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Sample records for current uk practice

  1. Current UK practices in the management of subacromial impingement

    PubMed Central

    Drury, Colin; Tait, Gavin R

    2015-01-01

    Background Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. Methods BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Results Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Conclusions Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections. PMID:27582972

  2. Rehabilitation following rotator cuff repair: a survey of current UK practice

    PubMed Central

    Bateman, Marcus

    2015-01-01

    Background Rotator cuff disorders, including rotator cuff tears, are common and can be treated conservatively or surgically. Data suggest that the incidence of surgery to repair the rotator cuff is rising. Despite this rise, the most effective approach to postoperative rehabilitation, a critical component of the recovery process, is not well developed. The present study aimed to describe current practice in the UK in relation to rehabilitation following rotator cuff repair. Methods An electronic survey was developed and disseminated to UK based physiotherapists and surgeons involved with rotator cuff repair. Results One hundred valid responses were received. Although there is a degree of variation, current practice for the majority of respondents consists of sling immobilization for 4 weeks to 6 weeks. During this time, passive movement would be commenced before active movement is introduced towards the end of this phase. Resisted exercise begins 7 weeks to 12 weeks postoperatively, alongside return to light work. A progressive resumption of function, including manual work and sport, is advised from approximately 13 weeks. Conclusions In the context of the current literature, it might be suggested that the current approach to rehabilitation following rotator cuff repair for the majority of respondents is somewhat cautious and has not progressed for over a decade. PMID:27582979

  3. Survey of current practice in clinical transvaginal ultrasound scanning in the UK.

    PubMed

    Martin, Eleanor; Shaw, Adam; Lees, Christoph

    2015-08-01

    During transvaginal ultrasound scanning, the fetus and other sensitive tissues are placed close to the transducer. Heating of these tissues occurs by direct conduction from the transducer and by absorption of ultrasound in the tissue. The extent of any heating will depend on the equipment and settings used, the duration of the scan, imaging modes and other aspects of scanning practice. To ensure that scans are performed with minimum risk, staff should have an appropriate knowledge of safety and follow guidelines issued by professional bodies. An online survey aiming to document current practice in transvaginal ultrasound in the UK was created and distributed to individuals performing this type of scanning. The survey posed questions about the respondents, the departments where scans were performed, the equipment used, knowledge of ultrasound safety, scanning practice and the frequency, duration and mode of transvaginal ultrasound scans for gynaecology, obstetrics and fertility applications. In all, 294 responses were obtained, mostly from sonographers (94%). From the analysis of the responses, it was clear that there was a good understanding of the general meaning of thermal and mechanical index and high awareness of guidelines issued by professional bodies. However, 40% of respondents stated that they rarely or never monitor Thermal or Mechanical indices during scanning. Scanning practice was consistent in terms of the duration of scans, scan protocols followed and use of imaging modes. The results highlight the importance of continued ultrasound safety training and promotion of safety guidelines to users.

  4. The use of central venous cannulae in neuroanaesthesia. A survey of current practice in the UK.

    PubMed

    Mills, S J; Tomlinson, A A

    2001-05-01

    A postal questionnaire was sent to all UK consultant members of the Neuroanaesthesia Society to ascertain whether there was any consensus on indications for use and route of insertion of central venous cannulae in elective neuroanaesthetic practice. Five brief clinical scenarios were presented. Of 179 respondents, 98% indicated that they would insert a central venous cannula into patients requiring excision of an acoustic neuroma in the sitting position, 76% for clipping of an intracranial aneurysm and 75% for resection of an arteriovenous malformation. The antecubital fossa was the preferred route of insertion for 43.5% of respondents with 36.5% preferring the internal jugular approach. The subclavian (17%) and femoral (3%) routes were unpopular first-choice approaches. A significant proportion of respondents (43.5%) do not routinely order a chest X-ray at any stage following pre-operative central venous cannulation. The indications for use and advantages and disadvantages of each route of insertion, with reference to neuro-anaesthetic practice, are discussed. PMID:11350335

  5. Internationalization of U.K. University Business Schools: A Survey of Current Practice

    ERIC Educational Resources Information Center

    Bennett, Roger; Kane, Suzanne

    2011-01-01

    A questionnaire was sent to the heads of internationalization in the business schools of all U.K. universities. Sixty-five replies were received. The document covered, inter alia, the internationalization activities undertaken by the respondents' schools, the intensities with which internationalization had been implemented, motives for…

  6. Employer Co-Funded Training in the UK: Current Practice and Policy Considerations

    ERIC Educational Resources Information Center

    Thomas, Rhodri; Parsons, David; Barry, John; Rowe, Valerie

    2007-01-01

    Purpose: This paper sets out to examine the contribution of employer co-funding of publicly-funded vocational education and training in the UK (i.e. training initiatives that are available to all qualified applicants but funded jointly by the public and private sectors). Design/methodology/approach: The paper draws on qualitative research…

  7. Sperm storage for cancer patients in the UK: a review of current practice.

    PubMed

    Sharma, Vinay

    2011-11-01

    An increasing number of cancer patients can now hope to have a full and normal life due to significant improvements in treatment outcomes and survival rates. The application of cryobiology to store fertile gametes before sterilizing treatments has been a natural progression. Greater awareness has markedly increased the worldwide demand for long-term storage of sperm, and has prompted the UK Human Fertilization and Embryology Authority to extend the period of storage permitted by their regulations to 55 years. Other patients undergoing sterilizing chemotherapy and/or radiotherapy such as haemoglobinopathies requiring bone marrow transplantation and autoimmune disorders such as rheumatoid arthritis may further increase the indications for sperm storage. Most adult and adolescent patients and their relatives/spouses/parents/guardians value this service even though very few eventually use the sperm. There is an urgent need to develop national and international guidelines for the provision, organization, maintenance and management of the cryopreservation services.

