PubMed

Pike, Jamison; Bogich, Tiffany; Elwood, Sarah; Finnoff, David C; Daszak, Peter

2014-12-30

Emerging pandemics threaten global health and economies and are increasing in frequency. Globally coordinated strategies to combat pandemics, similar to current strategies that address climate change, are largely adaptive, in that they attempt to reduce the impact of a pathogen after it has emerged. However, like climate change, mitigation strategies have been developed that include programs to reduce the underlying drivers of pandemics, particularly animal-to-human disease transmission. Here, we use real options economic modeling of current globally coordinated adaptation strategies for pandemic prevention. We show that they would be optimally implemented within 27 y to reduce the annual rise of emerging infectious disease events by 50% at an estimated one-time cost of approximately $343.7 billion. We then analyze World Bank data on multilateral "One Health" pandemic mitigation programs. We find that, because most pandemics have animal origins, mitigation is a more cost-effective policy than business-as-usual adaptation programs, saving between $344.0.7 billion and $360.3 billion over the next 100 y if implemented today. We conclude that globally coordinated pandemic prevention policies need to be enacted urgently to be optimally effective and that strategies to mitigate pandemics by reducing the impact of their underlying drivers are likely to be more effective than business as usual.

Economic optimization of a global strategy to address the pandemic threat

PubMed Central

Pike, Jamison; Bogich, Tiffany; Elwood, Sarah; Finnoff, David C.; Daszak, Peter

2014-01-01

Emerging pandemics threaten global health and economies and are increasing in frequency. Globally coordinated strategies to combat pandemics, similar to current strategies that address climate change, are largely adaptive, in that they attempt to reduce the impact of a pathogen after it has emerged. However, like climate change, mitigation strategies have been developed that include programs to reduce the underlying drivers of pandemics, particularly animal-to-human disease transmission. Here, we use real options economic modeling of current globally coordinated adaptation strategies for pandemic prevention. We show that they would be optimally implemented within 27 y to reduce the annual rise of emerging infectious disease events by 50% at an estimated one-time cost of approximately $343.7 billion. We then analyze World Bank data on multilateral “One Health” pandemic mitigation programs. We find that, because most pandemics have animal origins, mitigation is a more cost-effective policy than business-as-usual adaptation programs, saving between $344.0.7 billion and $360.3 billion over the next 100 y if implemented today. We conclude that globally coordinated pandemic prevention policies need to be enacted urgently to be optimally effective and that strategies to mitigate pandemics by reducing the impact of their underlying drivers are likely to be more effective than business as usual. PMID:25512538

Current trends in mass spectrometry of peptides and proteins: Application to veterinary and sports-doping control.

PubMed

van den Broek, Irene; Blokland, Marco; Nessen, Merel A; Sterk, Saskia

2015-01-01

Detection of misuse of peptides and proteins as growth promoters is a major issue for sport and food regulatory agencies. The limitations of current analytical detection strategies for this class of compounds, in combination with their efficacy in growth-promoting effects, make peptide and protein drugs highly susceptible to abuse by either athletes or farmers who seek for products to illicitly enhance muscle growth. Mass spectrometry (MS) for qualitative analysis of peptides and proteins is well-established, particularly due to tremendous efforts in the proteomics community. Similarly, due to advancements in targeted proteomic strategies and the rapid growth of protein-based biopharmaceuticals, MS for quantitative analysis of peptides and proteins is becoming more widely accepted. These continuous advances in MS instrumentation and MS-based methodologies offer enormous opportunities for detection and confirmation of peptides and proteins. Therefore, MS seems to be the method of choice to improve the qualitative and quantitative analysis of peptide and proteins with growth-promoting properties. This review aims to address the opportunities of MS for peptide and protein analysis in veterinary control and sports-doping control with a particular focus on detection of illicit growth promotion. An overview of potential peptide and protein targets, including their amino acid sequence characteristics and current MS-based detection strategies is, therefore, provided. Furthermore, improvements of current and new detection strategies with state-of-the-art MS instrumentation are discussed for qualitative and quantitative approaches. © 2013 Wiley Periodicals, Inc.

Chronic myelomonocytic leukemia: Forefront of the field in 2015

PubMed Central

Benton, Christopher B; Nazha, Aziz; Pemmaraju, Naveen; Garcia-Manero, Guillermo

2016-01-01

Chronic myelomonocytic leukemia (CMML) includes components of both myelodysplastic syndrome and myeloproliferative neoplasms and is associated with a characteristic peripheral monocytosis. CMML is caused by the proliferation of an abnormal hematopoietic stem cell clone and may be influenced by microenvironmental changes. The disease is rare and has undergone revisions in its classification. We review the recent classification strategies as well as diagnostic criteria, focusing on CMML’s genetic alterations and unique pathophysiology. We also discuss the latest molecular characterization of the disease, including how molecular factors affect current prognostic models. Finally, we focus on available treatment strategies, with a special emphasis on experimental and forthcoming therapies. PMID:25869097

Divorcing Mothers’ Use of Protective Strategies: Differences Over Time and by Violence Experience

PubMed Central

Haselschwerdt, Megan L.; Mitchell, Elissa Thomann; Raffaelli, Marcela; Hardesty, Jennifer L.

2015-01-01

Objective The current study considered protective strategy use at various points in time for divorcing mothers with a range of marital violence experiences (including no history of violence and different types of violence). Method Divorcing mothers (N = 170) from one Midwestern county participated in two in-person interviews that included structured assessments of intimate partner violence (IPV) during the last year of marriage and use of protective strategies at three time points – last year of marriage and at separation (both assessed at Time 1) and since the first interview (at a three month follow-up). Results Divorcing mothers, regardless of marital violence experience, used an array of private and public protective strategies during the last year of marriage, at separation, and at the three-month follow up interview. In general, mothers who experienced coercive controlling violence reported using more protective strategies than mothers who experienced situational couple violence or no violence. Strategy use peaked at separation with an increase in public strategy use. Conclusions All divorcing mothers use a range of active coping strategies over time, yet findings emphasize the importance of making distinctions between types of IPV so that divorcing mothers receive individualized resources and support that best meet their needs and minimize potentials risks and losses as they navigate the divorce process. PMID:26858851

[Relationships between motivational regulation strategies, motivational factors, and learning behaviors outside the classroom].

PubMed

Umemoto, Takatoyo; Tanaka, Kenshiro

2017-04-01

This study examined the relationships among motivational regulation strategies, motivational factors, and learning behaviors outside the classroom. There are three subtypes of motivational regulation strategies: autonomous regulation strategies, cooperative strategies, and performance-focused strategies. Motivational factors included in the investigation were self-efficacy and task value, while behavioral and emotional engagement and study time were selected as learning behaviors outside the classroom. A self-report questionnaire was administered to 322 undergraduates from two universities. Multiple regression analysis revealed the use of autonomous regulation strategies, and that task value was positively correlated with engagement and study time. Moreover, self-efficacy positively predicted study time. In contrast, the use of performance strategies negatively predicted engagement. The use of cooperative strategies did not predict learning behaviors. These results indicate that motivation, as well as the regulation of motivation, were important for learning outside the classroom. The effects of regulation of motivation and motivation on learning outside the classroom are discussed in light of the current findings.

Fourfold increased detection of Lynch syndrome by raising age limit for tumour genetic testing from 50 to 70 years is cost-effective.

PubMed

Sie, A S; Mensenkamp, A R; Adang, E M M; Ligtenberg, M J L; Hoogerbrugge, N

2014-10-01

Recognising colorectal cancer (CRC) patients with Lynch syndrome (LS) can increase life expectancy of these patients and their close relatives. To improve identification of this under-diagnosed disease, experts suggested raising the age limit for CRC tumour genetic testing from 50 to 70 years. The present study evaluates the efficacy and cost-effectiveness of this strategy. Probabilistic efficacy and cost-effectiveness analyses were carried out comparing tumour genetic testing of CRC diagnosed at age 70 or below (experimental strategy) versus CRC diagnosed at age 50 or below (current practice). The proportions of LS patients identified and cost-effectiveness including cascade screening of relatives, were calculated by decision analytic models based on real-life data. Using the experimental strategy, four times more LS patients can be identified among CRC patients when compared with current practice. Both the costs to detect one LS patient (€9437/carrier versus €4837/carrier), and the number needed to test for detecting one LS patient (42 versus 19) doubled. When family cascade screening was included, the experimental strategy was found to be highly cost-effective according to Dutch standards, resulting in an overall ratio of €2703 per extra life-year gained in additionally tested patients. Testing all CRC tumours diagnosed at or below age 70 for LS is cost-effective. Implementation is important as relatives from the large number of LS patients that are missed by current practice, can benefit from life-saving surveillance. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Is reconstruction the best management strategy for anterior cruciate ligament rupture? A systematic review and meta-analysis comparing anterior cruciate ligament reconstruction versus non-operative treatment.

PubMed

Smith, T O; Postle, K; Penny, F; McNamara, I; Mann, C J V

2014-03-01

The purpose of this study was to determine the optimal clinical and cost-effective strategy for managing people following ACL rupture. A systematic review of the published (AMED, CINAHL, MEDLINE, EMBASE, PubMed, psycINFO and the Cochrane Library) and unpublished literature (OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials and the UK National Research Register Archive) was conducted on April 2013. All randomised and non-randomised controlled trials evaluating clinical or health economic outcomes of isolated ligament reconstruction versus non-surgical management following ACL rupture were included. Methodological quality was assessed using the PEDro appraisal tool. When appropriate, meta-analysis was conducted to pool data. From a total of 943 citations, sixteen studies met the eligibility criteria. These included 1397 participants, 825 who received ACL reconstruction versus 592 who were managed non-surgically. The methodological quality of the literature was poor. The findings indicated that whilst reconstructed ACL offers significantly greater objective tibiofemoral stability (p<0.001), there appears limited evidence to suggest a superiority between reconstruction versus non-surgical management in functional outcomes. There was a small difference between the management strategies in respect to the development of osteoarthritis during the initial 20 years following index management strategy (Odds Ratio 1.56; p=0.05). The current literature is insufficient to base clinical decision-making with respect to treatment opinions for people following ACL rupture. Whilst based on a poor evidence, the current evidence would indicate that people following ACL rupture should receive non-operative interventions before surgical intervention is considered. © 2013.

Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

PubMed Central

Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario

2014-01-01

Objectives Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP. PMID:25285438

Predicting the Impact of Intervention Strategies for Sleeping Sickness in Two High-Endemicity Health Zones of the Democratic Republic of Congo.

PubMed

Rock, Kat S; Torr, Steve J; Lumbala, Crispin; Keeling, Matt J

2017-01-01

Two goals have been set for Gambian human African trypanosomiasis (HAT), the first is to achieve elimination as a public health problem in 90% of foci by 2020, and the second is to achieve zero transmission globally by 2030. It remains unclear if certain HAT hotspots could achieve elimination as a public health problem by 2020 and, of greater concern, it appears that current interventions to control HAT in these areas may not be sufficient to achieve zero transmission by 2030. A mathematical model of disease dynamics was used to assess the potential impact of changing the intervention strategy in two high-endemicity health zones of Kwilu province, Democratic Republic of Congo. Six key strategies and twelve variations were considered which covered a range of recruitment strategies for screening and vector control. It was found that effectiveness of HAT screening could be improved by increasing effort to recruit high-risk groups for screening. Furthermore, seven proposed strategies which included vector control were predicted to be sufficient to achieve an incidence of less than 1 reported case per 10,000 people by 2020 in the study region. All vector control strategies simulated reduced transmission enough to meet the 2030 goal, even if vector control was only moderately effective (60% tsetse population reduction). At this level of control the full elimination threshold was expected to be met within six years following the start of the change in strategy and over 6000 additional cases would be averted between 2017 and 2030 compared to current screening alone. It is recommended that a two-pronged strategy including both enhanced active screening and tsetse control is implemented in this region and in other persistent HAT foci to ensure the success of the control programme and meet the 2030 elimination goal for HAT.

Predicting the Impact of Intervention Strategies for Sleeping Sickness in Two High-Endemicity Health Zones of the Democratic Republic of Congo

PubMed Central

Torr, Steve J.; Lumbala, Crispin; Keeling, Matt J.

2017-01-01

Two goals have been set for Gambian human African trypanosomiasis (HAT), the first is to achieve elimination as a public health problem in 90% of foci by 2020, and the second is to achieve zero transmission globally by 2030. It remains unclear if certain HAT hotspots could achieve elimination as a public health problem by 2020 and, of greater concern, it appears that current interventions to control HAT in these areas may not be sufficient to achieve zero transmission by 2030. A mathematical model of disease dynamics was used to assess the potential impact of changing the intervention strategy in two high-endemicity health zones of Kwilu province, Democratic Republic of Congo. Six key strategies and twelve variations were considered which covered a range of recruitment strategies for screening and vector control. It was found that effectiveness of HAT screening could be improved by increasing effort to recruit high-risk groups for screening. Furthermore, seven proposed strategies which included vector control were predicted to be sufficient to achieve an incidence of less than 1 reported case per 10,000 people by 2020 in the study region. All vector control strategies simulated reduced transmission enough to meet the 2030 goal, even if vector control was only moderately effective (60% tsetse population reduction). At this level of control the full elimination threshold was expected to be met within six years following the start of the change in strategy and over 6000 additional cases would be averted between 2017 and 2030 compared to current screening alone. It is recommended that a two-pronged strategy including both enhanced active screening and tsetse control is implemented in this region and in other persistent HAT foci to ensure the success of the control programme and meet the 2030 elimination goal for HAT. PMID:28056016

The 'Toolbox' of strategies for managing Haemonchus contortus in goats: What's in and what's out.

PubMed

Kearney, P E; Murray, P J; Hoy, J M; Hohenhaus, M; Kotze, A

2016-04-15

A dynamic and innovative approach to managing the blood-consuming nematode Haemonchus contortus in goats is critical to crack dependence on veterinary anthelmintics. H. contortus management strategies have been the subject of intense research for decades, and must be selected to create a tailored, individualized program for goat farms. Through the selection and combination of strategies from the Toolbox, an effective management program for H. contortus can be designed according to the unique conditions of each particular farm. This Toolbox investigates strategies including vaccines, bioactive forages, pasture/grazing management, behavioural management, natural immunity, FAMACHA, Refugia and strategic drenching, mineral/vitamin supplementation, copper Oxide Wire Particles (COWPs), breeding and selection/selecting resistant and resilient individuals, biological control and anthelmintic drugs. Barbervax(®), the ground-breaking Haemonchus vaccine developed and currently commercially available on a pilot scale for sheep, is prime for trialling in goats and would be an invaluable inclusion to this Toolbox. The specialised behaviours of goats, specifically their preferences to browse a variety of plants and accompanying physiological adaptations to the consumption of secondary compounds contained in browse, have long been unappreciated and thus overlooked as a valuable, sustainable strategy for Haemonchus management. These strategies are discussed in this review as to their value for inclusion into the 'Toolbox' currently, and the future implications of ongoing research for goat producers. Combining and manipulating strategies such as browsing behaviour, pasture management, bioactive forages and identifying and treating individual animals for haemonchosis, in addition to continuous evaluation of strategy effectiveness, is conducted using a model farm scenario. Selecting strategies from the Toolbox, with regard to their current availability, feasibility, economical cost and potential ease of implementation depending on the systems of production and their complementary nature, is the future of managing H. contortus in farmed goats internationally and maintaining the remaining efficacy of veterinary anthelmintics. Copyright © 2016 Elsevier B.V. All rights reserved.

The Prevention of Schizophrenia—What Can We Learn From Eco-Epidemiology?

PubMed Central

Kirkbride, James B.; Jones, Peter B.

2011-01-01

The search for the causes of schizophrenia has predominantly originated from 2 research paradigms; genetics and epidemiology. While each approach has made important contributions to etiological understanding, neither has fully resolved the exact milieu of risk factors for schizophrenia, and there is growing recognition that several pathways to the onset of such disorders may exist. Eco-epidemiology offers an integrative framework to study schizophrenia etiology, incorporating multiple, interactive levels of causation, including genetic, epigenetic, individual, familial, community, and societal domains over the life course. In this article, we review the current evidence base, through the lens of eco-epidemiology, to determine whether it warrants the design and implementation of putative prevention strategies for schizophrenia. We argue that while there are potentially large public health gains available, we do not currently have sufficient empirical data to design effective prevention strategies. It will be important for the research community to more fully elucidate the likely multifactorial, multilevel, polygenetic, and eco-epidemiological basis of schizophrenia before we can design useful prevention strategies. We conclude by speculating on the forms effective strategies might take. PMID:20974748

Misconceptions about Psychological Science: A Review

ERIC Educational Resources Information Center

Hughes, Sean; Lyddy, Fiona; Lambe, Sinead

2013-01-01

This article provides an overview of the available evidence on psychological misconceptions, including key findings, current directions and emerging issues for investigation. We begin by defining misconceptions and then examine their prevalence and persistence, discuss their implications for student learning and highlight potential strategies to…

Practitioner Research Briefs, 1998-1999 Report Series.

ERIC Educational Resources Information Center

Virginia Adult Educators Research Network, Dayton.

The collection of articles addresses current issues in adult and adult basic education in Virginia communities. Titles include: "Goal-Setting in the New River Valley: Teachers' Perceptions and Strategies" (Sue Barton); "What Happens When ESL Students Experience Authentic Work Situations?" (Pat Bowyer); "Orientation to…

Marketing for Camp Trends.

ERIC Educational Resources Information Center

Biddle, Alicia

1998-01-01

To effectively market a camp, current trends and issues must be considered: specialty programming, the Americans With Disabilities Act, competing recreational programs, changes in the school year, programming for seniors, and accountability. Camps should have a marketing strategy that includes public relations, a marketing plan, a pricing…

OCLC: Changing the Tasks of Librarianship.

ERIC Educational Resources Information Center

Smith, K. Wayne

1993-01-01

Reviews the history of OCLC and describes current and future objectives. Highlights include membership; network affiliations; cataloging services; interlibrary loan; EPIC, a new reference system; a new telecommunications network; PRISM, a new online system for cataloging and resource sharing; pricing strategies; international operations; and…

Using Learning Trajectories to Enhance Formative Assessment

ERIC Educational Resources Information Center

Ebby, Caroline B.; Petit, Marjorie

2017-01-01

A learning trajectory describes the progression of student thinking and strategies over time in terms of sophistication of both conceptual understanding and procedural fluency. Currently, learning trajectories exist in the research literature for many mathematical domains, including counting, addition and subtraction, multiplicative thinking,…

12 CFR 1805.701 - Evaluation of applications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Comprehensive Business Plan and achieving community development impact, by considering factors such as: (1... management team; (5) Understanding of its market context, including its analysis of current and prospective..., marketing and outreach efforts, delivery strategy, and coordination with other institutions and/or a...

Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care: the Consortium Pain Task Force White Paper.

PubMed

Tick, Heather; Nielsen, Arya; Pelletier, Kenneth R; Bonakdar, Robert; Simmons, Samantha; Glick, Ronald; Ratner, Emily; Lemmon, Russell L; Wayne, Peter; Zador, Veronica

2018-03-01

Consortium Pain Taskforce White Paper Summary Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care Supplementary information can be found in the online version at https://doi.org/10.1016/j.explore.2018.02.001. Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Space Station Freedom altitude strategy

NASA Technical Reports Server (NTRS)

Mcdonald, Brian M.; Teplitz, Scott B.

1990-01-01

The Space Station Freedom (SSF) altitude strategy provides guidelines and assumptions to determine an altitude profile for Freedom. The process for determining an altitude profile incorporates several factors such as where the Space Shuttle will rendezvous with the SSF, when reboosts must occur, and what atmospheric conditions exist causing decay. The altitude strategy has an influence on all areas of SSF development and mission planning. The altitude strategy directly affects the micro-gravity environment for experiments, propulsion and control system sizing, and Space Shuttle delivery manifests. Indirectly the altitude strategy influences almost every system and operation within the Space Station Program. Evolution of the SSF altitude strategy has been a very dynamic process over the past few years. Each altitude strategy in turn has emphasized a different consideration. Examples include a constant Space Shuttle rendezvous altitude for mission planning simplicity, or constant micro-gravity levels with its inherent emphasis on payloads, or lifetime altitudes to provide a safety buffer to loss of control conditions. Currently a new altitude strategy is in development. This altitude strategy will emphasize Space Shuttle delivery optimization. Since propellant is counted against Space Shuttle payload-to-orbit capacity, lowering the rendezvous altitude will not always increase the net payload-to-orbit, since more propellant would be required for reboost. This altitude strategy will also consider altitude biases to account for Space Shuttle launch slips and an unexpected worsening of atmospheric conditions. Safety concerns will define a lower operational altitude limit, while radiation levels will define upper altitude constraints. The evolution of past and current SSF altitude strategies and the development of a new altitude strategy which focuses on operational issues as opposed to design are discussed.

Large Area Crop Inventory Experiment (LACIE). Second-generation sampling strategy evaluation report. [Kansas, North Dakota, and U.S.S.R.

NASA Technical Reports Server (NTRS)

Basu, J. P. (Principal Investigator); Dragich, S. M.; Mcguigan, D. P.

1978-01-01

The author has identified the following significant results. The stratification procedure in the new sampling strategy for LACIE included: (1) correlation test results indicating that an agrophysical stratum may be homogeneous with respect to agricultural density, but not with respect to wheat density; and (2) agrophysical unit homogeneity test results indicating that with respect to agricultural density many agrophysical units are not homogeneous, but removal of one or more refined strata from any such current agrophysical unit can make the strata homogeneous. The apportioning procedure results indicated that the current procedure is not performing well and that the apportioned estimates of refined strata wheat area are often unreliable.

Depression and Anxiety in Parkinson's Disease.

PubMed

Schrag, Anette; Taddei, Raquel N

2017-01-01

Depression and anxiety are some of the most common comorbidities arising in patients with Parkinson's disease. However, their timely recognition and diagnosis are often hindered by overlap with other somatic features and a low rate of self-report. There is a need for greater awareness and for better assessment and treatment options are highly required. Currently available scales can serve as tools to monitor change over time and the effect of interventional strategies. Development of new therapeutic strategies, including nonpharmacological approaches such as transcranial magnetic stimulation and deep brain stimulation, may provide alternatives to currently available treatment approaches. In this chapter we will give an overview of the most recent advances in the diagnosis and treatment of these important nonmotor symptoms. © 2017 Elsevier Inc. All rights reserved.

Host-Directed Therapeutics as a Novel Approach for Tuberculosis Treatment.

PubMed

Kim, Ye-Ram; Yang, Chul-Su

2017-09-28

Despite significant efforts to improve the treatment of tuberculosis (TB), it remains a prevalent infectious disease worldwide owing to the limitations of current TB therapeutic regimens. Recent work on novel TB treatment strategies has suggested that directly targeting host factors may be beneficial for TB treatment. Such strategies, termed host-directed therapeutics (HDTs), focus on host-pathogen interactions. HDTs may be more effective than the currently approved TB drugs, which are limited by the long durations of treatment needed and the emergence of drug-resistant strains. Targets of HDTs include host factors such as cytokines, immune checkpoints, immune cell functions, and essential enzyme activities. This review article discusses examples of potentially promising HDTs and introduces novel approaches for their development.

An Overview of Vaccination Strategies and Antigen Delivery Systems for Streptococcus agalactiae Vaccines in Nile Tilapia (Oreochromis niloticus).

PubMed

Munang'andu, Hetron Mweemba; Paul, Joydeb; Evensen, Øystein

2016-12-13

Streptococcus agalactiae is an emerging infectious disease adversely affecting Nile tilapia ( Niloticus oreochromis ) production in aquaculture. Research carried out in the last decade has focused on developing protective vaccines using different strategies, although no review has been carried out to evaluate the efficacy of these strategies. The purpose of this review is to provide a synopsis of vaccination strategies and antigen delivery systems currently used for S. agalactiae vaccines in tilapia. Furthermore, as shown herein, current vaccine designs include the use of replicative antigen delivery systems, such as attenuated virulent strains, heterologous vectors and DNA vaccines, while non-replicative vaccines include the inactivated whole cell (IWC) and subunit vaccines encoding different S. agalactiae immunogenic proteins. Intraperitoneal vaccination is the most widely used immunization strategy, although immersion, spray and oral vaccines have also been tried with variable success. Vaccine efficacy is mostly evaluated by use of the intraperitoneal challenge model aimed at evaluating the relative percent survival (RPS) of vaccinated fish. The major limitation with this approach is that it lacks the ability to elucidate the mechanism of vaccine protection at portals of bacterial entry in mucosal organs and prevention of pathology in target organs. Despite this, indications are that the correlates of vaccine protection can be established based on antibody responses and antigen dose, although these parameters require optimization before they can become an integral part of routine vaccine production. Nevertheless, this review shows that different approaches can be used to produce protective vaccines against S. agalactiae in tilapia although there is a need to optimize the measures of vaccine efficacy.

Power sharing. A transformational strategy for nurse retention, effectiveness, and extra effort.

PubMed

Trofino, Joan

2003-01-01

Power sharing with staff nurses is an essential strategy for organizational transformation. The current competitive health care environment requires a powerful team of participants, including staff at all levels, to provide health care in mutual partnership. The challenges of today's competitive and global environment call for collegial relationships among nurse executive leadership, middle nurse managers, and staff nurses. Research has demonstrated that middle nurse managers maintain primary responsibility for staff nurse retention. A higher retention rate was reported among nurses who were very satisfied with their nurse managers. Nurses considered favorably nurse managers who value staff contributions, promote information sharing, and exert influence for a stable work environment. Furthermore, as staff nurse satisfaction increased, effectiveness and extra effort also increased when staff nurses perceived transformational leadership strategies. Strategies for power sharing include serving as role models and mentors, energizing staff, resisting attitudes of staff ownership, reducing staff nurse stress of leader presence, and information sharing and commendations at meetings.

Breast cancer prevention across the cancer care continuum.

PubMed

Klemp, Jennifer R

2015-05-01

To review the current state of breast cancer prevention from primary prevention through survivorship, highlight cross-cutting issues, and discuss strategies for clinical integration and future research. Published articles between 1985 and 2015 and original research. Cancer risk persists across the lifespan. Interprofessional strategies to reduce morbidity and mortality from cancer include primary, secondary, and tertiary prevention (survivorship). Prevention strategies across the cancer care continuum are cross-cutting and focus on measures to: prevent the onset of disease, identify and treat asymptomatic persons who have already developed risk factors or preclinical disease, and restore function, minimize the negative effects of disease, and prevent disease-related complications. Oncology nurses and advanced practice nurses are vital in the delivery of breast cancer prevention strategies. Published by Elsevier Inc.

al-Qaida Strategy, Ideology, Doctrine, and Media

ScienceCinema

Dr. Jarret Brachman

2017-12-09

Dr. Jarret Brachman, an internationally recognized al-Qaida specialist, author and public lecturer, shares his thoughts on a range of topics, including the differences involved in fighting insurgent groups versus terrorist organizations, the future of the global al-Qaida movement, and assessing America's efforts to combat al-Qaida. In his talk, Brachman focuses specifically on current trends in al-Qaida's military and messaging strategies, both from the perspective of the group's senior leadership and its regional commands. Presented on June 17, 2010.

Challenges and issues facing lithium metal for solid-state rechargeable batteries

NASA Astrophysics Data System (ADS)

Mauger, A.; Armand, M.; Julien, C. M.; Zaghib, K.

2017-06-01

The commercial use of lithium metal batteries was delayed because of dendrite formation on the surface of the lithium electrode, and the difficulty finding a suitable electrolyte that has both the mechanical strength and ionic conductivity required for solid electrolytes. Recently, strategies have developed to overcome these difficulties, so that these batteries are currently an option for different applications, including electric cars. In this work, we review these strategies, and discuss the different routes that are promising for progress in the near future.

al-Qaida Strategy, Ideology, Doctrine, and Media

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

Dr. Jarret Brachman

Dr. Jarret Brachman, an internationally recognized al-Qaida specialist, author and public lecturer, shares his thoughts on a range of topics, including the differences involved in fighting insurgent groups versus terrorist organizations, the future of the global al-Qaida movement, and assessing America's efforts to combat al-Qaida. In his talk, Brachman focuses specifically on current trends in al-Qaida's military and messaging strategies, both from the perspective of the group's senior leadership and its regional commands. Presented on June 17, 2010.

Staphylococcal and Streptococcal Superantigen Exotoxins

PubMed Central

Spaulding, Adam R.; Salgado-Pabón, Wilmara; Kohler, Petra L.; Horswill, Alexander R.; Leung, Donald Y. M.

2013-01-01

SUMMARY This review begins with a discussion of the large family of Staphylococcus aureus and beta-hemolytic streptococcal pyrogenic toxin T lymphocyte superantigens from structural and immunobiological perspectives. With this as background, the review then discusses the major known and possible human disease associations with superantigens, including associations with toxic shock syndromes, atopic dermatitis, pneumonia, infective endocarditis, and autoimmune sequelae to streptococcal illnesses. Finally, the review addresses current and possible novel strategies to prevent superantigen production and passive and active immunization strategies. PMID:23824366

Challenges and lessons learned in conducting comparative-effectiveness trials.

PubMed

Herrick, Linda M; Locke, G Richard; Zinsmeister, Alan R; Talley, Nicholas J

2012-05-01

The current health-care environment is demanding evidence-based medicine that relies on clinical trials as the basis for decisions. Clinician investigators are more often finding that they are personally responsible for coordinating large, multisite trials. We present strategies for successful implementation and management of multisite clinical trials and knowledge gained through an international, multisite randomized clinical trial. Topics include team composition, regulatory requirements, study organization and governance, communication strategies, recruitment and retention efforts, budget, technology transfer, and publication.

Challenges and Lessons Learned in Conducting Comparative-Effectiveness Trials

PubMed Central

Herrick, Linda M.; Locke, G. Richard; Zinsmeister, Alan R.; Talley, Nicholas J.

2014-01-01

The current health-care environment is demanding evidence-based medicine that relies on clinical trials as the basis for decisions. Clinician investigators are more often finding that they are personally responsible for coordinating large, multisite trials. We present strategies for successful implementation and management of multisite clinical trials and knowledge gained through an international, multisite randomized clinical trial. Topics include team composition, regulatory requirements, study organization and governance, communication strategies, recruitment and retention efforts, budget, technology transfer, and publication. PMID:22552235

Clinical approach to wounds: débridement and wound bed preparation including the use of dressings and wound-healing adjuvants.

PubMed

Attinger, Christopher E; Janis, Jeffrey E; Steinberg, John; Schwartz, Jaime; Al-Attar, Ali; Couch, Kara

2006-06-01

This is a clinical review of current techniques in wound bed preparation found to be effective in assisting the wound-healing process. The process begins with the identification of a correct diagnosis of the wound's etiology and continues with optimizing the patient's medical condition, including blood flow to the wound site. Débridement as the basis of most wound-healing strategies is then emphasized. Various débridement techniques, including surgery, topical agents, and biosurgery, are thoroughly discussed and illustrated. Wound dressings, including the use of negative pressure wound therapy, are then reviewed. To properly determine the timing of advance therapeutic intervention, the wound-healing progress needs to be monitored carefully with weekly measurements. A reduction in wound area of 10 to 15 percent per week represents normal healing and does not mandate a change in the current wound-healing strategy. However, if this level of wound area reduction is not met consistently on a weekly basis, then alternative healing interventions should be considered. There is a growing body of evidence that can provide guidance on the appropriate use of such adjuvants in the problem wound. Several adjuvants are discussed, including growth factor, bioengineered tissues, and hyperbaric medicine.

Human capital strategy: talent management.

PubMed

Nagra, Michael

2011-01-01

Large organizations, including the US Army Medical Department and the Army Nurse Corps, are people-based organizations. Consequently, effective and efficient management of the human capital within these organizations is a strategic goal for the leadership. Over time, the Department of Defense has used many different systems and strategies to manage people throughout their service life-cycle. The current system in use is called Human Capital Management. In the near future, the Army's human capital will be managed based on skills, knowledge, and behaviors through various measurement tools. This article elaborates the human capital management strategy within the Army Nurse Corps, which identifies, develops, and implements key talent management strategies under the umbrella of the Corps' human capital goals. The talent management strategy solutions are aligned under the Nurse Corps business strategy captured by the 2008 Army Nurse Corps Campaign Plan, and are implemented within the context of the culture and core values of the organization.

Planning protected areas network that are relevant today and under future climate change is possible: the case of Atlantic Forest endemic birds.

PubMed

Vale, Mariana M; Souza, Thiago V; Alves, Maria Alice S; Crouzeilles, Renato

2018-01-01

A key strategy in biodiversity conservation is the establishment of protected areas. In the future, however, the redistribution of species in response to ongoing climate change is likely to affect species' representativeness in those areas. Here we quantify the effectiveness of planning protected areas network to represent 151 birds endemic to the Brazilian Atlantic Forest hotspot, under current and future climate change conditions for 2050. We combined environmental niche modeling and systematic conservation planning using both a county and a regional level planning strategy. We recognized the conflict between biodiversity conservation and economic development, including socio-economic targets (as opposed to biological only) and using planning units that are meaningful for policy-makers. We estimated an average contraction of 29,500 km 2 in environmentally suitable areas for birds, representing 52% of currently suitable areas. Still, the most cost-effective solution represented almost all target species, requiring only ca. 10% of the Atlantic Forest counties to achieve that representativeness, independent of strategy. More than 50% of these counties were selected both in the current and future planned networks, representing >83% of the species. Our results indicate that: (i) planning protected areas network currently can be useful to represent species under climate change; (ii) the overlapped planning units in the best solution for both current and future conditions can be considered as "no regret" areas; (iii) priority counties are spread throughout the biome, providing specific guidance wherever the possibility of creating protected area arises; and (iv) decisions can occur at different administrative spheres (Federal, State or County) as we found quite similar numerical solutions using either county or regional level strategies.

Planning protected areas network that are relevant today and under future climate change is possible: the case of Atlantic Forest endemic birds

PubMed Central

Souza, Thiago V.; Alves, Maria Alice S.; Crouzeilles, Renato

2018-01-01

Background A key strategy in biodiversity conservation is the establishment of protected areas. In the future, however, the redistribution of species in response to ongoing climate change is likely to affect species’ representativeness in those areas. Here we quantify the effectiveness of planning protected areas network to represent 151 birds endemic to the Brazilian Atlantic Forest hotspot, under current and future climate change conditions for 2050. Methods We combined environmental niche modeling and systematic conservation planning using both a county and a regional level planning strategy. We recognized the conflict between biodiversity conservation and economic development, including socio-economic targets (as opposed to biological only) and using planning units that are meaningful for policy-makers. Results We estimated an average contraction of 29,500 km2 in environmentally suitable areas for birds, representing 52% of currently suitable areas. Still, the most cost-effective solution represented almost all target species, requiring only ca. 10% of the Atlantic Forest counties to achieve that representativeness, independent of strategy. More than 50% of these counties were selected both in the current and future planned networks, representing >83% of the species. Discussion Our results indicate that: (i) planning protected areas network currently can be useful to represent species under climate change; (ii) the overlapped planning units in the best solution for both current and future conditions can be considered as “no regret” areas; (iii) priority counties are spread throughout the biome, providing specific guidance wherever the possibility of creating protected area arises; and (iv) decisions can occur at different administrative spheres (Federal, State or County) as we found quite similar numerical solutions using either county or regional level strategies. PMID:29844952

Silver nanowires as the current collector for a flexible in-plane micro-supercapacitor via a one-step, mask-free patterning strategy

NASA Astrophysics Data System (ADS)

Liu, Lang; Li, Han-Yu; Yu, Yao; Liu, Lin; Wu, Yue

2018-02-01

The fabrication of a current collector-contained in-plane micro-supercapacitor (MSC) usually requires the patterning of the current collector first and then subsequent patterning of the active material with the assistance of a photoresist and mask. However, this two-step patterning process is too complicated and the photoresist used is harmful to the properties of nanomaterials. Here, we demonstrate a one-step, mask-free strategy to pattern the current collector and the active material at the same time, for the fabrication of an all-solid-state flexible in-plane MSC. Silver nanowires (AgNWs) are used as the current collector. An atmospheric pressure pulsed cold micro-plasma-jet is used to realize the one-step, mask-free production of interdigitated multi-walled carbon nanotube (MWCNT)/AgNW electrodes. Remarkably, the fabricated MWCNT/AgNW-based MSC shows good flexibility and excellent rate capability. Moreover, the performance of properties including cyclic stability, equivalent series resistance, relaxation time and energy/power densities of the MWCNT/AgNW-based MSC are significantly enhanced by the presence of the AgNW current collector.

Immunotherapy for non-small cell lung cancer: current concepts and clinical trials

PubMed Central

Mayor, Marissa; Yang, Neng; Sterman, Daniel; Jones, David R.; Adusumilli, Prasad S.

2016-01-01

Recent successes in immunotherapeutic strategies are being investigated to combat cancers that have less than ideal responses to standard of care treatment, such as non-small-cell lung cancer. In this paper, we summarize concepts and the current status of immunotherapy for non-small cell lung cancer, including salient features of the major categories of immunotherapy—monoclonal antibody therapy, immune checkpoint blockade, immunotoxins, anticancer vaccines, and adoptive cell therapy. PMID:26516195

Scored Discussions.

ERIC Educational Resources Information Center

Zola, John

1992-01-01

Suggests a classroom strategy to help students learn to analyze and discuss significant issues from history and current policy debates. Describes scored discussions in which small groups of students receive points for participation. Provides an example of a discussion on gold mining. Includes an agenda. Explores uses of scored discussions and…

Virtual Reality: A Strategy for Training in Cross-Cultural Communication.

ERIC Educational Resources Information Center

Meyer, Catherine; Dunn-Roberts, Richard

1992-01-01

Defines virtual reality and explains terminology, theoretical concepts, and enabling technologies. Research and applications are described; limitations of current technology are considered; and future possibilities are discussed, including the use of virtual reality in training for cross-cultural communication. (22 references) (LRW)

Retiree Health Care: A Ticking Bomb.

ERIC Educational Resources Information Center

Daniels, Craig E.; Daniels, Janet D.

1992-01-01

With health insurance costs soaring for both current employees and retirees, governing boards of institutions of higher education must contain costs. Possible strategies include shifting some expenses from employer to employee, establishing flexible-benefit or cafeteria plans, using managed care to reduce unnecessary medical procedures,…

Challenges and Tensions in Implementing Current Directions for Indigenous Education.

ERIC Educational Resources Information Center

Tripcony, Penny

In 2001-02, the Queensland Indigenous Education Consultative Body conducted seven research projects examining Indigenous educational policies and strategies. Qualitative and quantitative methods included literature reviews; academic data collection; and interviews and focus groups with Indigenous and non-Indigenous educators, parents, community…

Integrative approaches: promoting socioecological resilience

Treesearch

J.W. Long; Carl Skinner; M. North; C.T. Hunsaker; L. Quinn-Davidson

2014-01-01

This chapter begins by discussing current challenges for ecosystem management that emerged from multiple chapters of the full synthesis. It then considers integrative approaches to promote resilience, including general strategies that recognize the integrated nature of socioecological systems, the importance of promoting disturbance regimes upon which these systems...

What Public Libraries Must Do To Survive.

ERIC Educational Resources Information Center

St. Lifer, Evan

2001-01-01

Considers the challenges facing public libraries in meeting the current needs of its users while still delivering traditional information and recreational services. Topics include keeping up with technological trends; recruitment, staffing, and continuing education; the role as community center; and creating effective marketing strategies. (LRW)

An informatics strategy for cancer care

PubMed Central

Wright, J; Shogan, A; McCune, J; Stevens, S

2008-01-01

Whether transitioning from paper to electronic records or attempting to leverage data from existing systems for outcome studies, oncology practices face many challenges in defining and executing an informatics strategy. With the increasing costs of oncology treatments and expected changes in reimbursement rules, including requirements for evidence that supports physician decisions, it will become essential to collect data on treatment decisions and treatment efficacy to run a successful program. This study evaluates the current state of informatics systems available for use in oncology programs and focuses on developing an informatics strategy to meet the challenges introduced by expected changes in reimbursement rules and in medical and information technologies. PMID:21611003

Rational design of gene-based vaccines.

PubMed

Barouch, Dan H

2006-01-01

Vaccine development has traditionally been an empirical discipline. Classical vaccine strategies include the development of attenuated organisms, whole killed organisms, and protein subunits, followed by empirical optimization and iterative improvements. While these strategies have been remarkably successful for a wide variety of viruses and bacteria, these approaches have proven more limited for pathogens that require cellular immune responses for their control. In this review, current strategies to develop and optimize gene-based vaccines are described, with an emphasis on novel approaches to improve plasmid DNA vaccines and recombinant adenovirus vector-based vaccines. Copyright 2006 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Research fellowship programs as a pathway for training independent clinical pharmacy scientists.

PubMed

Mueller, Eric W; Bishop, Jeffrey R; Kanaan, Abir O; Kiser, Tyree H; Phan, Hanna; Yang, Katherine Y

2015-03-01

The American College of Clinical Pharmacy (ACCP) Research Affairs Committee published a commentary in 2013 on training clinical pharmacy scientists in the context of changes in economic, professional, political, and research environments. The commentary centered on the opportunities for pharmacists in clinical/translational research including strategies for ACCP, colleges of pharmacy, and the profession to increase the number and impact of clinical pharmacy scientists. A postdoctoral fellowship is cited as a current training pathway, capable of producing independent and productive pharmacy researchers. However, a decline in the number of programs, decreased funding availability, and variability in fellowship program activities and research focus have brought into question the relevance of this research training pathway to meet demand and opportunities. In response to these points, this commentary examines the state of research fellowship training including the current ACCP research fellowship review process, the need for standardization of research fellowship programs, and strategies to strengthen and promote research fellowships as relevant researcher training pathways. © 2015 Pharmacotherapy Publications, Inc.

Antibiotic Adjuvants: Diverse Strategies for Controlling Drug-Resistant Pathogens

PubMed Central

Gill, Erin E; Franco, Octavio L; Hancock, Robert E W

2015-01-01

The growing number of bacterial pathogens that are resistant to numerous antibiotics is a cause for concern around the globe. There have been no new broad-spectrum antibiotics developed in the last 40 years, and the drugs we have currently are quickly becoming ineffective. In this article, we explore a range of therapeutic strategies that could be employed in conjunction with antibiotics and may help to prolong the life span of these life-saving drugs. Discussed topics include antiresistance drugs, which are administered to potentiate the effects of current antimicrobials in bacteria where they are no longer (or never were) effective; antivirulence drugs, which are directed against bacterial virulence factors; host-directed therapies, which modulate the host's immune system to facilitate infection clearance; and alternative treatments, which include such therapies as oral rehydration for diarrhea, phage therapy, and probiotics. All of these avenues show promise for the treatment of bacterial infections and should be further investigated to explore their full potential in the face of a postantibiotic era. PMID:25393203

Pubertal induction in hypogonadism: Current approaches including use of gonadotrophins.

PubMed

Zacharin, Margaret

2015-06-01

Primary disorders of the gonad or those secondary to abnormalities of the hypothalamic pituitary axis result in hypogonadism. The range of health problems of childhood and adolescence that affect this axis has increased, as most children now survive chronic illness, but many have persisting deficits in gonadal function as a result of their underlying condition or its treatment. An integrated approach to hormone replacement is needed to optimize adult hormonal and bone health, and to offer opportunities for fertility induction and preservation that were not considered possible in the past. Timing of presentation ranges from birth, with disorders of sexual development, through adolescent pubertal failure, to adult fertility problems. This review addresses diagnosis and management of hypogonadism and focuses on new management strategies to address current concerns with fertility preservation. These include Turner syndrome, and fertility presevation prior to childhood cancer treatment. New strategies for male hormone replacement therapy that may impinge upon future fertility are emphasized. Copyright © 2015 Elsevier Ltd. All rights reserved.

Current available strategies to mitigate greenhouse gas emissions in livestock systems: an animal welfare perspective.

PubMed

Llonch, P; Haskell, M J; Dewhurst, R J; Turner, S P

2017-02-01

Livestock production is a major contributor to greenhouse gas (GHG) emissions, so will play a significant role in the mitigation effort. Recent literature highlights different strategies to mitigate GHG emissions in the livestock sector. Animal welfare is a criterion of sustainability and any strategy designed to reduce the carbon footprint of livestock production should consider animal welfare amongst other sustainability metrics. We discuss and tabulate the likely relationships and trade-offs between the GHG mitigation potential of mitigation strategies and their welfare consequences, focusing on ruminant species and on cattle in particular. The major livestock GHG mitigation strategies were classified according to their mitigation approach as reducing total emissions (inhibiting methane production in the rumen), or reducing emissions intensity (Ei; reducing CH4 per output unit without directly targeting methanogenesis). Strategies classified as antimethanogenic included chemical inhibitors, electron acceptors (i.e. nitrates), ionophores (i.e. Monensin) and dietary lipids. Increasing diet digestibility, intensive housing, improving health and welfare, increasing reproductive efficiency and breeding for higher productivity were categorized as strategies that reduce Ei. Strategies that increase productivity are very promising ways to reduce the livestock carbon footprint, though in intensive systems this is likely to be achieved at the cost of welfare. Other strategies can effectively reduce GHG emissions whilst simultaneously improving animal welfare (e.g. feed supplementation or improving health). These win-win strategies should be strongly supported as they address both environmental and ethical sustainability. In order to identify the most cost-effective measures for improving environmental sustainability of livestock production, the consequences of current and future strategies for animal welfare must be scrutinized and contrasted against their effectiveness in mitigating climate change.

Defrost Temperature Termination in Supermarket Refrigeration Systems

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

Fricke, Brian A; Sharma, Vishaldeep

2011-11-01

The objective of this project was to determine the potential energy savings associated with implementing demand defrost strategies to defrost supermarket refrigerated display case evaporators, as compared to the widely accepted current practice of controlling display case defrost cycles with a preset timer. The defrost heater energy use of several representative display case types was evaluated. In addition, demand defrost strategies for refrigerated display cases as well as those used in residential refrigerator/freezers were evaluated. Furthermore, it is anticipated that future work will include identifying a preferred defrost strategy, with input from Retail Energy Alliance members. Based on this strategy,more » a demand defrost system will be designed which is suitable for supermarket refrigerated display cases. Limited field testing of the preferred defrost strategy will be performed in a supermarket environment.« less

Wavelet-Based Visible and Infrared Image Fusion: A Comparative Study

PubMed Central

Sappa, Angel D.; Carvajal, Juan A.; Aguilera, Cristhian A.; Oliveira, Miguel; Romero, Dennis; Vintimilla, Boris X.

2016-01-01

This paper evaluates different wavelet-based cross-spectral image fusion strategies adopted to merge visible and infrared images. The objective is to find the best setup independently of the evaluation metric used to measure the performance. Quantitative performance results are obtained with state of the art approaches together with adaptations proposed in the current work. The options evaluated in the current work result from the combination of different setups in the wavelet image decomposition stage together with different fusion strategies for the final merging stage that generates the resulting representation. Most of the approaches evaluate results according to the application for which they are intended for. Sometimes a human observer is selected to judge the quality of the obtained results. In the current work, quantitative values are considered in order to find correlations between setups and performance of obtained results; these correlations can be used to define a criteria for selecting the best fusion strategy for a given pair of cross-spectral images. The whole procedure is evaluated with a large set of correctly registered visible and infrared image pairs, including both Near InfraRed (NIR) and Long Wave InfraRed (LWIR). PMID:27294938

Wavelet-Based Visible and Infrared Image Fusion: A Comparative Study.

PubMed

Sappa, Angel D; Carvajal, Juan A; Aguilera, Cristhian A; Oliveira, Miguel; Romero, Dennis; Vintimilla, Boris X

2016-06-10

This paper evaluates different wavelet-based cross-spectral image fusion strategies adopted to merge visible and infrared images. The objective is to find the best setup independently of the evaluation metric used to measure the performance. Quantitative performance results are obtained with state of the art approaches together with adaptations proposed in the current work. The options evaluated in the current work result from the combination of different setups in the wavelet image decomposition stage together with different fusion strategies for the final merging stage that generates the resulting representation. Most of the approaches evaluate results according to the application for which they are intended for. Sometimes a human observer is selected to judge the quality of the obtained results. In the current work, quantitative values are considered in order to find correlations between setups and performance of obtained results; these correlations can be used to define a criteria for selecting the best fusion strategy for a given pair of cross-spectral images. The whole procedure is evaluated with a large set of correctly registered visible and infrared image pairs, including both Near InfraRed (NIR) and Long Wave InfraRed (LWIR).

Decision making about healthcare-related tests and diagnostic test strategies. Paper 2: a review of methodological and practical challenges.

PubMed

Mustafa, Reem A; Wiercioch, Wojtek; Cheung, Adrienne; Prediger, Barbara; Brozek, Jan; Bossuyt, Patrick; Garg, Amit X; Lelgemann, Monika; Büehler, Diedrich; Schünemann, Holger J

2017-12-01

In this first of a series of five articles, we provide an overview of how and why healthcare-related tests and diagnostic strategies are currently applied. We also describe how our findings can be integrated with existing frameworks for making decisions that guide the use of healthcare-related tests and diagnostic strategies. We searched MEDLINE, references of identified articles, chapters in relevant textbooks, and identified articles citing classic literature on this topic. We provide updated frameworks for the potential roles and applications of tests with suggested definitions and practical examples. We also discuss study designs that are commonly used to assess tests' performance and the effects of tests on people's health. These designs include diagnostic randomized controlled trials and retrospective validation. We describe the utility of these and other currently suggested designs, which questions they can answer and which ones they cannot. In addition, we summarize the challenges unique to decision-making resulting from the use of tests. This overview highlights current challenges in the application of tests in decision-making in healthcare, provides clarifications, and informs the proposed solutions. Copyright © 2017 Elsevier Inc. All rights reserved.

New Perspectives on the Use of Phytochemicals as an Emergent Strategy to Control Bacterial Infections Including Biofilms.

PubMed

Borges, Anabela; Abreu, Ana Cristina; Dias, Carla; Saavedra, Maria José; Borges, Fernanda; Simões, Manuel

2016-07-05

The majority of current infectious diseases are almost untreatable by conventional antibiotic therapy given the advent of multidrug-resistant bacteria. The degree of severity and the persistence of infections are worsened when microorganisms form biofilms. Therefore, efforts are being applied to develop new drugs not as vulnerable as the current ones to bacterial resistance mechanisms, and also able to target bacteria in biofilms. Natural products, especially those obtained from plants, have proven to be outstanding compounds with unique properties, making them perfect candidates for these much-needed therapeutics. This review presents the current knowledge on the potentialities of plant products as antibiotic adjuvants to restore the therapeutic activity of drugs. Further, the difficulties associated with the use of the existing antibiotics in the treatment of biofilm-related infections are described. To counteract the biofilm resistance problems, innovative strategies are suggested based on literature data. Among the proposed strategies, the use of phytochemicals to inhibit or eradicate biofilms is highlighted. An overview on the use of phytochemicals to interfere with bacterial quorum sensing (QS) signaling pathways and underlying phenotypes is provided. The use of phytochemicals as chelating agents and efflux pump inhibitors is also reviewed.

Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs

PubMed Central

Nachega, Jean B; Mugavero, Michael J; Zeier, Michele; Vitória, Marco; Gallant, Joel E

2011-01-01

Since the advent of highly active antiretroviral therapy (HAART), the treatment of human immunodeficiency virus (HIV) infection has become more potent and better tolerated. While the current treatment regimens still have limitations, they are more effective, more convenient, and less toxic than regimens used in the early HAART era, and new agents, formulations and strategies continue to be developed. Simplification of therapy is an option for many patients currently being treated with antiretroviral therapy (ART). The main goals are to reduce pill burden, improve quality of life and enhance medication adherence, while minimizing short- and long-term toxicities, reducing the risk of virologic failure and maximizing cost-effectiveness. ART simplification strategies that are currently used or are under study include the use of once-daily regimens, less toxic drugs, fixed-dose coformulations and induction-maintenance approaches. Improved adherence and persistence have been observed with the adoption of some of these strategies. The role of regimen simplification has implications not only for individual patients, but also for health care policy. With increased interest in ART regimen simplification, it is critical to study not only implications for individual tolerability, toxicity, adherence, persistence and virologic efficacy, but also cost, scalability, and potential for dissemination and implementation, such that limited human and financial resources are optimally allocated for maximal efficiency, coverage and sustainability of global HIV/AIDS treatment. PMID:21845035

Implementation of an optical diagnosis strategy saves costs and does not impair clinical outcomes of a fecal immunochemical test-based colorectal cancer screening program.

PubMed

Vleugels, Jasper L A; Greuter, Marjolein J E; Hazewinkel, Yark; Coupé, Veerle M H; Dekker, Evelien

2017-12-01

 In an optical diagnosis strategy, diminutive polyps that are endoscopically characterized with high confidence are removed without histopathological analysis and distal hyperplastic polyps are left in situ. We evaluated the effectiveness and costs of optical diagnosis.  Using the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model, we simulated biennial fecal immunochemical test (FIT) screening in individuals aged 55 - 75 years. In this program, we compared an optical diagnosis strategy with current histopathology assessment of all diminutive polyps. Base-case assumptions included 76 % high-confidence predictions and sensitivities of 88 %, 91 %, and 88 % for endoscopically characterizing adenomas, sessile serrated polyps, and hyperplastic polyps, respectively. Outcomes were colorectal cancer burden, number of colonoscopies, life-years, and costs.  Both the histopathology strategy and the optical diagnosis strategy resulted in 21 life-days gained per simulated individual compared with no screening. For optical diagnosis, €6 per individual was saved compared with the current histopathology strategy. These cost savings were related to a 31 % reduction in colonoscopies in which histopathology was needed for diminutive polyps. Projecting these results onto the Netherlands (17 million inhabitants), assuming a fully implemented FIT-based screening program, resulted in an annual undiscounted cost saving of € 1.7 - 2.2 million for optical diagnosis.  Implementation of optical diagnosis in a FIT-based screening program saves costs without decreasing program effectiveness when compared with current histopathology analysis of all diminutive polyps. Further work is required to evaluate how endoscopists participating in a screening program should be trained, audited, and monitored to achieve adequate competence in optical diagnosis.

Timing of definitive fixation of major long bone fractures: Can fat embolism syndrome be prevented?

PubMed

Blokhuis, Taco J; Pape, Hans-Christoph; Frölke, Jan-Paul

2017-06-01

Fat embolism is common in patients with major fractures, but leads to devastating consequences, named fat embolism syndrome (FES) in some. Despite advances in treatment strategies regarding the timing of definitive fixation of major fractures, FES still occurs in patients. In this overview, current literature is reviewed and optimal treatment strategies for patients with multiple traumatic injuries, including major fractures, are discussed. Considering the multifactorial etiology of FES, including mechanical and biochemical pathways, FES cannot be prevented in all patients. However, screening for symptoms of FES should be standard in the pre-operative work-up of these patients, prior to definitive fixation of major fractures. Copyright © 2017. Published by Elsevier Ltd.

Development of a tiered screening strategy for a molecular-initiating event: thyroperoxidase inhibition (SOT)

EPA Science Inventory

Adverse outcome pathway (AOP) analyses illustrate that some molecular-initiating events (MIEs) for thyroid disruption, including thyroperoxidase (TPO) inhibition, are not evaluated by current ToxCast/Tox21 high-throughput screening (HTS) assays. A novel HTS assay for TPO inhibiti...

Early Literacy and Very Young Children

ERIC Educational Resources Information Center

Parlakian, Rebecca

2004-01-01

For infants and toddlers, education and care are "two sides of the same coin." The author briefly reviews current research on the importance of relationships to cognitive development and early language and literacy. Instructional strategies that are most appropriate to the early years include "intentionality" and "scaffolding." Intentionality…

The Church's Ministry in Higher Education.

ERIC Educational Resources Information Center

Westerhoff, John H., Ed.

Papers presented include: "Hope, History, and Higher Education in the South," (James H. Smylie, response by Samuel S. Hill, Jr.); "Current Strategies: An Exploration and Evaluation," (Robert L. Wilson, response by Clyde O. Robinson, Jr.); "Trends in Higher Education: A Look to the Future," (Anne Flowers, response by…

76 FR 4697 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... engagement and on the current organizational culture and climate surrounding patient and family engagement... change in staff behavior before and after implementation of the Guide including organizational culture... organizational structure and vision. Policies and procedures related to Component 1 and Component 2 strategies of...

Maximizing the Effective Use of Formative Assessments

ERIC Educational Resources Information Center

Riddell, Nancy B.

2016-01-01

In the current age of accountability, teachers must be able to produce tangible evidence of students' concept mastery. This article focuses on implementation of formative assessments before, during, and after instruction in order to maximize teachers' ability to effectively monitor student achievement. Suggested strategies are included to help…

A Descriptive Assessment of Instruction-Based Interactions in the Preschool Classroom

ERIC Educational Resources Information Center

Ndoro, Virginia W.; Hanley, Gregory P.; Tiger, Jeffrey H.; Heal, Nicole A.

2006-01-01

The current study describes preschool teacher-child interactions during several commonly scheduled classroom activities in which teachers deliver instructions. An observation system was developed that incorporated measurement of evidence-based compliance strategies and included the types of instructions delivered (e.g., integral or deficient…

The 90 90 90 strategy to end the HIV Pandemic by 2030: Can the supply chain handle it?

PubMed Central

Jamieson, David

2016-01-01

Introduction UNAIDS “90-90-90” strategy calls for 90% of HIV-infected individuals to be diagnosed by 2020, 90% of whom will be on anti-retroviral therapy (ART) and 90% of whom will achieve sustained virologic suppression. Reaching these targets by 2020 will reduce the HIV epidemic to a low-level endemic disease by 2030. However, moving the global response towards this universal test and treat model will pose huge challenges to public health systems in resource-limited settings, including global and local supply chain systems. These challenges are especially acute in Africa, which accounts for over 70% of the persons affected by HIV. Discussion From a supply chain perspective, each of the “90's” has possible complications and roadblocks towards realizing the promise envisioned by 90-90-90. For instance, ensuring that 90% of HIV-infected persons know their status will require a large increase in access to HIV tests compared with what is currently available. To ensure that there are enough anti-retrovirals available to treat the nearly 25 million people that will require them by 2020 represents a near doubling of the ARV supplied to treat the 13 million currently on treatment. Similarly, to monitor those on treatment means an unprecedented scale-up of viral load testing throughout Africa. Conclusions Larger issues include whether the capacity exists at the local level to handle these commodities when they arrive in the most severely affected countries, including considerations of the human resources and costs needed to make this strategy effective. We believe that such “real world” analysis of proposed strategies and policies is essential to ensure their most effective implementation. PMID:27370169

The 90 90 90 strategy to end the HIV Pandemic by 2030: Can the supply chain handle it?

PubMed

Jamieson, David; Kellerman, Scott E

2016-01-01

UNAIDS "90-90-90" strategy calls for 90% of HIV-infected individuals to be diagnosed by 2020, 90% of whom will be on anti-retroviral therapy (ART) and 90% of whom will achieve sustained virologic suppression. Reaching these targets by 2020 will reduce the HIV epidemic to a low-level endemic disease by 2030. However, moving the global response towards this universal test and treat model will pose huge challenges to public health systems in resource-limited settings, including global and local supply chain systems. These challenges are especially acute in Africa, which accounts for over 70% of the persons affected by HIV. From a supply chain perspective, each of the "90's" has possible complications and roadblocks towards realizing the promise envisioned by 90-90-90. For instance, ensuring that 90% of HIV-infected persons know their status will require a large increase in access to HIV tests compared with what is currently available. To ensure that there are enough anti-retrovirals available to treat the nearly 25 million people that will require them by 2020 represents a near doubling of the ARV supplied to treat the 13 million currently on treatment. Similarly, to monitor those on treatment means an unprecedented scale-up of viral load testing throughout Africa. Larger issues include whether the capacity exists at the local level to handle these commodities when they arrive in the most severely affected countries, including considerations of the human resources and costs needed to make this strategy effective. We believe that such "real world" analysis of proposed strategies and policies is essential to ensure their most effective implementation.

The Safety of Available Immunotherapy for the Treatment of Glioblastoma

PubMed Central

Farber, S. Harrison; Elsamadicy, Aladine A.; Atik, Fatih; Suryadevara, Carter M.; Chongsathidkiet, Pakawat; Fecci, Peter E.; Sampson, John H.

2017-01-01

Introduction Glioblastoma (GBM) is the most common malignant primary brain tumor in adults. Current standard of care involves maximal surgical resection combined with adjuvant chemoradiation. Growing support exists for a role of immunotherapy in treating these tumors with the goal of targeted cytotoxicity. Here we review data on the safety for current immunotherapies being tested in GBM. Areas covered Safety data from published clinical trials, including ongoing clinical trials were reviewed. Immunotherapeutic classes currently under investigation in GBM include various vaccination strategies, adoptive T cell immunotherapy, immune checkpoint blockade, monoclonal antibodies, and cytokine therapies. Trials include children, adolescents, and adults with either primary or recurrent GBM. Expert commentary Based on the reviewed clinical trials, the current immunotherapies targeting GBM are safe and well-tolerated with minimal toxicities which should be noted. However, the gains in patient survival have been modest. A safe and well-tolerated combinatory immunotherapeutic approach may be essential for optimal efficacy towards GBM. PMID:27989218

[Oncofertility: a new focus in women health-care...].

PubMed

Chevalier, N; Dewailly, Didier; Fenichel, Patrick

2009-09-01

Although treatment and survival are the primary focus of health-care patients, with cancer survivors living longer it is now appropriate to consider their quality of life after treatment, including the possibility of becoming parents. There are several options for fertility preservation in cancer patients. Even though most of them are still experimental and their efficacy and reliability have not been determined, especially in women. The most successful alternative for female survivors is embryo cryopreservation, an approach not suitable for many single or virgin women or even possible for prepubertal girls. Reports of live birth after transplantation of human ovarian tissue have reinforced the clinical potential of ovarian tissue banking for fertility preservation. Many exciting studies are underway to improve the efficacy and solve the problems with current fertility preservation strategies, especially for in vitro culture of cryopreserved tissue or follicles. Continuous efforts to improve current strategies and to develop new strategies will benefit many women and children who are facing premature ovarian failure and sterility.

Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association.

PubMed

Cheng, Adam; Nadkarni, Vinay M; Mancini, Mary Beth; Hunt, Elizabeth A; Sinz, Elizabeth H; Merchant, Raina M; Donoghue, Aaron; Duff, Jonathan P; Eppich, Walter; Auerbach, Marc; Bigham, Blair L; Blewer, Audrey L; Chan, Paul S; Bhanji, Farhan

2018-06-21

The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time. This translates to suboptimal clinical care and poor survival outcomes from cardiac arrest. In many institutions, guidelines taught in courses are not thoughtfully implemented in the clinical environment. A current synthesis of the evidence supporting best educational and knowledge translation strategies in resuscitation is lacking. In this American Heart Association scientific statement, we provide a review of the literature describing key elements of educational efficiency and local implementation, including mastery learning and deliberate practice, spaced practice, contextual learning, feedback and debriefing, assessment, innovative educational strategies, faculty development, and knowledge translation and implementation. For each topic, we provide suggestions for improving provider performance that may ultimately optimize patient outcomes from cardiac arrest. © 2018 American Heart Association, Inc.

Infectious disease complications of combat-related injuries.

PubMed

Murray, Clinton K

2008-07-01

: Strategies currently used to prevent morbidity and mortality associated with combat-related injuries include better training of frontline medical personnel, improved personal protective equipment, and deployment of fast-forward surgical assets with state-of-the-art equipment. These strategies allow patients to survive near-catastrophic injuries, placing a greater emphasis on the medical infrastructure to mitigate short- and long-term complications associated with these injuries. : Wounds have certain characteristics that promote the development of infections: the presence of devitalized tissue, foreign bodies, clots, fluid collections, and contamination of wounds with bacteria from the casualty's skin, the environment, and the hospital. All of these factors culminate in placing the casualty at risk of developing an infection. : This article reviews the lessons learned from combat-related wound infections throughout history and in the current conflicts in Iraq and Afghanistan. Many of the management strategies used to prevent infections of combat-related injuries are applicable to the management of civilian trauma, whether associated with small arms fire or related to natural disasters such as earthquakes or tornadoes.

Perceived Discrimination, Coping Strategies, and Mexican Origin Adolescents’ Internalizing and Externalizing Behaviors: Examining the Moderating Role of Gender and Cultural Orientation

PubMed Central

Brittian, Aerika S.; Toomey, Russell B.; Gonzales, Nancy A.; Dumka, Larry E.

2013-01-01

The literature identifying effective coping strategies related to perceived discrimination has yielded mixed findings, suggesting that recommendations for effective coping may vary by individual and group differences. The current study examined the influence of perceived discrimination and coping strategies on Mexican origin adolescents’ later internalizing symptoms and externalizing behaviors, and assessed the moderating roles of gender and cultural orientation. Participants included 189 adolescents (46% male, 54% female) interviewed at 7th and 8th grade. Results suggested that the associations between perceived discrimination and internalizing symptoms were buffered by distraction coping among youth that were low on Anglo orientation but not among youth high on Anglo orientation. In addition, the associations between perceived discrimination and externalizing behaviors were buffered by social support seeking, but only among youth that were low on Mexican orientation. Directions for future research and application of the current research are discussed. PMID:23833550

Human Exploration of Mars Design Reference Architecture 5.0

NASA Technical Reports Server (NTRS)

Drake, Bret G.

2009-01-01

This document reviews the Design Reference Architecture (DRA) for human exploration of Mars. The DRA represents the current best strategy for human missions. The DRA is not a formal plan, but provides a vision and context to tie current systems and technology developments to potential missions to Mars, and it also serves as a benchmark against which alternative architectures can be measured. The document also reviews the objectives and products of the 2007 study that was to update NASA's human Mars mission reference architecture, assess strategic linkages between lunar and Mars strategies, develop an understanding of methods for reducing cost/risk of human missions through investment in research, technology development and synergy with other exploration plans. There is also a review of the process by which the DRA will continue to be refined. The unique capacities of human exploration is reviewed. The possible goals and objectives of the first three human missions are presented, along with the recommendation that the mission involve a long stay visiting multiple sites.The deployment strategy is outlined and diagrammed including the pre-deployment of the many of the material requirements, and a six crew travel to Mars on a six month trajectory. The predeployment and the Orion crew vehicle are shown. The ground operations requirements are also explained. Also the use of resources found on the surface of Mars is postulated. The Mars surface exploration strategy is reviewed, including the planetary protection processes that are planned. Finally a listing of the key decisions and tenets is posed.

Disease and health management in Asian aquaculture.

PubMed

Bondad-Reantaso, Melba G; Subasinghe, Rohana P; Arthur, J Richard; Ogawa, Kazuo; Chinabut, Supranee; Adlard, Robert; Tan, Zilong; Shariff, Mohamed

2005-09-30

Asia contributes more than 90% to the world's aquaculture production. Like other farming systems, aquaculture is plagued with disease problems resulting from its intensification and commercialization. This paper describes the various factors, providing specific examples, which have contributed to the current disease problems faced by what is now the fastest growing food-producing sector globally. These include increased globalization of trade and markets; the intensification of fish-farming practices through the movement of broodstock, postlarvae, fry and fingerlings; the introduction of new species for aquaculture development; the expansion of the ornamental fish trade; the enhancement of marine and coastal areas through the stocking of aquatic animals raised in hatcheries; the unanticipated interactions between cultured and wild populations of aquatic animals; poor or lack of effective biosecurity measures; slow awareness on emerging diseases; the misunderstanding and misuse of specific pathogen free (SPF) stocks; climate change; other human-mediated movements of aquaculture commodities. Data on the socio-economic impacts of aquatic animal diseases are also presented, including estimates of losses in production, direct and indirect income and employment, market access or share of investment, and consumer confidence; food availability; industry failures. Examples of costs of investment in aquatic animal health-related activities, including national strategies, research, surveillance, control and other health management programmes are also provided. Finally, the strategies currently being implemented in the Asian region to deal with transboundary diseases affecting the aquaculture sector are highlighted. These include compliance with international codes, and development and implementation of regional guidelines and national aquatic animal health strategies; new diagnostic and therapeutic techniques and new information technology; new biosecurity measures including risk analysis, epidemiology, surveillance, reporting and planning for emergency response to epizootics; targeted research; institutional strengthening and manpower development (education, training and extension research and diagnostic services).

Mitigating Future Avian Malaria Threats to Hawaiian Forest Birds from Climate Change.

PubMed

Liao, Wei; Atkinson, Carter T; LaPointe, Dennis A; Samuel, Michael D

2017-01-01

Avian malaria, transmitted by Culex quinquefasciatus mosquitoes in the Hawaiian Islands, has been a primary contributor to population range limitations, declines, and extinctions for many endemic Hawaiian honeycreepers. Avian malaria is strongly influenced by climate; therefore, predicted future changes are expected to expand transmission into higher elevations and intensify and lengthen existing transmission periods at lower elevations, leading to further population declines and potential extinction of highly susceptible honeycreepers in mid- and high-elevation forests. Based on future climate changes and resulting malaria risk, we evaluated the viability of alternative conservation strategies to preserve endemic Hawaiian birds at mid and high elevations through the 21st century. We linked an epidemiological model with three alternative climatic projections from the Coupled Model Intercomparison Project to predict future malaria risk and bird population dynamics for the coming century. Based on climate change predictions, proposed strategies included mosquito population suppression using modified males, release of genetically modified refractory mosquitoes, competition from other introduced mosquitoes that are not competent vectors, evolved malaria-tolerance in native honeycreepers, feral pig control to reduce mosquito larval habitats, and predator control to improve bird demographics. Transmission rates of malaria are predicted to be higher than currently observed and are likely to have larger impacts in high-elevation forests where current low rates of transmission create a refuge for highly-susceptible birds. As a result, several current and proposed conservation strategies will be insufficient to maintain existing forest bird populations. We concluded that mitigating malaria transmission at high elevations should be a primary conservation goal. Conservation strategies that maintain highly susceptible species like Iiwi (Drepanis coccinea) will likely benefit other threatened and endangered Hawai'i species, especially in high-elevation forests. Our results showed that mosquito control strategies offer potential long-term benefits to high elevation Hawaiian honeycreepers. However, combined strategies will likely be needed to preserve endemic birds at mid elevations. Given the delay required to research, develop, evaluate, and improve several of these currently untested conservation strategies we suggest that planning should begin expeditiously.

Mitigating future avian malaria threats to Hawaiian forest birds from climate change

USGS Publications Warehouse

Liao, Wei; Atkinson, Carter T.; LaPointe, Dennis; Samuel, Michael D.

2017-01-01

Avian malaria, transmitted by Culex quinquefasciatus mosquitoes in the Hawaiian Islands, has been a primary contributor to population range limitations, declines, and extinctions for many endemic Hawaiian honeycreepers. Avian malaria is strongly influenced by climate; therefore, predicted future changes are expected to expand transmission into higher elevations and intensify and lengthen existing transmission periods at lower elevations, leading to further population declines and potential extinction of highly susceptible honeycreepers in mid- and high-elevation forests. Based on future climate changes and resulting malaria risk, we evaluated the viability of alternative conservation strategies to preserve endemic Hawaiian birds at mid and high elevations through the 21st century. We linked an epidemiological model with three alternative climatic projections from the Coupled Model Intercomparison Project to predict future malaria risk and bird population dynamics for the coming century. Based on climate change predictions, proposed strategies included mosquito population suppression using modified males, release of genetically modified refractory mosquitoes, competition from other introduced mosquitoes that are not competent vectors, evolved malaria-tolerance in native honeycreepers, feral pig control to reduce mosquito larval habitats, and predator control to improve bird demographics. Transmission rates of malaria are predicted to be higher than currently observed and are likely to have larger impacts in high-elevation forests where current low rates of transmission create a refuge for highly-susceptible birds. As a result, several current and proposed conservation strategies will be insufficient to maintain existing forest bird populations. We concluded that mitigating malaria transmission at high elevations should be a primary conservation goal. Conservation strategies that maintain highly susceptible species like Iiwi (Drepanis coccinea) will likely benefit other threatened and endangered Hawai’i species, especially in high-elevation forests. Our results showed that mosquito control strategies offer potential long-term benefits to high elevation Hawaiian honeycreepers. However, combined strategies will likely be needed to preserve endemic birds at mid elevations. Given the delay required to research, develop, evaluate, and improve several of these currently untested conservation strategies we suggest that planning should begin expeditiously.

Public health and church-based constructions of HIV prevention: black Baptist perspective

PubMed Central

Roman Isler, Malika; Eng, Eugenia; Maman, Susanne; Adimora, Adaora; Weiner, Bryan

2014-01-01

The black church is influential in shaping health behaviors within African-American communities, yet few use evidence-based strategies for HIV prevention (abstinence, monogamy, condoms, voluntary counseling and testing, and prevention with positives). Using principles of grounded theory and interpretive description, we explored the social construction of HIV prevention within black Baptist churches in North Carolina. Data collection included interviews with church leaders (n = 12) and focus groups with congregants (n = 7; 36 participants). Analytic tools included open coding and case-level comparisons. Social constructions of HIV/AIDS prevention were influenced by two worldviews: public health and church-based. Areas of compatibility and incompatibility exist between the two worldviews that inform acceptability and adaptability of current evidence-based strategies. These findings offer insight into ways to increase the compatibility of evidence-based HIV prevention strategies within the black Baptist church context. PMID:24643141

Women in HIV cure research: multilevel interventions to improve sex equity in recruitment.

PubMed

Grewe, Mary E; Ma, Yuntong; Gilbertson, Adam; Rennie, Stuart; Tucker, Joseph D

Women are underrepresented in HIV cure research. In this paper we discuss the rationale for including women and propose multilevel strategies to improve sex equity in HIV cure research. The inadequate inclusion of women in HIV cure research is concerning for both scientific and ethical reasons. Biological responses to HIV and HIV treatment, as well as social contexts, differ between men and women, and this may affect the efficacy of curative interventions. Strategies for improving sex equity in HIV cure research include addressing eligibility criteria, adapting recruitment strategies, engaging community members early in the research process, and promoting funder policy changes. We conclude by describing the Gender, Race, and Clinical Experience (GRACE) study, which is one example of how women can be effectively recruited into HIV-related clinical trials. While HIV cure research is currently in the early stages, as it continues to develop it is important to mobilise for adequate inclusion of women.

Development of a Two-Wheel Contingency Mode for the MAP Spacecraft

NASA Technical Reports Server (NTRS)

Starin, Scott R.; ODonnell, James R., Jr.; Bauer, Frank (Technical Monitor)

2002-01-01

The Microwave Anisotropy Probe (MAP) is a follow-on mission to the Cosmic Background Explorer (COBE), and is currently collecting data from its orbit near the second Sun-Earth libration point. Due to limited mass, power, and financial resources, a traditional reliability concept including fully redundant components was not feasible for MAP. Instead, the MAP design employs selective hardware redundancy in tandem with contingency software modes and algorithms to improve the odds of mission success. One direction for such improvement has been the development of a two-wheel backup control strategy. This strategy would allow MAP to position itself for maneuvers and collect science data should one of its three reaction wheels fail. Along with operational considerations, the strategy includes three new control algorithms. These algorithms would use the remaining attitude control actuators-thrusters and two reaction wheels-in ways that achieve control goals while minimizing adverse impacts on the functionality of other subsystems and software.

Cost-effectiveness of three different vaccination strategies against measles in Zambian children.

PubMed

Dayan, Gustavo H; Cairns, Lisa; Sangrujee, Nalinee; Mtonga, Anne; Nguyen, Van; Strebel, Peter

2004-01-02

The vaccination program in Zambia includes one dose of measles vaccine at 9 months of age. The objective of this study was to compare the cost-effectiveness of the current one-dose measles vaccination program with an immunization schedule in which a second dose is provided either through routine health services or through supplemental immunization activities (SIAs). We simulated the expected cost and impact of the vaccination strategies for an annual cohort of 400,000 children, assuming 80% vaccination coverage in both routine and SIAs and an analytic horizon of 15 years. A vaccination program which includes SIAs reaching children not previously vaccinated would prevent on additional 29,242 measles cases and 1462 deaths for each vaccinated birth cohort when compared with a one-dose program. Given the parameters established for this analysis, such a program would be cost-saving and the most cost-effective vaccination strategy for Zambia.

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

Mendell, Mark J.; Apte, Mike G.

This report considers the question of whether the California Energy Commission should incorporate the ASHRAE 62.1 ventilation standard into the Title 24 ventilation rate (VR) standards, thus allowing buildings to follow the Indoor Air Quality Procedure. This, in contrast to the current prescriptive standard, allows the option of using ventilation rate as one of several strategies, which might include source reduction and air cleaning, to meet specified targets of indoor air concentrations and occupant acceptability. The research findings reviewed in this report suggest that a revised approach to a ventilation standard for commercial buildings is necessary, because the current prescriptivemore » ASHRAE 62.1 Ventilation Rate Procedure (VRP) apparently does not provide occupants with either sufficiently acceptable or sufficiently healthprotective air quality. One possible solution would be a dramatic increase in the minimum ventilation rates (VRs) prescribed by a VRP. This solution, however, is not feasible for at least three reasons: the current need to reduce energy use rather than increase it further, the problem of polluted outdoor air in many cities, and the apparent limited ability of increasing VRs to reduce all indoor airborne contaminants of concern (per Hodgson (2003)). Any feasible solution is thus likely to include methods of pollutant reduction other than increased outdoor air ventilation; e.g., source reduction or air cleaning. The alternative 62.1 Indoor Air Quality Procedure (IAQP) offers multiple possible benefits in this direction over the VRP, but seems too limited by insufficient specifications and inadequate available data to provide adequate protection for occupants. Ventilation system designers rarely choose to use it, finding it too arbitrary and requiring use of much non-engineering judgment and information that is not readily available. This report suggests strategies to revise the current ASHRAE IAQP to reduce its current limitations. These strategies, however, would make it more complex and more prescriptive, and would require substantial research. One practical intermediate strategy to save energy would be an alternate VRP, allowing VRs lower than currently prescribed, as long as indoor VOC concentrations were no higher than with VRs prescribed under the current VRP. This kind of hybrid, with source reduction and use of air cleaning optional but permitted, could eventually evolve, as data, materials, and air-cleaning technology allowed gradual lowering of allowable concentrations, into a fully developed IAQP. Ultimately, it seems that VR standards must evolve to resemble the IAQP, especially in California, where buildings must achieve zero net energy use within 20 years.« less

Healthy versus Entorhinal Cortical Atrophy Identification in Asymptomatic APOE4 Carriers at Risk for Alzheimer’s Disease

PubMed Central

Konishi, Kyoko; Joober, Ridha; Poirier, Judes; MacDonald, Kathleen; Chakravarty, Mallar; Patel, Raihaan; Breitner, John; Bohbot, Véronique D.

2018-01-01

Early detection of Alzheimer’s disease (AD) has been challenging as current biomarkers are invasive and costly. Strong predictors of future AD diagnosis include lower volume of the hippocampus and entorhinal cortex, as well as the ɛ4 allele of the Apolipoprotein E gene (APOE) gene. Therefore, studying functions that are critically mediated by the hippocampus and entorhinal cortex, such as spatial memory, in APOE ɛ4 allele carriers, may be key to the identification of individuals at risk of AD, prior to the manifestation of cognitive impairments. Using a virtual navigation task developed in-house, specifically designed to assess spatial versus non-spatial strategies, the current study is the first to differentiate functional and structural differences within APOE ɛ4 allele carriers. APOE ɛ4 allele carriers that predominantly use non-spatial strategies have decreased fMRI activity in the hippocampus and increased atrophy in the hippocampus, entorhinal cortex, and fimbria compared to APOE ɛ4 allele carriers who use spatial strategies. In contrast, APOE ɛ4 allele carriers who use spatial strategies have grey matter levels comparable to non-APOE ɛ4 allele carriers. Furthermore, in a leave-one-out analysis, grey matter in the entorhinal cortex could predict navigational strategy with 92% accuracy. PMID:29278888

Healthy versus Entorhinal Cortical Atrophy Identification in Asymptomatic APOE4 Carriers at Risk for Alzheimer's Disease.

PubMed

Konishi, Kyoko; Joober, Ridha; Poirier, Judes; MacDonald, Kathleen; Chakravarty, Mallar; Patel, Raihaan; Breitner, John; Bohbot, Véronique D

2018-01-01

Early detection of Alzheimer's disease (AD) has been challenging as current biomarkers are invasive and costly. Strong predictors of future AD diagnosis include lower volume of the hippocampus and entorhinal cortex, as well as the ɛ4 allele of the Apolipoprotein E gene (APOE) gene. Therefore, studying functions that are critically mediated by the hippocampus and entorhinal cortex, such as spatial memory, in APOE ɛ4 allele carriers, may be key to the identification of individuals at risk of AD, prior to the manifestation of cognitive impairments. Using a virtual navigation task developed in-house, specifically designed to assess spatial versus non-spatial strategies, the current study is the first to differentiate functional and structural differences within APOE ɛ4 allele carriers. APOE ɛ4 allele carriers that predominantly use non-spatial strategies have decreased fMRI activity in the hippocampus and increased atrophy in the hippocampus, entorhinal cortex, and fimbria compared to APOE ɛ4 allele carriers who use spatial strategies. In contrast, APOE ɛ4 allele carriers who use spatial strategies have grey matter levels comparable to non-APOE ɛ4 allele carriers. Furthermore, in a leave-one-out analysis, grey matter in the entorhinal cortex could predict navigational strategy with 92% accuracy.