  8. Developing new models of shared primary and specialist HIV care in the UK: a survey of current practice.

    PubMed

    Hutchinson, Jane; Sutcliffe, Loma J; Williams, Andy J; Estcourt, Claudia S

    2016-07-01

    HIV care in the UK is led by hospital-based specialists with limited general practitioner (GP) involvement. As GPs have expertise in some non-microbial HIV-associated co-morbidities (e.g. cardiovascular disease), and more people are disclosing their HIV status to their GPs, there could be benefits in sharing HIV care. We describe contemporary models of shared HIV care in relevant developed world settings to inform future shared HIV care in the UK. An interview survey of key informants was used to explore experiences and models of shared care, and identify promoting and inhibiting factors. We interviewed ten key informants from six shared care models. There were three broad categories of shared care, with varying degrees of GP involvement. Strong clinical leadership in primary care, good professional relationships and communication, and tailored GP training were facilitators. Barriers included stigma, confidentiality concerns, and low prevalence of HIV outside major conurbations. Contemporary shared HIV care models have emerged organically and seem to work when grounded in good collaboration between a small number of dedicated GPs and specialist units. We propose two models for further study which may only be feasible in high HIV caseload practices. User acceptability, clinical and cost effectiveness must be considered.

  9. Knowledge Exchange between Universities and the Creative Industries in the UK: A Case Study of Current Practice

    ERIC Educational Resources Information Center

    Ferguson, Morag

    2014-01-01

    The importance to the economy of knowledge exchange between universities and industry has long been recognized, and in the UK a number of initiatives are in place to support such activities. These initiatives have helped to stimulate engagement between universities and the creative industries, a sector of increasing importance to the UK economy.…

  10. How long should patients be followed-up after total hip replacement? Current practice in the UK.

    PubMed

    Bankes, M J; Coull, R; Ferris, B D

    1999-09-01

    Some 1000 postcard questionnaires were sent to Fellows of the British Orthopaedic Association (BOA) to establish current follow-up practice of primary total hip replacement (THR) patients. For cemented THRs, 50% of surgeons saw their patients for under 1 year, 78% under 5 years with indefinite follow-up being performed by 14%. There was significantly more follow-up of uncemented and hybrid prostheses with the proportions being 25%, 56% and 30% respectively (chi 2, P < 0.0001). This study has revealed a wide variation in practice between individual surgeons and has shown over one-third of surgeons feel they are prevented from performing as much follow-up as they would wish by the availability of clinic resources. Higher follow-up rates of uncemented components may reflect a lack of confidence in their long-term performance.

  11. Leadership Practices in German and UK Organisations

    ERIC Educational Resources Information Center

    McCarthy, Grace

    2005-01-01

    Purpose: The aim of this research was to determine whether leadership practices vary between German and UK organisations. Design/methodology/approach: The author used self-assessment documents submitted by German and UK organisations to the European Foundation for Quality Management (EFQM), to identify leadership practices in both countries. A…

  12. Post-trauma support in the workplace: the current status and practice of critical incident stress management (CISM) and psychological debriefing (PD) within organizations in the UK.

    PubMed

    Regel, Stephen

    2007-09-01

    Employers' duties of care under both common and statute law include the need to take reasonable care of the health and safety of the workforce. This includes both the moral and legal duties to consider the psychological needs of personnel following exposure to traumatic events related to the workplace. While this has been recognized within many high-risk occupations such the police, fire and rescue services and the military, there is also evidence that post-trauma support in the workplace is increasingly commonly provided not only among health and social services agencies, but within many private sector organizations. Over the past decade, however, there has been considerable controversy over the provision of early psychological support to personnel in the form of critical incident stress management (CISM) processes. In particular, one aspect of CISM, the use of psychological debriefing (PD) has come under scrutiny and criticism as two studies indicated that PD was ineffective and had the potential to do harm. Inevitably, this has provoked much uncertainty and confusion among some organizations as what should be the most appropriate support. It has also led to misconceptions and misunderstandings as to the aims and purpose of PD, together with inaccuracies of terminology, for example describing PD as 'counselling'. Despite the controversy, both CISM and PD continue to be provided on a widespread basis, often utilizing a framework of voluntary peer group support. This paper intends to (i) present a review of the current status of CISM practices, including the use of PD within various organizations in the UK and (ii) provide a clear framework and understanding of the main issues and to clarify conceptual misunderstandings. The history, principles and background of the use of post-trauma support in the workplace, charting trends over the past two decades, previous research, problems with the evidence base and current thinking and practice in the field are reviewed

  13. Post-trauma support in the workplace: the current status and practice of critical incident stress management (CISM) and psychological debriefing (PD) within organizations in the UK.