SSV Launch Monitoring Strategies: HGDS Design and Development Through System Maturity

NASA Technical Reports Server (NTRS)

Shoemaker, Marc D.; Crimi, Thomas

2010-01-01

This poster presentation reviews the design and development of the Hazardous Gas Detection System (HGDS). It includes a overview schematic of the HGDS, pictures of the shuttle on the Mobile Launch platform, the original HGDS, the current HGDS and parts of the original and current system. There are charts showing the dynamics of the orbiter during external tank loading, and transient leaks observed on HGDS during Power Reactant Storage and Distribution (PRSD) load.

Current Status of Protein Force Fields for Molecular Dynamics

PubMed Central

Lopes, Pedro E.M.; Guvench, Olgun

2015-01-01

Summary The current status of classical force fields for proteins is reviewed. These include additive force fields as well as the latest developments in the Drude and AMOEBA polarizable force fields. Parametrization strategies developed specifically for the Drude force field are described and compared with the additive CHARMM36 force field. Results from molecular simulations of proteins and small peptides are summarized to illustrate the performance of the Drude and AMOEBA force fields. PMID:25330958

The cytokine storm of severe influenza and development of immunomodulatory therapy.

PubMed

Liu, Qiang; Zhou, Yuan-hong; Yang, Zhan-qiu

2016-01-01

Severe influenza remains unusual in its virulence for humans. Complications or ultimately death arising from these infections are often associated with hyperinduction of proinflammatory cytokine production, which is also known as 'cytokine storm'. For this disease, it has been proposed that immunomodulatory therapy may improve the outcome, with or without the combination of antiviral agents. Here, we review the current literature on how various effectors of the immune system initiate the cytokine storm and exacerbate pathological damage in hosts. We also review some of the current immunomodulatory strategies for the treatment of cytokine storms in severe influenza, including corticosteroids, peroxisome proliferator-activated receptor agonists, sphingosine-1-phosphate receptor 1 agonists, cyclooxygenase-2 inhibitors, antioxidants, anti-tumour-necrosis factor therapy, intravenous immunoglobulin therapy, statins, arbidol, herbs, and other potential therapeutic strategies.

Current Methods for Skeletal Muscle Tissue Repair and Regeneration

PubMed Central

Liu, Juan; Saul, Dominik; Böker, Kai Oliver; Ernst, Jennifer; Lehman, Wolfgang

2018-01-01

Skeletal muscle has the capacity of regeneration after injury. However, for large volumes of muscle loss, this regeneration needs interventional support. Consequently, muscle injury provides an ongoing reconstructive and regenerative challenge in clinical work. To promote muscle repair and regeneration, different strategies have been developed within the last century and especially during the last few decades, including surgical techniques, physical therapy, biomaterials, and muscular tissue engineering as well as cell therapy. Still, there is a great need to develop new methods and materials, which promote skeletal muscle repair and functional regeneration. In this review, we give a comprehensive overview over the epidemiology of muscle tissue loss, highlight current strategies in clinical treatment, and discuss novel methods for muscle regeneration and challenges for their future clinical translation. PMID:29850487

Spatial organization of multi-enzyme biocatalytic cascades.

PubMed

Quin, M B; Wallin, K K; Zhang, G; Schmidt-Dannert, C

2017-05-23

Industrial biocatalysis is an economically attractive option for the production of valuable chemicals. Our repertoire of cheap building blocks and commodity target molecules is vastly enhanced by multi-enzyme biocatalytic cascades. In order to achieve suitable titers in complex novel biocatalytic schemes, spatial organization may become necessary to overcome barriers caused by slow or inhibited enzymes as well as instability of biocatalysts. A number of spatial organization strategies are currently available, which could be integrated in the design of complex cascades. These include fusion proteins, immobilization on solid supports, multi-dimensional scaffolding, and encapsulation within vessels. This review article highlights recent advances in cascade biocatalysis, discusses the role of spatial organization in reaction kinetics, and presents some of the currently employed strategies for spatial organization of multi-enzyme cascades.

A new concept for the exploration of Europa.

PubMed

Rampelotto, Pabulo Henrique

2012-06-01

The Europa Jupiter System Mission (EJSM) is the major Outer Planet Flagship Mission in preparation by NASA. Although well designed, the current EJSM concept may present problematic issues as a Flagship Mission for a long-term exploration program that will occur over the course of decades. For this reason, the present work reviews the current EJSM concept and presents a new strategy for the exploration of Europa. In this concept, the EJSM is reorganized to comprise three independent missions focused on Europa. The missions are split according to scientific goals, which together will give a complete understanding of the potential habitability of Europa, including in situ life's signal measurements. With this alternative strategy, a complete exploration of Europa would be possible in the next decades, even within a politically and economically constrained environment.

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes.

PubMed

Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

2017-03-06

Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care) perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Veterinary teaching hospitals: current challenges and pathways for the future.

PubMed

Hubbell, John A E

2008-01-01

University-based veterinary teaching hospitals must change to maintain their viability. A number of factors both internal and external to universities and the veterinary profession have contributed to the need for change. A task force formed by the Association of American Veterinary Medical Colleges and the American Association of Veterinary Clinicians was convened to identify the issues and propose individual and collective strategies for the future. Primary issues include a shortage of faculty and staff, the nature of the case load, the need for fiscal management strategies, and the need to manage stakeholder expectations. The majority of the proposed strategies for the future will be managed individually by the colleges. Proposed collective strategies center on increasing the number of specialists and improving recruitment and retention of faculty and staff.

A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research.

PubMed

Crowley, Max; Jones, Damon

2017-03-01

Investing in strategies that aim to build a more nurturing society offers tremendous opportunities for the field of prevention science. Yet, scientists struggle to consistently take their research beyond effectiveness evaluations and actually value the impact of preventive strategies. Ultimately, it is clear that convincing policymakers to make meaningful investments in children and youth will require estimates of the fiscal impact of such strategies across public service systems. The framework offered here values such investments. First, we review current public spending on children and families. Then, we describe how to quantify and monetize the impact of preventive interventions. This includes a new measurement strategy for assessing multisystem service utilization and a price list for key service provision from public education, social services, criminal justice, health care and tax systems.

A new, but old business model for family physicians: cash.

PubMed

Weber, J Michael

2013-01-01

The following study is an exploratory investigation into the opportunity identification, opportunity analysis, and strategic implications of implementing a cash-only family physician practice. The current market dynamics (i.e., increasing insurance premiums, decreasing benefits, more regulations and paperwork, and cuts in federal and state programs) suggest that there is sufficient motivation for these practitioners to change their current business model. In-depth interviews were conducted with office managers and physicians of family physician practices. The results highlighted a variety of issues, including barriers to change, strategy issues, and opportunities/benefits. The implications include theory applications, strategic marketing applications, and managerial decision-making.

Educating Parents on Developmentally Age-Appropriate Learning in Preschool.

ERIC Educational Resources Information Center

Brown, Mitzi C.

This practicum paper reports on a project undertaken to enhance the knowledge of age-appropriate learning for parents of 3-year-old preschoolers. The project implemented a variety of techniques and strategies to improve parent knowledge, including parent education classes, a monthly newsletter for parents that addressed current research on…

Mapping Climate Change: Six U.S. Case Studies

ERIC Educational Resources Information Center

Holmberg, Marjorie O.

2010-01-01

This research focuses on the current role of mapping practices in communicating climate change in the United States. This includes maps used in monitoring climate change, projecting its potential impacts, and identifying potential adaptation strategies at particular scales. Since few, if any, studies have been done specifically on mapping…

Influence of shelterbelts on organic matter of chernozems in the light of global climate change

USDA-ARS?s Scientific Manuscript database

Achieving the ambitious cellulosic biofuel production goals currently in place in the United States will require a dramatic increase in cellulosic feedstock supply. One strategy to meet this need is to utilize perennial species including short-rotation woody species on marginal agricultural lands. F...

Journalism in the "Post-Factual Age".

ERIC Educational Resources Information Center

Ettema, James S.

1987-01-01

Discusses current themes in communication research. Claims that this research offers an increasingly sophisticated view of journalism as a reflection not of an objective reality, but of political-economic power and sociocultural conflict. Includes an example of an imaginary symposium and a strategy for reframing the journalistic quest for truth.…

Modifying Reading Instruction to Maximize Its Effectiveness for All Students. Technical Report No. 489.

ERIC Educational Resources Information Center

Garcia, Georgia Earnest; Pearson, P. David

This report discusses how reading instruction should be modified to facilitate the development of comprehension strategies in all children (including those labeled as "at-risk" or "disadvantaged"). Current theoretical views of reading comprehension do not support a discrete skills perspective, but classroom research has…

Adaptive or Transactional Leadership in Current Higher Education: A Brief Comparison

ERIC Educational Resources Information Center

Khan, Natalie

2017-01-01

Higher education institutions operate in a complex environment that includes influence from external factors, new technologies for teaching and learning, globalization, and changing student demographics to name a few. Maneuvering such complexity and change requires a leadership strategy that is flexible and supportive. This paper reviews two…

Learning to Write and Loving It! Preschool-Kindergarten

ERIC Educational Resources Information Center

Trehearne, Miriam P.

2011-01-01

"Learning to Write and Loving It!" equips teachers of young children with practical strategies, assessment tools, and motivating writing activities that are based on current research and proven practice and are easily applicable to all kinds of learning environments. Included are many authentic writing samples and photos to illustrate effective,…

76 FR 11279 - Agency Information Collection Activities: Extension of a Currently Approved Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-01

... (institutions of higher education) of the Grants to Reduce Violent Crimes Against Women on Campus Program whose... of higher education to develop and strengthen effective security and investigation strategies to combat violent crimes against women on campuses, including domestic violence, dating violence, sexual...

Psychological Issues in Cancer Genetics: Current Research and Future Priorities.

ERIC Educational Resources Information Center

Hopwood, Penelope

1997-01-01

Data concerning the psychological impact of high risk of cancer are reviewed, including implications of genetic testing, breast screening,and accuracy of women's risk estimates. Work in progress on prophylactic mastectomy and chemoprevention is reviewed. Research on cancer families, and interventions and prevention strategies for high-risk…

Weed biocontrol in the EU: from serendipity to strategy

USDA-ARS?s Scientific Manuscript database

Biological control of weeds is a globally-recognized approach to the management of the worst invasive plants in the world. Unfortunately, accidental introduction of agents account for most weed biocontrol in the EU, but do include a number of current or emerging successes. From the redistribution of...

Electrically heated particulate filter restart strategy

DOEpatents

Gonze, Eugene V [Pinckney, MI; Ament, Frank [Troy, MI

2011-07-12

A control system that controls regeneration of a particulate filter is provided. The system generally includes a propagation module that estimates a propagation status of combustion of particulate matter in the particulate filter. A regeneration module controls current to the particulate filter to re-initiate regeneration based on the propagation status.

Teaching Strategy: Using the Civil Law Poster.

ERIC Educational Resources Information Center

Update on Law-Related Education, 1997

1997-01-01

Presents a series of instructional activities to be used in conjunction with a poster that identifies types of cases and processes associated with civil law. Includes procedures for the instructional activities, objectives, a poster, and student handouts using tables and graphs to illustrate current facts about tort law. (MJP)

Rediscovering Renaissance Research: Information Literacy Strategies for Success

ERIC Educational Resources Information Center

Gilchrist, Sarah Burns

2016-01-01

While remaining cognizant of several aspects of current information literacy (IL) instruction methods, including threshold concepts, the author re-created experiences shared by students as she searched for, analyzed, and compiled resources pertaining to the Renaissance. Good IL instruction supports education of the whole person, develops new modes…

Computer-Aided Authoring of Programmed Instruction for Teaching Symbol Recognition. Final Report.

ERIC Educational Resources Information Center

Braby, Richard; And Others

This description of AUTHOR, a computer program for the automated authoring of programmed texts designed to teach symbol recognition, includes discussions of the learning strategies incorporated in the design of the instructional materials, hardware description and the algorithm for the software, and current and future developments. Appendices…

The Geography of Connection: Bringing the World to Students.

ERIC Educational Resources Information Center

Black, Mary S.

2000-01-01

Discusses strategies used by two teachers for teaching geography to at-risk students to connect the subject matter to the student's lives. Includes techniques such as integrating music, art, language, employing simulations when teaching, using current events to improve students' reading skills, and utilizing computer technology. (CMK)

American Indian Adolescent Girls: Vulnerability to Sex Trafficking, Intervention Strategies

ERIC Educational Resources Information Center

Pierce, Alexandra

2012-01-01

The Minnesota Indian Women's Resource Center offers harm reduction programming to at-risk adolescent American Indian girls, including outreach, case management, advocacy, healthy sexuality education, and support groups. To evaluate program impact, participants are assessed at intake and every 6 months afterward for current vulnerability to…

Web OPAC Interfaces: An Overview.

ERIC Educational Resources Information Center

Babu, B. Ramesh; O'Brien, Ann

2000-01-01

Discussion of Web-based online public access catalogs (OPACs) focuses on a review of six Web OPAC interfaces in use in academic libraries in the United Kingdom. Presents a checklist and guidelines of important features and functions that are currently available, including search strategies, access points, display, links, and layout. (Author/LRW)

Thinking Happens in the Head.

ERIC Educational Resources Information Center

Wagner, Betty Jane

Students are most likely to retain information presented in the classroom when it is made meaningful and personal to them. Strategies for immersing students in a subject can include, for example, holding an authentic style Roman feast for a Latin class, letting students hold their own "town meeting" and discuss current issues to learn…

Body Awareness and Movement for Students with Multiple Disabilities Including Visual Impairments

ERIC Educational Resources Information Center

DePountis, Vicki; Cady, Deborah; Hallak, Tracy

2013-01-01

This conference presentation examines concept development for congenitally blind students. It presents current research on best-practice for teaching this population. Examples of strategies to reinforce understanding of body concepts, spatial awareness, and positional language, while promoting mirroring, self regulation, and purposeful movement to…

Timing and Methodology of Application of Azoxystrobin to Control Rhizoctonia Solani in Sugarbeet

USDA-ARS?s Scientific Manuscript database

Rhizoctonia solani AG 2-2 is the causal agent of Rhizoctonia root and crown rot of sugar beet (Beta vulgaris) in North Dakota and Minnesota. This disease is a major limiting factor to sugar beet production. Management strategies currently include using partially resistant cultivars and fungicides. ...

Academe Sings the Blues

ERIC Educational Resources Information Center

Wood, Robert

1975-01-01

Lack of an overall strategy for change, hostile political and social environment, and a mood of hesitancy to defend themselves, have contributed to the current problems of higher education. New directions for the future are proposed which include rational decision making based upon how the university fits the purposes and problems of the times.…

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

ERIC Educational Resources Information Center

George, Amiso M.

2003-01-01

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

Why Teach the Electron Configuration of the Elements as We Do?

ERIC Educational Resources Information Center

Millikan, Roger C.

1982-01-01

Discusses pros and cons of current methods of teaching electron configurations of elements. Offers alternative instructional strategies, suggesting that although tables of electron configurations are useful and in conjunction with periodic tables may help solve many problems, they should be included as reference material. (Author/JN)

Review of Mathematics Interventions for Secondary Students with Learning Disabilities

ERIC Educational Resources Information Center

Marita, Samantha; Hord, Casey

2017-01-01

Recent educational policy has raised the standards that all students, including students with disabilities, must meet in mathematics. To examine the strategies currently used to support students with learning disabilities, the authors reviewed literature from 2006 to 2014 on mathematics interventions for students with learning disabilities. The 12…

A Proposed Conceptual Model to Measure Unwarranted Practice Variation

DTIC Science & Technology

2007-05-03

its design. The AMEDD should be proud of its long history of clinical, educational, and technological innovation in the field of medicine. Its current...estimate or any other aspect of this collection ofinformation , including suggestions for reducing the burden, to Department of Defense. Washington...Strategy.................................................................. 11 Role of the Researcher

Bunch Splitting Simulations for the JLEIC Ion Collider Ring

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

Satogata, Todd J.; Gamage, Randika

2016-05-01

We describe the bunch splitting strategies for the proposed JLEIC ion collider ring at Jefferson Lab. This complex requires an unprecedented 9:6832 bunch splitting, performed in several stages. We outline the problem and current results, optimized with ESME including general parameterization of 1:2 bunch splitting for JLEIC parameters.

Perspectives on the utilization of aquaculture coproduct in Europe and Asia: prospects for value addition and improved resource efficiency.

PubMed

Newton, Richard; Telfer, Trevor; Little, Dave

2014-01-01

Aquaculture has often been criticized for its environmental impacts, especially efficiencies concerning global fisheries resources for use in aquafeeds among others. However, little attention has been paid to the contribution of coproducts from aquaculture, which can vary between 40% and 70% of the production. These have often been underutilized and could be redirected to maximize the efficient use of resource inputs including reducing the burden on fisheries resources. In this review, we identify strategies to enhance the overall value of the harvested yield including noneffluent processing coproducts for three of the most important global aquaculture species, and discuss the current and prospective utilization of these resources for value addition and environmental impact reduction. The review concludes that in Europe coproducts are often underutilized because of logistical reasons such as the disconnected nature of the value chain, and perceived legislative barriers. However, in Asia, most coproducts are used, often innovatively but not to their full economic potential and sometimes with possible human health and biosecurity risks. These include possible spread of diseased material and low traceability in some circumstances. Full economic and environmental appraisal is long overdue for the current and potential strategies available for coproduct utilization.

Vaccination against Salmonella Infection: the Mucosal Way.

PubMed

Gayet, Rémi; Bioley, Gilles; Rochereau, Nicolas; Paul, Stéphane; Corthésy, Blaise

2017-09-01

Salmonella enterica subspecies enterica includes several serovars infecting both humans and other animals and leading to typhoid fever or gastroenteritis. The high prevalence of associated morbidity and mortality, together with an increased emergence of multidrug-resistant strains, is a current global health issue that has prompted the development of vaccination strategies that confer protection against most serovars. Currently available systemic vaccine approaches have major limitations, including a reduced effectiveness in young children and a lack of cross-protection among different strains. Having studied host-pathogen interactions, microbiologists and immunologists argue in favor of topical gastrointestinal administration for improvement in vaccine efficacy. Here, recent advances in this field are summarized, including mechanisms of bacterial uptake at the intestinal epithelium, the assessment of protective host immunity, and improved animal models that closely mimic infection in humans. The pros and cons of existing vaccines are presented, along with recent progress made with novel formulations. Finally, new candidate antigens and their relevance in the refined design of anti- Salmonella vaccines are discussed, along with antigen vectorization strategies such as nanoparticles or secretory immunoglobulins, with a focus on potentiating mucosal vaccine efficacy. Copyright © 2017 American Society for Microbiology.

Preparing for the future: a review of tools and strategies to support autonomous goal setting for children and youth with autism spectrum disorders.

PubMed

Hodgetts, Sandra; Park, Elly

2017-03-01

Despite recognized benefits, current clinical practice rarely includes direct input from children and youth with autism spectrum disorder (ASD) in setting rehabilitation goals. This study reviews tools and evidence-based strategies to assist with autonomous goal settings for children and youth with ASD. This study included two components: (1) A scoping review of existing tools and strategies to assist with autonomous goal setting in individuals with ASD and (2) a chart review of inter-disciplinary service plan goals for children and youth with ASD. Eleven data sources, evaluating five different tools to assist with autonomous goal setting for children and youth with ASD, were found. Three themes emerged from the integration of the scoping review and chart review, which are discussed in the paper: (1) generalizability of findings, (2) adaptations to support participation and (3) practice implications. Children and youth with ASD can participate in setting rehabilitation goals, but few tools to support their participation have been evaluated, and those tools that do exist do not align well with current services foci. Visual aids appear to be one effective support, but further research on effective strategies for meaningful engagement in autonomous goal setting for children and youth with ASD is warranted. Implications for rehabilitation Persons with ASD are less self-determined than their peers. Input into one's own rehabilitation goals and priorities is an important component of self-determination. Few tools exist to help engage children and youth with ASD in setting their own rehabilitation goals. An increased focus on identifying, developing and evaluating effective tools and strategies to facilitate engagement of children and youth with ASD in setting their own rehabilitation goals is warranted.

An Overview of Vaccination Strategies and Antigen Delivery Systems for Streptococcus agalactiae Vaccines in Nile Tilapia (Oreochromis niloticus)

PubMed Central

Munang’andu, Hetron Mweemba; Paul, Joydeb; Evensen, Øystein

2016-01-01

Streptococcus agalactiae is an emerging infectious disease adversely affecting Nile tilapia (Niloticus oreochromis) production in aquaculture. Research carried out in the last decade has focused on developing protective vaccines using different strategies, although no review has been carried out to evaluate the efficacy of these strategies. The purpose of this review is to provide a synopsis of vaccination strategies and antigen delivery systems currently used for S. agalactiae vaccines in tilapia. Furthermore, as shown herein, current vaccine designs include the use of replicative antigen delivery systems, such as attenuated virulent strains, heterologous vectors and DNA vaccines, while non-replicative vaccines include the inactivated whole cell (IWC) and subunit vaccines encoding different S. agalactiae immunogenic proteins. Intraperitoneal vaccination is the most widely used immunization strategy, although immersion, spray and oral vaccines have also been tried with variable success. Vaccine efficacy is mostly evaluated by use of the intraperitoneal challenge model aimed at evaluating the relative percent survival (RPS) of vaccinated fish. The major limitation with this approach is that it lacks the ability to elucidate the mechanism of vaccine protection at portals of bacterial entry in mucosal organs and prevention of pathology in target organs. Despite this, indications are that the correlates of vaccine protection can be established based on antibody responses and antigen dose, although these parameters require optimization before they can become an integral part of routine vaccine production. Nevertheless, this review shows that different approaches can be used to produce protective vaccines against S. agalactiae in tilapia although there is a need to optimize the measures of vaccine efficacy. PMID:27983591

The Political Economy of the Ebola Virus Disease (EVD); Taking Individual and Community Ownership in the Prevention and Control of EVD.

PubMed

Obilade, Titilola T

2015-01-28

The outbreak of an emerging infectious disease of zoonotic origin has exposed the weaknesses in the health systems of the nations affected. The purpose of this paper was to explore the political economy of the existing outcome of the management strategies. In addition, it proposed a new strategy in the management of the current Ebola virus disease (EVD) outbreak. This paper admits that the current management strategy which is a top to bottom approach has not worked in reducing the spread of the disease. Instead of waiting for the disease before treatment is commenced, this paper suggests aggressively preventing infection from the EVD. It presents a bottom to top approach where there is individual ownership and community ownership in the prevention and control of the EVD outbreak. In addition, the paper presents the socio-economic situation of the three most affected countries including the ecology and stigmatization of EVD. It highlights the need for cross border surveillance across the West African nations to prevent importation of the disease as occurred in Nigeria and Senegal. It points out the need for aggressive international cooperation, an aggressive prevention and a sustainable control strategy.

Prevention and control of malaria in pregnancy - new threats, new opportunities?

PubMed

Rogerson, Stephen J; Unger, Holger W

2017-04-01

Over 100 million women and their babies are at risk of malaria in pregnancy each year. Malaria prevention in pregnancy relies on long-lasting insecticidal nets (LLINs), and, in Africa, intermittent preventive treatment in pregnancy (IPTp). Increasing resistance of malaria parasites to sulfadoxine-pyrimethamine, the only drug endorsed for IPTp, and increasing mosquito resistance to pyrethroids used in LLINs, threaten the efficacy of these proven strategies, while operational challenges restrict their implementation in areas of great need. Areas Covered: This review summarizes strategies for malaria prevention in pregnancy (both currently used and those undergoing preclinical and clinical evaluation), primarily drawing on publications and study protocols from the last decade. Challenges associated with each strategy are discussed, including the particular problem of HIV and malaria in pregnancy, and areas of further research are highlighted. Expert Commentary: Alternative drugs for IPTp are needed. Dihydroartemisinin-piperaquine is particularly promising, but requires further evaluation, and might contribute to artemisinin resistance. Intermittent screening and treatment in pregnancy (ISTp) is an alternative to IPTp that could reduce unnecessary antenatal drug exposure and resistance risk, but it is not recommended with current, insensitive screening tests. Optimal strategies for areas of low or declining malaria transmission remain to be determined.

The Political Economy of the Ebola Virus Disease (EVD); Taking Individual and Community Ownership in the Prevention and Control of EVD

PubMed Central

Obilade, Titilola T.

2015-01-01

The outbreak of an emerging infectious disease of zoonotic origin has exposed the weaknesses in the health systems of the nations affected. The purpose of this paper was to explore the political economy of the existing outcome of the management strategies. In addition, it proposed a new strategy in the management of the current Ebola virus disease (EVD) outbreak. This paper admits that the current management strategy which is a top to bottom approach has not worked in reducing the spread of the disease. Instead of waiting for the disease before treatment is commenced, this paper suggests aggressively preventing infection from the EVD. It presents a bottom to top approach where there is individual ownership and community ownership in the prevention and control of the EVD outbreak. In addition, the paper presents the socio-economic situation of the three most affected countries including the ecology and stigmatization of EVD. It highlights the need for cross border surveillance across the West African nations to prevent importation of the disease as occurred in Nigeria and Senegal. It points out the need for aggressive international cooperation, an aggressive prevention and a sustainable control strategy. PMID:27417746

Recruiting Young Adult Cancer Survivors for Behavioral Research

PubMed Central

Horowitz, Santina; Marcus, Bess

2012-01-01

Young adults have been dramatically underrepresented in cancer survivorship research. One contributing factor is the difficulty recruiting this population. To identify effective recruitment strategies, the current study assessed the yield of strategies used to recruit young survivors for an exercise intervention including: clinic-based recruitment, recruitment at cancer-related events, mailings, telephone-based recruitment, advertising on the internet, radio, television and social networking media, distributing brochures and word-of-mouth referrals. When taking into account the strategies for which we could track the number of survivors approached, recruitment at an oncology clinic was the most productive: 38 % of those approached were screened and 8 % enrolled. When evaluating which strategy yielded the greatest percentage of the sample, however, mailings were the most productive. Given widespread use of the internet and social networking by young adults, investigators should also consider these low-cost recruitment strategies. PMID:22810954

Recruiting young adult cancer survivors for behavioral research.

PubMed

Rabin, Carolyn; Horowitz, Santina; Marcus, Bess

2013-03-01

Young adults have been dramatically underrepresented in cancer survivorship research. One contributing factor is the difficulty recruiting this population. To identify effective recruitment strategies, the current study assessed the yield of strategies used to recruit young survivors for an exercise intervention including: clinic-based recruitment, recruitment at cancer-related events, mailings, telephone-based recruitment, advertising on the internet, radio, television and social networking media, distributing brochures and word-of-mouth referrals. When taking into account the strategies for which we could track the number of survivors approached, recruitment at an oncology clinic was the most productive: 38 % of those approached were screened and 8 % enrolled. When evaluating which strategy yielded the greatest percentage of the sample, however, mailings were the most productive. Given widespread use of the internet and social networking by young adults, investigators should also consider these low-cost recruitment strategies.

Emerging Mitochondrial Therapeutic Targets in Optic Neuropathies.

PubMed

Lopez Sanchez, M I G; Crowston, J G; Mackey, D A; Trounce, I A

2016-09-01

Optic neuropathies are an important cause of blindness worldwide. The study of the most common inherited mitochondrial optic neuropathies, Leber hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (ADOA) has highlighted a fundamental role for mitochondrial function in the survival of the affected neuron-the retinal ganglion cell. A picture is now emerging that links mitochondrial dysfunction to optic nerve disease and other neurodegenerative processes. Insights gained from the peculiar susceptibility of retinal ganglion cells to mitochondrial dysfunction are likely to inform therapeutic development for glaucoma and other common neurodegenerative diseases of aging. Despite it being a fast-evolving field of research, a lack of access to human ocular tissues and limited animal models of mitochondrial disease have prevented direct retinal ganglion cell experimentation and delayed the development of efficient therapeutic strategies to prevent vision loss. Currently, there are no approved treatments for mitochondrial disease, including optic neuropathies caused by primary or secondary mitochondrial dysfunction. Recent advances in eye research have provided important insights into the molecular mechanisms that mediate pathogenesis, and new therapeutic strategies including gene correction approaches are currently being investigated. Here, we review the general principles of mitochondrial biology relevant to retinal ganglion cell function and provide an overview of the major optic neuropathies with mitochondrial involvement, LHON and ADOA, whilst highlighting the emerging link between mitochondrial dysfunction and glaucoma. The pharmacological strategies currently being trialed to improve mitochondrial dysfunction in these optic neuropathies are discussed in addition to emerging therapeutic approaches to preserve retinal ganglion cell function. Copyright © 2016 Elsevier Inc. All rights reserved.

A Synthesis of Language Learning Strategies: Current Issues, Problems and Claims Made in Learner Strategy Research

ERIC Educational Resources Information Center

Barjesteh, Hamed; Mukundan, Jayakaran; Vaseghi, Reza

2014-01-01

The current paper presented theoretical assumptions behind language learning strategies (LLS) and an overview of methods used to identify learners' strategies, first, and then summarized what have been reported from large number of descriptive studies of strategies by language learners. Moreover, the paper tried to present the variety of…

Drug delivery strategies for Alzheimer's disease treatment.

PubMed

Di Stefano, Antonio; Iannitelli, Antonio; Laserra, Sara; Sozio, Piera

2011-05-01

Current Alzheimer's disease (AD) therapy is based on the administration of the drugs donepezil, galantamine, rivastigmine and memantine. Until disease-modifying therapies become available, further research is needed to develop new drug delivery strategies to ensure ease of administration and treatment persistence. In addition to the conventional oral formulations, a variety of drug delivery strategies applied to the treatment of AD are reviewed in this paper, with a focus on strategies leading to simplified dosage regimens and to providing new pharmacological tools. Alternatives include extended release, orally disintegrating or sublingual formulations, intranasal or short- and long-acting intramuscular or transdermal forms, and nanotechnology-based delivery systems. The advent of new research on molecular mechanisms of AD pathogenesis has outlined new strategies for therapeutic intervention; these include the stimulation of α-secretase cleavage, the inhibition of γ-secretase activity, the use of non-steroidal anti-inflammatory drugs, neuroprotection based on antioxidant therapy, the use of estrogens, NO synthetase inhibitors, and natural agents such as polyphenols. Unfortunately, these compounds might not help patients with end stage AD, but might hopefully slow or stop the disease process in its early stage. Nanotechnologies may prove to be a promising contribution in future AD drug delivery strategies, in particular drug carrier nano- or microsystems, which can limit the side effects of anti-Alzheimer drugs.

One Northwest community - People, salmon, rivers, and the sea: Towards sustainable salmon fisheries

USGS Publications Warehouse

MacDonald, Donald D.; Steward, Cleveland R.; Knudsen, E. Eric; Knudsen, E. Eric; Steward, Cleveland R.; MacDonald, Donald; Williams, Jack E.; Reiser, Dudley W.

1999-01-01

Pacific salmon management is in crisis. Throughout their range, salmon and steelhead populations are being adversely affected by human activities. Without coordinated, effective, and timely action, the future of the Pacific salmon resource is most certainly in doubt. To address the challenges that are currently facing salmon management, concerned citizens representing a diverse array of government agencies and non-governmental organizations have agreed to cooperate in the development of a Sustainable Fisheries Strategy for west coast salmon and steelhead populations. The Strategy builds on the contents of this book, resulting from the Sustainable Fisheries Conference and subsequent community- and watershed-based citizen forums. This chapter presents the key elements of the Strategy including a common vision for the future, a series of guiding principles, and specific strategies for supporting sustainable fisheries. As such, the Strategy embraces an ecosystem-based approach to managing human activities, rather than the traditional egocentric approach to managing salmonid populations and associated habitats. A system of community-based, watershed-oriented councils, including all stakeholders and agency representatives, is proposed for effective transition to ecosystem-based salmon and steelhead management. It is our hope that everyone involved in Pacific salmon management will embrace both the spirit and the specific elements of the Sustainable Fisheries Strategy as we face the difficult challenges ahead.

[Clinical assessment of drug safety].

PubMed

Imbs, J-L; Welsch, M

2007-09-01

The environment of drug safety is changing. In addition to the current system of pharmacovigilance based on spontaneous report of adverse events, clinical data observed in a given patient with a given symptom is taken into consideration and compared with information coming from pharmacovigilance data bases, which is then analyzed for causality by the experts of both the promotor and the public network. Such information is integrated into a risk management strategy, defined together by the French drug agency (Afssaps) and the marketing authorization holder. This strategy includes a pharmacovigilance plan and, if possible, a risk minimisation plan.

Physical Therapists' Role in Solving the Opioid Epidemic.

PubMed

Mintken, Paul E; Moore, Jeff R; Flynn, Timothy W

2018-05-01

An estimated 116 million Americans suffer from chronic pain, at a cost of over $600 billion per year, or roughly $2000 per person per year. In this Viewpoint, the authors highlight the challenges of the current opioid epidemic and outline strategies that the physical therapy profession may adopt to be part of the solution. These strategies include facilitating and providing patient education, early access to physical therapy services, and the promotion of health, wellness, and prevention. J Orthop Sports Phys Ther 2018;48(5):349-353. doi:10.2519/jospt.2018.0606.

Evaluation of bovine viral diarrhoea virus control strategies in dairy herds in Hokkaido, Japan, using stochastic modelling.

PubMed

Sekiguchi, S; Presi, P; Omori, R; Staerk, K; Schuppers, M; Isoda, N; Yoshikawa, Y; Umemura, T; Nakayama, H; Fujii, Y; Sakoda, Y

2018-02-01

Bovine viral diarrhoea virus (BVDV) infection in cattle can result in growth retardation, reduced milk production, reproductive disorders and death. Persistently infected animals are the primary source of infection. In Hokkaido, Japan, all cattle entering shared pastures in summer are vaccinated before movement for disease control. Additionally, these cattle may be tested for BVDV and culled if positive. However, the effectiveness of this control strategy aiming to reduce the number of BVDV-infected animals has not been assessed. The aim of this study was to evaluate the effectiveness of various test-and-cull and/or vaccination strategies on BVDV control in dairy farms in two districts of Hokkaido, Nemuro and Hiyama. A stochastic model was developed to compare the different control strategies over a 10-year period. The model was individual-based and simulated disease dynamics both within and between herds. Parameters included in the model were obtained from the literature, the Hokkaido government and the Japanese Ministry of Agriculture, Forestry and Fisheries. Nine different scenarios were compared as follows: no control, test-and-cull strategies based on antigen testing of either calves or only cattle entering common pastures, vaccination of all adult cattle or only cattle entering shared pastures and combinations thereof. The results indicate that current strategies for BVDV control in Hokkaido slightly reduced the number of BVDV-infected animals; however, alternative strategies such as testing all calves and culling any positives or vaccinating all susceptible adult animals dramatically reduced those. To our knowledge, this is the first report regarding the comparison of the effectiveness between the current strategies in Hokkaido and the alternative strategies for BVDV control measures. © 2017 Blackwell Verlag GmbH.

The relationship between childhood trauma and the severity of adulthood depression and anxiety symptoms in a clinical sample: The mediating role of cognitive emotion regulation strategies.

PubMed

Huh, Hyu Jung; Kim, Kyung Hee; Lee, Hee-Kyung; Chae, Jeong-Ho

2017-04-15

Childhood trauma is an important factor in adverse mental health outcomes, including depression and anxiety. The purpose of the present study was to evaluate a hypothesized model describing a pathway of childhood trauma and its influence on psychiatric symptoms in patients with depressive disorder. In this model, childhood trauma was positively associated with current depression and anxiety symptoms, which were mediated by a cognitive emotional regulation strategy. Patients with depressive disorder (n=585, 266 men, 316 women) completed the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Childhood Trauma Questionnaire (CTQ), and Cognitive Emotion Regulation Questionnaire (CERQ). We divided the cognitive emotion regulation strategies into adaptive and maladaptive strategies using a CERQ subscore. We employed structural equation modeling (SEM) and simple/multiple mediation analyses. The indirect effect of maladaptive strategies was significant in the relationship between overall childhood trauma and depression/anxiety severity, whereas the mediation effect of adaptive strategies was limited to depressive symptoms. With respect to specific types of trauma, maladaptive strategies mediated the association between emotional abuse and current depression/anxiety, while the mediation effect of adaptive strategies was limited to emotional neglect. This study's cross-sectional design does not allow establishment of causal relationships. Childhood trauma recall bias may be possible. These findings support the hypothesized model in which childhood trauma is associated with adulthood depression/anxiety symptoms in clinical samples, and mediated by emotion regulation strategies. These results suggest that cognitive emotion dysregulation is an important factor affecting depression/anxiety symptoms in patients with childhood trauma. Copyright © 2017 Elsevier B.V. All rights reserved.

Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

PubMed

Munce, Sarah E P; Perrier, Laure; Shin, Saeha; Adhihetty, Chamila; Pitzul, Kristen; Nelson, Michelle L A; Bayley, Mark T

2017-09-07

While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex. This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs. PROSPERO, CRD42017064141.

New idea for treatment strategies for Barcelona Clinic Liver Cancer stages based on a network meta-analysis.

PubMed

Li, Kun; Wang, Hai-Tao; He, Yu-Kun; Guo, Tao

2017-05-01

Currently, the Barcelona Clinic Liver Cancer staging (BCLC) system still remains controversies in the management of hepatocellular carcinoma. We are trying to determine the best therapeutic strategy for each BCLC stage through a network meta-analysis and provide a new treatment idea. We conducted a systematic literature search of the PubMed, EMBASE, and Cochrane Library databases and extracted data from randomized controlled trials (RCTs) that compared various strategies. Network meta-analyses were conducted in ADDIS by evaluating different overall survival of each stage. Cumulative probability was used to rank the included strategies. A node-splitting model assessed whether direct and indirect evidence on a specific node was in agreement. Of the 24 included RCTs, 3667 patients were included. Based on the probability P values, the results showed that TACE plus surgical resection (SR) was the first choice for BCLC Stage A (P = .38 and P = .52 for 3- and 5-year OS, respectively). The application of SR was the best strategy for BCLC Stage B (P = .51 and P = .95 for 1- and 3-year OS, respectively). For Stage C, whole net connections could not be established in this research, but combined therapy seemed to produce better results based on 3 separated net connections (P = .92, P = .80, and P = .69 for 1-year OS). The updated therapy strategies discussed in this study are recommended. More importantly, we deemed that the recommended strategy for each patient may be subject to adjustment due to individual clinical factors. The applicable scope of each strategy should also be evaluated before application.

Novel strategies for the management of recurrent pregnancy loss.

PubMed

Kutteh, William H

2015-05-01

This article discusses the current trends in the diagnosis and treatment of recurrent pregnancy loss. Genetic testing of the miscarriage tissue by 23-chromosome microarray and the ability to identify maternal cell contamination have increased our awareness of the role of aneuploidy as a cause of recurrent pregnancy loss. This increasing influence and the role of genetic testing in developing a strategy for the evaluation of recurrent pregnancy loss are described and discussed. The most common questions that practicing physicians ask about recurrent pregnancy loss include how many losses are needed to make the diagnosis, what counts as a pregnancy loss, what constitutes a full workup, should we get karyotypes on the parents and the miscarriage, and what is the prognosis for a live birth? This review attempts to answer those questions based on current research and clinical experience to expand our current understanding of recurrent pregnancy loss. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Research Agenda to Underpin Malaria Eradication

PubMed Central

Alonso, Pedro L.; Brown, Graham; Arevalo-Herrera, Myriam; Binka, Fred; Chitnis, Chetan; Collins, Frank; Doumbo, Ogobara K.; Greenwood, Brian; Hall, B. Fenton; Levine, Myron M.; Mendis, Kamini; Newman, Robert D.; Plowe, Christopher V.; Rodríguez, Mario Henry; Sinden, Robert; Slutsker, Laurence; Tanner, Marcel

2011-01-01

The interruption of malaria transmission worldwide is one of the greatest challenges for international health and development communities. The current expert view suggests that, by aggressively scaling up control with currently available tools and strategies, much greater gains could be achieved against malaria, including elimination from a number of countries and regions; however, even with maximal effort we will fall short of global eradication. The Malaria Eradication Research Agenda (malERA) complements the current research agenda—primarily directed towards reducing morbidity and mortality—with one that aims to identify key knowledge gaps and define the strategies and tools that will result in reducing the basic reproduction rate to less than 1, with the ultimate aim of eradication of the parasite from the human population. Sustained commitment from local communities, civil society, policy leaders, and the scientific community, together with a massive effort to build a strong base of researchers from the endemic areas will be critical factors in the success of this new agenda. PMID:21311579

Breaking the current density threshold in spin-orbit-torque magnetic random access memory

NASA Astrophysics Data System (ADS)

Zhang, Yin; Yuan, H. Y.; Wang, X. S.; Wang, X. R.

2018-04-01

Spin-orbit-torque magnetic random access memory (SOT-MRAM) is a promising technology for the next generation of data storage devices. The main bottleneck of this technology is the high reversal current density threshold. This outstanding problem is now solved by a new strategy in which the magnitude of the driven current density is fixed while the current direction varies with time. The theoretical limit of minimal reversal current density is only a fraction (the Gilbert damping coefficient) of the threshold current density of the conventional strategy. The Euler-Lagrange equation for the fastest magnetization reversal path and the optimal current pulse is derived for an arbitrary magnetic cell and arbitrary spin-orbit torque. The theoretical limit of minimal reversal current density and current density for a GHz switching rate of the new reversal strategy for CoFeB/Ta SOT-MRAMs are, respectively, of the order of 105 A/cm 2 and 106 A/cm 2 far below 107 A/cm 2 and 108 A/cm 2 in the conventional strategy. Furthermore, no external magnetic field is needed for a deterministic reversal in the new strategy.

Choroidal neovascular membrane.

PubMed

Bhatt, N S; Diamond, J G; Jalali, S; Das, T

1998-06-01

Choroidal neovascular membrane in the macular area is one of the leading causes of severe visual loss. Usually a manifestation in elderly population, it is often associated with age-related macular degeneration. The current mainstay of management is early diagnosis, usually by fundus examination, aided by angiography and photocoagulation in selected cases. Various other modalities of treatment including surgery are being considered as alternate options, but with limited success. The purpose of this review is to briefly outline the current concepts and the management strategy from a clinician's viewpoint.

Assessing the Impact of the Work Environment on Training Transfer: An Investigation of the Air Force Acquisition Management Course

DTIC Science & Technology

2007-06-01

Hult et al., 2003); yet it is most often taken for granted or is simply not transferred for the benefit of the organization. The Air Force...budget increase of 7 percent over last year. Today , companies are spending $1,273 per learner on training, including staff salaries. These higher...with the business strategy to develop plans to ensure training is being efficiently transferred to the organization. Current Knowledge Current

Aging and List-Wide Modulations of Strategy Execution:A Study in Arithmetic.

PubMed

Hinault, Thomas; Lemaire, Patrick

2017-01-01

Background/Study Context: This study aimed at further our understanding of the cognitive processes involved during strategy execution, and how the processes involved change with age. More specifically, the main goal was to investigate whether poorer-strategy effects (i.e., poorer performance when a cued strategy is not the best) and sequential modulations of poorer-strategy effects (i.e., decreased poorer-strategy effects on current problems following poorer-strategy problems compared with after better-strategy problems) are influenced by proportions of poorer-strategy problems. We used a computational estimation task (i.e., providing approximate products to two-digit multiplication problems such as 38 × 74) with problems sets including 75%, 50%, or 25% of poorer-strategy problems (i.e., participants have to estimate products with another strategy than the better strategy). The remaining problems were cued with the better strategy. Age-related differences were also investigated. We found that proportions of poorer-strategy problems influenced sequential modulations of poorer-strategy effects. Indeed, sequential modulations of poorer-strategy effects were larger when proportions of poorer-strategy problems were equal than unequal. Moreover, proportion effects were different for young and older adults, as older adults benefited more from low proportions of poorer-strategy problems compared with young adults. These findings have important implications regarding cognitive control mechanisms underlying both list-wide and trial-to-trial modulations of strategy execution, and how these processes change during aging.

Systems resilience : a new analytical framework for nuclear nonproliferation.

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

Pregenzer, Arian Leigh

2011-12-01

This paper introduces the concept of systems resilience as a new framework for thinking about the future of nonproliferation. Resilience refers to the ability of a system to maintain its vital functions in the face of continuous and unpredictable change. The nonproliferation regime can be viewed as a complex system, and key themes from the literature on systems resilience can be applied to the nonproliferation system. Most existing nonproliferation strategies are aimed at stability rather than resilience, and the current nonproliferation system may be over-constrained by the cumulative evolution of strategies, increasing its vulnerability to collapse. The resilience of themore » nonproliferation system can be enhanced by diversifying nonproliferation strategies to include general international capabilities to respond to proliferation and focusing more attention on reducing the motivation to acquire nuclear weapons in the first place. Ideas for future research, include understanding unintended consequences and feedbacks among nonproliferation strategies, developing methodologies for measuring the resilience of the nonproliferation system, and accounting for interactions of the nonproliferation system with other systems on larger and smaller scales.« less

Integrated Pest Management of Coffee Berry Borer: Strategies from Latin America that Could Be Useful for Coffee Farmers in Hawaii.

PubMed

Aristizábal, Luis F; Bustillo, Alex E; Arthurs, Steven P

2016-02-03

The coffee berry borer (CBB), Hypothenemus hampei Ferrari (Coleoptera: Curculionidae: Scolytinae) is the primary arthropod pest of coffee plantations worldwide. Since its detection in Hawaii (September 2010), coffee growers are facing financial losses due to reduced quality of coffee yields. Several control strategies that include cultural practices, biological control agents (parasitoids), chemical and microbial insecticides (entomopathogenic fungi), and a range of post-harvest sanitation practices have been conducted to manage CBB around the world. In addition, sampling methods including the use of alcohol based traps for monitoring CBB populations have been implemented in some coffee producing countries in Latin America. It is currently unclear which combination of CBB control strategies is optimal under economical, environmental, and sociocultural conditions of Hawaii. This review discusses components of an integrated pest management program for CBB. We focus on practical approaches to provide guidance to coffee farmers in Hawaii. Experiences of integrated pest management (IPM) of CBB learned from Latin America over the past 25 years may be relevant for establishing strategies of control that may fit under Hawaiian coffee farmers' conditions.

Top-down approach to biological therapy of Crohn's disease.

PubMed

Hirschmann, Simon; Neurath, Markus F

2017-03-01

Crohn's disease (CD) is a chronic, immune-mediated condition with a potentially disabling and destructive course. Despite growing data on when to use a therapeutic 'top-down' strategy, clinical management of this complex disorder is still challenging. Currently, the discussion of 'top-down' strategy in CD mostly includes biological therapy alone or in combination. Areas covered: This article is based on a review of existing literature regarding the use of biological therapy in a 'top-down' approach for the treatment of Crohn's disease. The authors reviewed all the major databases including MEDLINE as well as DDW and ECCO abstracts, respectively. Expert opinion: A 'top-down' therapeutic approach in Crohn's disease is strongly supported by existing data in patients with several risk factors for a severe course of disease. Moreover, there is an increasing amount of published data recommending a more individualised therapeutic strategy to identify candidates for 'top-down' treatment, based on enhanced diagnostics using biomarkers. Emerging therapeutic approaches besides existing therapy concepts using biologicals may possibly redefine the 'top-down' therapeutic strategy for Crohn's disease in the future.

Competency of new graduate nurses: a review of their weaknesses and strategies for success.

PubMed

Theisen, Janelle L; Sandau, Kristin E

2013-09-01

Because of the ongoing nursing shortage and the increasing acuity of patients, new graduate nurses must master both psychomotor and critical thinking skills rapidly. Inadequate orientation leads to high turnover rates for new graduates. Health care leaders must examine the competencies needed for new graduate nurses to succeed in this environment. A critical review of studies (n = 26) was conducted to identify crucial competencies that are needed for new graduate nurses to be successful. Six areas were identified in which new graduates lacked competence: communication, leadership, organization, critical thinking, specific situations, and stress management. Strategies were identified to improve the transition of new graduates. Hospitals should consider implementing nurse residency programs that include strategies for clear communication and conflict management, prioritization skills, and leadership development. Schools of nursing should add communication strategies to their current focus on critical thinking, clinical reasoning, and simulation scenarios and include situation-specific skills such as end-of-life scenarios. Further research should focus on stress management, leadership, clinical reasoning, and evaluation of measurement tools for new graduates. Copyright 2013, SLACK Incorporated.

External Memory Aid Preferences of Individuals with Mild Memory Impairments.

PubMed

Lanzi, Alyssa; Wallace, Sarah E; Bourgeois, Michelle S

2018-07-01

Individuals with mild memory impairments often rely on external memory aids (EMAs) to compensate for impaired cognitive abilities and to support independent completion of activities of daily living. These strategies are evidence based; however, professionals have limited knowledge regarding individual preferences and guidance on how to incorporate a person-centered approach into the EMA development phase. The purpose of the current study was to qualitatively investigate individuals' preferences and experiences as they relate to EMAs. Data analysis included (1) evaluation of a posttreatment questionnaire to explore individual strategy preferences following intervention and (2) evaluation of group intervention videos using thematic coding to investigate individuals' experiences with strategies during intervention. Results suggest that older adults with mild memory impairments have unique preferences and experiences, despite limited variability in demographic characteristics. Some themes that emerged included memory ability awareness and attitudes toward technology. Within a person-centered approach, skilled professionals must consider individuals' unique needs, preferences, and experiences when developing strategies throughout the continuum of care to promote sustained EMA use within everyday settings. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Scaffolds in Tendon Tissue Engineering

PubMed Central

Longo, Umile Giuseppe; Lamberti, Alfredo; Petrillo, Stefano; Maffulli, Nicola; Denaro, Vincenzo

2012-01-01

Tissue engineering techniques using novel scaffold materials offer potential alternatives for managing tendon disorders. Tissue engineering strategies to improve tendon repair healing include the use of scaffolds, growth factors, cell seeding, or a combination of these approaches. Scaffolds have been the most common strategy investigated to date. Available scaffolds for tendon repair include both biological scaffolds, obtained from mammalian tissues, and synthetic scaffolds, manufactured from chemical compounds. Preliminary studies support the idea that scaffolds can provide an alternative for tendon augmentation with an enormous therapeutic potential. However, available data are lacking to allow definitive conclusion on the use of scaffolds for tendon augmentation. We review the current basic science and clinical understanding in the field of scaffolds and tissue engineering for tendon repair. PMID:22190961

Biomaterials and bone mechanotransduction

NASA Technical Reports Server (NTRS)

Sikavitsas, V. I.; Temenoff, J. S.; Mikos, A. G.; McIntire, L. V. (Principal Investigator)

2001-01-01

Bone is an extremely complex tissue that provides many essential functions in the body. Bone tissue engineering holds great promise in providing strategies that will result in complete regeneration of bone and restoration of its function. Currently, such strategies include the transplantation of highly porous scaffolds seeded with cells. Prior to transplantation the seeded cells are cultured in vitro in order for the cells to proliferate, differentiate and generate extracellular matrix. Factors that can affect cellular function include the cell-biomaterial interaction, as well as the biochemical and the mechanical environment. To optimize culture conditions, good understanding of these parameters is necessary. The new developments in bone biology, bone cell mechanotransduction, and cell-surface interactions are reviewed here to demonstrate that bone mechanotransduction is strongly influenced by the biomaterial properties.

Cancer gene therapy with targeted adenoviruses.

PubMed

Bachtarzi, Houria; Stevenson, Mark; Fisher, Kerry

2008-11-01

Clinical experience with adenovirus vectors has highlighted the need for improved delivery and targeting. This manuscript aims to provide an overview of the techniques currently under development for improving adenovirus delivery to malignant cells in vivo. Primary research articles reporting improvements in adenoviral gene delivery are described. Strategies include genetic modification of viral coat proteins, non-genetic modifications including polymer encapsulation approaches and pharmacological interventions. Reprogramming adenovirus tropism in vitro has been convincingly demonstrated using a range of genetic and physical strategies. These studies have provided new insights into our understanding of virology and the field is progressing. However, there are still some limitations that need special consideration before adenovirus-targeted cancer gene therapy emerges as a routine treatment in the clinical setting.

Human sex differences in solving a virtual navigation problem.

PubMed

Astur, Robert S; Purton, Andrea J; Zaniewski, Melanie J; Cimadevilla, Jose; Markus, Etan J

2016-07-15

The current study examined sex differences in initial and subsequent strategies in solving a navigational problem within a virtual reality environment. We tested 163 undergraduates on a virtual T-maze task that included probe trials designed to assess whether participants were responding using either a place or response strategy. Participants were also tested on a mental rotation task and memory of the details of the virtual room. There were no differences between the sexes in copying or recalling a map of the room or on first trial performance of the T-maze. However, at trial two, males show a significant advantage in solving the task, and approximately 80% of the males adopt a place strategy to solve the T-maze whereas females at that point showed no strategy preference. Across all testing, both males and females preferentially used a place strategy. We discuss how factors such as spatial priming affect strategy preferences and how such factors may differentially affect males and females. Copyright © 2016 Elsevier B.V. All rights reserved.

Daylight strategies for architectural studio facilities: the literature review

NASA Astrophysics Data System (ADS)

Othman, Muhammad Anas Bin; Azfahani Ahmad, Nur; Ajis, Azizah Md

2017-05-01

The implementation of daylighting strategies in buildings is a common aspect in architecture. However, due to the availability of inexpensive electricity, natural lighting strategies became insignificant, and been overlooked by designers. With the current concern over rapid increment on electricity cost, many designers now try to revitalized daylighting strategies in buildings. This includes educational buildings. In Malaysian cases, it is a norm that universities; especially during lecture and studio sessions, used artificial lighting throughout the day. Definitely, this is not parallel with the “green” aim made by the Government in the Malaysian Plan. Therefore, this paper aims to explore the impact of daylight strategies for educational studios in universities, by maximising the penetration of natural daylight into the space towards creating a more green-conducive studio. The paper review literature about the types, criteria and benefits of daylight strategies. This paper also presented a pilot study that has been performed in one university in Perak, Malaysia, by selecting architectural studios as the main subject.

Defensive applications of gene transfer technology in the face of bioterrorism: DNA-based vaccines and immune targeting.

PubMed

Ackley, Catherine J; Greene, Michael R; Lowrey, Christopher H

2003-12-01

Gene transfer involves the introduction of an engineered gene into a person's cells with the expectation that the protein expressed from the gene will produce a therapeutic benefit. Strategies based on this principle have led to the approval of > 600 clinical trials and enrollment of approximately 3500 subjects worldwide in attempts to treat diseases ranging from cancer to AIDS to cystic fibrosis. While gene therapy has met with limited success and still has many hurdles to overcome before it sees wide application, it may be useful as a defensive strategy against bioterrorism agents including infectious microbes and toxins. Although many defensive strategies are possible, immunological strategies are currently the most developed and are being actively applied to the development of strategies against several of the most virulent potential bio-weapons. While most of these strategies are not yet ready for human application, DNA-based vaccines appear to be among the most promising in the fight against bioterrorism.

Calming and Focusing: Students' Perceptions of Short Classroom Strategies for Fostering Presence.

PubMed

VanKuiken, Debra; Bradley, Jennifer; Harland, Barbara; King, Margaret O'Brien

2016-05-05

Presence is the essence of professional nursing in the nurse-patient connection. Nursing students have little exposure to strategies fostering presence. This pilot study explored students' perceptions of strategies to encourage presence in the classroom. A three-question survey was distributed to students in the last week of classes. Faculty not teaching that course administered the survey. Four faculty used strategies aimed at encouraging presence. These strategies included starting class with a mindfulness minute, mindful movement, singing bowl, peace and power check in, and a discussion of a current event. Each class used only one strategy consistently through the semester. Participants were undergraduate and graduate students enrolled in one of seven classes taught by these faculty. Overall the students found strategies to be beneficial. In reflecting on the experience with the strategies, four themes emerged: calming/relaxing; focusing/centering; setting aside distractions; and feeling community and connection. These brief strategies were acceptable to most students and were helpful to the students in preparing for class. The response to mindfulness minute was most positive. Further research is needed on the introduction of strategies that help students in the classroom and may also increase presence at the bedside. © The Author(s) 2016.

Current management strategies for patellofemoral pain: an online survey of 99 practising UK physiotherapists.

PubMed

Smith, Benjamin E; Hendrick, Paul; Bateman, Marcus; Moffatt, Fiona; Rathleff, Michael Skovdal; Selfe, James; Smith, Toby O; Logan, Pip

2017-05-08

Patellofemoral pain (PFP) is considered one of the commonest forms of knee pain. This study aimed to identify how physiotherapists in the United Kingdom (UK) currently manage patellofemoral pain (PFP), particularly in relation to exercise prescription, and response to pain. An anonymous survey was designed with reference to previous surveys and recent systematic reviews. Practising UK physiotherapists who treat patients with PFP were invited to take part via an invitation email sent through professional networks, the 'interactive Chartered Society of Physiotherapy (iCSP)' message board, and social media (Twitter). Descriptive statistics were used to analyse the data. A total of 99 surveys were completed. Responders reported a wide range of management strategies, including a broad selection of type and dose of exercise prescription. The five most common management strategies chosen were: closed chain strengthening exercises (98%); education and advice (96%); open chain strengthening exercises (76%); taping (70%) and stretches (65%). Physiotherapists with a special interest in treating PFP were statistically more likely to manage patients with orthotics (P = 0.02) and bracing (P = 0.01) compared to physiotherapists without a special interest. Approximately 55% would not prescribe an exercise if it was painful. Thirty-one percent of physiotherapists would advise patients not to continue with leisure and/or sporting activity if they experienced any pain. Current UK practice in the management strategies of PFP is variable. Further high quality research on which to inform physiotherapy practice is warranted for this troublesome musculoskeletal condition.

Systems and methods for providing power to a load based upon a control strategy

DOEpatents

Perisic, Milun; Lawrence, Christopher P; Ransom, Ray M; Kajouke, Lateef A

2014-11-04

Systems and methods are provided for an electrical system. The electrical system, for example, includes a first load, an interface configured to receive a voltage from a voltage source, and a controller configured to receive the voltage through the interface and to provide a voltage and current to the first load. The controller may be further configured to, receive information on a second load electrically connected to the voltage source, determine an amount of reactive current to return to the voltage source such that a current drawn by the electrical system and the second load from the voltage source is substantially real, and provide the determined reactive current to the voltage source.

Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges

PubMed Central

Salem, Haitham; Nagpal, Caesa; Pigott, Teresa; Teixeira, Antonio Lucio

2017-01-01

Background: Akathisia continues to be a significant challenge in current neurological and psychiatric practice. Prompt and accurate detection is often difficult and there is a lack of consensus concerning the neurobiological basis of akathisia. No definitive treatment has been established for akathisia despite numerous preclinical and clinical studies. Method: We reviewed antipsychotic-induced akathisia including its clinical presentation, proposed underlying pathophysiology, current and under investigation therapeutic strategies. Conclusion: Despite the initial promise that second generation antipsychotics would be devoid of akathisia effects, this has not been confirmed. Currently, there are limited therapeutic options for the clinical practice and the evidence supporting the most widely used treatments (beta blockers, anticholinergic drugs) is still absent or inconsistent. PMID:27928948

A Multi-Disciplinary University Research Initiative in Hard and Soft Information Fusion: Overview, Research Strategies and Initial Results

DTIC Science & Technology

2010-07-01

Multisource Information Fusion ( CMIF ) along with a team including the Pennsylvania State University (PSU), Iona College (Iona), and Tennessee State...License. 14. ABSTRACT The University at Buffalo (UB) Center for Multisource Information Fusion ( CMIF ) along with a team including the Pennsylvania...of CMIF current research on methods for Test and Evaluation ([7], [8]) involving for example large- factor-space experimental design techniques ([9

Prevention of Overweight and Obesity: How Effective is the Current Public Health Approach

PubMed Central

Chan, Ruth S.M; Woo, Jean

2010-01-01

Obesity is a public health problem that has become epidemic worldwide. Substantial literature has emerged to show that overweight and obesity are major causes of co-morbidities, including type II diabetes, cardiovascular diseases, various cancers and other health problems, which can lead to further morbidity and mortality. The related health care costs are also substantial. Therefore, a public health approach to develop population-based strategies for the prevention of excess weight gain is of great importance. However, public health intervention programs have had limited success in tackling the rising prevalence of obesity. This paper reviews the definition of overweight and obesity and the variations with age and ethnicity; health consequences and factors contributing to the development of obesity; and critically reviews the effectiveness of current public health strategies for risk factor reduction and obesity prevention. PMID:20617002

Social inclusion facilitates risky mating behavior in men.

PubMed

Sacco, Donald F; Brown, Christina M; Young, Steven G; Bernstein, Michael J; Hugenberg, Kurt

2011-07-01

Although past research has reliably established unique effects of social exclusion on human cognition and behavior, the current research focuses on the unique effects of social inclusion. Recent evidence indicates that social inclusion leads to enhanced prioritization of reproductive interests. The current study extends these findings by showing that the pursuit of these inclusion-induced reproductive goals occurs in sex-specific ways. Across three experiments, social inclusion led men, but not women, to endorse riskier, more aggressive mating strategies compared to control and socially excluded participants. Specifically, included men were more likely to endorse sexual aggression (Experiment 1), high-risk mate poaching behaviors (Experiment 2), and high-risk mate retention tactics (Experiment 3). These results demonstrate that the experience of social inclusion can affect sex-differentiated preferences for risky mating strategies. © 2011 by the Society for Personality and Social Psychology, Inc

Chromoendoscopy and Advanced Imaging Technologies for Surveillance of Patients with IBD

PubMed Central

Barkin, Jodie A.; Abreu, Maria T.

2012-01-01

Inflammatory bowel disease patients with long-standing colitis have an increased risk of colorectal cancer. The high rate of interval colitis-associated cancers among patients who adhere to a nontargeted, random biopsy surveillance strategy underlies the need for improved methods of early dysplasia detection. Compelling evidence supports the efficacy of chromoendoscopy for increasing the detection rate of dysplasia; however, this technology is currently underutilized in the clinical setting. Other contrast-based technologies—including confocal laser endomicroscopy (Pentax), endocytoscopy, multiband imaging, i-scan (Pentax), and molecular-targeted techniques—show promise in the detection of dysplasia in patients with inflammatory bowel disease. The strategies currently available for identifying patients with dysplasia or colitis-associated cancers remain inadequate and need to demonstrate both cost and time efficiency before they can be adopted in community-based practices. PMID:24693269

Dismantling the Dual Housing Market in Chicago

ERIC Educational Resources Information Center

Williams, Kale

1975-01-01

This testimony, before a public hearing of the New York City Commission on Human Rights in May 1974, focuses on the activities of the Leadership Council: its current strategy includes full enforcement of the federal fair housing laws, increase in the supply of housing available to people of low and moderate income, and effective marketing of…

Addressing Student Misconceptions Concerning Electron Flow in Aqueous Solutions with Instruction Including Computer Animations and Conceptual Change Strategies.

ERIC Educational Resources Information Center

Sanger, Michael J.; Greenbowe, Thomas J.

2000-01-01

Investigates the effects of both computer animations of microscopic chemical processes occurring in a galvanic cell and conceptual-change instruction based on chemical demonstrations on students' conceptions of current flow in electrolyte solutions. Finds that conceptual change instruction was effective at dispelling student misconceptions but…

A strategy for rangeland management based on best available knowledge and information

USDA-ARS?s Scientific Manuscript database

Changes to rangeland systems are happening at spatial and temporal scales beyond the capability of our current knowledge and information systems. In this paper we look at how Web 2.0 tools such as wikis and crowd-sourcing and new technologies including mobile devices and massive online databases are...

Investigating the Use of an Enterotropic Newcastle Disease Virus as a Recombinant Vaccine Platform Targeting Poultry Enteric Viruses

USDA-ARS?s Scientific Manuscript database

Control strategies for poultry viral enteric disease must include vaccine platforms that have been specifically designed to improve flock performance, lessen disease severity, and reduce viral transmission. With the exception of certain autogenous vaccines, no vaccines currently exist to aid in the ...

Urbanization in contemporary Arab Gulf states.

PubMed

Qutub, I Y

1983-01-01

Urbanization in the Arab Gulf states of Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates is analyzed. Topics discussed include the historical background to urbanization; current demographic trends in the region; urban characteristics and growth; socioeconomic factors influencing urbanization, with an emphasis on labor force structure; future urban strategy; and the need for urban research.

Blended Learning in Higher Education: Current and Future Challenges in Surveying Education

ERIC Educational Resources Information Center

El-Mowafy, Ahmed; Kuhn, Michael; Snow, Tony

2013-01-01

The development of a blended learning approach to enhance surveying education is discussed. The need for this learning strategy is first investigated based on a major review of the surveying course, including analysis of its content, benchmarking with key national and international universities, and surveys of key stakeholders. Appropriate blended…

Improving Schools' Partnership Programs in the National Network of Partnership Schools

ERIC Educational Resources Information Center

Sanders, Mavis; Sheldon, Steven; Epstein, Joyce

2005-01-01

The current wave of educational reform includes an emphasis on family and community involvement as a strategy for school improvement. Yet, to effectively engage families and communities in the educational process, educators need assistance and support. In 1996, the National Network of Partnership Schools (NNPS) was established to build the…

Effects of Cognitive Strategy Interventions on Word Problem Solving and Working Memory in Children with Math Disabilities

ERIC Educational Resources Information Center

Swanson, H. Lee; Lussier, Catherine; Orosco, Michael

2011-01-01

Although current categories of learning disabilities include as specific disabilities calculation and mathematical problem solving [see IDEA reauthorization, 2004, Sec. 300.8(c)(10)], the majority of research focuses on calculation disabilities. Previous studies have shown, however, that deficits in word problem solving difficulties are persistent…

Measurement and Control Strategies for Sterol Glucosides to Improve Biodiesel Quality: Isolation and Characterization of Acylated Steryl Glucosides in Oilseed Crops of the Pacific Northwest

DOT National Transportation Integrated Search

2010-01-01

Acylated steryl glucosides (ASG), a form of phytosterols, have been identified in a variety of agricultural products, including the oilseeds of soybean and rapeseed. Currently, there are limited data available on the quality and quantity of phytoster...

Teaching Notes: Reframing Multicultural Education--Teaching White Privilege in the Social Work Curriculum

ERIC Educational Resources Information Center

Abrams, Laura S.; Gibson, Priscilla

2007-01-01

This article proposes a model of teaching diversity in social work education that includes significant content on White privilege. The authors first discuss some limitations of social work's current multicultural framework. Next, they introduce concepts and pedagogical strategies concerning White identity and privilege that are drawn from…

Teacher Perceptions of School Consultant Social Influence Strategies: Replication and Expansion

ERIC Educational Resources Information Center

Owens, Julie Sarno; Schwartz, Madeline E.; Erchul, William P.; Himawan, Lina; Evans, Steven W.; Coles, Erika K.; Schulte, Ann C.

2017-01-01

The goals were to (a) replicate the findings of Erchul, Raven, and Whichard (2001) with regard to the Consultee/Teacher Version of the Interpersonal Power Inventory (IPI; Raven, Schwarzwald, & Koslowsky, 1998), and (b) advance the literature by examining IPI scores about a current consultation relationship. Sample 1 included 99 elementary…

Family Environments, Adrenarche, and Sexual Maturation: A Longitudinal Test of a Life History Model

ERIC Educational Resources Information Center

Ellis, Bruce J.; Essex, Marilyn J.

2007-01-01

Life history theorists have proposed that humans have evolved to be sensitive to specific features of early childhood environments and that exposure to different environments biases children toward development of different reproductive strategies, including differential pubertal timing. The current research provides a longitudinal test of this…

Systematic Instruction of Functional Skills for Students and Adults with Disabilities

ERIC Educational Resources Information Center

Storey, Keith; Miner, Craig

2011-01-01

This text is a clear and current description of the instructional strategies that can be immediately applied across age groups and disability labels. An evidence-based instructional methodology is provided, which has proved to be effective in teaching skills to students and adults with disabilities. Signature topics include: (1) a…

The Database Business: Managing Today--Planning for Tomorrow. Issues and Futures.

ERIC Educational Resources Information Center

Aitchison, T. M.; And Others

1988-01-01

Current issues and the future of the database business are discussed in five papers. Topics covered include aspects relating to the quality of database production; international ownership in the U.S. information marketplace; an overview of pricing strategies in the electronic information industry; and pricing issues from the viewpoints of online…

Effects of an Alternative to Suspension Intervention in a Therapeutic High School

ERIC Educational Resources Information Center

Hernandez-Melis, Claudia; Fenning, Pamela; Lawrence, Elizabeth

2016-01-01

The purpose of the current study was to assess the effects of an alternative to suspension intervention on students' subsequent major referrals. The intervention included activities designed to teach social coping strategies as well as mediation to resolve interpersonal conflicts. The intervention was implemented in a therapeutic high school, and…

How To Build a Strategic Plan: A Step-by-Step Guide for School Managers.

ERIC Educational Resources Information Center

Clay, Katherine; And Others

Strategic planning techniques for administrators, with a focus on process managers, are presented in this guidebook. The three major tasks of the strategic planning process include the assessment of the current organizational situation, goal setting, and the development of strategies to accomplish this. Strategic planning differs from long-range…

Improving Students' Study Habits by Demonstrating the Mnemonic Benefits of Semantic Processing

ERIC Educational Resources Information Center

Bugg, Julie M.; DeLosh, Edward L.; McDaniel, Mark A.

2008-01-01

This article describes an in-class exercise that illustrates the advantage of semantic over nonsemantic study habits. The exercise includes a survey of students' current study strategies, followed by the presentation of an abbreviated version of Craik and Tulving's(1975) classic levels-of-processing experiment. We observed significant benefits of…

New Directions in Composition Research. Perspectives in Writing Research.

ERIC Educational Resources Information Center

Beach, Richard, Ed.; Bridwell, Lillian S., Ed.

This book contains 20 articles, from a wide variety of perspectives, designed to bridge the interests of researchers and teachers on the topic of current composition research. The following articles are included: "Studying the Writing Abilities of a University Freshman Class: Strategies from a Case Study" (Charles R. Cooper, with Roger…

77 FR 23224 - Request for Technical Input-Standards in Trade Workshops

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... Institute of Standards and Technology (NIST) invites all interested parties, including U.S.-based... the current National Export Strategy. NIST will offer a limited number of workshops each year. Most workshops will be scheduled for a 3 to 5 day period at NIST in Gaithersburg, Maryland. NIST will evaluate...

The 10th Annual Bioassays and Bioanalytical Method Development Conference.

PubMed

Ma, Mark; Tudan, Christopher; Koltchev, Dolly

2015-01-01

The 10th Annual Bioassays and Bioanalytical Method Development Conference was hosted in Boston, MA, USA on 20-22 October 2014. This meeting brought together scientists from the biopharmaceutical and life sciences industries, the regulatory agency and academia to share and discuss current trends in cell-based assays and bioanalysis, challenges and ideas for the future of the bioassays and bioanalytical method development. The experiences associated with new and innovative technologies were evaluated as well as their impact on the current bioassays methodologies and bioanalysis workflow, including quality, feasibility, outsourcing strategies and challenges, productivity and compliance. Several presentations were also provided by members of the US FDA, sharing both scientific and regulatory paradigms including a most recent update on the position of the FDA with specific aspects of the draft Bioanalytical Method Validation guidance following its review of the industry's responses. The meeting was jointly coincided with the 15th Annual Immunogenicity for Biotherapeutics meeting, allowing for attendees to also familiarize themselves with new and emerging approaches to overcome the effect of immunogenicity, in addition to investigative strategies.

Contributions for Repositioning a Regional Strategy for Healthy Municipalities, Cities and Communities (HM&C): Results of a Pan-American Survey

PubMed Central

Rice, Marilyn; Vizzotti, Carlos; Frassia, Romina; Vizzotti, Pablo; Akerman, Marco

2010-01-01

This article presents the results of the 1st Regional Survey of Healthy Municipalities, Cities and Communities (HM&C) carried out in 2008 by the Pan American Health Organization (PAHO) and ISALUD University of Argentina. It discusses the responses obtained from 12 countries in the Americas Region. Key informants in Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Mexico, Paraguay, Peru, and Uruguay were selected and encouraged to answer the survey, while informants from Canada and Honduras answered voluntarily and were included in this analysis. The discussion of the results of the Survey provides insight into the current status of HM&C in the Region and suggests key topics for repositioning the Regional strategy relative to: (1) the conceptual identity and tools for HM&C; (2) challenging areas in the implementation process (scale, legal framework, and development of capacities); (3) related strategies and participatory processes such as the ways citizen empowerment in governance is supported; (4) the need to monitor and assess the impact of the HM&C strategy on the health and quality of life of the populations involved; and (5) the need for developing a strategic research and training agenda. The analysis and discussion of these results aims to provide useful input for repositioning the strategy in the Region and contributing to the emergence of a second generation of concepts and tools capable of meeting the developing priorities and needs currently faced by the HM&C strategy. PMID:20532989

The Relationship between PTSD and Chronic Pain: Mediating Role of Coping Strategies and Depression

PubMed Central

Morasco, Benjamin J.; Lovejoy, Travis I.; Lu, Mary; Turk, Dennis C.; Lewis, Lynsey; Dobscha, Steven K.

2013-01-01

People with chronic pain and comorbid posttraumatic stress disorder (PTSD) report more severe pain and poorer quality of life than those with chronic pain alone. This study evaluated the extent to which associations between PTSD and chronic pain interference and severity are mediated by pain-related coping strategies and depressive symptoms. Veterans with chronic pain were divided into two groups, those with (n=65) and those without (n=136) concurrent PTSD. All participants completed measures of pain severity, interference, emotional functioning, and coping strategies. Those with current PTSD reported significantly greater pain severity and pain interference, had more symptoms of depression, and were more likely to meet diagnostic criteria for a current alcohol or substance use disorder (all p-values ≤ 0.01). Participants with PTSD reported more use of several coping strategies, including guarding, resting, relaxation, exercise/stretching, and coping self-statements. Illness-focused pain coping (i.e., guarding, resting, and asking for assistance) and depressive symptoms jointly mediated the relationship between PTSD and both pain interference (total indirect effect = 0.194, p < 0.001) and pain severity (total indirect effect = 0.153, p = 0.004). Illness-focused pain coping also evidenced specific mediating effects, independent of depression. In summary, specific pain coping strategies and depressive symptoms partially mediated the relationship between PTSD and both pain interference and severity. Future research should examine whether changes in types of coping strategies following targeted treatments predict improvements in pain-related function for chronic pain patients with concurrent PTSD. PMID:23398939

Contributions for repositioning a regional strategy for Healthy Municipalities, Cities and Communities (HM&C): results of a pan-American survey.

PubMed

Meresman, Sergio; Rice, Marilyn; Vizzotti, Carlos; Frassia, Romina; Vizzotti, Pablo; Akerman, Marco

2010-09-01

This article presents the results of the 1st Regional Survey of Healthy Municipalities, Cities and Communities (HM&C) carried out in 2008 by the Pan American Health Organization (PAHO) and ISALUD University of Argentina. It discusses the responses obtained from 12 countries in the Americas Region. Key informants in Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Mexico, Paraguay, Peru, and Uruguay were selected and encouraged to answer the survey, while informants from Canada and Honduras answered voluntarily and were included in this analysis. The discussion of the results of the Survey provides insight into the current status of HM&C in the Region and suggests key topics for repositioning the Regional strategy relative to: (1) the conceptual identity and tools for HM&C; (2) challenging areas in the implementation process (scale, legal framework, and development of capacities); (3) related strategies and participatory processes such as the ways citizen empowerment in governance is supported; (4) the need to monitor and assess the impact of the HM&C strategy on the health and quality of life of the populations involved; and (5) the need for developing a strategic research and training agenda. The analysis and discussion of these results aims to provide useful input for repositioning the strategy in the Region and contributing to the emergence of a second generation of concepts and tools capable of meeting the developing priorities and needs currently faced by the HM&C strategy.

Education and technology used to improve the quality of life for people with diabetes mellitus type II.

PubMed

Dudley, Brooke; Heiland, Brianne; Kohler-Rausch, Elizabeth; Kovic, Mark

2014-01-01

The incidence of type II diabetes mellitus (DMT2) is expected to continue to rise. Current research has analyzed various tools, strategies, programs, barriers, and support in regards to the self-management of this condition. However, past researchers have yet to analyze the education process; including the adaptation of specific strategies in activities of daily living and roles, as well as the influence of health care providers in the integration of these strategies. The purpose of this qualitative case study was to identify the strengths and limitations of the current model of diabetes education in the United States and hypothesize how technology can impact quality of life. Key informants on diabetes education were recruited from diabetes education centers through the American Association of Diabetes Educators. Semi-structured interviews were conducted with participants. Health care practitioners convey limited knowledge of DMT2. Individuals with DMT2 often have limited understanding of the implications of poor self-management. There appears to be no consistent standard of care for how to effectively incorporate self-management strategies. There is limited education for the use of technology in self-management. Diabetes educators describe that technology could be beneficial. Findings suggest the importance of the role of care providers in emphasizing the implications of poor self-management strategies; that a multidisciplinary approach may enhance the education process; and a need for further developments in technology to address DMT2 self-management strategies.

Knowledge Translation: Moving Proteomics Science to Innovation in Society.

PubMed

Holmes, Christina; McDonald, Fiona; Jones, Mavis; Graham, Janice

2016-06-01

Proteomics is one of the pivotal next-generation biotechnologies in the current "postgenomics" era. Little is known about the ways in which innovative proteomics science is navigating the complex socio-political space between laboratory and society. It cannot be assumed that the trajectory between proteomics laboratory and society is linear and unidirectional. Concerned about public accountability and hopes for knowledge-based innovations, funding agencies and citizens increasingly expect that emerging science and technologies, such as proteomics, are effectively translated and disseminated as innovation in society. Here, we describe translation strategies promoted in the knowledge translation (KT) and science communication literatures and examine the use of these strategies within the field of proteomics. Drawing on data generated from qualitative interviews with proteomics scientists and ethnographic observation of international proteomics conferences over a 5-year period, we found that proteomics science incorporates a variety of KT strategies to reach knowledge users outside the field. To attain the full benefit of KT, however, proteomics scientists must challenge their own normative assumptions and approaches to innovation dissemination-beyond the current paradigm relying primarily on publication for one's scientific peers within one's field-and embrace the value of broader (interdisciplinary) KT strategies in promoting the uptake of their research. Notably, the Human Proteome Organization (HUPO) is paying increasing attention to a broader range of KT strategies, including targeted dissemination, integrated KT, and public outreach. We suggest that increasing the variety of KT strategies employed by proteomics scientists is timely and would serve well the omics system sciences community.

A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research

PubMed Central

Crowley, Max; Jones, Damon

2017-01-01

Investing in strategies that aim to build a more nurturing society offers tremendous opportunities for the field of prevention science. Yet, scientists struggle to consistently take their research beyond effectiveness evaluations and actually value the impact of preventive strategies. Ultimately, it is clear that convincing policymakers to make meaningful investments in children and youth will require estimates of the fiscal impact of such strategies across public service systems. The framework offered here values such investments. First, we review current public spending on children and families. Then, we describe how to quantify and monetize the impact of preventive interventions. This includes a new measurement strategy for assessing multi-system service utilization and a price list for key service provision from public education, social services, criminal justice, healthcare, and tax systems. PMID:28247294

Rehabilitation strategies enhancing participation in shopping malls for persons living with a disability.

PubMed

Alary Gauvreau, Christine; Kairy, Dahlia; Mazer, Barbara; Guindon, Andréanne; Le Dorze, Guylaine

2018-04-01

After rehabilitation, it is not clear the extent to which persons living with a disability return to their former activities in the community, such as going to shopping malls. Rehabilitation professionals are faced with the challenge to adequately prepare their clients to resume community participation. The purpose of this study was to identify rehabilitation strategies aimed at preparing clients to engage in activities in shopping malls. Twenty-two participants including 16 rehabilitation clinicians and 6 persons living with a disability participated in four nominal group sessions. Participants were questioned on current or potential rehabilitation strategies carried out to enhance participation in shopping malls for persons living with a disability. Discussions were audio-recorded and qualitative content analysis was conducted. Participants mentioned strategies that were either carried out by the clinician, or in collaboration with other parties. The latter type of strategies was either carried out with the collaboration of the client, the interdisciplinary team, the relatives, or community organizations. Rehabilitation clinicians have a role to play in preparing persons living with a disability to resume activities in a shopping mall. Additionally, therapeutic interventions in community settings may enhance the participation of rehabilitation clients in their everyday activities. Implications for rehabilitation Many strategies are currently used in rehabilitation to prepare persons living with a disability to resume shopping activities. Clinicians could implement shopping-oriented rehabilitation strategies with the client and/or with other rehabilitation partners. Involving clients in activities related to shopping might enhance their participation in shopping malls after rehabilitation. Rehabilitation clinicians can be facilitators for people living with a disability to reach optimal participation.