    PubMed

    Regel, Stephen

    2007-09-01

    Employers' duties of care under both common and statute law include the need to take reasonable care of the health and safety of the workforce. This includes both the moral and legal duties to consider the psychological needs of personnel following exposure to traumatic events related to the workplace. While this has been recognized within many high-risk occupations such the police, fire and rescue services and the military, there is also evidence that post-trauma support in the workplace is increasingly commonly provided not only among health and social services agencies, but within many private sector organizations. Over the past decade, however, there has been considerable controversy over the provision of early psychological support to personnel in the form of critical incident stress management (CISM) processes. In particular, one aspect of CISM, the use of psychological debriefing (PD) has come under scrutiny and criticism as two studies indicated that PD was ineffective and had the potential to do harm. Inevitably, this has provoked much uncertainty and confusion among some organizations as what should be the most appropriate support. It has also led to misconceptions and misunderstandings as to the aims and purpose of PD, together with inaccuracies of terminology, for example describing PD as 'counselling'. Despite the controversy, both CISM and PD continue to be provided on a widespread basis, often utilizing a framework of voluntary peer group support. This paper intends to (i) present a review of the current status of CISM practices, including the use of PD within various organizations in the UK and (ii) provide a clear framework and understanding of the main issues and to clarify conceptual misunderstandings. The history, principles and background of the use of post-trauma support in the workplace, charting trends over the past two decades, previous research, problems with the evidence base and current thinking and practice in the field are reviewed

  14. Tuberculosis screening in patients with HIV: An audit against UK national guidelines to assess current practice and the effectiveness of an electronic tuberculosis-screening prompt.

    PubMed

    Fox-Lewis, A; Brima, N; Muniina, P; Grant, A D; Edwards, S G; Miller, R F; Pett, S L

    2016-09-01

    A retrospective clinical audit was performed to assess if the British HIV Association 2011 guidelines on routine screening for tuberculosis in HIV are being implemented in a large UK urban clinic, and if a tuberculosis-screening prompt on the electronic patient record for new attendees was effective. Of 4658 patients attending during the inclusion period, 385 were newly diagnosed first-time attendees and routine tuberculosis screening was recommended in 165. Of these, only 6.1% of patients had a completed tuberculosis screening prompt, and 12.1% underwent routine tuberculosis screening. This audit represents the first published UK data on routine screening rates for tuberculosis in HIV and demonstrates low rates of tuberculosis screening despite an electronic screening prompt designed to simplify adherence to the national guideline. Reasons why tuberculosis screening rates were low, and the prompt ineffective, are unclear. A national audit is ongoing, and we await the results to see if our data reflect a lack of routine tuberculosis screening in HIV-infected patients at a national level.

  15. Use of small bowel imaging for the diagnosis and staging of Crohn’s disease—a survey of current UK practice

    PubMed Central

    Hafeez, R; Greenhalgh, R; Rajan, J; Bloom, S; McCartney, S; Halligan, S; Taylor, S A

    2011-01-01

    Objectives This study used a postal survey to assess the current use of small bowel imaging investigations for Crohn’s disease within National Health Service (NHS) radiological practice and to gauge gastroenterological referral patterns. Methods Similar questionnaires were posted to departments of radiology (n = 240) and gastroenterology (n = 254) identified, by the databases of the Royal College of Radiologists and British Society of Gastroenterologists. Questionnaires enquired about the use of small bowel imaging in the assessment of Crohn’s disease. In particular, questionnaires described clinical scenarios including first diagnosis, disease staging and assessment of suspected extraluminal complications, obstruction and disease flare. The data were stratified according to patient age. Results 63 (27%) departments of radiology (20 in teaching hospitals and 43 in district general hospitals (DGHs)) and 73 (29%) departments of gastroenterology replied. These departments were in 119 institutions. Of the 63 departments of radiology, 55 (90%) routinely performed barium follow-though (BaFT), 50 (80%) CT, 29 (46%) small bowel ultrasound (SbUS) and 24 (38%) small bowel MRI. BaFT was the most commonly used investigation across all age groups and indications. SbUS was used mostly for patients younger than 40 years of age with low index of clinical suspicion for Crohn’s disease (in 44% of radiology departments (28/63)). MRI was most frequently used in patients under 20 years of age for staging new disease (in 27% of radiology departments (17/63)) or in whom obstruction was suspected (in 29% of radiology departments (18/63)). CT was preferred for suspected extraluminal complications or obstruction (in 73% (46/63) and 46% (29/63) of radiology departments, respectively). Gastroenterological referrals largely concurred with the imaging modalities chosen by radiologists, although gastroenterologists were less likely to request SbUS and MRI. Conclusion BaFT remains the

  16. Learning the law: practical proposals for UK medical education.

    PubMed

    Margetts, J K

    2016-02-01

    Ongoing serious breaches in medical professionalism might be avoided if UK doctors rethink their approach to law. UK medical education has a role in creating a climate of change by re-examining how law is taught to medical students. Adopting a more insightful approach in the UK to the impact of The Human Rights Act and learning to manipulate legal concepts, such as conflict of interest, need to be taught to medical students now if UK doctors are to manage complex decision-making in the NHS of the future. The literature is reviewed from a unique personal perspective of a doctor and lawyer, and practical proposals for developing medical education in law in the UK are suggested.