Empowering Students with Language Learning Strategies: A Critical Review of Current Issues

ERIC Educational Resources Information Center

Rivera-Mills, Susanna V.; Plonsky, Luke

2007-01-01

This article analyzes the body of research literature that has brought us to the state of our current knowledge regarding learning strategies in general and learning strategies Instruction as they relate to second language acquisition (SLA). Three categories are discussed: (1) types of learning strategies, (2) learning autonomy and strategy…

Diagnostic accuracy of high-risk HPV genotyping in women with high-grade cervical lesions: evidence for improving the cervical cancer screening strategy in China.

PubMed

Xu, Huihui; Lin, Aifen; Shao, Xiujuan; Shi, Weiwu; Zhang, Yang; Yan, Weihua

2016-12-13

Currently, clinical data for primary HPV screening alone are lacking in China. Here, we evaluate cervical cancer screening with primary HPV genotyping, as well as possible future screening strategy. Overall, high-risk HPV (hrHPV) prevalence was 18.2% among hospital-based population in Taizhou area. For cervical intraepithelial neoplasia 2 or worse (CIN2+), the sensitivity of primary hrHPV genotyping strategy and current cervical cancer screening strategy were 93.5%, and 71.1%, respectively; whereas the specificity was 17.5%, and 62.4%, respectively. Current cervical screening strategy had slightly higher positive predictive values (28.4%) for CIN2+ than hrHPV genotyping strategy (21.9%), whereas primary hrHPV genotyping strategy demonstrated higher negative predictive values (94.7%) than current cervical screening strategy (91.1%). Compared to HPV35/39/45/51/56/59/66/68 genotypes, the odds ratios (OR) for CIN2+ in HPV16/18/31/33/52/58 infection women were 3.2 (95% confidence interval [CI] 2.3-4.1). Primary hrHPV genotyping strategy provides a better predictive value than HPV16/18 genotyping alone in guiding the clinical management of the current cervical cancer screening. HPV testing without adjunctive cytology may be sufficiently sensitive for primary cervical cancer screening.

Economic Evaluation of Immunisation Programme of 23-Valent Pneumococcal Polysaccharide Vaccine and the Inclusion of 13-Valent Pneumococcal Conjugate Vaccine in the List for Single-Dose Subsidy to the Elderly in Japan.

PubMed

Hoshi, Shu-ling; Kondo, Masahide; Okubo, Ichiro

2015-01-01

Currently in Japan, both 23-valent pneumococcal polysaccharide vaccine (PPSV-23) and 13-valent pneumococcal conjugate vaccine (PCV-13) are available for the elderly for the prevention of S. pneumoniae-related diseases. PPSV-23 was approved in 1988, while the extended use of PCV-13 was approved for adults aged 65 and older in June 2014. Despite these two vaccines being available, the recently launched national immunisation programme for the elderly only subsidised PPSV-23. The framework of the current immunisation programme lasts for five years. The elderly population eligible for the subsidised PPSV-23 shot for the 1st year are those aged 65, 70, 75, 80, 85, 90, 95 and ≥ 100. While from the 2nd year to the 5th year, those who will age 65, 70, 75, 80, 85, 90, 95 and 100 will receive the same subsidised shot. We performed economic evaluations to (1) evaluate the efficiency of alternative strategies of PPSV-23 single-dose immunisation programme, and (2) investigate the efficiency of PCV-13 inclusion in the list for single-dose pneumococcal vaccine immunisation programme. Three alternative strategies were created in this study, namely: (1) current PPSV-23 strategy, (2) 65 to 80 (as "65-80 PPSV-23 strategy"), and (3) 65 and older (as "≥ 65 PPSV-23 strategy"). We constructed a Markov model depicting the S. pneumoniae-related disease course pathways. The transition probabilities, utility weights to estimate quality adjusted life year (QALY) and disease treatment costs were either calculated or cited from literature. Cost of per shot of vaccine was ¥ 8,116 (US$74; US$1 = ¥ 110) for PPSV-23 and ¥ 10,776 (US$98) for PCV-13. The model runs for 15 years with one year cycle after immunisation. Discounting was at 3%. Compared to current PPSV-23 strategy, 65-80 PPSV-23 strategy cost less but gained less, while the incremental cost-effectiveness ratios (ICERs) of ≥ 65 PPSV-23 strategy was ¥ 5,025,000 (US$45,682) per QALY gained. PCV-13 inclusion into the list for single-dose subsidy has an ICER of ¥ 377,000 (US$3,427) per QALY gained regardless of the PCV-13 diffusion level. These ICERs were found to be cost-effective since they are lower than the suggested criterion by WHO of three times GDP (¥ 11,000,000 or US$113,636 per QALY gained), which is the benchmark used in judging the cost-effectiveness of an immunisation programmne. The results suggest that switching current PPSV-23 strategy to ≥ 65 PPSV-23 strategy or including PCV-13 into the list for single-dose subsidy to the elderly in Japan has value for money.

Evasion of Neutrophil Extracellular Traps by Respiratory Pathogens.

PubMed

Storisteanu, Daniel M L; Pocock, Joanna M; Cowburn, Andrew S; Juss, Jatinder K; Nadesalingam, Angalee; Nizet, Victor; Chilvers, Edwin R

2017-04-01

The release of neutrophil extracellular traps (NETs) is a major immune mechanism intended to capture pathogens. These histone- and protease-coated DNA structures are released by neutrophils in response to a variety of stimuli, including respiratory pathogens, and have been identified in the airways of patients with respiratory infection, cystic fibrosis, acute lung injury, primary graft dysfunction, and chronic obstructive pulmonary disease. NET production has been demonstrated in the lungs of mice infected with Staphylococcus aureus, Klebsiella pneumoniae, and Aspergillus fumigatus. Since the discovery of NETs over a decade ago, evidence that "NET evasion" might act as an immune protection strategy among respiratory pathogens, including group A Streptococcus, Bordetella pertussis, and Haemophilus influenzae, has been growing, with the majority of these studies being published in the past 2 years. Evasion strategies fall into three main categories: inhibition of NET release by down-regulating host inflammatory responses; degradation of NETs using pathogen-derived DNases; and resistance to the microbicidal components of NETs, which involves a variety of mechanisms, including encapsulation. Hence, the evasion of NETs appears to be a widespread strategy to allow pathogen proliferation and dissemination, and is currently a topic of intense research interest. This article outlines the evidence supporting the three main strategies of NET evasion-inhibition, degradation, and resistance-with particular reference to common respiratory pathogens.

Evasion of Neutrophil Extracellular Traps by Respiratory Pathogens

PubMed Central

Storisteanu, Daniel M. L.; Pocock, Joanna M.; Cowburn, Andrew S.; Juss, Jatinder K.; Nadesalingam, Angalee; Nizet, Victor

2017-01-01

The release of neutrophil extracellular traps (NETs) is a major immune mechanism intended to capture pathogens. These histone- and protease-coated DNA structures are released by neutrophils in response to a variety of stimuli, including respiratory pathogens, and have been identified in the airways of patients with respiratory infection, cystic fibrosis, acute lung injury, primary graft dysfunction, and chronic obstructive pulmonary disease. NET production has been demonstrated in the lungs of mice infected with Staphylococcus aureus, Klebsiella pneumoniae, and Aspergillus fumigatus. Since the discovery of NETs over a decade ago, evidence that “NET evasion” might act as an immune protection strategy among respiratory pathogens, including group A Streptococcus, Bordetella pertussis, and Haemophilus influenzae, has been growing, with the majority of these studies being published in the past 2 years. Evasion strategies fall into three main categories: inhibition of NET release by down-regulating host inflammatory responses; degradation of NETs using pathogen-derived DNases; and resistance to the microbicidal components of NETs, which involves a variety of mechanisms, including encapsulation. Hence, the evasion of NETs appears to be a widespread strategy to allow pathogen proliferation and dissemination, and is currently a topic of intense research interest. This article outlines the evidence supporting the three main strategies of NET evasion—inhibition, degradation, and resistance—with particular reference to common respiratory pathogens. PMID:27854516

Nanobiotechnology-based delivery strategies: New frontiers in brain tumor targeted therapies.

PubMed

Mangraviti, Antonella; Gullotti, David; Tyler, Betty; Brem, Henry

2016-10-28

Despite recent technological advancements and promising preclinical experiments, brain tumor patients are still met with limited treatment options. Some of the barriers to clinical improvements include the systemic toxicity of cytotoxic compounds, the impedance of the blood brain barrier (BBB), and the lack of therapeutic agents that can selectively target the intracranial tumor environment. To overcome such barriers, a number of chemotherapeutic agents and nucleic acid-based therapies are rapidly being synthesized and tested as new brain tumor-targeted delivery strategies. Novel carriers include liposomal and polymeric nanoparticles, wafers, microchips, microparticle-based nanoplatforms and cells-based vectors. Strong preclinical results suggest that these nanotechnologies are set to transform the therapeutic paradigm for brain tumor treatment. In addition to new tumoricidal agents, parallel work is also being conducted on the BBB front. Preclinical testing of chemical and physical modulation strategies is yielding improved intracranial concentrations. New diagnostic and therapeutic imaging techniques, such as high-intensity focused ultrasound and MRI-guided focused ultrasound, are being used to modulate the BBB in a more precise and non-invasive manner. This review details some of the tremendous advances that are being explored in current brain tumor targeted therapies, including local implant development, nanobiotechnology-based delivery strategies, and techniques of BBB manipulation. Copyright © 2016 Elsevier B.V. All rights reserved.

HIV cure strategies: how good must they be to improve on current antiretroviral therapy?

PubMed

Sax, Paul E; Sypek, Alexis; Berkowitz, Bethany K; Morris, Bethany L; Losina, Elena; Paltiel, A David; Kelly, Kathleen A; Seage, George R; Walensky, Rochelle P; Weinstein, Milton C; Eron, Joseph; Freedberg, Kenneth A

2014-01-01

We examined efficacy, toxicity, relapse, cost, and quality-of-life thresholds of hypothetical HIV cure interventions that would make them cost-effective compared to life-long antiretroviral therapy (ART). We used a computer simulation model to assess three HIV cure strategies: Gene Therapy, Chemotherapy, and Stem Cell Transplantation (SCT), each compared to ART. Efficacy and cost parameters were varied widely in sensitivity analysis. Outcomes included quality-adjusted life expectancy, lifetime cost, and cost-effectiveness in dollars/quality-adjusted life year ($/QALY) gained. Strategies were deemed cost-effective with incremental cost-effectiveness ratios <$100,000/QALY. For patients on ART, discounted quality-adjusted life expectancy was 16.4 years and lifetime costs were $591,400. Gene Therapy was cost-effective with efficacy of 10%, relapse rate 0.5%/month, and cost $54,000. Chemotherapy was cost-effective with efficacy of 88%, relapse rate 0.5%/month, and cost $12,400/month for 24 months. At $150,000/procedure, SCT was cost-effective with efficacy of 79% and relapse rate 0.5%/month. Moderate efficacy increases and cost reductions made Gene Therapy cost-saving, but substantial efficacy/cost changes were needed to make Chemotherapy or SCT cost-saving. Depending on efficacy, relapse rate, and cost, cure strategies could be cost-effective compared to current ART and potentially cost-saving. These results may help provide performance targets for developing cure strategies for HIV.

Canadian Headache Society guideline for migraine prophylaxis.

PubMed

Pringsheim, Tamara; Davenport, W Jeptha; Mackie, Gordon; Worthington, Irene; Aubé, Michel; Christie, Suzanne N; Gladstone, Jonathan; Becker, Werner J

2012-03-01

The primary objective of this guideline is to assist the practitioner in choosing an appropriate prophylactic medication for an individual with migraine, based on current evidence in the medical literature and expert consensus. This guideline is focused on patients with episodic migraine (headache on ≤ 14 days a month). Through a comprehensive search strategy, randomized, double blind, controlled trials of drug treatments for migraine prophylaxis and relevant Cochrane reviews were identified. Studies were graded according to criteria developed by the US Preventive Services Task Force. Recommendations were graded according to the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group. In addition, a general literature review and expert consensus were used for aspects of prophylactic therapy for which randomized controlled trials are not available. Prophylactic drug choice should be based on evidence for efficacy, side-effect profile, migraine clinical features, and co-existing disorders. Based on our review, 11 prophylactic drugs received a strong recommendation for use (topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, butterbur, riboflavin, coenzyme Q10, and magnesium citrate) and 6 received a weak recommendation (divalproex sodium, flunarizine, pizotifen, venlafaxine, verapamil, and lisinopril). Quality of evidence for different medications varied from high to low. Prophylactic treatment strategies were developed to assist the practitioner in selecting a prophylactic drug for specific clinical situations. These strategies included: first time strategies for patients who have not had prophylaxis before (a beta-blocker and a tricyclic strategy), low side effect strategies (including both drug and herbal/vitamin/mineral strategies), a strategy for patients with high body mass index, strategies for patients with co-existent hypertension or with co-existent depression and /or anxiety, and additional monotherapy drug strategies for patients who have failed previous prophylactic trials. Further strategies included a refractory migraine strategy and strategies for prophylaxis during pregnancy and lactation. There is good evidence from randomized controlled trials for use of a number of different prophylactic medications in patients with migraine. Medication choice for an individual patient requires careful consideration of patient clinical features.

Development and testing of an implementation strategy for a complex housing intervention: protocol for a mixed methods study.

PubMed

Watson, Dennis P; Young, Jeani; Ahonen, Emily; Xu, Huiping; Henderson, Macey; Shuman, Valery; Tolliver, Randi

2014-10-17

There is currently a lack of scientifically designed and tested implementation strategies. Such strategies are particularly important for highly complex interventions that require coordination between multiple parts to be successful. This paper presents a protocol for the development and testing of an implementation strategy for a complex intervention known as the Housing First model (HFM). Housing First is an evidence-based practice for chronically homeless individuals demonstrated to significantly improve a number of outcomes. Drawing on practices demonstrated to be useful in implementation and e-learning theory, our team is currently adapting a face-to-face implementation strategy so that it can be delivered over a distance. Research activities will be divided between Chicago and Central Indiana, two areas with significantly different barriers to HFM implementation. Ten housing providers (five from Chicago and five from Indiana) will be recruited to conduct an alpha test of each of four e-learning modules as they are developed. Providers will be requested to keep a detailed log of their experience completing the modules and participate in one of two focus groups. After refining the modules based on alpha test results, we will test the strategy among a sample of four housing organizations (two from Chicago and two from Indiana). We will collect and analyze both qualitative and quantitative data from administration and staff. Measures of interest include causal factors affecting implementation, training outcomes, and implementation outcomes. This project is an important first step in the development of an evidence-based implementation strategy to increase scalability and impact of the HFM. The project also has strong potential to increase limited scientific knowledge regarding implementation strategies in general.

Antenatal Breastfeeding Education and Support: Summary and Analysis of 2 Cochrane Publications.

PubMed

Jacobsen, Noelle

Key breastfeeding outcomes identified by the World Health Organization, the United Nations Children's Fund, the American Academy of Pediatrics, and Healthy People 2020 include early initiation, any such feeding at 6 months of age, and exclusivity. Broader themes in the current literature include infants who ever breastfed and overall duration. Healthcare providers need to know what current practices demonstrate effectiveness. A review of 2 Cochrane articles on which interventions impact these selected outcomes does not reveal any significant implications for clinical practice. Scant evidence exists to support any specific support efforts or educational outreach to improve these outcomes. A discussion of potential strategies to consider for future research and clinical practice is put forth.

Assessing vulnerability of giant pandas to climate change in the Qinling Mountains of China.

PubMed

Li, Jia; Liu, Fang; Xue, Yadong; Zhang, Yu; Li, Diqiang

2017-06-01

Climate change might pose an additional threat to the already vulnerable giant panda ( Ailuropoda melanoleuca ). Effective conservation efforts require projections of vulnerability of the giant panda in facing climate change and proactive strategies to reduce emerging climate-related threats. We used the maximum entropy model to assess the vulnerability of giant panda to climate change in the Qinling Mountains of China. The results of modeling included the following findings: (1) the area of suitable habitat for giant pandas was projected to decrease by 281 km 2 from climate change by the 2050s; (2) the mean elevation of suitable habitat of giant panda was predicted to shift 30 m higher due to climate change over this period; (3) the network of nature reserves protect 61.73% of current suitable habitat for the species, and 59.23% of future suitable habitat; (4) current suitable habitat mainly located in Chenggu, Taibai, and Yangxian counties (with a total area of 987 km 2 ) was predicted to be vulnerable. Assessing the vulnerability of giant panda provided adaptive strategies for conservation programs and national park construction. We proposed adaptation strategies to ameliorate the predicted impacts of climate change on giant panda, including establishing and adjusting reserves, establishing habitat corridors, improving adaptive capacity to climate change, and strengthening monitoring of giant panda.

De-escalating Antibiotic Use in the Inpatient Setting: Strategies, Controversies, and Challenges.

PubMed

Daniel Markley, J; Bernard, Shaina; Bearman, Gonzalo; Stevens, Michael P

2017-04-01

Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. A consensus definition of ADE remains elusive at this time. Preliminary studies utilizing rapid diagnostic tests including matrix-assisted laser desorption/ionization time of flight (MALDI-TOF), procalcitonin, and other molecular techniques have demonstrated the potential to support ADE strategies. In the absence of evidence-based, highly specific ADE protocols, the likelihood that individual providers will make consistent, often challenging, decisions to de-escalate antibiotic therapy is low. Antimicrobial stewardship programs should support local physicians with ADE and develop innovative ways to integrate ADE into the broader construct of antimicrobial stewardship programs. The evolving field of rapid diagnostics has significant potential to improve ADE strategies, but more research is needed to fully realize this goal.

Post-Closure Strategy for Use-Restricted Sites on the Nevada National Security Site, Nevada Test and Training Range, and Tonopah Test Range, Nevada

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

Silvas, A. J.

The purpose of this Post-Closure Strategy is to provide a consistent methodology for continual evaluation of post-closure requirements for use-restricted areas on the Nevada National Security Site (NNSS), Nevada Test and Training Range (NTTR), and Tonopah Test Range (TTR) to consolidate, modify, or streamline the program. In addition, this document stipulates the creation of a single consolidated Post-Closure Plan that will detail the current post-closure requirements for all active use restrictions (URs) and outlines its implementation and subsequent revision. This strategy will ensure effective management and control of the post-closure sites. There are currently over 200 URs located on themore » NNSS, NTTR, and TTR. Post-closure requirements were initially established in the Closure Report for each site. In some cases, changes to the post-closure requirements have been implemented through addenda, errata sheets, records of technical change, or letters. Post-closure requirements have been collected from these multiple sources and consolidated into several formats, such as summaries and databases. This structure increases the possibility of inconsistencies and uncertainty. As more URs are established and the post-closure program is expanded, the need for a comprehensive approach for managing the program will increase. Not only should the current requirements be obtainable from a single source that supersedes all previous requirements, but the strategy for modifying the requirements should be standardized. This will enable more effective management of the program into the future. This strategy document and the subsequent comprehensive plan are to be implemented under the assumption that the NNSS and outlying sites will be under the purview of the U.S. Department of Energy, National Nuclear Security Administration for the foreseeable future. This strategy was also developed assuming that regulatory control of the sites remains static. The comprehensive plan is not intended to be a permanent long-term stewardship plan. However, it is intended to clarify requirements and identify components to effectively manage the sites until regulatory requirements are met or management of the site changes. The Environmental Management Program is required to manage these sites until the NNSS Environmental Restoration program is completed, currently planned for 2030. Prior to completion of the Environmental Restoration program, additional planning will be conducted to ensure that long-term stewardship of the sites is maintained. A comprehensive post-closure plan can be transitioned effectively into any future site-wide long-term stewardship program that may be developed. Therefore, the post-closure plan will include current aspects of the post-closure program that are also important aspects of long-term stewardship, including the following: • Management of physical and engineering controls such as fences, signs, and soil covers • Management of institutional and administrative controls such as use restrictions and real estate systems • Management of monitoring and maintenance programs • Management of information related to the sites such as geographic information system data and related documentation The strategy will also allow for periodic review and modification of any aspect of the program to ensure continued effectiveness.« less

Topiramate in schizophrenia: a review of effects on psychopathology and metabolic parameters.

PubMed

Hahn, Margaret K; Cohn, Tony; Teo, Celine; Remington, Gary

2013-01-01

Less than half of patients with schizophrenia obtain full response to antipsychotic drugs and, while clozapine represents the treatment of choice for refractory psychosis, a significant number of individuals remain only partially responsive. Despite a need for augmentation in this subpopulation, to date clear choices have not been forthcoming. Because clozapine, along with the majority of second-generation agents (SGAs), are linked to metabolic disturbances, augmentation strategies that do not further exacerbate these side effects are needed. Topiramate, unlike other anticonvulsants used for augmentation purposes, has been associated with weight loss. This article reviews the safety and efficacy of topiramate in treatment-refractory schizophrenia, including effects on metabolic disturbances, which burden this population. While current evidence specifically examining improvements in psychopathology demonstrates small to moderate benefits with topiramate augmentation, a growing body of evidence suggests that topiramate may have beneficial effects on antipsychotic-induced weight gain. We conclude that topiramate's metabolic profile, taken together with a current lack of evidence supporting a particular augmentation strategy, argues for further well-controlled studies examining its potential as an augmentation strategy in schizophrenia.

Anal cancer and intraepithelial neoplasia screening: A review

PubMed Central

Leeds, Ira L; Fang, Sandy H

2016-01-01

This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors early in the disease process. It is thought that such a strategy of identifying early anal intraepithelial neoplasia will reduce the incidence of invasive anal cancer. The low prevalence of anal cancer in the general population prevents the use of routine screening. However, routine screening of selected populations has been shown to be a more promising strategy. Potential screening modalities include digital anorectal exam, anal Papanicolaou testing, human papilloma virus co-testing, and high-resolution anoscopy. Additional research associating high-grade dysplasia treatment with anal cancer prevention as well as direct comparisons of screening regimens is necessary to develop further anal cancer screening recommendations. PMID:26843912

Problem-solving strategies of women undergoing chemotherapy for breast cancer.

PubMed

Lyons, Kathleen D; Erickson, Kelly S; Hegel, Mark T

2012-02-01

Many women undergoing chemotherapy for breast cancer experience side effects that make it difficult to perform daily occupations. To summarize the types of challenges, goals, and adaptive strategies identified by women with stage 1-3 breast cancer participating in a pilot study of Problem-solving Treatment-Occupational Therapy (PST-OT). Content analysis of 80 PST-OT sessions. Women addressed 11 types of challenging activities, with exercise and instrumental activities of daily living (IADL) being the most common. Most women set a goal to adapt a current activity, but also set goals to find a new activity, plan the steps of a current activity, or gather information about a possible activity change in the future. The adaptive strategies generated by the women were grouped into five types. Most often they found ways to add a new step to an activity, but they also brainstormed about when, how, where, and with whom they could do activities. The women were usually trying to adapt familiar activities but also were looking for ways to include new, healthy occupations into their routines.

Proton pump inhibitors as anti vacuolar-ATPases drugs: a novel anticancer strategy.

PubMed

Spugnini, Enrico P; Citro, Gennaro; Fais, Stefano

2010-05-08

The vacuolar ATPases are ATP-dependent proton pumps whose functions include the acidification of intracellular compartments and the extrusion of protons through the cell cytoplasmic membrane. These pumps play a pivotal role in the regulation of cell pH in normal cells and, to a much greater extent, in tumor cells. In fact, the glucose metabolism in hypoxic conditions by the neoplasms leads to an intercellular pH drift towards acidity. The acid microenvironment is modulated through the over-expression of H+ transporters that are also involved in tumor progression, invasiveness, distant spread and chemoresistance. Several strategies to block/downmodulate the efficiency of these transporters are currently being investigated. Among them, proton pump inhibitors have shown to successfully block the H+ transporters in vitro and in vivo, leading to apoptotic death. Furthermore, their action seems to synergize with conventional chemotherapy protocols, leading to chemosensitization and reversal of chemoresistance. Aim of this article is to critically revise the current knowledge of this cellular machinery and to summarize the therapeutic strategies developed to counter this mechanism.

Acoustic noise and functional magnetic resonance imaging: current strategies and future prospects.

PubMed

Amaro, Edson; Williams, Steve C R; Shergill, Sukhi S; Fu, Cynthia H Y; MacSweeney, Mairead; Picchioni, Marco M; Brammer, Michael J; McGuire, Philip K

2002-11-01

Functional magnetic resonance imaging (fMRI) has become the method of choice for studying the neural correlates of cognitive tasks. Nevertheless, the scanner produces acoustic noise during the image acquisition process, which is a problem in the study of auditory pathway and language generally. The scanner acoustic noise not only produces activation in brain regions involved in auditory processing, but also interferes with the stimulus presentation. Several strategies can be used to address this problem, including modifications of hardware and software. Although reduction of the source of the acoustic noise would be ideal, substantial hardware modifications to the current base of installed MRI systems would be required. Therefore, the most common strategy employed to minimize the problem involves software modifications. In this work we consider three main types of acquisitions: compressed, partially silent, and silent. For each implementation, paradigms using block and event-related designs are assessed. We also provide new data, using a silent event-related (SER) design, which demonstrate higher blood oxygen level-dependent (BOLD) response to a simple auditory cue when compared to a conventional image acquisition. Copyright 2002 Wiley-Liss, Inc.

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

Yu, Ai-Qun; Pratomo Juwono, Nina Kurniasih; Synthetic Biology Research Program, National University of Singapore, Singapore

Fatty acid derivatives, such as hydroxy fatty acids, fatty alcohols, fatty acid methyl/ethyl esters, and fatty alka(e)nes, have a wide range of industrial applications including plastics, lubricants, and fuels. Currently, these chemicals are obtained mainly through chemical synthesis, which is complex and costly, and their availability from natural biological sources is extremely limited. Metabolic engineering of microorganisms has provided a platform for effective production of these valuable biochemicals. Notably, synthetic biology-based metabolic engineering strategies have been extensively applied to refactor microorganisms for improved biochemical production. Here, we reviewed: (i) the current status of metabolic engineering of microbes that produce fattymore » acid-derived valuable chemicals, and (ii) the recent progress of synthetic biology approaches that assist metabolic engineering, such as mRNA secondary structure engineering, sensor-regulator system, regulatable expression system, ultrasensitive input/output control system, and computer science-based design of complex gene circuits. Furthermore, key challenges and strategies were discussed. Finally, we concluded that synthetic biology provides useful metabolic engineering strategies for economically viable production of fatty acid-derived valuable chemicals in engineered microbes.« less

Production of Fatty Acid-Derived Valuable Chemicals in Synthetic Microbes

PubMed Central

Yu, Ai-Qun; Pratomo Juwono, Nina Kurniasih; Leong, Susanna Su Jan; Chang, Matthew Wook

2014-01-01

Fatty acid derivatives, such as hydroxy fatty acids, fatty alcohols, fatty acid methyl/ethyl esters, and fatty alka(e)nes, have a wide range of industrial applications including plastics, lubricants, and fuels. Currently, these chemicals are obtained mainly through chemical synthesis, which is complex and costly, and their availability from natural biological sources is extremely limited. Metabolic engineering of microorganisms has provided a platform for effective production of these valuable biochemicals. Notably, synthetic biology-based metabolic engineering strategies have been extensively applied to refactor microorganisms for improved biochemical production. Here, we reviewed: (i) the current status of metabolic engineering of microbes that produce fatty acid-derived valuable chemicals, and (ii) the recent progress of synthetic biology approaches that assist metabolic engineering, such as mRNA secondary structure engineering, sensor-regulator system, regulatable expression system, ultrasensitive input/output control system, and computer science-based design of complex gene circuits. Furthermore, key challenges and strategies were discussed. Finally, we concluded that synthetic biology provides useful metabolic engineering strategies for economically viable production of fatty acid-derived valuable chemicals in engineered microbes. PMID:25566540

Current nutritional recommendations and novel dietary strategies to manage sarcopenia

PubMed Central

Calvani, Riccardo; Miccheli, Alfredo; Landi, Francesco; Bossola, Maurizio; Cesari, Matteo; Leeuwenburgh, Christiaan; Sieber, Cornel C.; Bernabei, Roberto; Marzetti, Emanuele

2015-01-01

Sarcopenia, the loss of skeletal muscle mass and function that occurs with aging, is associated with increased risk for several adverse health outcomes, including frailty, disability, falls, loss of independent living, and mortality. At present, no pharmacological treatment exists that is able to definitely halt the progression of sarcopenia. Likewise, no pharmacological remedies are yet available to prevent the onset of age-related muscle wasting. In this scenario, the combination of nutritional interventions and physical exercise appears to be the most effective strategy presently available for the management of sarcopenia. The purposes of this review are to summarize the current knowledge on the role of nutrition as a countermeasure for sarcopenia, illustrate the mechanisms of action of relevant dietary agents on the aging muscle, and introduce novel nutritional strategies that may help preserve muscle mass and function into old age. Issues related to the identification of the optimal timing of nutritional interventions in the context of primary and secondary prevention are also discussed. Finally, the prospect of elaborating personalized dietary and physical exercise recommendations through the implementation of integrated, high-throughput analytic approaches is illustrated. PMID:26082911

Are Expectations the Missing Link between Life History Strategies and Psychopathology?

PubMed

Kavanagh, Phillip S; Kahl, Bianca L

2018-01-01

Despite advances in knowledge and thinking about using life history theory to explain psychopathology there is still a missing link. That is, we all have a life history strategy, but not all of us develop mental health problems. We propose that the missing link is expectations - a mismatch between expected environmental conditions (including social) set by variations in life history strategies and the current environmental conditions. The mismatch hypothesis has been applied at the biological level in terms of health and disease and we believe that it can also be applied more broadly at the psychological level in terms of perceived expectations in the social environment and the resulting distress-psychopathology-that manifests when our expectations are not met.

A critical review of the research literature on Six Sigma, Lean and StuderGroup's Hardwiring Excellence in the United States: the need to demonstrate and communicate the effectiveness of transformation strategies in healthcare

PubMed Central

Vest, Joshua R; Gamm, Larry D

2009-01-01

Background U.S. healthcare organizations are confronted with numerous and varied transformational strategies promising improvements along all dimensions of quality and performance. This article examines the peer-reviewed literature from the U.S. for evidence of effectiveness among three current popular transformational strategies: Six Sigma, Lean/Toyota Production System, and Studer's Hardwiring Excellence. Methods The English language health, healthcare management, and organizational science literature (up to December 2007) indexed in Medline, Web of Science, ABI/Inform, Cochrane Library, CINAHL, and ERIC was reviewed for studies on the aforementioned transformation strategies in healthcare settings. Articles were included if they: appeared in a peer-reviewed journal; described a specific intervention; were not classified as a pilot study; provided quantitative data; and were not review articles. Nine references on Six Sigma, nine on Lean/Toyota Production System, and one on StuderGroup meet the study's eligibility criteria. Results The reviewed studies universally concluded the implementations of these transformation strategies were successful in improving a variety of healthcare related processes and outcomes. Additionally, the existing literature reflects a wide application of these transformation strategies in terms of both settings and problems. However, despite these positive features, the vast majority had methodological limitations that might undermine the validity of the results. Common features included: weak study designs, inappropriate analyses, and failures to rule out alternative hypotheses. Furthermore, frequently absent was any attention to changes in organizational culture or substantial evidence of lasting effects from these efforts. Conclusion Despite the current popularity of these strategies, few studies meet the inclusion criteria for this review. Furthermore, each could have been improved substantially in order to ensure the validity of the conclusions, demonstrate sustainability, investigate changes in organizational culture, or even how one strategy interfaced with other concurrent and subsequent transformation efforts. While informative results can be gleaned from less rigorous studies, improved design and analysis can more effectively guide healthcare leaders who are motivated to transform their organizations and convince others of the need to employ such strategies. Demanding more exacting evaluation of projects consultants, or partnerships with health management researchers in academic settings, can support such efforts. PMID:19570218

A critical review of the research literature on Six Sigma, Lean and StuderGroup's Hardwiring Excellence in the United States: the need to demonstrate and communicate the effectiveness of transformation strategies in healthcare.

PubMed

Vest, Joshua R; Gamm, Larry D

2009-07-01

U.S. healthcare organizations are confronted with numerous and varied transformational strategies promising improvements along all dimensions of quality and performance. This article examines the peer-reviewed literature from the U.S. for evidence of effectiveness among three current popular transformational strategies: Six Sigma, Lean/Toyota Production System, and Studer's Hardwiring Excellence. The English language health, healthcare management, and organizational science literature (up to December 2007) indexed in Medline, Web of Science, ABI/Inform, Cochrane Library, CINAHL, and ERIC was reviewed for studies on the aforementioned transformation strategies in healthcare settings. Articles were included if they: appeared in a peer-reviewed journal; described a specific intervention; were not classified as a pilot study; provided quantitative data; and were not review articles. Nine references on Six Sigma, nine on Lean/Toyota Production System, and one on StuderGroup meet the study's eligibility criteria. The reviewed studies universally concluded the implementations of these transformation strategies were successful in improving a variety of healthcare related processes and outcomes. Additionally, the existing literature reflects a wide application of these transformation strategies in terms of both settings and problems. However, despite these positive features, the vast majority had methodological limitations that might undermine the validity of the results. Common features included: weak study designs, inappropriate analyses, and failures to rule out alternative hypotheses. Furthermore, frequently absent was any attention to changes in organizational culture or substantial evidence of lasting effects from these efforts. Despite the current popularity of these strategies, few studies meet the inclusion criteria for this review. Furthermore, each could have been improved substantially in order to ensure the validity of the conclusions, demonstrate sustainability, investigate changes in organizational culture, or even how one strategy interfaced with other concurrent and subsequent transformation efforts. While informative results can be gleaned from less rigorous studies, improved design and analysis can more effectively guide healthcare leaders who are motivated to transform their organizations and convince others of the need to employ such strategies. Demanding more exacting evaluation of projects consultants, or partnerships with health management researchers in academic settings, can support such efforts.

Strategies for the promotion of computer applications in radiology in healthcare delivery.

PubMed

Reiner, B; Siegel, E; Allman, R

1998-08-01

The objective of this paper is to identify current trends in the development and implementation of computer applications in today's ever-changing healthcare environment. Marketing strategies are discussed with the goal of promoting computer applications in radiology as a means to advance future healthcare acceptance of technologic developments from the medical imaging field. With the rapid evolution of imaging and and information technologies along with the transition to filmless imaging, radiologists must assume a proactive role in the development and application of these advancements. This expansion can be accomplished in a number of ways including internet based educational programs, research partnerships, and professional membership in societies such as the Society of Computer Applications in Radiology (SCAR). Professional societies such as SCAR, in turn, should reach out to include other professionals from the healthcare community. These would include financial, administrative, and information systems disciplines to promote these technologies in a cost conscious and value added manner.

Evaluation of emission control strategies for airfield operations at the Los Angeles and San Francisco International Airports. Final report

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

Gelinas, C.G.

1978-08-01

This report reviews potential air pollutant emission reductions which could be achieved by various strategies to control airfield operations at Los Angeles and San Francisco International Airports, and examines safety problems, cost impacts, potential fuel savings, time frame for strategy implementation, and potential regulatory and jurisdictional conflicts associated with each strategy. Airfield emission sources studied included aircraft operation in the idle, taxi, takeoff, and landing modes; ground service vehicles; fuel handling and storage; and aircraft engine maintenance. Nineteen potential strategies were identified, and seven strategies were selected for detailed analysis and examination after a preliminary evaluation. Two strategies, aircraft towingmore » and reducing the number of operating engines on the ground, appear to provide the most significant emission reduction. Both of these strategies offer potential reductions in the range of 20 to 40 percent of the carbon monoxide and nitrogen oxides which are currently emitted by ground operations. The aircraft towing strategy also offers a comparable improvement in suspended particulate matter emissions. When the overall feasibility of each strategy is evaluated, the strategy to reduce the number of operating engines appears to be the most viable since its implementation would result in fuel savings, no apparent safety problems, and it can be implemented immediately.« less

The genetics of Charcot–Marie–Tooth disease: current trends and future implications for diagnosis and management

PubMed Central

Hoyle, J Chad; Isfort, Michael C; Roggenbuck, Jennifer; Arnold, W David

2015-01-01

Charcot–Marie–Tooth (CMT) disease is the most common hereditary polyneuropathy and is classically associated with an insidious onset of distal predominant motor and sensory loss, muscle wasting, and pes cavus. Other forms of hereditary neuropathy, including sensory predominant or motor predominant forms, are sometimes included in the general classification of CMT, but for the purpose of this review, we will focus primarily on the forms associated with both sensory and motor deficits. CMT has a great deal of genetic heterogeneity, leading to diagnostic considerations that are still rapidly evolving for this disorder. Clinical features, inheritance pattern, gene mutation frequencies, and electrodiagnostic features all are helpful in formulating targeted testing algorithms in practical clinical settings, but these still have shortcomings. Next-generation sequencing (NGS), combined with multigene testing panels, is increasing the sensitivity and efficiency of genetic testing and is quickly overtaking targeted testing strategies. Currently, multigene panel testing and NGS can be considered first-line in many circumstances, although obtaining initial targeted testing for the PMP22 duplication in CMT patients with demyelinating conduction velocities is still a reasonable strategy. As technology improves and cost continues to fall, targeted testing will be completely replaced by multigene NGS panels that can detect the full spectrum of CMT mutations. Nevertheless, clinical acumen is still necessary given the variants of uncertain significance encountered with NGS. Despite the current limitations, the genetic diagnosis of CMT is critical for accurate prognostication, genetic counseling, and in the future, specific targeted therapies. Although whole exome and whole genome sequencing strategies have the power to further elucidate the genetics of CMT, continued technological advances are needed. PMID:26527893

A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

PubMed

Brathwaite, Rachel; Addo, Juliet; Smeeth, Liam; Lock, Karen

2015-01-01

To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries. Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions. 26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries. Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website. Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%). Rwanda had the highest prevalence of women smokers (12.6%) and Ghana had the lowest (0.2%). Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents. Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

Strategies to Reduce Dietary Sodium Intake

PubMed Central

Cobb, Laura K; Appel, Lawrence J; Anderson, Cheryl A.M.

2013-01-01

Opinion Excess sodium intake has an important, if not predominant, role in the pathogenesis of elevated blood pressure, one of the most important modifiable determinants of cardiovascular disease (CVD). In the United States, almost 80% of sodium in the diet comes from packaged and restaurant foods. Given the current food environment, educational efforts such as clinician counseling are useful, but a comprehensive public health approach is necessary to achieve meaningful reductions in sodium intake. A successful approach includes several key strategies, which together will both promote positive decisions by individuals and change the context in which they make those decisions. The strategies include: (1) public education, (2) individual dietary counseling, (3) food labeling, (4) coordinated, voluntary industry sodium reduction, (5) government and private sector food procurement policies, and (6) FDA regulations, as recommended by the Institute of Medicine, to modify sodium’s generally regarded as safe (GRAS) status. Population-wide reduction in sodium intake has the potential to substantially reduce the public burden of preventable CVD and reduce health care costs. PMID:22580974

Reconstruction of Craniomaxillofacial Bone Defects Using Tissue-Engineering Strategies with Injectable and Non-Injectable Scaffolds

PubMed Central

Gaihre, Bipin; Uswatta, Suren; Jayasuriya, Ambalangodage C.

2017-01-01

Engineering craniofacial bone tissues is challenging due to their complex structures. Current standard autografts and allografts have many drawbacks for craniofacial bone tissue reconstruction; including donor site morbidity and the ability to reinstate the aesthetic characteristics of the host tissue. To overcome these problems; tissue engineering and regenerative medicine strategies have been developed as a potential way to reconstruct damaged bone tissue. Different types of new biomaterials; including natural polymers; synthetic polymers and bioceramics; have emerged to treat these damaged craniofacial bone tissues in the form of injectable and non-injectable scaffolds; which are examined in this review. Injectable scaffolds can be considered a better approach to craniofacial tissue engineering as they can be inserted with minimally invasive surgery; thus protecting the aesthetic characteristics. In this review; we also focus on recent research innovations with different types of stem-cell sources harvested from oral tissue and growth factors used to develop craniofacial bone tissue-engineering strategies. PMID:29156629

New agents for the management of resistant metastatic breast cancer.