  17. Developing Competence Frameworks in UK Healthcare: Lessons from Practice

    ERIC Educational Resources Information Center

    Mitchell, Lindsay; Boak, George

    2009-01-01

    Purpose: The purpose of this article is to review the use of competence frameworks in the UK healthcare sector and to explore characteristics of the sector that may influence the success of projects to develop new frameworks. Design/methodology/approach: The paper draws on project reports and evaluations of practice in a range of recent projects…

  18. Current management of Paget-Schroetter syndrome in the UK.

    PubMed Central

    Khan, Shaukat N.; Stansby, Gerard

    2004-01-01

    INTRODUCTION: Untreated symptomatic patients with Paget-Schroetter syndrome (PSS) can sustain chronic disability from venous obstruction, with arm swelling, pain and early exercise fatigue. This may result in significant loss of occupational productivity and quality of life. For this reason, active management is recommended in the majority of the recent literature. The objective of the this study was to assess current trends of management of PSS in the UK. METHODS: A 9-part questionnaire was sent to 90 ordinary members of the Vascular Surgical Society of Great Britain and Ireland (VSS-GBI). Names and addresses were selected by highlighting every fourth ordinary member from the UK, in the 2000 VSS-GBI handbook. Ordinary members of the VSS-GBI who were clearly radiologists were excluded. RESULTS: Of the 90 questionnaires sent, 60 were returned (66.67%). The majority of respondents used both duplex and venography (61%) as the major investigative tools though some employed duplex only (17%). Multimodality treatment (radiological and operative) was the favoured approach. Only 17% still favoured conservative management alone. Thrombolysis was the most common intervention (86.7%) usually followed by elective thoracic outlet decompression. Most favoured a delayed approach for surgery of 6-12 weeks. First rib resection was the most commonly performed operation (58%), usually by the transaxillary approach (55%). Most of the respondents were doubtful of the role of stenting in this condition and did not use it. CONCLUSIONS: There is no definite consensus on treatment of this condition in the UK. A majority tend to favour a multimodal approach. Thrombolysis is the most common form of treatment employed and first rib resection via the transaxillary approach remains the most popular surgical procedure. The lack of consensus of this potentially disabling condition highlights the need for randomised clinical trials to guide management. PMID:15005942

  19. Smartphone Applications for the Clinical Oncologist in UK Practice.

    PubMed

    Rozati, Hamoun; Shah, Sonya Pratik; Shah, Neha

    2015-06-01

    A number of medical smartphone applications have been developed to assist clinical oncology specialists. Concerns have arisen that the information provided may not be under sufficient scrutiny. This study aims to analyse the current applications available for clinical oncologists in the UK. Applications aimed specifically at physician clinical oncologists were searched for on the major smartphone operating systems: Apple iOS; Google Android; Microsoft Windows OS; and Blackberry OS. All applications were installed and analysed. The applications were scrutinised to assess the following information: cost; whether the information included was referenced; when the information was last updated; and whether they made any reference to UK guidelines. A novel rating score based on these criteria was applied to each application. Fifty applications were identified: 24 for Apple's iOS; 23 for Google's Android; 2 for Blackberry OS; and 1 for Windows OS. The categories of applications available were: drug reference; journal reference; learning; clinical calculators; decision support; guidelines; and dictionaries. Journal reference and guideline applications scored highly on our rating system. Drug reference application costs were prohibitive. Learning tools were poorly referenced and not up-to-date. Smartphones provide easy access to information. There are numerous applications devoted to oncology physicians, many of which are free and contain referenced, up-to-date data. The cost and quality of drug reference and learning applications have significant scope for improvement. A regulatory body is needed to ensure the presence of peer-reviewed, validated applications to ensure their reliability. PMID:24903139

  20. The challenges of communicating research evidence in practice: perspectives from UK health visitors and practice nurses

    PubMed Central

    2013-01-01

    Background Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice. Methods A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data. Results The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task. Conclusions If health practitioners are to be effective at communicating research evidence, we suggest that more research

  1. Staffing UK University Campuses Overseas: Lessons from MNE Practice

    ERIC Educational Resources Information Center

    Salt, John; Wood, Peter

    2014-01-01

    This article suggests that as their internal labor markets become more multinational in scope, UK universities may acquire similar staffing characteristics to commercial multinational enterprises (MNEs). Comparing evidence from four UK universities with several surveys of MNEs it concludes that, although there are broad similarities in the…

  2. Air quality management: evolution of policy and practice in the UK as exemplified by the experience of English local government

    NASA Astrophysics Data System (ADS)

    Beattie, C. I.; Longhurst, J. W. S.; Woodfield, N. K.

    The air quality management (AQM) framework in the UK is designed to be an effects-based solution to air pollutants currently affecting human health. The AQM process has been legislated through The Environment Act 1995, which required the National Air Quality Strategy (NAQS) to be published. AQM practice and capability within local authorities has flourished since the publication of the NAQS in March 1997. This paper outlines the policy framework within which the UK operates, both at a domestic and European level, and reviews the air quality management process relating to current UK policy and EU policy. Data from questionnaire surveys are used to indicate the involvement of various sectors of local government in the air quality management process. These data indicate an increasing use of monitoring, and use of air dispersion modelling by English local authorities. Data relating to the management of air quality, for example, the existence and work of air quality groups, dissemination of information to the public and policy measures in place on a local scale to improve air quality, have also been reported. The UK NAQS has been reviewed in 1999 to reflect developments in European legislation, technological and scientific advances, improved air pollution modelling techniques and an increasingly better understanding of the socio-economic issues involved. The AQM process, as implemented by UK local authorities, provides an effective model for other European member states with regards to the implementation of the Air Quality Framework Directive. The future direction of air quality policy in the UK is also discussed.

  3. The current status of the UK-FMOS spectrograph

    NASA Astrophysics Data System (ADS)

    Tosh, Ian A.; Woodhouse, Guy F.; Froud, Tim; Dowell, Allan; Patel, Mukesh; Wallner, Mattias; Lewis, Ian J.; Dalton, Gavin B.; Holmes, Alan; Brooks, Barney; Band, Cyril; Bonfield, David G.; Murray, Graham J.; Robertson, David J.; Dipper, Nigel A.

    2004-09-01

    FMOS is a near-IR OH-suppressed multi-fibre fed spectrograph for the Subaru telescope. The spectrograph will accept 200 optical fibres from the ECHIDNA positioner system at the 30arcmin Prime focus of the telescope. We will describe the recent activities here in the UK in progressing the instrument from its conceptual phase through detailed design and into manufacture. A variety of technical areas will be described including: the opto-mechanical system design and construction, development of the HAWAII-II detector control system, the thermal system design & control and OH suppression techniques.

  4. Tuberculosis screening of migrants to low-burden nations: insights from evaluation of UK practice.

    PubMed

    Pareek, M; Abubakar, I; White, P J; Garnett, G P; Lalvani, A

    2011-05-01

    Tuberculosis (TB) primarily occurs in the foreign-born in European countries, such as the UK, where increasing notifications and the high proportion of foreign-born cases has refocused attention on immigrant (new entrant) screening. We investigated how UK primary care organisations (PCOs) screen new entrants and whether this differs according to TB burden in the PCOs (incidence < 20 or ≥ 20 cases per 100,000 per annum). An anonymous, 20-point questionnaire was sent to all 192 UK PCOs asking which new entrants are screened, who is screened for active TB/latent TB infection (LTBI) and the methods used. Descriptive analyses were undertaken. Categorical responses were compared using the Chi-squared test. 177 (92.2%) out of 192 PCOs responded; all undertook screening action in response to abnormal chest radiographs, but only 107 (60.4%) screened new entrants for LTBI. Few new entrants had active TB diagnosed (median 0.0%, interquartile range (IQR) 0.0-0.5%) but more were identified with LTBI (median 7.85%, IQR 4.30-13.50%). High-burden PCOs were significantly less likely to screen new entrants for LTBI (OR 0.26, 95% CI 0.12-0.54; p<0.0001). Among PCOs screening for LTBI, there was substantial deviation from national guidance in selection of new entrant subgroups and screening method. Considerable heterogeneity and deviation from national guidance exist throughout the UK new entrant screening process, with high-burden regions undertaking the least screening. Forming an accurate picture of current front-line practice will help to inform future development of European new entrant screening policy.

  5. Air gun wounding and current UK laws controlling air weapons.

    PubMed

    Bruce-Chwatt, Robert Michael

    2010-04-01

    Air weapons whether rifles or pistols are, potentially, lethal weapons. The UK legislation is complex and yet little known to the public. Hunting with air weapons and the laws controlling those animals that are permitted to be shot with air weapons is even more labyrinthine due to the legal power limitations on the possession of air weapons. Still relatively freely available by mail order or on the Internet, an increasing number of deaths have been reported from the misuse of air weapons or accidental discharges. Ammunition for air weapons has become increasingly sophisticated, effective and therefore increasingly dangerous if misused, though freely available being a mere projectile without a concomitant cartridge containing a propellant and an initiator.

  6. Domestic violence: knowledge, attitudes, and clinical practice of selected UK primary healthcare clinicians

    PubMed Central

    Ramsay, Jean; Rutterford, Clare; Gregory, Alison; Dunne, Danielle; Eldridge, Sandra; Sharp, Debbie; Feder, Gene