PubMed

Anampa, Jesus; Sparano, Joseph A

2017-12-01

Metastatic breast cancer (MBC) is an incurable disease and treatment is directed towards symptom palliation and survival prolongation. Treatment selection in patients is based on tumor biology, age, comorbidities, performance status, tumor burden, and prior treatment history. Areas covered: This present review summarizes the recent treatment strategies in the management of MBC, highlighting regimens after first-line therapy. Topics discussed include new strategies for endocrine therapy, anti-HER2 therapy, and promising strategies for the management of triple negative breast cancer. Expert opinion: MBC is a heterogeneous entity and despite recent advances, there is significant room for improvement of treatment beyond first-line therapies. Combination regimens that can maximize clinical efficacy while minimizing toxicities are required. Current investigation approaches in advanced stages of clinical development include immunoconjugates, immune checkpoint blockade, novel cyclin-dependent-kinase inhibitors, and PARP inhibitors for MBC associated with germline BRCA mutations. We recommend that every patient with MBC should be evaluated for clinical trial options.

Collaboration Strategies in Nontraditional Community-Based Participatory Research Partnerships: Lessons From an Academic–Community Partnership With Autistic Self-Advocates

PubMed Central

Nicolaidis, Christina; Raymaker, Dora; McDonald, Katherine; Dern, Sebastian; Ashkenazy, Elesia; Boisclair, Cody; Robertson, Scott; Baggs, Amanda

2012-01-01

Background Most community-based participatory research (CBPR) projects involve local communities defined by race, ethnicity, geography, or occupation. Autistic self-advocates, a geographically dispersed community defined by disability, experience issues in research similar to those expressed by more traditional minorities. Objectives We sought to build an academic–community partnership that uses CBPR to improve the lives of people on the autistic spectrum. Methods The Academic Autistic Spectrum Partnership in Research and Education (AASPIRE) includes representatives from academic, self-advocate, family, and professional communities. We are currently conducting several studies about the health care experiences and well-being of autistic adults. Lessons Learned We have learned a number of strategies that integrate technology and process to successfully equalize power and accommodate diverse communication and collaboration needs. Conclusions CBPR can be conducted successfully with autistic self-advocates. Our strategies may be useful to other CBPR partnerships, especially ones that cannot meet in person or that include people with diverse communication needs. PMID:21623016

Bundled-rate legislation for Medicare reimbursement for dialysis services: implications for anemia management with ESAs.

PubMed

Charytan, Chaim

2010-12-01

With the incidence of ESRD on the rise, there is a continuing need to control anemia-related treatment costs in dialysis patients receiving reimbursement through Medicare. Currently, erythropoiesis-stimulating agents (ESAs) are billed separately from dialysis services, potentially creating little financial incentive for more efficient use. The Medicare Improvement for Patients and Providers Act, passed by the U.S. Congress in July 2008, includes provisions intended to address this concern. Under this act, dialysis services will be reimbursed using a fully bundled, comprehensive payment system that includes all services currently covered in the basic composite rate, as well as certain separately billable items, including ESAs. A base rate of $229.63 per treatment has been assigned, to be individualized using case-mix adjusters. The implications of this new system for anemia management with ESAs continue to be elucidated. With fixed compensation for ESAs, management strategies that maximize efficiencies and, thereby, optimize cost savings will be favored. Select strategies may include switching from intravenous (IV) to subcutaneous routes, lowering Hb targets and ESA doses in hyporesponsive patients, increasing administration of IV iron, increasing use of home dialysis, and optimizing ESA dosing intervals. Once-monthly ESA therapy has potential advantages under this new system as an alternative to more frequently administered ESAs and may help achieve quality metrics in a cost-efficient manner.

Building SAWE Capability as an ANSI Accredited Standards Developer

NASA Technical Reports Server (NTRS)

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

2014-01-01

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

Improved efficacy in onychomycosis therapy.

PubMed

Gupta, Aditya K; Paquet, Maryse

2013-01-01

The success rate of onychomycosis treatment is limited by several factors, including the access of the therapeutic agent to the fungal mass, the presence of conidia, and the susceptibility of the different infectious agents to the antifungals. Different strategies used to improve efficacy of the currently available antifungal treatments, their rationale, and the published evidence of their beneficial effects are reviewed. An improved efficacy was demonstrated for some of these strategies, such as combined oral and topical antifungal therapies, whereas most of them lack clear and direct evidence of an increase in therapeutic success. © 2013 Elsevier Inc. All rights reserved.

Understanding food insecurity among Thai older women in an urban community.

PubMed

Piaseu, Noppawan; Komindr, Surat; Belza, Basia

2010-12-01

In this qualitative study we aimed to describe how older women in a crowded urban community perceive the food insecurity experience and deal with it. In-depth interviews were conducted among 30 Thai older women. Results revealed that older women perceived their food insecurity experience as a negative effect of the current economic downturn globally. They felt that they were confronting a crisis. Problems they dealt with included six issues. The women employed management strategies around food, health, money, and family. Our results suggest a need for welfare reform that facilitates management strategies aimed to meet food security.

Anorexia of Aging.

PubMed

Visvanathan, Renuka

2015-08-01

The anorexia of aging is common, leading to adverse health consequences. As populations age, the impacts from anorexia in the older population are set to increase. Only greater awareness will allow for prevention or early intervention. This article discusses the physiologic anorexia of aging, highlights contributing factors, and proposes management strategies, including screening, especially in primary care. Many neuroendocrine factors have been implicated in the pathophysiology; it is clear that further human research is necessary if there is to be a pharmacologic breakthrough. There are currently no approved pharmacologic treatment strategies to prevent or treat the anorexia of aging. Copyright © 2015 Elsevier Inc. All rights reserved.

Surgical Management of Rib Fractures: Strategies and Literature Review.

PubMed

de Jong, M B; Kokke, M C; Hietbrink, F; Leenen, L P H

2014-06-01

Rib fractures can cause significant problems in trauma patients, often resulting in pain and difficulty with respiration. To prevent pulmonary complications and decrease the morbidity and mortality rates of patients with rib fractures, currently there is a trend to provide surgical management of patients with flail chest. However, the indications for rib fracture fixation require further specification. Past and current strategies are described according to a review of the medical literature. A systematic review was performed including current indications for rib fracture fixation. MEDLINE (2000-2013) was searched, as well as Embase (2000-2013) and Cochrane Databases, using the keywords rib, fracture, fixation, plate, repair, and surgery. Three retrospective studies were found that described different techniques for rib fracture fixation. The results demonstrated a reduced number of ventilation days, decreased long-term morbidity and pain, and satisfactory rehabilitation after surgical treatment. In addition to flail chest, age, Injury Severity Score, and the number of rib fractures were important predictive factors for morbidity and mortality. Surgical rib fracture fixation might be indicated in a broader range of cases than is currently performed. Prospective randomized trials are needed for further confirmation. © The Finnish Surgical Society 2014.

Homozygous autosomal dominant hypercholesterolaemia: prevalence, diagnosis, and current and future treatment perspectives.

PubMed

Sjouke, Barbara; Hovingh, G Kees; Kastelein, John J P; Stefanutti, Claudia

2015-06-01

Homozygous autosomal dominant hypercholesterolemia (hoADH) is a rare genetic disorder caused by mutations in LDL receptor, apolipoprotein B, and/or proprotein convertase subtilisin-kexin type 9. Both the genetic mutations and the clinical phenotype vary largely among individual patients, but patients with hoADH are typically characterized by extremely elevated LDL-cholesterol (LDL-C) levels, and a very high-risk for premature cardiovascular disease. Current lipid-lowering therapies include bile acid sequestrants, statins, and ezetimibe. To further decrease LDL-C levels in hoADH, lipoprotein apheresis is recommended, but this therapy is not available in all countries. Recently, the microsomal triglyceride transfer protein inhibitor lomitapide and the RNA antisense inhibitor of apolipoprotein B mipomersen were approved by the Food and Drug Administration/European Medicine Agency and the Food and Drug Administration, respectively. Several other LDL-C-lowering strategies and therapeutics targeting the HDL-C pathway are currently in the clinical stage of development. Novel therapies have been introduced for LDL-C-lowering and innovative drug candidates for HDL-C modulation for the treatment of hoADH. Here, we review the current available literature on the prevalence, diagnosis, and therapeutic strategies for hoADH.

The effect of simple nitrogen fertilizer recommendation strategies on product carbon footprint and gross margin of wheat and maize production in the North China Plain.

PubMed

Ha, Nan; Feike, Til; Back, Hans; Xiao, Haifeng; Bahrs, Enno

2015-11-01

Overuse of nitrogen (N) fertilizer constitutes the major issue of current crop production in China, exerting a substantial effect on global warming through massive emission of greenhouse gas (GHG). Despite the ongoing effort, which includes the promotion of technologically sophisticated N management schemes, farmers' N rates maintain at excessive rates. Therefore the current study tests three simple and easily to apply N fertilizer recommendation strategies, which could be implemented on large scale through the existing agricultural advisory system of China, at comparatively low cost. Building on a detailed crop production dataset of 65 winter wheat (WW) and summer maize (SM) producing farm households of the North China Plain, scenario analysis is applied. The effects of the three N strategies under constant and changing yield levels on product carbon footprint (PCF) and gross margin (GM) are determined for the production condition of every individual farm household. The N fixed rate strategy realized the highest improvement potential in PCF and GM in WW; while the N coefficient strategy performed best in SM. The analysis furthermore revealed that improved N management has a significant positive effect on PCF, but only a marginal and insignificant effect on GM. On the other side, a potential 10% yield loss would have only a marginal effect on PCF, but a detrimental effect on farmers' income. With farmers currently applying excessive N rates as "cheap insurance" against potential N limitation, it will be of vital importance to avoid any yield reductions (caused by N limitation) and respective severe financial losses, when promoting and implementing advanced fertilization strategies. To achieve this, it is furthermore recommended to increase the price of fertilizer, improve the agricultural extensions system, and recognize farmers' fertilizer related decision-making processes as key research areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

River Blindness: Mathematical Models for Control and Elimination.

PubMed

Basáñez, M G; Walker, M; Turner, H C; Coffeng, L E; de Vlas, S J; Stolk, W A

2016-01-01

Human onchocerciasis (river blindness) is one of the few neglected tropical diseases (NTDs) whose control strategies have been informed by mathematical modelling. With the change in focus from elimination of the disease burden to elimination of Onchocerca volvulus, much remains to be done to refine, calibrate and validate existing models. Under the impetus of the NTD Modelling Consortium, the teams that developed EPIONCHO and ONCHOSIM have joined forces to compare and improve these frameworks to better assist ongoing elimination efforts. We review their current versions and describe how they are being used to address two key questions: (1) where can onchocerciasis be eliminated with current intervention strategies by 2020/2025? and (2) what alternative/complementary strategies could help to accelerate elimination where (1) cannot be achieved? The control and elimination of onchocerciasis from the African continent is at a crucial crossroad. The African Programme for Onchocerciasis Control closed at the end of 2015, and although a new platform for support and integration of NTD control has been launched, the disease will have to compete with a myriad of other national health priorities at a pivotal time in the road to elimination. However, never before had onchocerciasis control a better arsenal of intervention strategies as well as diagnostics. It is, therefore, timely to present two models of different geneses and modelling traditions as they come together to produce robust decision-support tools. We start by describing the structural and parametric assumptions of EPIONCHO and ONCHOSIM; we continue by summarizing the modelling of current treatment strategies with annual (or biannual) mass ivermectin distribution and introduce a number of alternative strategies, including other microfilaricidal therapies (such as moxidectin), macrofilaricidal (anti-wolbachial) treatments, focal vector control and the possibility of an onchocerciasis vaccine. We conclude by discussing challenges, opportunities and future directions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Coping strategies as mediators in relation to resilience and posttraumatic stress disorder.

PubMed

Thompson, Nicholas J; Fiorillo, Devika; Rothbaum, Barbara O; Ressler, Kerry J; Michopoulos, Vasiliki

2018-01-01

Resilience has been shown to protect against the development of posttraumatic stress disorder (PTSD) in the aftermath of trauma. However, it remains unclear how coping strategies influence resilience and PTSD development in the acute aftermath of trauma. The current prospective, longitudinal study investigated the relationship between resilience, coping strategies, and the development of chronic PTSD symptoms. A sample of patients was recruited from an emergency department following a Criterion A trauma. Follow-up assessments were completed at 1-, 3-, and 6-months post-trauma to assess PTSD symptom development (N = 164). Resilience at 1-month positively correlated with the majority of active coping strategies (all p < .05) and negatively correlated with the majority of avoidant coping strategies (all p < .05), as well as future PTSD symptoms (p < .001). Additionally, all avoidant coping strategies, including social withdrawal, positively correlated with future PTSD symptoms (all p < .01). After controlling for demographic and clinical variables, social withdrawal at 3-months fully mediated the relationship between resilience at 1-month and PTSD symptoms at 6-months. Limitations include participant drop out and the conceptual overlap between avoidant coping and PTSD. These data suggest that resilience and social withdrawal may be possible therapeutic targets for mitigating the development of chronic PTSD in the aftermath of trauma. Copyright © 2017 Elsevier B.V. All rights reserved.

Biological Risks to Public Health: Lessons from an International Conference to Inform the Development of National Risk Communication Strategies

PubMed Central

Bhatiasevi, Aphaluck; Chaib, Fadela; Baggio, Ombretta; Banluta, Christina; Hollenweger, Lilian; Maaroufi, Abderrahmane

2016-01-01

Biological risk management in public health focuses on the impact of outbreaks on health, the economy, and other systems and on ensuring biosafety and biosecurity. To address this broad range of risks, the International Health Regulations (IHR, 2005) request that all member states build defined core capacities, risk communication being one of them. While there is existing guidance on the communication process and on what health authorities need to consider to design risk communication strategies that meet the requirements on a governance level, little has been done on implementation because of a number of factors, including lack of resources (human, financial, and others) and systems to support effective and consistent capacity for risk communication. The international conference on “Risk communication strategies before, during and after public health emergencies” provided a platform to present current strategies, facilitate learning from recent outbreaks of infectious diseases, and discuss recommendations to inform risk communication strategy development. The discussion concluded with 4 key areas for improvement in risk communication: consider communication as a multidimensional process in risk communication, broaden the biomedical paradigm by integrating social science intelligence into epidemiologic risk assessments, strengthen multisectoral collaboration including with local organizations, and spearhead changes in organizations for better risk communication governance. National strategies should design risk communication to be proactive, participatory, and multisectoral, facilitating the connection between sectors and strengthening collaboration. PMID:27875654

Biological Risks to Public Health: Lessons from an International Conference to Inform the Development of National Risk Communication Strategies.

PubMed

Dickmann, Petra; Bhatiasevi, Aphaluck; Chaib, Fadela; Baggio, Ombretta; Banluta, Christina; Hollenweger, Lilian; Maaroufi, Abderrahmane

Biological risk management in public health focuses on the impact of outbreaks on health, the economy, and other systems and on ensuring biosafety and biosecurity. To address this broad range of risks, the International Health Regulations (IHR, 2005) request that all member states build defined core capacities, risk communication being one of them. While there is existing guidance on the communication process and on what health authorities need to consider to design risk communication strategies that meet the requirements on a governance level, little has been done on implementation because of a number of factors, including lack of resources (human, financial, and others) and systems to support effective and consistent capacity for risk communication. The international conference on "Risk communication strategies before, during and after public health emergencies" provided a platform to present current strategies, facilitate learning from recent outbreaks of infectious diseases, and discuss recommendations to inform risk communication strategy development. The discussion concluded with 4 key areas for improvement in risk communication: consider communication as a multidimensional process in risk communication, broaden the biomedical paradigm by integrating social science intelligence into epidemiologic risk assessments, strengthen multisectoral collaboration including with local organizations, and spearhead changes in organizations for better risk communication governance. National strategies should design risk communication to be proactive, participatory, and multisectoral, facilitating the connection between sectors and strengthening collaboration.

Polyvalent vaccine approaches to combat HIV-1 diversity

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

Korber, Bette; Hraber, Peter Thomas; Wagh, Kshitij

In this study, a key unresolved challenge for developing an effective HIV-1 vaccine is the discovery of strategies to elicit immune responses that are able to cross-protect against a significant fraction of the diverse viruses that are circulating worldwide. Here, we summarize some of the immunological implications of HIV-1 diversity, and outline the rationale behind several polyvalent vaccine design strategies that are currently under evaluation. Vaccine-elicited T-cell responses, which contribute to the control of HIV-1 in natural infections, are currently being considered in both prevention and treatment settings. Approaches now in preclinical and human trials include full proteins in novelmore » vectors, concatenated conserved protein regions, and polyvalent strategies that improve coverage of epitope diversity and enhance the cross-reactivity of responses. While many barriers to vaccine induction of broadly neutralizing antibody (bNAb) responses remain, epitope diversification has emerged as both a challenge and an opportunity. Recent longitudinal studies have traced the emergence of bNAbs in HIV-1 infection, inspiring novel approaches to recapitulate and accelerate the events that give rise to potent bNAb in vivo. In this review, we have selected two such lineage-based design strategies to illustrate how such in-depth analysis can offer conceptual improvements that may bring us closer to an effective vaccine.« less

Perinatal thrombosis: implications for mothers and neonates.

PubMed

O'Brien, Sarah H

2015-01-01

Stroke is more likely to occur in the perinatal period than any other time in childhood, and these events can lead to a lifetime of intellectual and motor disabilities, epilepsy, and behavioral challenges. This review describes the epidemiology and natural history of perinatal arterial ischemic stroke (PAIS) and cerebral sinovenous thrombosis (CSVT), risk factors for these complications, recent evidence regarding treatment strategies, and current gaps in knowledge. Existing evidence demonstrates the multifactorial etiology of symptomatic ischemic stroke in neonates, which includes a combination of maternal, delivery, and neonatal factors. The importance of inherited thrombophilia in the pathophysiology and long-term outcomes of perinatal stroke requires additional study. At this time, there is no evidence to support routine extensive thrombophilia screening outside of a research setting. Despite the frequency of perinatal stroke and its association with substantial morbidity, treatment strategies are currently limited, and prevention strategies are nonexistent. Anticoagulation is rarely indicated in PAIS, and more work needs to focus on neuroprotective prevention and alternate treatment strategies. Anticoagulation does appear to be safe in CSVT and may prevent thrombus progression but clinical equipoise remains, and clinical trials are needed to obtain evidence regarding short- and long-term efficacy outcomes. © 2015 by The American Society of Hematology. All rights reserved.

Polyvalent vaccine approaches to combat HIV-1 diversity

DOE PAGES

Korber, Bette; Hraber, Peter Thomas; Wagh, Kshitij; ...

2017-01-30

In this study, a key unresolved challenge for developing an effective HIV-1 vaccine is the discovery of strategies to elicit immune responses that are able to cross-protect against a significant fraction of the diverse viruses that are circulating worldwide. Here, we summarize some of the immunological implications of HIV-1 diversity, and outline the rationale behind several polyvalent vaccine design strategies that are currently under evaluation. Vaccine-elicited T-cell responses, which contribute to the control of HIV-1 in natural infections, are currently being considered in both prevention and treatment settings. Approaches now in preclinical and human trials include full proteins in novelmore » vectors, concatenated conserved protein regions, and polyvalent strategies that improve coverage of epitope diversity and enhance the cross-reactivity of responses. While many barriers to vaccine induction of broadly neutralizing antibody (bNAb) responses remain, epitope diversification has emerged as both a challenge and an opportunity. Recent longitudinal studies have traced the emergence of bNAbs in HIV-1 infection, inspiring novel approaches to recapitulate and accelerate the events that give rise to potent bNAb in vivo. In this review, we have selected two such lineage-based design strategies to illustrate how such in-depth analysis can offer conceptual improvements that may bring us closer to an effective vaccine.« less

An emerging epidemic: cancer and heart failure.

PubMed

Thavendiranathan, Paaladinesh; Nolan, Mark T

2017-01-01

Heart disease and cancer are the two leading causes of mortality globally. Cardiovascular complications of cancer therapy significantly contribute to the global burden of cardiovascular disease. Heart failure (HF) in particular is a relatively common and life-threatening complication. The increased risk is driven by the shared risk factors for cancer and HF, the direct impact of cancer therapy on the heart, an existing care gap in the cardiac care of patients with cancer and the increasing population of adult cancer survivors. The clear relationship between cancer treatment initiation and the potential for myocardial injury makes this population attractive for prevention strategies, targeted cardiovascular monitoring and treatment. However, there is currently no consensus on the optimal strategy for managing this at-risk population. Uniform treatment using cardioprotective medications may reduce the incidence of HF, but would impose frequently unnecessary and burdensome side effects. Ideally we could use validated risk-prediction models to target HF-preventive strategies, but currently no such models exist. In the present review, we focus on evidence and rationales for contemporary clinical decision-making in this novel field and discuss issues, including the burden of HF in patients with cancer, the reasons for the elevated risk and potential prevention strategies. © 2016 The Author(s). published by Portland Press Limited on behalf of the Biochemical Society.

Position and speed control of brushless DC motors using sensorless techniques and application trends.

PubMed

Gamazo-Real, José Carlos; Vázquez-Sánchez, Ernesto; Gómez-Gil, Jaime

2010-01-01

This paper provides a technical review of position and speed sensorless methods for controlling Brushless Direct Current (BLDC) motor drives, including the background analysis using sensors, limitations and advances. The performance and reliability of BLDC motor drivers have been improved because the conventional control and sensing techniques have been improved through sensorless technology. Then, in this paper sensorless advances are reviewed and recent developments in this area are introduced with their inherent advantages and drawbacks, including the analysis of practical implementation issues and applications. The study includes a deep overview of state-of-the-art back-EMF sensing methods, which includes Terminal Voltage Sensing, Third Harmonic Voltage Integration, Terminal Current Sensing, Back-EMF Integration and PWM strategies. Also, the most relevant techniques based on estimation and models are briefly analysed, such as Sliding-mode Observer, Extended Kalman Filter, Model Reference Adaptive System, Adaptive observers (Full-order and Pseudoreduced-order) and Artificial Neural Networks.

Addressing weight bias and discrimination: moving beyond raising awareness to creating change.

PubMed

Ramos Salas, X; Alberga, A S; Cameron, E; Estey, L; Forhan, M; Kirk, S F L; Russell-Mayhew, S; Sharma, A M

2017-11-01

Weight discrimination is the unjust treatment of individuals because of their weight. There have been very few interventions to address weight discrimination, due in part to the lack of consensus on key messages and strategies. The objective of the third Canadian Weight Bias Summit was to review current evidence and move towards consensus on key weight bias and obesity discrimination reduction messages and strategies. Using a modified brokered dialogue approach, participants, including researchers, health professionals, policy makers and people living with obesity, reviewed the evidence and moved towards consensus on key messages and strategies for future interventions. Participants agreed to these key messages: (1) Weight bias and obesity discrimination should not be tolerated in education, health care and public policy sectors; (2) obesity should be recognized and treated as a chronic disease in health care and policy sectors; and (3) in the education sector, weight and health need to be decoupled. Consensus on future strategies included (1) creating resources to support policy makers, (2) using personal narratives from people living with obesity to engage audiences and communicate anti-discrimination messages and (3) developing a better clinical definition for obesity. Messages and strategies should be implemented and evaluated using consistent theoretical frameworks and methodologies. © 2017 World Obesity Federation.

Climate change and forests of the future: Managing in the face of uncertainty

USGS Publications Warehouse

Millar, C.I.; Stephenson, N.L.; Stephens, S.L.

2007-01-01

We offer a conceptual framework for managing forested ecosystems under an assumption that future environments will be different from present but that we cannot be certain about the specifics of change. We encourage flexible approaches that promote reversible and incremental steps, and that favor ongoing learning and capacity to modify direction as situations change. We suggest that no single solution fits all future challenges, especially in the context of changing climates, and that the best strategy is to mix different approaches for different situations. Resources managers will be challenged to integrate adaptation strategies (actions that help ecosystems accommodate changes adaptively) and mitigation strategies (actions that enable ecosystems to reduce anthropogenic influences on global climate) into overall plans. Adaptive strategies include resistance options (forestall impacts and protect highly valued resources), resilience options (improve the capacity of ecosystems to return to desired conditions after disturbance), and response options (facilitate transition of ecosystems from current to new conditions). Mitigation strategies include options to sequester carbon and reduce overall greenhouse gas emissions. Priority-setting approaches (e.g., triage), appropriate for rapidly changing conditions and for situations where needs are greater than available capacity to respond, will become increasingly important in the future. ?? 2007 by the Ecological Society of America.

Half-time strategies to enhance second-half performance in team-sports players: a review and recommendations.

PubMed

Russell, Mark; West, Daniel J; Harper, Liam D; Cook, Christian J; Kilduff, Liam P

2015-03-01

A number of intermittent team sports require that two consecutive periods of play (lasting for ~30-45 min) are separated by a 10-20 min half-time break. The half-time practices employed by team-sports players generally include returning to the changing rooms, temporarily relaxing from the cognitive and physical demands of the first half, rehydration and re-fuelling strategies, addressing injury or equipment concerns, and receiving tactical instruction and coach feedback. However, the typically passive nature of these actions has been associated with physiological changes that impair performance during the second half. Both physical and cognitive performances have been found to decline in the initial stages of subsequent exercise that follows half-time. An increased risk of injury has also been observed during this period. Therefore, half-time provides sports scientists and strength and conditioning coaches with an opportunity to optimise second-half performance. An overview of strategies thought to benefit team-sports athletes is presented; specifically, the efficacy of heat maintenance strategies (including passive and active methods), post-activation potentiation, hormonal priming, and modified hydro-nutritional practices are discussed. A theoretical model of applying these strategies in a manner that compliments current practice is also offered.

Palliative wound care management strategies for palliative patients and their circles of care.

PubMed

Woo, Kevin Y; Krasner, Diane L; Kennedy, Bruce; Wardle, David; Moir, Olivia

2015-03-01

To provide information about palliative wound care management strategies for palliative patients and their circles of care. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to: 1. Recognize study findings, assessment tools, and non-pharmacologic strategies used for patients with palliative wounds. 2. Summarize pharmacologic and dressing treatment strategies used for wound care management of palliative patients. The principles of palliative wound care should be integrated along the continuum of wound care to address the whole person care needs of palliative patients and their circles of care, which includes members of the patient unit including family, significant others, caregivers, and other healthcare professionals that may be external to the current interprofessional team. Palliative patients often present with chronic debilitating diseases, advanced diseases associated with major organ failure (renal, hepatic, pulmonary, or cardiac), profound dementia, complex psychosocial issues, diminished self-care abilities, and challenging wound-related symptoms. This article introduces key concepts and strategies for palliative wound care that are essential for interprofessional team members to incorporate in clinical practice when caring for palliative patients with wounds and their circles of care.

Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association.

PubMed

Donofrio, Mary T; Moon-Grady, Anita J; Hornberger, Lisa K; Copel, Joshua A; Sklansky, Mark S; Abuhamad, Alfred; Cuneo, Bettina F; Huhta, James C; Jonas, Richard A; Krishnan, Anita; Lacey, Stephanie; Lee, Wesley; Michelfelder, Erik C; Rempel, Gwen R; Silverman, Norman H; Spray, Thomas L; Strasburger, Janette F; Tworetzky, Wayne; Rychik, Jack

2014-05-27

The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin-twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care. © 2014 American Heart Association, Inc.

Live-cell imaging of mammalian RNAs with Spinach2.

PubMed

Strack, Rita L; Jaffrey, Samie R

2015-01-01

The ability to monitor RNAs of interest in living cells is crucial to understanding the function, dynamics, and regulation of this important class of molecules. In recent years, numerous strategies have been developed with the goal of imaging individual RNAs of interest in living cells, each with their own advantages and limitations. This chapter provides an overview of current methods of live-cell RNA imaging, including a detailed discussion of genetically encoded strategies for labeling RNAs in mammalian cells. This chapter then focuses on the development and use of "RNA mimics of GFP" or Spinach technology for tagging mammalian RNAs and includes a detailed protocol for imaging 5S and CGG60 RNA with the recently described Spinach2 tag. © 2015 Elsevier Inc. All rights reserved.

Leveraging Event Reporting Through Knowledge Support: A Knowledge-Based Approach to Promoting Patient Fall Prevention.

PubMed

Yao, Bin; Kang, Hong; Miao, Qi; Zhou, Sicheng; Liang, Chen; Gong, Yang

2017-01-01

Patient falls are a common safety event type that impairs the healthcare quality. Strategies including solution tools and reporting systems for preventing patient falls have been developed and implemented in the U.S. However, the current strategies do not include timely knowledge support, which is in great need in bridging the gap between reporting and learning. In this study, we constructed a knowledge base of fall events by combining expert-reviewed fall prevention solutions and then integrating them into a reporting system. The knowledge base enables timely and tailored knowledge support and thus will serve as a prevailing fall prevention tool. This effort holds promise in making knowledge acquisition and management a routine process for enhancing the reporting and understanding of patient safety events.

Activity-dependent plasticity in spinal cord injury

PubMed Central

Lynskey, James V.; Belanger, Adam; Jung, Ranu

2008-01-01

The adult mammalian central nervous system (CNS) is capable of considerable plasticity, both in health and disease. After spinal neurotrauma, the degrees and extent of neuroplasticity and recovery depend on multiple factors, including the level and extent of injury, postinjury medical and surgical care, and rehabilitative interventions. Rehabilitation strategies focus less on repairing lost connections and more on influencing CNS plasticity for regaining function. Current evidence indicates that strategies for rehabilitation, including passive exercise, active exercise with some voluntary control, and use of neuroprostheses, can enhance sensorimotor recovery after spinal cord injury (SCI) by promoting adaptive structural and functional plasticity while mitigating maladaptive changes at multiple levels of the neuraxis. In this review, we will discuss CNS plasticity that occurs both spontaneously after SCI and in response to rehabilitative therapies. PMID:18566941

Refining search terms for nanotechnology

NASA Astrophysics Data System (ADS)

Porter, Alan L.; Youtie, Jan; Shapira, Philip; Schoeneck, David J.

2008-05-01

The ability to delineate the boundaries of an emerging technology is central to obtaining an understanding of the technology's research paths and commercialization prospects. Nowhere is this more relevant than in the case of nanotechnology (hereafter identified as "nano") given its current rapid growth and multidisciplinary nature. (Under the rubric of nanotechnology, we also include nanoscience and nanoengineering.) Past efforts have utilized several strategies, including simple term search for the prefix nano, complex lexical and citation-based approaches, and bootstrapping techniques. This research introduces a modularized Boolean approach to defining nanotechnology which has been applied to several research and patenting databases. We explain our approach to downloading and cleaning data, and report initial results. Comparisons of this approach with other nanotechnology search formulations are presented. Implications for search strategy development and profiling of the nanotechnology field are discussed.

Reconstruction of structure and function in tissue engineering of solid organs: Toward simulation of natural development based on decellularization.

PubMed

Zheng, Chen-Xi; Sui, Bing-Dong; Hu, Cheng-Hu; Qiu, Xin-Yu; Zhao, Pan; Jin, Yan

2018-04-27

Failure of solid organs, such as the heart, liver, and kidney, remains a major cause of the world's mortality due to critical shortage of donor organs. Tissue engineering, which uses elements including cells, scaffolds, and growth factors to fabricate functional organs in vitro, is a promising strategy to mitigate the scarcity of transplantable organs. Within recent years, different construction strategies that guide the combination of tissue engineering elements have been applied in solid organ tissue engineering and have achieved much progress. Most attractively, construction strategy based on whole-organ decellularization has become a popular and promising approach, because the overall structure of extracellular matrix can be well preserved. However, despite the preservation of whole structure, the current constructs derived from decellularization-based strategy still perform partial functions of solid organs, due to several challenges, including preservation of functional extracellular matrix structure, implementation of functional recellularization, formation of functional vascular network, and realization of long-term functional integration. This review overviews the status quo of solid organ tissue engineering, including both advances and challenges. We have also put forward a few techniques with potential to solve the challenges, mainly focusing on decellularization-based construction strategy. We propose that the primary concept for constructing tissue-engineered solid organs is fabricating functional organs based on intact structure via simulating the natural development and regeneration processes. Copyright © 2018 John Wiley & Sons, Ltd.

Helping Students Cope in an Age of Terrorism: Strategies for School Counselors

ERIC Educational Resources Information Center

Chibbaro, Julia S.; Jackson, C. Marie

2006-01-01

School counselors experience unique challenges as they struggle to provide students with coping skills geared to the outside world including acts of terrorism. School-aged students in the United States are one of the most vulnerable populations in the event of a terrorist act. This article offers a review of the current and most relevant…

Teacher Perceptions of School Consultant Social Influence Strategies: Replication and Expansion

ERIC Educational Resources Information Center

Owens, Julie Sarno; Schwartz, Madeleine E.; Erchul, William P.; Himawan, Lina K.; Evans, Steven W.; Coles, Erika K.; Schulte, Ann C.

2017-01-01

The goals were to (a) replicate the findings of previous research with regard to the Consultee/Teacher Version of the Interpersonal Power Inventory (IPI), and (b) advance the literature by examining IPI scores about a current consultation relationship. Sample 1 included 99 elementary school teachers (44.4% Hispanic) who completed the IPI. Results…

Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

ERIC Educational Resources Information Center

Moyer, Michael R.; Brown, Rhonda Douglas

2011-01-01

Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

Spotlight on the Future. NECC '99: National Educational Computing Conference Proceedings (20th, Atlantic City, NJ, June 22-24, 1999).

ERIC Educational Resources Information Center

International Society for Technology in Education, Eugene, OR.

This proceedings contains summaries of sessions on topics related to the use of computing across a wide range of disciplines and levels of education, including curriculum and instructional strategies, current and emerging technologies, social and ethical issues, library/media, technology implementation, exhibitors, teacher education and training,…

Seven Rules for Effective History Teaching or Bringing Life to the History Class.

ERIC Educational Resources Information Center

Formwalt, Lee W.

2002-01-01

Introduces a new column that focuses on successful strategies used by U.S. historians. Includes seven rules for effective history teaching: (1) teach with enthusiasm; (2) rely less on textbooks; (3) use secondary sources; (4) explore current topics; (5) use local history; (6) use music and film; and (7) become computer literate. (CMK)

Potlatch. NECC '97: Proceedings of the Annual National Educational Computing Conference (18th, Seattle, Washington, June 30-July 2, 1997).

ERIC Educational Resources Information Center

National Educational Computing Conference.

These conference proceedings report on the current trends, practices, and research in the field of educational technology. Papers and project descriptions are included on the following topics: digital portfolios; United Nations convention for children's rights; virtual communities and classrooms; study strategies; e-mail communication across the…

Challenging and Supporting the First-Year Student: A Handbook for Improving the First Year of College

ERIC Educational Resources Information Center

Upcraft, M. Lee, Ed.; Gardner, John N., Ed.; Barefoot, Betsy O., Ed.

2004-01-01

An authoritative, comprehensive guide to the first year of college, this book includes the most current information about the policies, strategies, programs, and services designed to help first-year students make a successful transition to college and fulfill their educational and personal goals. Following the introduction, "The First Year of…

Choosing Teaching in Hong Kong: A Strategy to Survive the Financial Crisis?

ERIC Educational Resources Information Center

Draper, Janet

2012-01-01

Background: Hong Kong is currently a Special Administrative Region of the People's Republic of China. It has autonomy over many policy areas, including finance and education. It is a community of seven million people, which has changed its focus and identity significantly over the last 25 years, from predominantly manufacturing to a service and…

Responsible gambling among older adults: a qualitative exploration.

PubMed

Subramaniam, Mythily; Satghare, Pratika; Vaingankar, Janhavi A; Picco, Louisa; Browning, Colette J; Chong, Siow Ann; Thomas, Shane A

2017-04-04

Responsible gambling (RG) is defined as gambling for pleasure and entertainment but with an awareness of the likelihood of losing, an understanding of the associated risks and the ability to exercise control over one's gambling activity. The current study describes a qualitative approach to explore RG among older adults (aged 60 years and above) in Singapore and reports on the cognitive and behavioural strategies employed by them to regulate their gambling. Inclusion criteria included Singapore residents aged 60 years and above, who could speak in English, Chinese, Malay or Tamil and were current or past regular gamblers. Participants were recruited using a combination of network and purposive sampling. Socio-demographic information on age, age of onset of gambling, gender, ethnicity, marital status, education and employment was collected. The South Oaks Gambling Screen (SOGS) was used to collect information on gambling activities and problems associated with gambling behaviour. Qualitative interviews were conducted with 25 older adults (60 years and above) who currently gambled. The data was analyzed using thematic network analysis. This global theme of RG comprised two organising themes: self -developed strategies to limit gambling related harm and family interventions to reduce gambling harm. The basic themes included delayed gratification, perception of futility of gambling, setting limits, maintaining balance, help-seeking and awareness of disordered gambling in self or in others. Family interventions included pleading and threatening, compelling help-seeking as well as family exclusion order. The study highlights the significant role that families play in Asian societies in imposing RG. Education of family members both in terms of the importance of RG, and communication of the ways in which older adults can incorporate RG behaviours including the use of exclusion in specific scenarios is important.

Regulatory considerations for pluripotent stem cell therapies.

PubMed

Carpenter, Melissa K

2017-01-01

The development of pluripotent stem cell (PSC) therapies is rapidly advancing, and a number of PSC-derived cell products are currently being tested in clinical trials. The biological complexity of these therapies results in specific challenges in complying with regulatory guidelines. This includes the choice of starting material, reproducible and consistent manufacturing, and preclinical safety and efficacy assessment of the PSC-derived product. This review discusses current US cell therapy regulations and strategies for compliance with these regulations when developing PSC-derived products. © 2017 Elsevier B.V. All rights reserved.

[A SWOT (strengths, weaknesses, opportunities, threats) analysis of the current immunization program in Zhejiang Province].

PubMed

He, Han-Qing; Ling, Luo-Ya; Xu, Xu-Qing

2009-02-01

To know the status of Immunization program in Zhejiang Province. The investigation on immunization program in zhejiang province was conducted, and the SWOT analysis was corducted to make a comprehensive evaluation. 11 cities, 22 counties and 44 towns were investigated in this study, and the current immunization program in Zhejiang province were explored by SWOT analysis. The SWOT Matrix, includes SO (strength-opportunity), ST (strength-threat), WO (weakness-opportunity) and WT (weakness-threat) can apply to make optimal strategy for the development of expanded program on immunization.

Grand challenges in bioengineered nanorobotics for cancer therapy.

PubMed

Lenaghan, Scott C; Wang, Yongzhong; Xi, Ning; Fukuda, Toshio; Tarn, Tzyhjong; Hamel, William R; Zhang, Mingjun

2013-03-01

One of the grand challenges currently facing engineering, life sciences, and medicine is the development of fully functional nanorobots capable of sensing, decision making, and actuation. These nanorobots may aid in cancer therapy, site-specific drug delivery, circulating diagnostics, advanced surgery, and tissue repair. In this paper, we will discuss, from a bioinspired perspective, the challenges currently facing nanorobotics, including core design, propulsion and power generation, sensing, actuation, control, decision making, and system integration. Using strategies inspired from microorganisms, we will discuss a potential bioengineered nanorobot for cancer therapy.

A new strategy for tuberculosis control in North Korea.

PubMed

Shin, Young-Jeon; Ki, Moran; Sung, Nackmoon

2015-01-01

Tuberculosis is one of the most prevalent diseases in North Korea. Despite some positive accomplishments by current aid projects, it is still necessary to investigate the existing aid system. The following are necessary for improvement: sustaining a high degree of expertise, cooperation among various related parties including the international community, mediation to induce this cooperation, a more active role of the South Korean government, and encouragement of North Korea to more actively participate. Achieving these will help solve the issues of current tuberculosis aid projects in North Korea and lead to more successful outcomes.

Regulatory and quality considerations for continuous manufacturing. May 20-21, 2014 Continuous Manufacturing Symposium.

PubMed

Allison, Gretchen; Cain, Yanxi Tan; Cooney, Charles; Garcia, Tom; Bizjak, Tara Gooen; Holte, Oyvind; Jagota, Nirdosh; Komas, Bekki; Korakianiti, Evdokia; Kourti, Dora; Madurawe, Rapti; Morefield, Elaine; Montgomery, Frank; Nasr, Moheb; Randolph, William; Robert, Jean-Louis; Rudd, Dave; Zezza, Diane

2015-03-01

This paper assesses the current regulatory environment, relevant regulations and guidelines, and their impact on continuous manufacturing. It summarizes current regulatory experience and learning from both review and inspection perspectives. It outlines key regulatory aspects, including continuous manufacturing process description and control strategy in regulatory files, process validation, and key Good Manufacturing Practice (GMP) requirements. In addition, the paper identifies regulatory gaps and challenges and proposes a way forward to facilitate implementation. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Development of an operation strategy for hydrogen production using solar PV energy based on fluid dynamic aspects

NASA Astrophysics Data System (ADS)

Amores, Ernesto; Rodríguez, Jesús; Oviedo, José; de Lucas-Consuegra, Antonio

2017-06-01

Alkaline water electrolysis powered by renewable energy sources is one of the most promising strategies for environmentally friendly hydrogen production. However, wind and solar energy sources are highly dependent on weather conditions. As a result, power fluctuations affect the electrolyzer and cause several negative effects. Considering these limiting effects which reduce the water electrolysis efficiency, a novel operation strategy is proposed in this study. It is based on pumping the electrolyte according to the current density supplied by a solar PV module, in order to achieve the suitable fluid dynamics conditions in an electrolysis cell. To this aim, a mathematical model including the influence of electrode-membrane distance, temperature and electrolyte flow rate has been developed and used as optimization tool. The obtained results confirm the convenience of the selected strategy, especially when the electrolyzer is powered by renewable energies.