    2012-01-01

    Background Domestic violence affects one in four women and has significant health consequences. Women experiencing abuse identify doctors and other health professionals as potential sources of support. Primary care clinicians agree that domestic violence is a healthcare issue but have been reluctant to ask women if they are experiencing abuse. Aim To measure selected UK primary care clinicians’ current levels of knowledge, attitudes, and clinical skills in this area. Design and setting Prospective observational cohort in 48 general practices from Hackney in London and Bristol, UK. Method Administration of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), comprising five sections: responder profile, background (perceived preparation and knowledge), actual knowledge, opinions, and practice issues. Results Two hundred and seventy-two (59%) clinicians responded. Minimal previous domestic violence training was reported by participants. Clinicians only had basic knowledge about domestic violence but expressed a positive attitude towards engaging with women experiencing abuse. Many clinicians felt poorly prepared to ask relevant questions about domestic violence or to make appropriate referrals if abuse was disclosed. Forty per cent of participants never or seldom asked about abuse when a woman presented with injuries. Eighty per cent said that they did not have an adequate knowledge of local domestic violence resources. GPs were better prepared and more knowledgeable than practice nurses; they also identified a higher number of domestic violence cases. Conclusion Primary care clinicians’ attitudes towards women experiencing domestic violence are generally positive but they only have basic knowledge of the area. Both GPs and practice nurses need more comprehensive training on assessment and intervention, including the availability of local domestic violence services. PMID:22947586

  7. Ensuring reliability in UK written tests of general practice: the MRCGP examination 1998-2003.

    PubMed

    Munro, Neil; Denney, Mei Ling; Rughani, Amar; Foulkes, John; Wilson, Andrew; Tate, Peter

    2005-01-01

    Reliability in written examinations is taken very seriously by examination boards and candidates alike. Within general education many factors influence reliability including variations between markers, within markers, within candidates and within teachers. Mechanisms designed to overcome, or at least minimize, the impact of such variables are detailed. Methods of establishing reliability are also explored in the context of a range of assessment situations. In written tests of general practice within the Membership of the Royal College of General Practitioner (MRCGP) examination considerable effort has put been put into achieving acceptable levels of reliability. Current mechanisms designed to ensure high reliability are described and related to the evolution of the written component of the examination. In addition to description of marker selection and training, question development including construct a detailed example of specific and generic marking schedules is provided. Examination results for the Written Paper of the MRCGP from 1998 to 2003 are reported including Cronbach's alpha coefficients and standard error of measurements, mean scores (and SD) and pass rates. In addition individual discrimination scores for each question in the October 2002 paper are shown. Consistent high reliability of the written component of the MRCGP examination provides valuable lessons in terms of selection, training and monitoring of markers as well as practical methods of moderating factors affecting candidate variability. The challenge for examination developers is to carry these important lessons forward into a modernized assessment structure of UK general practice. PMID:16147769

  8. Practical microbiology in schools: a survey of UK teachers.

    PubMed

    Redfern, James; Burdass, Dariel; Verran, Joanna

    2013-11-01

    A survey of secondary school teachers investigated practical microbiology in the classroom. The results were heartening (practical microbiology was common), but concerns were expressed regarding equipment, time, cost, and expertise. Microbiologists should engage more with school education to support teachers and maintain the health of microbiology for future generations.

  9. Current Practice of Duodenoscope Reprocessing.

    PubMed

    Kim, Stephen; Muthusamy, V Raman

    2016-10-01

    Numerous outbreaks of duodenoscope-associated transmission of multi-drug resistant bacteria have recently been reported. Unlike prior episodes of endoscope-transmitted infections, the latest outbreaks have occurred despite strict adherence to duodenoscope reprocessing guidelines. The current standard for all flexible endoscope reprocessing includes pre-cleaning, leak testing, an additional manual cleaning step, and high-level disinfection. When these steps are strictly followed, the risk of infection transmission during endoscopy is exceedingly rare. However, due to its complex design, the duodenoscope may not be able to be adequately disinfected using the current reprocessing standards. Supplemental measures to enhance scope reprocessing have subsequently been recommended to reduce the infection risk in patients undergoing endoscopic retrograde cholangiopancreatography. These methods are likely short-term solutions that have yet to be validated regarded their effectiveness. Additional approaches to monitor the quality of duodenoscope reprocessing may also be useful. Ultimately, a definitive, yet logistically feasible, method of duodenoscope reprocessing is required to ensure the safety of our patients. PMID:27595583

  10. Gypsy, Roma and Traveller Pupils in Schools in the UK: Inclusion and "Good Practice"

    ERIC Educational Resources Information Center

    Bhopal, Kalwant; Myers, Martin

    2009-01-01

    This paper examines inclusionary processes and examples of "good practice" in primary and secondary schools for Gypsy, Roma and Traveller pupils in one inner London Borough in the UK. It will explore the role of the Traveller Education Service (TES) and argue that the support provided by the TES to schools is essential for the development of "good…

  11. Evaluation, or Just Data Collection? An Exploration of the Evaluation Practice of Selected UK Environmental Educators

    ERIC Educational Resources Information Center

    West, Sarah Elizabeth

    2015-01-01

    Little is known about the evaluation practices of environmental educators. Questionnaires and discussion groups with a convenience sample of UK-based practitioners were used to uncover their evaluation methods. Although many report that they are evaluating regularly, this is mainly monitoring numbers of participants or an assessment of enjoyment.…

  12. Broken Voices or a Broken Curriculum? The Impact of Research on UK School Choral Practice with Boys

    ERIC Educational Resources Information Center

    Ashley, Martin R.

    2013-01-01

    Work such as that of John Cooksey on boys' changing voices has influenced choral practice in the USA and in certain UK youth choirs, but has hitherto had little impact in UK schools where many teachers continue to believe that boys' voices "break". Different practices are found across the independent and maintained sectors of…

  13. Proofreading in a UK University: Proofreaders' Beliefs, Practices, and Experiences

    ERIC Educational Resources Information Center

    Harwood, Nigel; Austin, Liz; Macaulay, Rowena

    2009-01-01

    This article presents key findings from an interview-based study of the beliefs, practices, and experiences of 16 proofreaders of student writing in a university setting. "Proofreading" is defined for the purposes of this research as "third-party interventions (entailing written alteration) on assessed work in progress." We report results relating…

  14. Language Practices and Language Management in a UK Yemeni Community

    ERIC Educational Resources Information Center

    Ferguson, Gibson Ronald

    2013-01-01

    Through observation, questionnaires and, particularly, ethnographic interviews with parents, pupils, teachers and community organisers associated with a Yemeni complementary school, this paper develops a portrait of language repertoires, practices and preferences in a Yemeni diasporic community in a northern English city. Also investigated are the…

  15. Manufacture and use of nanomaterials: current status in the UK and global trends.

    PubMed

    Aitken, R J; Chaudhry, M Q; Boxall, A B A; Hull, M

    2006-08-01

    This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.

  16. Air pollution control residues from waste incineration: current UK situation and assessment of alternative technologies.

    PubMed

    Rani, D Amutha; Boccaccini, A R; Deegan, D; Cheeseman, C R

    2008-11-01

    Current disposal options for APC residues in the UK and alternative treatment technologies developed world-wide have been reviewed. APC residues are currently landfilled in the UK where they undergo in situ solidification, although the future acceptability of this option is uncertain because the EU waste acceptance criteria (WAC) introduce strict limits on leaching that are difficult to achieve. Other APC residue treatment processes have been developed which are reported to reduce leaching to below relevant regulatory limits. The Ferrox process, the VKI process, the WES-PHix process, stabilisation/solidification using cementitious binders and a range of thermal treatment processes are reviewed. Thermal treatment technologies convert APC residues combined with other wastes into inert glass or glass-ceramics that encapsulate heavy metals. The waste management industry will inevitably use the cheapest available option for treating APC residues and strict interpretation and enforcement of waste legislation is required if new, potentially more sustainable technologies are to become commercially viable.

  17. Integrating Radiology and Anatomy Teaching in Medical Education in the UK--The Evidence, Current Trends, and Future Scope.

    PubMed

    Heptonstall, N B; Ali, T; Mankad, K

    2016-04-01

    This review article presents the current evidence of the importance of integrating radiology and anatomy in medical education in the UK, a recommendation by a number of key anatomy, education, and radiology organizations. Current evidence highlights that on average only 5% of total teaching time in medical education is dedicated to radiology. Often, radiology teaching does not adequately fulfill students' learning needs and potentially leaves them underprepared for medical practice. Benefits of integrating radiology and anatomy include improved clinical application of anatomy, an increase in student's interest in anatomy, and ultimately improved radiological interpretation. Various modalities exist for the integration of radiology and anatomy, facilitated by the vast portability of radiological images. It appears that combining radiological resources with traditional anatomy teaching methodology in a blended approach is most beneficial. PMID:26970390

  18. Survey of Oxygen Delivery Practices in UK Paediatric Intensive Care Units

    PubMed Central

    Peters, Mark J.

    2016-01-01

    Purpose. Administration of supplemental oxygen is common in paediatric intensive care. We explored the current practice of oxygen administration using a case vignette in paediatric intensive care units (PICU) in the united kingdom. Methods. We conducted an online survey of Paediatric Intensive Care Society members in the UK. The survey outlined a clinical scenario followed by questions on oxygenation targets for 5 common diagnoses seen in critically ill children. Results. Fifty-three paediatric intensive care unit members from 10 institutions completed the survey. In a child with moderate ventilatory requirements, 21 respondents (42%) did not follow arterial partial pressure of oxygen (PaO2) targets. In acute respiratory distress syndrome, cardiac arrest, and sepsis, there was a trend to aim for lower PaO2 as the fraction of inspired oxygen (FiO2) increased. Conversely, in traumatic brain injury and pulmonary hypertension, respondents aimed for normal PaO2 even as the FiO2 increased. Conclusions. In this sample of clinicians PaO2 targets were not commonly used. Clinicians target lower PaO2 as FiO2 increases in acute respiratory distress syndrome, cardiac arrest, and sepsis whilst targeting normal range irrespective of FiO2 in traumatic brain injury and pulmonary hypertension. PMID:27516901

  19. Group Therapy for School-Aged Children Who Stutter: A Survey of Current Practices

    ERIC Educational Resources Information Center

    Liddle, Hilary; James, Sarah; Hardman, Margaret

    2011-01-01

    Although group therapy is recommended for school-aged children who stutter (CWS), it is not widely researched. This study aimed to explore this provision, using a postal survey which investigated the current practices of Speech & Language Therapists (SLTs) in the UK. Seventy percent of SLT services provided some group therapy, but the level of…