Current Management Strategy for Active Surveillance in Prostate Cancer.

PubMed

Syed, Jamil S; Javier-Desloges, Juan; Tatzel, Stephanie; Bhagat, Ansh; Nguyen, Kevin A; Hwang, Kevin; Kim, Sarah; Sprenkle, Preston C

2017-02-01

Active surveillance has been increasingly utilized as a strategy for the management of favorable-risk, localized prostate cancer. In this review, we describe contemporary management strategies of active surveillance, with a focus on traditional stratification schemes, new prognostic tools, and patient outcomes. Patient selection, follow-up strategy, and indication for delayed intervention for active surveillance remain centered around PSA, digital rectal exam, and biopsy findings. Novel tools which include imaging, biomarkers, and genetic assays have been investigated as potential prognostic adjuncts; however, their role in active surveillance remains institutionally dependent. Although 30-50% of patients on active surveillance ultimately undergo delayed treatment, the vast majority will remain free of metastasis with a low risk of dying from prostate cancer. The optimal method for patient selection into active surveillance is unknown; however, cancer-specific mortality rates remain excellent. New prognostication tools are promising, and long-term prospective, randomized data regarding their use in active surveillance will be beneficial.

Ecology of Fungus Gnats (Bradysia spp.) in Greenhouse Production Systems Associated with Disease-Interactions and Alternative Management Strategies.

PubMed

Cloyd, Raymond A

2015-04-09

Fungus gnats (Bradysia spp.) are major insect pests of greenhouse-grown horticultural crops mainly due to the direct feeding damage caused by the larvae, and the ability of larvae to transmit certain soil-borne plant pathogens. Currently, insecticides and biological control agents are being used successively to deal with fungus gnat populations in greenhouse production systems. However, these strategies may only be effective as long as greenhouse producers also implement alternative management strategies such as cultural, physical, and sanitation. This includes elimination of algae, and plant and growing medium debris; placing physical barriers onto the growing medium surface; and using materials that repel fungus gnat adults. This article describes the disease-interactions associated with fungus gnats and foliar and soil-borne diseases, and the alternative management strategies that should be considered by greenhouse producers in order to alleviate problems with fungus gnats in greenhouse production systems.

Biomaterial-mediated strategies targeting vascularization for bone repair.

PubMed

García, José R; García, Andrés J

2016-04-01

Repair of non-healing bone defects through tissue engineering strategies remains a challenging feat in the clinic due to the aversive microenvironment surrounding the injured tissue. The vascular damage that occurs following a bone injury causes extreme ischemia and a loss of circulating cells that contribute to regeneration. Tissue-engineered constructs aimed at regenerating the injured bone suffer from complications based on the slow progression of endogenous vascular repair and often fail at bridging the bone defect. To that end, various strategies have been explored to increase blood vessel regeneration within defects to facilitate both tissue-engineered and natural repair processes. Developments that induce robust vascularization will need to consolidate various parameters including optimization of embedded therapeutics, scaffold characteristics, and successful integration between the construct and the biological tissue. This review provides an overview of current strategies as well as new developments in engineering biomaterials to induce reparation of a functional vascular supply in the context of bone repair.

Schistosomiasis elimination strategies and potential role of a vaccine in achieving global health goals.

PubMed

Mo, Annie X; Agosti, Jan M; Walson, Judd L; Hall, B Fenton; Gordon, Lance

2014-01-01

In March 2013, the National Institute of Allergy and Infectious Diseases and the Bill and Melinda Gates Foundation co-sponsored a meeting entitled "Schistosomiasis Elimination Strategy and Potential Role of a Vaccine in Achieving Global Health Goals" to discuss the potential role of schistosomiasis vaccines and other tools in the context of schistosomiasis control and elimination strategies. It was concluded that although schistosomiasis elimination in some focal areas may be achievable through current mass drug administration programs, global control and elimination will face several significant scientific and operational challenges, and will require an integrated approach with other, additional interventions. These challenges include vector (snail) control; environmental modification; water, sanitation, and hygiene; and other future innovative tools such as vaccines. Defining a clear product development plan that reflects a vaccine strategy as complementary to the existing control programs to combat different forms of schistosomiasis will be important to develop a vaccine effectively.

You Look Familiar: How Malaysian Chinese Recognize Faces

PubMed Central

Tan, Chrystalle B. Y.; Stephen, Ian D.; Whitehead, Ross; Sheppard, Elizabeth

2012-01-01

East Asian and white Western observers employ different eye movement strategies for a variety of visual processing tasks, including face processing. Recent eye tracking studies on face recognition found that East Asians tend to integrate information holistically by focusing on the nose while white Westerners perceive faces featurally by moving between the eyes and mouth. The current study examines the eye movement strategy that Malaysian Chinese participants employ when recognizing East Asian, white Western, and African faces. Rather than adopting the Eastern or Western fixation pattern, Malaysian Chinese participants use a mixed strategy by focusing on the eyes and nose more than the mouth. The combination of Eastern and Western strategies proved advantageous in participants' ability to recognize East Asian and white Western faces, suggesting that individuals learn to use fixation patterns that are optimized for recognizing the faces with which they are more familiar. PMID:22253762

Ecology of Fungus Gnats (Bradysia spp.) in Greenhouse Production Systems Associated with Disease-Interactions and Alternative Management Strategies

PubMed Central

Cloyd, Raymond A.

2015-01-01

Fungus gnats (Bradysia spp.) are major insect pests of greenhouse-grown horticultural crops mainly due to the direct feeding damage caused by the larvae, and the ability of larvae to transmit certain soil-borne plant pathogens. Currently, insecticides and biological control agents are being used successively to deal with fungus gnat populations in greenhouse production systems. However, these strategies may only be effective as long as greenhouse producers also implement alternative management strategies such as cultural, physical, and sanitation. This includes elimination of algae, and plant and growing medium debris; placing physical barriers onto the growing medium surface; and using materials that repel fungus gnat adults. This article describes the disease-interactions associated with fungus gnats and foliar and soil-borne diseases, and the alternative management strategies that should be considered by greenhouse producers in order to alleviate problems with fungus gnats in greenhouse production systems. PMID:26463188

Nanomedicine strategies for sustained, controlled and targeted treatment of cancer stem cells.

PubMed

Gao, Jie; Li, Wei; Guo, Yajun; Feng, Si-Shen

2016-12-01

Cancer stem cells (CSCs) are original cancer cells that are of characteristics associated with normal stem cells. CSCs are toughest against various treatments and thus responsible for cancer metastasis and recurrence. Therefore, development of specific and effective treatment of CSCs plays a key role in improving survival and life quality of cancer patients, especially those in the metastatic stage. Nanomedicine strategies, which include prodrugs, micelles, liposomes and nanoparticles of biodegradable polymers, could substantially improve the therapeutic index of conventional therapeutics due to its manner of sustained, controlled and targeted delivery of high transportation efficiency across the cell membrane and low elimination by intracellular autophagy, and thus provide a practical solution to solve the problem encountered in CSCs treatment. This review gives briefly the latest information to summarize the concept, strategies, mechanisms and current status as well as future promises of nanomedicine strategies for treatment of CSCs.

Protective behavioral strategies and negative alcohol-related consequences in college students.

PubMed

Araas, Teresa E; Adams, Troy B

2008-01-01

Alcohol abuse among college students is associated with a quality of life burden. The current study replicated and extended previous research on protective behavioral strategies (PBS) by examining relationships between PBS use and negative alcohol-related consequences. A national sample of 29,792 U.S. college students who completed the National College Health Assessment during spring 2004 was included. Using a retrospective analysis of cross-sectional data, relationships between PBS use and negative alcohol-related consequences were examined. Greater PBS use was associated with fewer negative alcohol-related consequences, while less frequent use of PBS was correlated with increased negative alcohol-related consequences. The current study findings strongly support expanded educational alcohol-intervention programs promoting greater PBS use aimed at reducing or completely alleviating negative alcohol-related consequences (e.g., BASICS, ASTP). Future research should further investigate such PBS-based intervention programs, examine the existence of latent PBS, and study use of combined PBS.

The Health Promoting Prison (HPP) and its imperative for nursing.

PubMed

Whitehead, Dean

2006-01-01

The World Health Organisation's (WHO) Ottawa Charter for Health Promotion in 1986 provided the catalyst from which the Health Promoting Prison (HPP) movement emerged. Here, an extensive review of the available prison-related health literature provides the basis for critical discussion and recommendations for nursing services and prison-related health care. The findings suggest that current prison-based nursing services are seriously neglected and woefully lacking in structure and resources. This article recommends strategies for reform that includes nurses who practice in all settings, and not just prison-based nurses. If nurses wish to be at the forefront of future HPP strategies, they must first embrace the radical health promotion reforms that are emerging from the current literature. Building sustainable group capacity into prison-based health care, through developing social interaction, cohesion, participation and political action can only benefit the community at large and further emphasise the health promotion role of nursing.

[Chickenpox and shingles: one virus, two diseases and current vaccination recommendations in Switzerland].

PubMed

Eckert, Nadine; Masserey Spicher, Virginie

2016-01-01

Adults, pregnant women, premature babies and immunocompromised persons are at increased risk for varicella complications. Therefore the current Swiss vaccination recommendations against varicella include a general recommendation for 11 to 15 year old adolescents with a negative varicella history, as well as a specific recommendation for risk groups. The goal of both recommendations is to reduce varicella complications in persons most at risk. The vaccine is not universally recommended for all toddlers in Switzerland, while this is the case in some countries such as the United States. Pros and cons of different vaccination strategies, as well as possible short- and long-term effects on herpes zoster incidence are taken into account. In the United States, there was a marked decline in incidence and hospitalisations, but an increased herpes zoster incidence in the short term. Finally, public health aspects of herpes zoster, post-herpetic neuralgia and possible vaccination strategies are outlined.

HSV-2 Vaccine: Current Status and Insight into Factors for Developing an Efficient Vaccine

PubMed Central

Zhu, Xiao-Peng; Muhammad, Zaka S.; Wang, Jian-Guang; Lin, Wu; Guo, Shi-Kun; Zhang, Wei

2014-01-01

Herpes simplex virus type 2 (HSV-2), a globally sexually transmitted virus, and also one of the main causes of genital ulcer diseases, increases susceptibility to HIV-1. Effective vaccines to prevent HSV-2 infection are not yet available, but are currently being developed. To facilitate this process, the latest progress in development of these vaccines is reviewed in this paper. A summary of the most promising HSV-2 vaccines tested in animals in the last five years is presented, including the main factors, and new ideas for developing an effective vaccine from animal experiments and human clinical trials. Experimental results indicate that future HSV-2 vaccines may depend on a strategy that targets mucosal immunity. Furthermore, estradiol, which increases the effectiveness of vaccines, may be considered as an adjuvant. Therefore, this review is expected to provide possible strategies for development of future HSV-2 vaccines. PMID:24469503

Prevention of human immunodeficiency virus-1 transmission to the infant through breastfeeding: new developments.

PubMed

Kourtis, Athena P; Jamieson, Denise J; de Vincenzi, Isabelle; Taylor, Allan; Thigpen, Michael C; Dao, Halima; Farley, Timothy; Fowler, Mary Glenn

2007-09-01

Breastfeeding accounts for up to half of all infant human immunodeficiency virus (HIV) infections worldwide and carries an estimated transmission risk of about 15% when continued into the second year of life. Because replacement feeding is not safely available, culturally acceptable, or affordable in many parts of the world and because breastfeeding provides protection against other causes of infant mortality, approaches that reduce breastfeeding mother-to child transmission of HIV are being explored. These include exclusive breastfeeding for the infant's first few months of life followed by rapid weaning, treatments of expressed milk to inactivate the virus, and antiretroviral prophylaxis taken by the infant or mother during breastfeeding, which are strategies currently being tested in clinical trials. Passive (antibodies) and active (vaccine) immunoprophylaxis will also soon begin to be tested. This paper focuses on current and planned research on strategies to prevent breastfeeding transmission of HIV.

Recent advances in microparticle and nanoparticle delivery vehicles for mucosal vaccination.

PubMed

McNeela, E A; Lavelle, E C

2012-01-01

The great potential of mucosal vaccination is widely accepted but progress in the clinical development of subunit mucosal vaccines has been disappointing. Of the available approaches, the use of polymer-based microparticles is attractive because these delivery vehicles can be specifically tailored for vaccines and they offer the potential for integration of adjuvant. Here we address recent developments in the use of particulates as mucosal vaccines and the potential of novel targeting strategies, formulation approaches and adjuvant combinations to enhance the efficacy of particle-based mucosal vaccines. This review discusses the current status of mucosal vaccines based on particles and highlights several of the strategies that are currently under investigation for improving their immunogenicity. These include enhancing the stability of formulations in the luminal environment, increasing uptake by specifically targeting particles to mucosal inductive sites, and augmenting immunogenicity through co-formulation with immunostimulatory agents.

Current perspective of neuroprotection and glaucoma

PubMed Central

Tian, Kailin; Shibata-Germanos, Shannon; Pahlitzsch, Milena; Cordeiro, M Francesca

2015-01-01

Glaucoma is the second leading cause of blindness worldwide and is most notably characterized by progressive optic nerve atrophy and advancing loss of retinal ganglion cells (RGCs). The main concomitant factor is the elevated intraocular pressure (IOP). Existing treatments are focused generally on lowering IOP. However, both RGC loss and optic nerve atrophy can independently occur with IOP at normal levels. In recent years, there has been substantial progress in the development of neuroprotective therapies for glaucoma in order to restore vital visual function. The present review intends to offer a brief insight into conventional glaucoma treatments and discuss exciting current developments of mostly preclinical data in novel neuroprotective strategies for glaucoma that include recent advances in noninvasive diagnostics going beyond IOP maintenance for an enhanced global view. Such strategies now target RGC loss and optic nerve damage, opening a critical therapeutic window for preventative monitoring and treatment. PMID:26635467

ToxCast HTS Assay Development and Retrofitting: Strategies ...

EPA Pesticide Factsheets

A presentation to EC JRC partners on new ToxCast HTS assay methods and strategies to address current limitations to HTS methods Slide presentation to EC JRC partners on new ToxCast HTS assay methods and strategies to address current limitations to HTS methods.

A lignocellulosic ethanol strategy via nonenzymatic sugar production: process synthesis and analysis.

PubMed

Han, Jeehoon; Luterbacher, Jeremy S; Alonso, David Martin; Dumesic, James A; Maravelias, Christos T

2015-04-01

The work develops a strategy for the production of ethanol from lignocellulosic biomass. In this strategy, the cellulose and hemicellulose fractions are simultaneously converted to sugars using a γ-valerolactone (GVL) solvent containing a dilute acid catalyst. To effectively recover GVL for reuse as solvent and biomass-derived lignin for heat and power generation, separation subsystems, including a novel CO2-based extraction for the separation of sugars from GVL, lignin and humins have been designed. The sugars are co-fermented by yeast to produce ethanol. Furthermore, heat integration to reduce utility requirements is performed. It is shown that this strategy leads to high ethanol yields and the total energy requirements could be satisfied by burning the lignin. The integrated strategy using corn stover feedstock leads to a minimum selling price of $5 per gallon of gasoline equivalent, which suggests that it is a promising alternative to current biofuels production approaches. Copyright © 2015 Elsevier Ltd. All rights reserved.

Implementing international osteoarthritis treatment guidelines in primary health care: study protocol for the SAMBA stepped wedge cluster randomized controlled trial.

PubMed

Østerås, Nina; van Bodegom-Vos, Leti; Dziedzic, Krysia; Moseng, Tuva; Aas, Eline; Andreassen, Øyvor; Mdala, Ibrahim; Natvig, Bård; Røtterud, Jan Harald; Schjervheim, Unni-Berit; Vlieland, Thea Vliet; Hagen, Kåre Birger

2015-12-02

Previous research indicates that people with osteoarthritis (OA) are not receiving the recommended and optimal treatment. Based on international treatment recommendations for hip and knee OA and previous research, the SAMBA model for integrated OA care in Norwegian primary health care has been developed. The model includes physiotherapist (PT) led patient OA education sessions and an exercise programme lasting 8-12 weeks. This study aims to assess the effectiveness, feasibility, and costs of a tailored strategy to implement the SAMBA model. A cluster randomized controlled trial with stepped wedge design including an effect, process, and cost evaluation will be conducted in six municipalities (clusters) in Norway. The municipalities will be randomized for time of crossover from current usual care to the implementation of the SAMBA model by a tailored strategy. The tailored strategy includes interactive workshops for general practitioners (GPs) and PTs in primary care covering the SAMBA model for integrated OA care, educational material, educational outreach visits, feedback, and reminder material. Outcomes will be measured at the patient, GP, and PT levels using self-report, semi-structured interviews, and register based data. The primary outcome measure is patient-reported quality of care (OsteoArthritis Quality Indicator questionnaire) at 6-month follow-up. Secondary outcomes include referrals to PT, imaging, and referrals to the orthopaedic surgeon as well as participants' treatment satisfaction, symptoms, physical activity level, body weight, and self-reported and measured lower limb function. The actual exposure to the tailor made implementation strategy and user experiences will be measured in a process evaluation. In the economic evaluation, the difference in costs of usual OA care and the SAMBA model for integrated OA care will be compared with the difference in health outcomes and reported by the incremental cost-effectiveness ratio (ICER). The results from the present study will add to the current knowledge on tailored strategies, which aims to improve the uptake of evidence-based OA care recommendations and improve the quality of OA care in primary health care. The new knowledge can be used in national and international initiatives designed to improve the quality of OA care. ClinicalTrials.gov NCT02333656.

How high-performance work systems drive health care value: an examination of leading process improvement strategies.

PubMed

Robbins, Julie; Garman, Andrew N; Song, Paula H; McAlearney, Ann Scheck

2012-01-01

As hospitals focus on increasing health care value, process improvement strategies have proliferated, seemingly faster than the evidence base supporting them. Yet, most process improvement strategies are associated with work practices for which solid evidence does exist. Evaluating improvement strategies in the context of evidence-based work practices can provide guidance about which strategies would work best for a given health care organization. We combined a literature review with analysis of key informant interview data collected from 5 case studies of high-performance work practices (HPWPs) in health care organizations. We explored the link between an evidence-based framework for HPWP use and 3 process improvement strategies: Hardwiring Excellence, Lean/Six Sigma, and Baldrige. We found that each of these process improvement strategies has not only strengths but also important gaps with respect to incorporating HPWPs involving engaging staff, aligning leaders, acquiring and developing talent, and empowering the front line. Given differences among these strategies, our analyses suggest that some may work better than others for individual health care organizations, depending on the organizations' current management systems. In practice, most organizations implementing improvement strategies would benefit from including evidence-based HPWPs to maximize the potential for process improvement strategies to increase value in health care.

Strategies for implementing zero discharge in an industrial smelter : 1. Managing fluroide in groundwater

NASA Astrophysics Data System (ADS)

Stagnitti, F.; Salzman, S.; Thwaites, L.; Allinson, G.; Le Blanc, M.; Hill, J.; Doerr, S.; de Rooij, G.

2003-04-01

The Portland Aluminium smelter produces approximately 75 ML of process wastewater each year. This is combined with storm water runoff from the site to give an annual production of 715 ML. In common with many other smelters, this wastewater stream is currently discharged to the ocean. However, although the quality of the water Portland Aluminium discharges currently meets all Australian Environmental Protection Agency license requirements, this mode of release is unlikely to be acceptable in the near future, and alternative disposal options for the water are required. The Portland smelter has developed strategies which will enable it to achieve zero-discharge within 5 years. These strategies include separating process water from storm water, recycling storm water, construction of evaporation ponds to receive process water, irrigation of process water and storm water on lands within the site and maintenance of important wetland functions. The poster presents a summary of the management strategies currently being trialed and in particular focuses on modeling the spatial and temporal variations of fluoride found in the shallow groundwater and the implications of achieving zero-discharge. The poster also discusses the possible impacts on the distribution of fluoride and other solutes in the vadose zone by the irrigation of treated process water on blue-gum plantations. Computer simulations indicate that irrigation of process water (either treated or untreated) on the land poses no significant long-term threat to regional or surficial groundwater. However the impacts of increased solute transport through the vadose zone on changes in soil structure and nutrition require further investigation.

New advances in models and strategies for developing anti-obesity drugs

PubMed Central

Kim, Gilbert W.; Lin, Jieru E.; Blomain, Erik S.; Waldman, Scott A.

2014-01-01

Introduction Obesity is a worldwide pandemic. Obesity-related health and economic costs are staggering. Existing strategies to combat obesity through lifestyle improvements and medical intervention have had limited success. Pharmacotherapy, in combination with lifestyle modification, may play a vital role in reversing the disease burden. However, past and current weight-loss medications have had serious safety risks, notably cardiovascular and psychiatric events. Areas covered We review the strategies for designing new anti-obesity drugs by describing those currently in development. We describe their target, mechanism of action, and developmental or regulatory status. We also discuss the problem of weight regain following weight loss, and its relevance to the long-term success of anti-obesity pharmacotherapy. Expert opinion For weight management drugs to achieve the safety and efficacy required to be impactful, current studies are uncovering and characterizing new targets, including new signaling circuits and hormones regulating appetite and metabolism, and re-evaluating the role of pharmacotherapy in weight management. To avoid the safety failures of many past weight-loss drugs, the models and strategies covered in this article incorporate recent advances in knowledge and technology. We discuss the emergence of cGMP signaling as a potentially transformative target in weight management. Modulating cGMP signaling may represent an ideal goal for an anti-obesity pharmacotherapy, reflecting some of the major themes described in the present review: targeting pathways that are newly realized as relevant for weight management; promoting safety by re-purposing drugs that are safe, proven, and approved for clinical use; and having a synergistic effect on multiple, reinforcing pathways. PMID:23621300

The Use of Protective Behaviors in Relation to Gambling Among College Students

PubMed Central

Lostutter, Ty W.; Lewis, Melissa A.; Cronce, Jessica M.; Neighbors, Clayton; Larimer, Mary E.

2012-01-01

The purpose of the current study was to evaluate a measure of gambling protective behaviors and examine the relationship between indices of gambling behavior, including frequency, quantity and problem severity, and the use of gambling protective behaviors. Undergraduates from a large public university (N = 4,014) completed a web-based screening survey comprising measures of gambling and health behaviors, from which those who gambled within the past 6-months (n = 1,922, 48% of the entire sample) were invited to complete the baseline assessment, including the Gambling Protective Behavior Scale (GPBS). The GPBS was determined to have two subscales, primarily consisting of harm reduction strategies that reduce the money or time spent on gambling, or avoidance strategies that help to minimize engagement in gambling activities. Hierarchical multiple regressions found participants’ sex moderated the relationship between use of protective behavioral strategies and gambling outcomes. However, effects were in the opposite direction to those hypothesized. Specifically, because women gambled less, had lower gambling problem severity, and reported more frequent use of gambling avoidance protective behaviors, the relationship between use of gambling protective behaviors and gambling outcomes was stronger for men than women. Men who used more avoidance strategies gambled less frequently compared to men who used fewer avoidance strategies. Similarly, men who used more harm reduction strategies spent fewer dollars on gambling and had lower scores on gambling problem severity compared to men using fewer harm reduction strategies for women these relationships were less pronounced. Implications of incorporating specific gambling protective behavioral strategies into prevention and treatment programs are discussed. PMID:23224712

Prevalence of behavior changing strategies in fitness video games: theory-based content analysis.

PubMed

Lyons, Elizabeth Jane; Hatkevich, Claire

2013-05-07

Fitness video games are popular, but little is known about their content. Because many contain interactive tools that mimic behavioral strategies from weight loss intervention programs, it is possible that differences in content could affect player physical activity and/or weight outcomes. There is a need for a better understanding of what behavioral strategies are currently available in fitness games and how they are implemented. The purpose of this study was to investigate the prevalence of evidence-based behavioral strategies across fitness video games available for home use. Games available for consoles that used camera-based controllers were also contrasted with games available for a console that used handheld motion controllers. Fitness games (N=18) available for three home consoles were systematically identified and play-tested by 2 trained coders for at least 3 hours each. In cases of multiple games from one series, only the most recently released game was included. The Sony PlayStation 3 and Microsoft Xbox360 were the two camera-based consoles, and the Nintendo Wii was the handheld motion controller console. A coding list based on a taxonomy of behavioral strategies was used to begin coding. Codes were refined in an iterative process based on data found during play-testing. The most prevalent behavioral strategies were modeling (17/18), specific performance feedback (17/18), reinforcement (16/18), caloric expenditure feedback (15/18), and guided practice (15/18). All games included some kind of feedback on performance accuracy, exercise frequency, and/or fitness progress. Action planning (scheduling future workouts) was the least prevalent of the included strategies (4/18). Twelve games included some kind of social integration, with nine of them providing options for real-time multiplayer sessions. Only two games did not feature any kind of reward. Games for the camera-based consoles (mean 12.89, SD 2.71) included a greater number of strategies than those for the handheld motion controller console (mean 10.00, SD 2.74, P=.04). Behavioral strategies for increasing self-efficacy and self-regulation are common in home console fitness video games. Social support and reinforcement occurred in approximately half of the studied games. Strategy prevalence varies by console type, partially due to greater feedback afforded by camera-based controllers. Experimental studies are required to test the effects of these strategies when delivered as interactive tools, as this medium may represent an innovative platform for disseminating evidence-based behavioral weight loss intervention components.

Prevalence of Behavior Changing Strategies in Fitness Video Games: Theory-Based Content Analysis

PubMed Central

Hatkevich, Claire

2013-01-01

Background Fitness video games are popular, but little is known about their content. Because many contain interactive tools that mimic behavioral strategies from weight loss intervention programs, it is possible that differences in content could affect player physical activity and/or weight outcomes. There is a need for a better understanding of what behavioral strategies are currently available in fitness games and how they are implemented. Objective The purpose of this study was to investigate the prevalence of evidence-based behavioral strategies across fitness video games available for home use. Games available for consoles that used camera-based controllers were also contrasted with games available for a console that used handheld motion controllers. Methods Fitness games (N=18) available for three home consoles were systematically identified and play-tested by 2 trained coders for at least 3 hours each. In cases of multiple games from one series, only the most recently released game was included. The Sony PlayStation 3 and Microsoft Xbox360 were the two camera-based consoles, and the Nintendo Wii was the handheld motion controller console. A coding list based on a taxonomy of behavioral strategies was used to begin coding. Codes were refined in an iterative process based on data found during play-testing. Results The most prevalent behavioral strategies were modeling (17/18), specific performance feedback (17/18), reinforcement (16/18), caloric expenditure feedback (15/18), and guided practice (15/18). All games included some kind of feedback on performance accuracy, exercise frequency, and/or fitness progress. Action planning (scheduling future workouts) was the least prevalent of the included strategies (4/18). Twelve games included some kind of social integration, with nine of them providing options for real-time multiplayer sessions. Only two games did not feature any kind of reward. Games for the camera-based consoles (mean 12.89, SD 2.71) included a greater number of strategies than those for the handheld motion controller console (mean 10.00, SD 2.74, P=.04). Conclusions Behavioral strategies for increasing self-efficacy and self-regulation are common in home console fitness video games. Social support and reinforcement occurred in approximately half of the studied games. Strategy prevalence varies by console type, partially due to greater feedback afforded by camera-based controllers. Experimental studies are required to test the effects of these strategies when delivered as interactive tools, as this medium may represent an innovative platform for disseminating evidence-based behavioral weight loss intervention components. PMID:23651701

The future of PrEP among transgender women: the critical role of gender affirmation in research and clinical practices.

PubMed

Sevelius, Jae M; Deutsch, Madeline B; Grant, Robert

2016-01-01

Globally, transgender ("trans") women are one of the key populations most disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is the newest and most promising biomedical HIV prevention intervention to date. This paper reviews relevant literature to describe the current state of the science and describes the potential role of PrEP among trans women, including a discussion of unique considerations for maximizing the impact of PrEP for this vulnerable population. Available information, including but not limited to existing scientific literature, about trans women and PrEP was reviewed and critiqued based on author expertise, including PrEP clinical trials and rollout. To date, PrEP demonstration projects and clinical trials have largely excluded trans women, or have not included them in a meaningful way. Data collection strategies that fail to identify trans women in clinical trials and research further limit the ability to draw conclusions about trans women's unique needs and devise strategies to meet them. Gender-affirming providers and clinic environments are essential components of any sexual health programme that aims to serve trans women, as they will largely avoid settings that may result in stigmatizing encounters and threats to their identities. While there is currently no evidence to suggest drug-drug interactions between PrEP and commonly used feminizing hormone regimens, community concerns about potential interactions may limit interest in and uptake of PrEP among trans women. In scaling up PrEP for trans women, it is essential to engage trans communities, utilize trans-inclusive research and marketing strategies and identify and/or train healthcare providers to provide gender-affirming healthcare to trans women, including transition-related care such as hormone provision. PrEP implementation guidelines must consider and address trans women's unique barriers and facilitators to uptake and adherence.

The future of PrEP among transgender women: the critical role of gender affirmation in research and clinical practices

PubMed Central

Sevelius, Jae M; Deutsch, Madeline B; Grant, Robert

2016-01-01

Introduction Globally, transgender (“trans”) women are one of the key populations most disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is the newest and most promising biomedical HIV prevention intervention to date. This paper reviews relevant literature to describe the current state of the science and describes the potential role of PrEP among trans women, including a discussion of unique considerations for maximizing the impact of PrEP for this vulnerable population. Methods Available information, including but not limited to existing scientific literature, about trans women and PrEP was reviewed and critiqued based on author expertise, including PrEP clinical trials and rollout. Results To date, PrEP demonstration projects and clinical trials have largely excluded trans women, or have not included them in a meaningful way. Data collection strategies that fail to identify trans women in clinical trials and research further limit the ability to draw conclusions about trans women's unique needs and devise strategies to meet them. Gender-affirming providers and clinic environments are essential components of any sexual health programme that aims to serve trans women, as they will largely avoid settings that may result in stigmatizing encounters and threats to their identities. While there is currently no evidence to suggest drug-drug interactions between PrEP and commonly used feminizing hormone regimens, community concerns about potential interactions may limit interest in and uptake of PrEP among trans women. Conclusions In scaling up PrEP for trans women, it is essential to engage trans communities, utilize trans-inclusive research and marketing strategies and identify and/or train healthcare providers to provide gender-affirming healthcare to trans women, including transition-related care such as hormone provision. PrEP implementation guidelines must consider and address trans women's unique barriers and facilitators to uptake and adherence. PMID:27760683

Cost-effective management of women with minor cervical lesions: Revisiting the application of HPV DNA testing.

PubMed

Pedersen, Kine; Burger, Emily A; Sy, Stephen; Kristiansen, Ivar S; Kim, Jane J

2016-11-01

Lack of consensus in management guidelines for women with minor cervical lesions, coupled with novel screening approaches, such as human papillomavirus (HPV) genotyping, necessitate revisiting prevention policies. We evaluated the cost-effectiveness and resource trade-offs of alternative triage strategies to inform cervical cancer prevention in Norway. We used a decision-analytic model to compare the lifetime health and economic consequences associated with ten novel candidate approaches to triage women with minor cervical lesions. Candidate strategies varied by: 1) the triage test(s): HPV testing in combination with cytology, HPV testing alone with or without genotyping for HPV-16 and -18, and immediate colposcopy, and 2) the length of time between index and triage testing (i.e., 6, 12 or 18months). Model outcomes included quality-adjusted life-years (QALYs), lifetime societal costs, and resource use (e.g., colposcopy referrals). The current Norwegian guidelines were less effective and more costly than candidate strategies. Given a commonly-cited willingness-to-pay threshold in Norway of $100,000 per QALY gained, the preferred strategy involved HPV genotyping with immediate colposcopy referral for HPV-16 or -18 positive and repeat HPV testing at 12months for non-HPV-16 or -18 positive ($78,010 per QALY gained). Differences in health benefits among candidate strategies were small, while resource use varied substantially. More effective strategies required a moderate increase in colposcopy referrals (e.g., a 9% increase for the preferred strategy) compared with current levels. New applications of HPV testing may improve management of women with minor cervical lesions, yet are accompanied by a trade-off of increased follow-up procedures. Copyright © 2016 Elsevier Inc. All rights reserved.

Cost-effective management of women with minor cervical lesions: Revisiting the application of HPV DNA testing

PubMed Central

Pedersen, Kine; Burger, Emily A.; Sy, Stephen; Kristiansen, Ivar S.; Kim, Jane J.

2016-01-01

Background Lack of consensus in management guidelines for women with minor cervical lesions, coupled with novel screening approaches, such as human papillomavirus (HPV) genotyping, necessitate revisiting prevention policies. We evaluated the cost-effectiveness and resource trade-offs of alternative triage strategies to inform cervical cancer prevention in Norway. Methods We used a decision-analytic model to compare the lifetime health and economic consequences associated with ten novel candidate approaches to triage women with minor cervical lesions. Candidate strategies varied by: 1) the triage test(s): HPV testing in combination with cytology, HPV testing alone with or without genotyping for HPV-16 and-18, and immediate colposcopy, and 2) the length of time between index and triage testing (i.e., 6, 12 or 18 months). Model outcomes included quality-adjusted life-years (QALYs), lifetime societal costs, and resource use (e.g., colposcopy referrals). Results The current Norwegian guidelines were less effective and more costly than candidate strategies. Given a commonly-cited willingness-to-pay threshold in Norway of $100,000 per QALY gained, the preferred strategy involved HPV genotyping with immediate colposcopy referral for HPV-16 or -18 positive and repeat HPV testing at 12 months for non-HPV-16 or -18 positive ($78,010 per QALY gained). Differences in health benefits among candidate strategies were small, while resource use varied substantially. More effective strategies required a moderate increase in colposcopy referrals (e.g., a 9% increase for the preferred strategy) compared with current levels. Conclusion New applications of HPV testing may improve management for women with minor cervical lesions, yet are accompanied by a trade-off of increased follow-up procedures. PMID:27542966

Which strategies reduce breast cancer mortality most? Collaborative modeling of optimal screening, treatment, and obesity prevention.

PubMed

Mandelblatt, Jeanne; van Ravesteyn, Nicolien; Schechter, Clyde; Chang, Yaojen; Huang, An-Tsun; Near, Aimee M; de Koning, Harry; Jemal, Ahmedin

2013-07-15

US breast cancer mortality is declining, but thousands of women still die each year. Two established simulation models examine 6 strategies that include increased screening and/or treatment or elimination of obesity versus continuation of current patterns. The models use common national data on incidence and obesity prevalence, competing causes of death, mammography characteristics, treatment effects, and survival/cure. Parameters are modified based on obesity (defined as BMI  ≥  30 kg/m(2) ). Outcomes are presented for the year 2025 among women aged 25+ and include numbers of cases, deaths, mammograms and false-positives; age-adjusted incidence and mortality; breast cancer mortality reduction and deaths averted; and probability of dying of breast cancer. If current patterns continue, the models project that there would be about 50,100-57,400 (range across models) annual breast cancer deaths in 2025. If 90% of women were screened annually from ages 40 to 54 and biennially from ages 55 to 99 (or death), then 5100-6100 fewer deaths would occur versus current patterns, but incidence, mammograms, and false-positives would increase. If all women received the indicated systemic treatment (with no screening change), then 11,400-14,500 more deaths would be averted versus current patterns, but increased toxicity could occur. If 100% received screening plus indicated therapy, there would be 18,100-20,400 fewer deaths. Eliminating obesity yields 3300-5700 fewer breast cancer deaths versus continuation of current obesity levels. Maximal reductions in breast cancer deaths could be achieved through optimizing treatment use, followed by increasing screening use and obesity prevention. © 2013 American Cancer Society.

Implementing the national priorities for injury surveillance.

PubMed

Mitchell, Rebecca J; McClure, Rod J; Williamson, Ann M; McKenzie, Kirsten

2008-04-07

Injury is a leading cause of disability and death in Australia and is recognised as a national health priority area. The foundation of successful injury prevention is injury surveillance, and national policies and strategies developed over the past 20 years to reduce the burden of injury in Australia have included 22 recommendations on surveillance--only three of which have been completely implemented. Priorities for improving injury surveillance include: improving current injury mortality and morbidity data collection systems; filling the gaps in injury surveillance; maintaining vigilance over data quality; increasing the integration and accessibility of injury data; developing technical expertise in surveillance. Barriers to implementation of the current National Injury Prevention and Safety Promotion Plan include the lack of an implementation plan, performance management structure, appropriate national governance structure and resources--all of which could be overcome with government commitment.

Perceived effective and feasible strategies to promote healthy eating in young children: focus groups with parents, family child care providers and daycare assistants.

PubMed

Vandeweghe, Laura; Moens, Ellen; Braet, Caroline; Van Lippevelde, Wendy; Vervoort, Leentje; Verbeken, Sandra

2016-10-04

The aim of the current study is to identify strategies to promote healthy eating in young children that can be applied by caregivers, based on their own perceptions of effectiveness and feasibility. Whereas previous research mainly focused on parental influences on children's eating behavior, the growing role of other caregivers in the upbringing of children can no longer be denied. Four focus groups were conducted with three types of caregivers of post-weaning children under 6 years old: parents (n = 14), family child care providers (n = 9), and daycare assistants (n = 10). The audiotaped focus group discussions were transcribed and imported into Nvivo 10.0 for thematic analysis. The behaviors put forward by the caregivers were categorized within three broad dimensions: global influences, general behaviors, and specific feeding practices. Perceived effective strategies to promote healthy eating behavior in children included rewards, verbal encouragement, a taste-rule, sensory sensations, involvement, variation, modeling, repeated exposure, and a peaceful atmosphere. Participants mainly disagreed on the perceived feasibility of each strategy, which largely depended on the characteristics of the caregiving setting (e.g. infrastructure, policy). Based on former research and the current results, an intervention to promote healthy eating behaviors in young children should be adapted to the caregiving setting or focus on specific feeding practices, since these involve simple behaviors that are not hindered by the limitations of the caregiving setting. Due to various misconceptions regarding health-promoting strategies, clear instructions about when and how to use these strategies are necessary.

Current overview of extrinsic and intrinsic factors in etiology and progression of inflammatory bowel diseases.

PubMed

Sobczak, Marta; Fabisiak, Adam; Murawska, Natalia; Wesołowska, Ewelina; Wierzbicka, Paulina; Wlazłowski, Marcin; Wójcikowska, Marta; Zatorski, Hubert; Zwolińska, Marta; Fichna, Jakub

2014-10-01

Inflammatory bowel diseases (IBD) are chronic, relapsing disorders affecting gastrointestinal (GI) tract and associated with intestinal mucosa damage and inflammation. The principal therapeutic goals in IBD include control of the intestinal inflammation and treatment of the major symptoms, mainly abdominal pain and diarrhea. Current therapeutic strategies for IBD rely on the use of non-specific anti-inflammatory agents and immunosuppressive drugs (e.g. aminosalicylates, monoclonal antibodies, and antibiotics), which cause severe side effects, and - in a significant number of patients - do not induce long-term benefits. In this review, we summarize the epidemiology and the most important risk factors of IBD, including genetic, immunological and environmental. Our main focus is to discuss pharmacological targets for current and future treatments of IBD. Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Oligonucleotide-based strategies to combat polyglutamine diseases

PubMed Central

Fiszer, Agnieszka; Krzyzosiak, Wlodzimierz J.

2014-01-01

Considerable advances have been recently made in understanding the molecular aspects of pathogenesis and in developing therapeutic approaches for polyglutamine (polyQ) diseases. Studies on pathogenic mechanisms have extended our knowledge of mutant protein toxicity, confirmed the toxicity of mutant transcript and identified other toxic RNA and protein entities. One very promising therapeutic strategy is targeting the causative gene expression with oligonucleotide (ON) based tools. This straightforward approach aimed at halting the early steps in the cascade of pathogenic events has been widely tested for Huntington's disease and spinocerebellar ataxia type 3. In this review, we gather information on the use of antisense oligonucleotides and RNA interference triggers for the experimental treatment of polyQ diseases in cellular and animal models. We present studies testing non-allele-selective and allele-selective gene silencing strategies. The latter include targeting SNP variants associated with mutations or targeting the pathologically expanded CAG repeat directly. We compare gene silencing effectors of various types in a number of aspects, including their design, efficiency in cell culture experiments and pre-clinical testing. We discuss advantages, current limitations and perspectives of various ON-based strategies used to treat polyQ diseases. PMID:24848018

Integrated Pest Management of Coffee Berry Borer: Strategies from Latin America that Could Be Useful for Coffee Farmers in Hawaii

PubMed Central

Aristizábal, Luis F.; Bustillo, Alex E.; Arthurs, Steven P.

2016-01-01

The coffee berry borer (CBB), Hypothenemus hampei Ferrari (Coleoptera: Curculionidae: Scolytinae) is the primary arthropod pest of coffee plantations worldwide. Since its detection in Hawaii (September 2010), coffee growers are facing financial losses due to reduced quality of coffee yields. Several control strategies that include cultural practices, biological control agents (parasitoids), chemical and microbial insecticides (entomopathogenic fungi), and a range of post-harvest sanitation practices have been conducted to manage CBB around the world. In addition, sampling methods including the use of alcohol based traps for monitoring CBB populations have been implemented in some coffee producing countries in Latin America. It is currently unclear which combination of CBB control strategies is optimal under economical, environmental, and sociocultural conditions of Hawaii. This review discusses components of an integrated pest management program for CBB. We focus on practical approaches to provide guidance to coffee farmers in Hawaii. Experiences of integrated pest management (IPM) of CBB learned from Latin America over the past 25 years may be relevant for establishing strategies of control that may fit under Hawaiian coffee farmers’ conditions. PMID:26848690

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

PubMed Central

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

2015-01-01

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

Acanthamoeba keratitis: current status and urgent research priorities.

PubMed

Khan, Naveed Ahmed; Anwar, Ayaz; Siddiqui, Ruqaiyyah

2018-05-10

First discovered in the early 1970s, Acanthamoeba keratitis has remained a major eye infection and presents a significant threat to the public health, especially in developing countries. The aim is to present a timely review of our current understanding of the advances made in this field in a comprehensible manner and includes novel concepts and provides clear directions for immediate research priorities. We undertook a search of bibliographic databases for peer-reviewed research literature and also summarized our published results in this field. The present review focuses on novel diagnostic and therapeutic strategies in details which can provide access to management and treatment of Acanthamoeba keratitis. This coupled with the recently available genome sequence information together with high throughput genomics technology and innovative approaches should stimulate interest in the rational design of preventative and therapeutic measures. Current treatment of Acanthamoeba keratitis is problematic and often leads to infection recurrence. Better understanding of diagnosis, pathogenesis, pathophysiology and therapeutic regimens, would lead to novel strategies in treatment and prophylaxis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Overcoming Drug Resistance in Pancreatic Cancer

PubMed Central

Long, Jiang; Zhang, Yuqing; Yu, Xianjun; Yang, Jingxuan; LeBrun, Drake; Chen, Changyi; Yao, Qizhi; Li, Min

2011-01-01

Introduction Pancreatic cancer has the worst survival rate of all cancers. The current standard care for metastatic pancreatic cancer is gemcitabine, however, the success of this treatment is poor and overall survival has not improved for decades. Drug resistance (both intrinsic and acquired) is thought to be a major reason for the limited benefit of most pancreatic cancer therapies. Areas covered Previous studies have indicated various mechanisms of drug resistance in pancreatic cancer, including changes in individual genes or signaling pathways, the influence of the tumor microenvironment, and the presence of highly resistant stem cells. This review summarizes recent advances in the mechanisms of drug resistance in pancreatic cancer, and potential strategies to overcome this. Expert Opinion Increasing drug delivery efficiency and decreasing drug resistance is the current aim in pancreatic cancer treatment, and will also benefit the treatment of other cancers. Understanding the molecular and cellular basis of drug resistance in pancreatic cancer will lead to the development of novel therapeutic strategies with the potential to sensitize pancreatic cancer to chemotherapy, and to increase the efficacy of current treatments in a wide variety of human cancers. PMID:21391891

Toward single cell traction microscopy within 3D collagen matrices

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

Hall, Matthew S.; Long, Rong; Feng, Xinzeng

Mechanical interaction between the cell and its extracellular matrix (ECM) regulates cellular behaviors, including proliferation, differentiation, adhesion, and migration. Cells require the three-dimensional (3D) architectural support of the ECM to perform physiologically realistic functions. However, current understanding of cell–ECM and cell–cell mechanical interactions is largely derived from 2D cell traction force microscopy, in which cells are cultured on a flat substrate. 3D cell traction microscopy is emerging for mapping traction fields of single animal cells embedded in either synthetic or natively derived fibrous gels. We discuss here the development of 3D cell traction microscopy, its current limitations, and perspectives onmore » the future of this technology. Emphasis is placed on strategies for applying 3D cell traction microscopy to individual tumor cell migration within collagen gels. - Highlights: • Review of the current state of the art in 3D cell traction force microscopy. • Bulk and micro-characterization of remodelable fibrous collagen gels. • Strategies for performing 3D cell traction microscopy within collagen gels.« less

The Potential of Nano-Vehicle Mediated Therapy in Vasculitis and Multiple Sclerosis.

PubMed

In't Veld, R Huis; Da Silva, C G; Kaijzel, E L; Chan, A B; Cruz, L J

2017-01-01

The induction of immune tolerance towards self-antigens presents as a viable future strategy in the treatment of auto-immune diseases, including vasculitis and multiple sclerosis (MS). As specific targets are currently lacking for vasculitis due to incomplete understanding of the pathologies underlying this disease, current treatment options are based on modalities that induce general immune suppression. However, many immune suppressants used in the clinic are known to display wide biodistribution and are thus often accompanied by several adverse effects. Nano-vehicles (NVs) possess the ability to overcome such limitations by enabling more specific delivery of their content through modifications with targeting moieties. In this review, we describe the latest insights in the pathology of vasculitis that may function as potential targets for NV carrier systems, allowing more specific delivery of currently used immune suppressants. In addition, we describe the existing strategies to induce artificial immune tolerance and explore the feasibility of inducing regulatory T cell (Treg) mediated tolerance for MS, possibly mediated by NVs. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cost-effectiveness of active-passive prophylaxis and antiviral prophylaxis during pregnancy to prevent perinatal hepatitis B virus infection.

PubMed

Fan, Lin; Owusu-Edusei, Kwame; Schillie, Sarah F; Murphy, Trudy V

2016-05-01

In an era of antiviral treatment, reexamination of the cost-effectiveness of strategies to prevent perinatal hepatitis B virus (HBV) transmission in the United States is needed. We used a decision tree and Markov model to estimate the cost-effectiveness of the current U.S. strategy and two alternatives: (1) Universal hepatitis B vaccination (HepB) strategy: No pregnant women are screened for hepatitis B surface antigen (HBsAg). All infants receive HepB before hospital discharge; no infants receive hepatitis B immunoglobulin (HBIG). (2) Current strategy: All pregnant women are screened for HBsAg. Infants of HBsAg-positive women receive HepB and HBIG ≤12 hours of birth. All other infants receive HepB before hospital discharge. (3) Antiviral prophylaxis strategy: All pregnant women are screened for HBsAg. HBsAg-positive women have HBV-DNA load measured. Antiviral prophylaxis is offered for 4 months starting in the third trimester to women with DNA load ≥10(6) copies/mL. HepB and HBIG are administered at birth to infants of HBsAg-positive women, and HepB is administered before hospital discharge to infants of HBsAg-negative women. Effects were measured in quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICER). Compared to the universal HepB strategy, the current strategy prevented 1,006 chronic HBV infections and saved 13,600 QALYs (ICER: $6,957/QALY saved). Antiviral prophylaxis dominated the current strategy, preventing an additional 489 chronic infections, and saving 800 QALYs and $2.8 million. The results remained robust over a wide range of assumptions. The current U.S. strategy for preventing perinatal HBV remains cost-effective compared to the universal HepB strategy. An antiviral prophylaxis strategy was cost saving compared to the current strategy and should be considered to continue to decrease the burden of perinatal hepatitis B in the United States. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

HIV risk-taking behaviour among injecting drug users currently, previously and never enrolled in methadone treatment.

PubMed

Baker, A; Kochan, N; Dixon, J; Wodak, A; Heather, N

1995-04-01

This study compares the injecting and sexual risk-taking behaviour among injecting drug users (IDUs) currently, previously and never enrolled in methadone maintenance treatment (MMT). All subjects had injected during the 6 months prior to the day of interview. The current MMT group showed significantly lower injecting risk-taking behaviour subscale scores on the HIV Risk-taking Behaviour Scale (HRBS) of the Opiate Treatment Index than the previous MMT and non-MMT groups together. The current MMT group differed from the other two groups in the frequency of injecting and cleaning of injection equipment with bleach. There was no difference between the current MMT group and the other two groups combined in sexual risk-taking behaviour scores on the HRBS. There were no differences between the previous MMT and non-MMT groups in injecting and sexual risk-taking behaviour. HIV seroprevalence was low and there was no difference in seroprevalence between groups. Thus, IDUs currently enrolled in MMT are at reduced risk for HIV infection when compared with IDUs who have previously or never been enrolled in MMT. However, the absence of a difference between the current MMT and other two groups in frequency of sharing behaviours suggests the need for additional strategies among MMT clients to reduce needle-sharing. Possible strategies include the application of relapse prevention interventions and the availability of sterile injecting equipment in MMT clinics. Further research is needed to identify factors which increase attraction and retention of IDUs to MMT.

Culturally diverse health care students' experiences with teaching strategies in Finland: a national survey.

PubMed

Pitkajarvi, Marianne; Eriksson, Elina; Pitkala, Kaisu

2013-06-01

All over the world, current health care students come from a variety of cultural, linguistic and educational backgrounds. Their expectations and learning needs vary, yet little is known about how our current education system meets their needs. The purpose of this study was to explore culturally diverse health care students' experiences of teaching strategies in polytechnic faculties of health care in Finland. Specifically, we aimed to compare how international students and Finnish students experience the same curriculum. A cross sectional survey. Ten polytechnic faculties of health care in Finland offering English-Language-Taught Degree Programmess (ELTDPs). 283 students studying nursing, public health nursing, or physiotherapy in English. Of these, 166 were international students and 112 were Finnish students. The data were collected using a questionnaire designed specifically for this study. The survey included items grouped into seven dimensions: 1. concreteness of theoretical instruction, 2. encouragement of student activity, 3. use of skills labs, 4. variation among teaching strategies, 5. assessment, 6. interaction in the English-Language-Taught Degree Programmes, and 7. approach to diversity in the English-Language-Taught Degree Programmes. The most positive experiences for all students were with the approach to cultural diversity and the concreteness of theoretical instruction, whereas the most negative experiences were with assessment. International students' experiences were more positive than Finnish students' in the following dimensions: encouragement of student activity (p=0.005), variation among teaching strategies (p<0.001), and assessment (p<0.001). Compared to the Finnish students, more than double the number of international students were dissatisfied with their lives (p<0.001). The implications for education include the strengthening teachers' leadership role in small group activities, providing individual and detailed feedback, and ensuring appropriate support mechanisms for all students. Copyright © 2012 Elsevier Ltd. All rights reserved.

Randomized trials and quality assurance in gastric cancer surgery.

PubMed

Dikken, Johan L; Cats, Annemieke; Verheij, Marcel; van de Velde, Cornelis J H

2013-03-01

A D2 lymphadenectomy can be considered standard of surgical care for advanced resectable gastric cancer. Currently, several multimodality strategies are used, including postoperative monochemotherapy in Asia, postoperative chemoradiotherapy in the United States, and perioperative chemotherapy in Europe. As the majority of gastric cancer patients are treated outside the framework of clinical trials, quality assurance programs, including referral to high-volume centers and clinical auditing are needed to improve gastric cancer care on a nationwide level. Copyright © 2012 Wiley Periodicals, Inc.

[Imaging assessment of bone and cartilage destruction in rheumatoid arthritis].

PubMed

Hirata, Shintaro; Tanaka, Yoshiya

2015-12-01

Rheumatoid arthritis (RA) is characterized by synovitis and subsequent joint destruction involving bone and cartilage. Recent therapeutic development have improved outcomes including disease activity and structural progression in RA, and standardized procedures of imaging assessment including modified total Sharp score (mTSS) have contributed largely for the development of therapeutic strategy. In addition, ultrasonography and MRI of joints have been recently emerging as novel imaging methods for RA. Here, we review current imaging assessments of bone and cartilage destruction in RA.

Physiology of Hyperuricemia and Urate-Lowering Treatments.

PubMed

Benn, Caroline L; Dua, Pinky; Gurrell, Rachel; Loudon, Peter; Pike, Andrew; Storer, R Ian; Vangjeli, Ciara

2018-01-01

Gout is the most common form of inflammatory arthritis and is a multifactorial disease typically characterized by hyperuricemia and monosodium urate crystal deposition predominantly in, but not limited to, the joints and the urinary tract. The prevalence of gout and hyperuricemia has increased in developed countries over the past two decades and research into the area has become progressively more active. We review the current field of knowledge with emphasis on active areas of hyperuricemia research including the underlying physiology, genetics and epidemiology, with a focus on studies which suggest association of hyperuricemia with common comorbidities including cardiovascular disease, renal insufficiency, metabolic syndrome and diabetes. Finally, we discuss current therapies and emerging drug discovery efforts aimed at delivering an optimized clinical treatment strategy.

The NASA Deep Space Network (DSN) Array

NASA Technical Reports Server (NTRS)

Gatti, Mark

2006-01-01

The DSN Array Project is currently working with Senior Management at both JPL and NASA to develop strategies towards starting a major implementation project. Several studies within NASA are concluding, all of which recommend that any future DSN capability include arraying of antennas to increase performance. Support of Deep Space, Lunar, and CEV (crewed exploration vehicle) missions is possible. High data rate and TDRSS formatting is being investigated. Any future DSN capacity must include Uplink. Current studies ongoing to investigate and develop technologies for uplink arraying; provides advantages in three ways: 1) N2 effect. EIRP grows as N2(-vs-N for a downlink array); 2) Improved architectural options (can separate uplink and downlink); and 3) Potential for more cost effective transmitters for fixed EIRP.

Current Treatment and Recent Clinical Research in Alzheimer's Disease

PubMed Central

Neugroschl, Judith; Sano, Mary

2010-01-01

The transition from either epidemiological observation or the bench to rigorously tested clinical trials in patients with Alzheimer's disease is crucial in understanding which treatments are beneficial to patients. The amyloid hypothesis has undergone scrutiny recently, as many trials aimed at reducing amyloid and plaque have been completed or are in the testing phase. Examples include modulation of the secretases involved in beta amyloid formation, anti-aggregation agents, and immunotherapeutic trials. Other therapies targeting hyperphosphorylated tau and novel targets such as enhancement of mitochondrial function, serotonin receptors, receptor for advanced glycation end products, and nerve growth factor, as well as other strategies, are discussed. A brief review of the current Food and Drug Administration–approved treatments is included. PMID:20101716

Implementation of Policies and Strategies for Control of Noncommunicable Diseases in Malawi: Challenges and Opportunities.

PubMed

Lupafya, Phindile Chitsulo; Mwagomba, Beatrice L Matanje; Hosig, Kathy; Maseko, Lucy M; Chimbali, Henry

2016-04-01

Malawi is a Sub-Saharan African country experiencing the epidemiological transition from predominantly infectious to noncommunicable diseases (NCDs) with dramatically increasing prevalence of lifestyle-related diseases such as obesity, hypertension, and diabetes. Malawi's 2011-2016 Health Sector Strategic Plan included NCDs, and an NCD Control Program was established with subsequent development of a National Action Plan for prevention and management of NCDs launched in 2013. The current study was designed to identify gaps in implementation of NCD control program policies and action plan strategies by describing current efforts toward prevention and management of NCDs in Malawi with emphasis on challenges and opportunities. Semistructured questionnaires were used to collect quantitative and qualitative data from Malawi Ministry of Health personnel (senior officers, service providers, health education officers, and nutritionists) in 10 health districts and 3 central hospitals. Frequencies were generated for quantitative data. Qualitative data were used to generate themes and most common responses. Results showed that current services focus on facility-based NCD screening and clinical services rather than active screening, prevention, and community awareness and outreach, although respondents emphasized the importance of prevention, lifestyle education, and community outreach. Respondents indicated inadequate resources for NCD services including financial capital, human resources, equipment and supplies, and transportation. While Malawi has begun to address NCDs, policy and practice implications include (a) better integration of services within the existing infrastructure with emphasis on capacity building; (b) greater implementation of planned NCD activities; (c) a stronger, more comprehensive data management system; and (d) innovative funding solutions. © 2015 Society for Public Health Education.

Behavioral HIV Prevention Interventions Among Latinas in the US: A Systematic Review of the Evidence.

PubMed

Daniel-Ulloa, Jason; Ulibarri, M; Baquero, B; Sleeth, C; Harig, H; Rhodes, S D

2016-12-01

Compared to White women, Latinas are 4 times more likely to contract HIV. In an effort to determine the overall state of the science meant to address this disparity, we reviewed the current HIV prevention intervention literature for U.S. Latinas. We searched 5 online electronic databases from their inception through July, 2014, for HIV prevention interventions including a majority sample of Latinas. Of 1041 articles identified, 20 studies met inclusion criteria. We documented study designs, participant characteristics, outcomes, theories used, and other intervention characteristics. Overall, HIV knowledge and attitudes were the predominant outcome; a small minority of studies included self-reported condom use or STD incidence. Strategies used to address cultural factors specific to Latinas and HIV included; lay health advisors, using ethnographic narratives, or using the Theory of Gender and Power, however few of the interventions adopted these strategies. This study identified several gaps in the intervention literature that need to be addressed. In addition to including more direct measures of decreased HIV risk (ex. condom use), more systematic use of strategies meant to address gender and cultural factors that may place Latinas at increased risk (e.g., gender inequity, traditional gender role norms such as machismo and marianismo, and relationship power dynamics).

Strategies to circumvent the T315I gatekeeper mutation in the Bcr-Abl tyrosine kinase

PubMed Central

Bose, Prithviraj; Park, Haeseong; Al-Khafaji, Jawad; Grant, Steven

2013-01-01

Despite the remarkable success of imatinib against Bcr-Abl, development of secondary resistance, most often due to point mutations in the Bcr-Abl tyrosine kinase (TK) domain, is quite common. Of these, the T315I “gatekeeper” mutation is resistant to all currently registered Bcr-Abl TK inhibitors (TKIs) with the notable exception of ponatinib (Iclusig™), which was very recently approved by the United States Food and Drug Administration (FDA). Besides ponatinib, numerous strategies have been developed to circumvent this problem. These include the protein synthesis inhibitor omacetaxine (Synribo®), and “switch-control” inhibitors. Dual Bcr-Abl and aurora kinase inhibitors represent another promising strategy. Finally, several promising synergistic combinations, such as TKIs with histone deacetylase inhibitors (HDACIs), warrant attention. PMID:23977454

Cryoprotectant Toxicity: Facts, Issues, and Questions

PubMed Central

2015-01-01

Abstract High levels of penetrating cryoprotectants (CPAs) can eliminate ice formation during cryopreservation of cells, tissues, and organs to cryogenic temperatures. But CPAs become increasingly toxic as concentration increases. Many strategies have been attempted to overcome the problem of eliminating ice while minimizing toxicity, such as attempting to optimize cooling and warming rates, or attempting to optimize time of adding individual CPAs during cooling. Because strategies currently used are not adequate, CPA toxicity remains the greatest obstacle to cryopreservation. CPA toxicity stands in the way of cryogenic cryopreservation of human organs, a procedure that has the potential to save many lives. This review attempts to describe what is known about CPA toxicity, theories of CPA toxicity, and strategies to reduce CPA toxicity. Critical analysis and suggestions are also included. PMID:25826677

Preferences for intervention among Peruvian women in intimate partner violence relationships.

PubMed

Cripe, Swee May; Espinoza, Damarys; Rondon, Marta B; Jimenez, Maria Luisa; Sanchez, Elena; Ojeda, Nely; Sanchez, Sixto; Williams, Michelle A

2015-01-01

We sought to identify what abused Peruvian women want or need as intervention strategies. We conducted five focus groups with 30 women with prior or current experience with intimate partner violence. Participants noted that abused women need compassionate support, professional counseling, and informational and practical (e.g., work skills training, employment, shelter, financial support) interventions. We propose a 2-tiered intervention strategy that includes community support groups and individual professional counseling. This strategy is intended to offer broad coverage, meeting the needs of large groups of women who experience abuse, whereas providing specialized counseling for those requiring intensive support. Respect for each woman's autonomy in the decision-making process is a priority. Interventions targeted toward women and men should address structural factors that contribute to violence against women.

Preferences for Intervention Among Peruvian Women in Intimate Partner Violence Relationships

PubMed Central

Cripe, Swee May; Espinoza, Damarys; Rondon, Marta B.; Jimenez, Maria Luisa; Sanchez, Elena; Ojeda, Nely; Sanchez, Sixto; Williams, Michelle A.

2015-01-01

We sought to identify what abused Peruvian women want or need as intervention strategies. We conducted five focus groups with thirty women with prior or current experience with intimate partner violence. Participants noted that abused women need compassionate support, professional counseling, informational and practical (e.g., work skills training, employment, shelter, financial support) interventions. We propose a two-tiered intervention strategy that includes community support groups and individual professional counseling. This strategy is intended to offer broad coverage, meeting the needs of large groups of women who experience abuse, while providing specialized counseling for those requiring intensive support. Respect for each woman’s autonomy in the decision-making process is a priority. Interventions targeted towards women and men should address structural factors that contribute to violence against women. PMID:25741931

Equity in primary health care delivery: an examination of the cohesiveness of strategies relating to the primary healthcare system, the health workforce and hepatitis C.

PubMed

Scarborough, Jane; Eliott, Jaklin; Miller, Emma; Aylward, Paul

2015-04-01

To suggest ways of increasing the cohesiveness of national primary healthcare strategies and hepatitis C strategies, with the aim of ensuring that all these strategies include ways to address barriers and facilitators to access to primary healthcare and equity for people with hepatitis C. A critical review was conducted of the first national Primary Healthcare System Strategy and Health Workforce Strategy with the concurrent Hepatitis C Strategy. Content relating to provision of healthcare in private general practice was examined, focussing on issues around access and equity. In all strategies, achieving access to care and equity was framed around providing sufficient medical practitioners for particular locations. Equity statements were present in all policies but only the Hepatitis C Strategy identified discrimination as a barrier to equity. Approaches detailed in the Primary Healthcare System Strategy and Health Workforce Strategy regarding current resource allocation, needs assessment and general practitioner incentives were limited to groups defined within these documents and may not identify or meet the needs of people with hepatitis C. Actions in the primary healthcare system and health workforce strategies should be extended to additional groups beyond those listed as priority groups within the strategies. Future hepatitis C strategies should outline appropriate, detailed needs assessment methodologies and specify how actions in the broad strategies can be applied to benefit the primary healthcare needs of people with hepatitis C.

Challenging aging stereotypes: strategies for creating a more active society.

PubMed

Ory, Marcia; Kinney Hoffman, Melane; Hawkins, Margaret; Sanner, Brigid; Mockenhaupt, Robin

2003-10-01

The myths of aging provide a partial explanation for why older people have not been primary targets for health promotion and disease-prevention programs. Accelerated population aging signals an urgent need for increased attention to health promotion and disease-prevention interventions across the entire life course. The purpose of this article is to review what is known about: (1). the prevalence and nature of ageist stereotypes; (2). the varied ways in which ageist stereotypes are harmful to health, functioning, and well-being; and (3). strategies for effective communication with older adults around lifestyle issues, with particular emphasis on physical activity. This article reviews literature on current myths and reality of aging in the context of designing health promotion programs for older adults. Strategies for combating ageist stereotypes are based on a multilevel view of determinants of health and aging. Ageist stereotypes are pervasive in U.S. society and harmful to older adults' psychological well-being, physical and cognitive functioning, and survival. Concrete strategies for communicating with older adults can increase the effectiveness of health promotion programs. Strategies for combating ageism and creating a healthier society must address all segments of society, and include educational and media campaigns, an expansion of current research foci, greater sensitivity from care providers, more opportunities for intergenerational linkages, the design of productive roles for older adults, a retrofit of the built environment, and intensified and collaborative action from both the public and private sectors.

Therapeutic vaccines in HBV: lessons from HCV.

PubMed

Barnes, Eleanor

2015-02-01

Currently, millions of people infected with hepatitis B virus (HBV) are committed to decades of treatment with anti-viral therapy to control viral replication. However, new tools for immunotherapy that include both viral vectors and molecular checkpoint inhibitors are now available. This has led to a resurgence of interest in new strategies to develop immunotherapeutic strategies with the aim of inducing HBeAg seroconversion--an end-point that has been associated with a decrease in the rates of disease progression. Ultimately, a true cure will involve the elimination of covalently closed circular DNA which presents a greater challenge for immunotherapy. In this manuscript, I describe the development of immunotherapeutic strategies for HBV that are approaching or currently in clinical studies, and draw on observations of T cell function in natural infection supported by recent animal studies that may lead to additional rational vaccine strategies using checkpoint inhibitors. I also draw on our recent experience in developing potent vaccines for HCV prophylaxis based on simian adenoviral and MVA vectors used in prime-boost strategies in both healthy volunteers and HCV infected patients. I have shown that the induction of T cell immune responses is markedly attenuated when administered to people with persistent HCV viremia. These studies and recently published animal studies using the woodchuck model suggest that potent vaccines based on DNA or adenoviral vectored vaccination represent a rational way forward. However, combining these with drugs to suppress viral replication, alongside checkpoint inhibitors may be required to induce long-term immune control.

WE-E-BRB-01: Personalized Motion Management Strategies for Pencil Beam Scanning Proton Therapy

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

Zhu, X.

Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed.more » Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian.; H. Li, Na.« less

Self-Regulation and Recall: Growth Curve Modeling of Intervention Outcomes for Older Adults

PubMed Central

West, Robin L.; Hastings, Erin C.

2013-01-01

Memory training has often been supported as a potential means to improve performance for older adults. Less often studied are the characteristics of trainees that benefit most from training. Using a self-regulatory perspective, the current project examined a latent growth curve model to predict training-related gains for middle-aged and older adult trainees from individual differences (e.g., education), information processing skills (strategy use) and self-regulatory factors such as self-efficacy, control, and active engagement in training. For name recall, a model including strategy usage and strategy change as predictors of memory gain, along with self-efficacy and self-efficacy change, showed comparable fit to a more parsimonious model including only self-efficacy variables as predictors. The best fit to the text recall data was a model focusing on self-efficacy change as the main predictor of memory change, and that model showed significantly better fit than a model also including strategy usage variables as predictors. In these models, overall performance was significantly predicted by age and memory self-efficacy, and subsequent training-related gains in performance were best predicted directly by change in self-efficacy (text recall), or indirectly through the impact of active engagement and self-efficacy on gains (name recall). These results underscore the benefits of targeting self-regulatory factors in intervention programs designed to improve memory skills. PMID:21604891

Self-regulation and recall: growth curve modeling of intervention outcomes for older adults.

PubMed

West, Robin L; Hastings, Erin C

2011-12-01

Memory training has often been supported as a potential means to improve performance for older adults. Less often studied are the characteristics of trainees that benefit most from training. Using a self-regulatory perspective, the current project examined a latent growth curve model to predict training-related gains for middle-aged and older adult trainees from individual differences (e.g., education), information processing skills (strategy use) and self-regulatory factors such as self-efficacy, control, and active engagement in training. For name recall, a model including strategy usage and strategy change as predictors of memory gain, along with self-efficacy and self-efficacy change, showed comparable fit to a more parsimonious model including only self-efficacy variables as predictors. The best fit to the text recall data was a model focusing on self-efficacy change as the main predictor of memory change, and that model showed significantly better fit than a model also including strategy usage variables as predictors. In these models, overall performance was significantly predicted by age and memory self-efficacy, and subsequent training-related gains in performance were best predicted directly by change in self-efficacy (text recall), or indirectly through the impact of active engagement and self-efficacy on gains (name recall). These results underscore the benefits of targeting self-regulatory factors in intervention programs designed to improve memory skills.

Animal models of transcranial direct current stimulation: Methods and mechanisms.

PubMed

Jackson, Mark P; Rahman, Asif; Lafon, Belen; Kronberg, Gregory; Ling, Doris; Parra, Lucas C; Bikson, Marom

2016-11-01

The objective of this review is to summarize the contribution of animal research using direct current stimulation (DCS) to our understanding of the physiological effects of transcranial direct current stimulation (tDCS). We comprehensively address experimental methodology in animal studies, broadly classified as: (1) transcranial stimulation; (2) direct cortical stimulation in vivo and (3) in vitro models. In each case advantages and disadvantages for translational research are discussed including dose translation and the overarching "quasi-uniform" assumption, which underpins translational relevance in all animal models of tDCS. Terminology such as anode, cathode, inward current, outward current, current density, electric field, and uniform are defined. Though we put key animal experiments spanning decades in perspective, our goal is not simply an exhaustive cataloging of relevant animal studies, but rather to put them in context of ongoing efforts to improve tDCS. Cellular targets, including excitatory neuronal somas, dendrites, axons, interneurons, glial cells, and endothelial cells are considered. We emphasize neurons are always depolarized and hyperpolarized such that effects of DCS on neuronal excitability can only be evaluated within subcellular regions of the neuron. Findings from animal studies on the effects of DCS on plasticity (LTP/LTD) and network oscillations are reviewed extensively. Any endogenous phenomena dependent on membrane potential changes are, in theory, susceptible to modulation by DCS. The relevance of morphological changes (galvanotropy) to tDCS is also considered, as we suggest microscopic migration of axon terminals or dendritic spines may be relevant during tDCS. A majority of clinical studies using tDCS employ a simplistic dose strategy where excitability is singularly increased or decreased under the anode and cathode, respectively. We discuss how this strategy, itself based on classic animal studies, cannot account for the complexity of normal and pathological brain function, and how recent studies have already indicated more sophisticated approaches are necessary. One tDCS theory regarding "functional targeting" suggests the specificity of tDCS effects are possible by modulating ongoing function (plasticity). Use of animal models of disease are summarized including pain, movement disorders, stroke, and epilepsy. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Animal Models of transcranial Direct Current Stimulation: Methods and Mechanisms

PubMed Central

Jackson, Mark P.; Rahman, Asif; Lafon, Belen; Kronberg, Gregory; Ling, Doris; Parra, Lucas C.; Bikson, Marom

2016-01-01

The objective of this review is to summarize the contribution of animal research using direct current stimulation (DCS) to our understanding of the physiological effects of transcranial direct current stimulation (tDCS). We comprehensively address experimental methodology in animal studies, broadly classified as: 1) transcranial stimulation; 2) direct cortical stimulation in vivo and 3) in vitro models. In each case advantages and disadvantages for translational research are discussed including dose translation and the overarching “quasi-uniform” assumption, which underpins translational relevance in all animal models of tDCS. Terminology such as anode, cathode, inward current, outward current, current density, electric field, and uniform are defined. Though we put key animal experiments spanning decades in perspective, our goal is not simply an exhaustive cataloging of relevant animal studies, but rather to put them in context of ongoing efforts to improve tDCS. Cellular targets, including excitatory neuronal somas, dendrites, axons, interneurons, glial cells, and endothelial cells are considered. We emphasize neurons are always depolarized and hyperpolarized such that effects of DCS on neuronal excitability can only be evaluated within subcellular regions of the neuron. Findings from animal studies on the effects of DCS on plasticity (LTP/LTD) and network oscillations are reviewed extensively. Any endogenous phenomena dependent on membrane potential changes are, in theory, susceptible to modulation by DCS. The relevance of morphological changes (galvanotropy) to tDCS is also considered, as we suggest microscopic migration of axon terminals or dendritic spines may be relevant during tDCS. A majority of clinical studies using tDCS employ a simplistic dose strategy where excitability is singularly increased or decreased under the anode and cathode, respectively. We discuss how this strategy, itself based on classic animal studies, cannot account for the complexity of normal and pathological brain function, and how recent studies have already indicated more sophisticated approaches are necessary. One tDCS theory regarding “functional targeting” suggests the specificity of tDCS effects are possible by modulating ongoing function (plasticity). Use of animal models of disease are summarized including pain, movement disorders, stroke, and epilepsy. PMID:27693941

Adaptive PI control strategy for flat permanent magnet linear synchronous motor vibration suppression

NASA Astrophysics Data System (ADS)

Meng, Fanwei; Liu, Chengying; Li, Zhijun; Wang, Liping

2013-01-01

Due to low damping ratio, flat permanent magnet linear synchronous motor's vibration is difficult to be damped and the accuracy is limited. The vibration suppressing results are not good enough in the existing research because only the longitudinal direction vibration is considered while the normal direction vibration is neglected. The parameters of the direct-axis current controller are set to be the same as those of the quadrature-axis current controller commonly. This causes contradiction between signal noise and response. To suppress the vibration, the electromagnetic force model of the flat permanent magnet synchronous linear motor is formulated first. Through the analysis of the effect that direct-axis current noise and quadrature-axis current noise have on both direction vibration, it can be declared that the conclusion that longitudinal direction vibration is only related to the quadrature-axis current noise while the normal direction vibration is related to both the quadrature-axis current noise and direct-axis current noise. Then, the simulation test on current loop with a low-pass filter is conducted and the results show that the low-pass filter can not suppress the vibration but makes the vibration more severe. So a vibration suppressing strategy that the proportional gain of direct-axis current controller adapted according to quadrature-axis reference current is proposed. This control strategy can suppress motor vibration by suppressing direct-axis current noise. The experiments results about the effect of K p and T i on normal direction vibration, longitudinal vibration and the position step response show that this strategy suppresses vibration effectively while the motor's motion performance is not affected. The maximum reduction of vibration can be up to 40%. In addition, current test under rated load condition is also conducted and the results show that the control strategy can avoid the conflict between the direct-axis current and the quadrature-axis current under typical load. Adaptive PI control strategy can effectively suppress the flat permanent magnet linear synchronous motor's vibration without affecting the motor's performance.

Impact and cost-effectiveness of chlamydia testing in Scotland: a mathematical modelling study.

PubMed

Looker, Katharine J; Wallace, Lesley A; Turner, Katherine M E

2015-01-15

Chlamydia is the most common sexually transmitted bacterial infection in Scotland, and is associated with potentially serious reproductive outcomes, including pelvic inflammatory disease (PID) and tubal factor infertility (TFI) in women. Chlamydia testing in Scotland is currently targeted towards symptomatic individuals, individuals at high risk of existing undetected infection, and young people. The cost-effectiveness of testing and treatment to prevent PID and TFI in Scotland is uncertain. A compartmental deterministic dynamic model of chlamydia infection in 15-24 year olds in Scotland was developed. The model was used to estimate the impact of a change in testing strategy from baseline (16.8% overall testing coverage; 0.4 partners notified and tested/treated per treated positive index) on PID and TFI cases. Cost-effectiveness calculations informed by best-available estimates of the quality-adjusted life years (QALYs) lost due to PID and TFI were also performed. Increasing overall testing coverage by 50% from baseline to 25.2% is estimated to result in 21% fewer cases in young women each year (PID: 703 fewer; TFI: 88 fewer). A 50% decrease to 8.4% would result in 20% more PID (669 additional) and TFI (84 additional) cases occurring annually. The cost per QALY gained of current testing activities compared to no testing is £40,034, which is above the £20,000-£30,000 cost-effectiveness threshold. However, calculations are hampered by lack of reliable data. Any increase in partner notification from baseline would be cost-effective (incremental cost per QALY gained for a partner notification efficacy of 1 compared to baseline: £5,119), and would increase the cost-effectiveness of current testing strategy compared to no testing, with threshold cost-effectiveness reached at a partner notification efficacy of 1.5. However, there is uncertainty in the extent to which partner notification is currently done, and hence the amount by which it could potentially be increased. Current chlamydia testing strategy in Scotland is not cost-effective under the conservative model assumptions applied. However, with better data enabling some of these assumptions to be relaxed, current coverage could be cost-effective. Meanwhile, increasing partner notification efficacy on its own would be a cost-effective way of preventing PID and TFI from current strategy.

Systems and methods for providing power to a load based upon a control strategy

DOEpatents

Perisic, Milun; Kajouke, Lateef A; Ransom, Ray M

2013-12-24

Systems and methods are provided for an electrical system. The electrical system includes a load, an interface configured to receive a voltage from a voltage source, and a controller configured to receive the voltage from the voltage source through the interface and to provide a voltage and current to the load. Wherein, when the controller is in a constant voltage mode, the controller provides a constant voltage to the load, when the controller is in a constant current mode, the controller provides a constant current to the load, and when the controller is in a constant power mode, the controller provides a constant power to the load.

Assessment of Emerging Regional Air Quality (AQ) and Greenhouse Gas (GHG) Impacts and Potential Mitigation Strategies in U.S. Energy Sectors

NASA Astrophysics Data System (ADS)

Kinnon, Michael Mac

The current domestic reliance on high-emitting fossil fuels for energy needs is the key driver of U.S. greenhouse gas (GHG) and pollutant emissions driving both climate change and regional air quality (AQ) concerns. Moving forward, emission sources in U.S. energy sectors will be subjected to changes driven by numerous phenomena, including technology evolution, environmental impacts, sustainability goals, and socioeconomic factors. This evolution will directly affect emissions source-related impacts on regional AQ that effective emissions control strategies must account for, including relative source contributions. Though previous studies have evaluated the emissions and AQ impacts of different sectors, technologies and fuels, most previous studies have assessed emissions impacts only without using advanced atmospheric models to accurately account for both spatial and temporal emissions perturbations and atmospheric chemistry and transport. In addition, few previous studies have considered the integration of multiple technologies and fuels in different U.S. regions.. Finally, most studies do not project emissions several decades into the future to assess what sources should be targeted with priority over time. These aspects are critical for understanding how both emissions sources and potential mitigation strategies impact the formation and fate of primary and secondary pollutants, including ground-level ozone and particulate matter concentrations. Therefore, this work utilizes a set of modeling tools to project and then to spatially and temporally resolve emissions as input into a 3-D Eulerian AQ model to assess how sources of emissions contribute to future atmospheric pollutant burdens. Further, analyses of the potential impacts of alternative energy strategies contained in potential mitigation strategies are conducted for priority targets to develop an understanding of how to maximize AQ benefits and avoid unforeseen deleterious tradeoffs between GHG reduction and AQ. Findings include changes in the relative contribution to AQ that elevate the importance of addressing emissions from all sectors and sources including some that may be more difficult to control, including industry, petroleum refineries, and nonlight duty vehicle transportation sources. Additionally, mitigation strategies must consider the full range of life cycle and system effects in order to avoid AQ tradeoffs spatially and temporally.

Staying connected: online education engagement and retention using educational technology tools.

PubMed

Salazar, Jose

2010-01-01

The objective of this article is to inform educators about the use of currently available educational technology tools to promote student retention, engagement and interaction in online courses. Educational technology tools include content management systems, podcasts, video lecture capture technology and electronic discussion boards. Successful use of educational technology tools requires planning, organization and use of effective learning strategies.

Wellness Promotion Strategies. Selected Proceedings of the Annual National Wellness Conference (8th, Stevens Point, Wisconsin).

ERIC Educational Resources Information Center

Opatz, Joseph P., Ed.

A major concern to practitioners in the wellness movement has been the dearth of high quality up-to-date information about their field. This book provides a comprehensive and current look at the wellness field. Presentations in part 1 include: (1) "The History and Future of the Wellness Movement" (Donald B. Ardell); (2) "Presenting…

Pathways for Preparation: Locating Suicide Education in Preparing Professionals for Encounters with Suicidal Adolescents

ERIC Educational Resources Information Center

Ranahan, Patti

2013-01-01

Current suicide prevention strategies often include suicide education based on the premise that education can lead to recognition of those at risk of suicide and others who are prepared can respond and potentially save lives. As suicide is a leading cause of death for young people, it is relevant to explore how suicide education is made available…

Are Australian Universities Promoting Learning and Teaching Activity Effectively? An Assessment of the Effects on Science and Engineering Academics

ERIC Educational Resources Information Center

Cretchley, Patricia

2009-01-01

The Australian Federal Government and Australian universities have embarked on a bid to raise the profile of learning and teaching (L&T) in universities. Current strategies include increased funding of competitive grants for L&T projects, a wider range of teaching awards and fellowships and a controversial new national competitive Learning…

The Mother Centers in Germany--Empowerment Strategies for Community Women in Germany.

ERIC Educational Resources Information Center

Jaeckel, Monika

Mother Centers are a grassroots self-help movement in Germany that help stay-at-home mothers break through the isolation they experience in German society when they have children and are not available for full-time employment. There are about 300 mother center projects currently in Germany, including 40 in the former East Germany. The programs…