  20. Current and future perspectives on lumbar degenerative disc disease: a UK survey exploring specialist multidisciplinary clinical opinion

    PubMed Central

    McGregor, Alison H

    2016-01-01

    Objectives Despite lumbar degenerative disc disease (LDDD) being significantly associated with non-specific low back pain and effective treatment remaining elusive, specialist multidisciplinary clinical stakeholder opinion remains unexplored. The present study examines the views of such experts. Design A reliable and valid electronic survey was designed to establish trends using theoretical constructs relating to current assessment and management practices. Clinicians from the Society of Back Pain Research (SBPR) UK were invited to take part. Quantitative data were collated and coded using Bristol Online Surveys (BOS) software, and content analysis was used to systematically code and categorise qualitative data. Setting Specialist multidisciplinary spinal interest group in the UK. Participants 38/141 clinically active, multidisciplinary SBPR members with specialist spinal interest participated. Among them, 84% had >9 years postgraduate clinical experience. Interventions None. Outcome measures Frequency distributions were used to establish general trends in quantitative data. Qualitative responses were coded and categorised in relation to each theme and percentage responses were calculated. Results LDDD symptom recurrence, in the absence of psychosocial influence, was associated with physical signs of joint stiffness (26%), weakness (17%) and joint hypermobility (6%), while physical factors (21%) and the ability to adapt (11%) were postulated as reasons why some experience pain and others do not. No one management strategy was supported exclusively or with consensus. Regarding effective modalities, there was no significant difference between allied health professional and medic responses (p=0.1–0.8). The future of LDDD care was expressed in terms of improvements in patient communication (35%), patient education (38%) and treatment stratification (24%). Conclusions Results suggest that multidisciplinary expert spinal clinicians appear to follow UK

  1. "Teamwork" or "Working as a Team"? The Theory and Practice of Top Team Working in UK Higher Education

    ERIC Educational Resources Information Center

    Woodfield, Steve; Kennie, Tom

    2008-01-01

    This article focuses on the theory and practice of teamwork in "top management teams" in UK higher education institutions. It is informed by some of the key findings from a recent two-year research project sponsored by the Leadership Foundation for Higher Education that investigated the different ways in which UK higher education institutions…

  2. Perceived future career prospects in general practice: quantitative results from questionnaire surveys of UK doctors

    PubMed Central

    Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

    2016-01-01

    Background There are more studies of current job satisfaction among GPs than of their views about their future career prospects, although both are relevant to commitment to careers in general practice. Aim To report on the views of GPs compared with clinicians in other specialties about their future career prospects. Design and setting Questionnaire surveys were sent to UK medical doctors who graduated in selected years between 1974 and 2008. Method Questionnaires were sent to the doctors at different times after graduation, ranging from 3 to 24 years. Results Based on the latest survey of each graduation year of the 20 940 responders, 66.2% of GPs and 74.2% of hospital doctors were positive about their prospects and 9.7% and 8.3%, respectively, were negative. However, with increasing time since graduation and increasing levels of seniority, GPs became less positive about their prospects; by contrast, over time, surgeons became more positive. Three to 5 years after graduation, 86.3% of those training in general practice were positive about their prospects compared with 52.9% of surgical trainees: in surveys conducted 12–24 years after graduation, 60.2% of GPs and 76.6% of surgeons were positive about their prospects. Conclusion GPs held broadly positive views of their career prospects, as did other doctors. However, there was an increase in negativity with increasing time since graduation that was not seen in hospital doctors. Research into the causes of this negativity and policy measures to ameliorate it would contribute to the continued commitment of GPs and may help to reduce attrition. PMID:27578813

  3. A medico-legal review of some current UK guidelines in orthodontics: a personal view.

    PubMed

    Jones, J W

    1999-12-01

    This article is a critical analysis from a medico-legal perspective of some current authoritative UK clinical guidelines in orthodontics. Two clinical guidelines have been produced by the Royal College of Surgeons of England and four by the British Orthodontic Society. Each guideline is published with the analysis immediately following it. Following recent UK case law (Bolitho v City & Hackney Health Authority, 1997) which allows the courts to choose between two bodies of responsible expert medical opinion where they feel one opinion is not 'logical', it is likely that the UK courts will increasingly turn to authoritative clinical guidelines to assist them in judging whether or not an appropriate standard of care has been achieved in medical negligence cases. It is thus important for clinicians to be aware of the recommendations of such guidelines, and if these are not followed the reasons should be discussed with the patient and recorded in the clinical case notes. This article attempts to highlight aspects of the guidelines that have medico-legal implications.

  4. Fever management: Evidence vs current practice

    PubMed Central

    El-Radhi, A Sahib Mehdi

    2012-01-01

    Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department. Parents are concerned about fever and it’s potential complications. The biological value of fever (i.e., whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures. The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence. There is still a significant contrast between the current concept and practice, and the scientific evidence. Why is that the case in such a common complaint like fever The article will discuss the significant contrast between the current concepts and practice of fever management on one hand, and the scientific evidence against such concepts and practice. PMID:25254165

  5. Current economic trends in equine practice.

    PubMed

    Clark, Andrew R

    2009-12-01

    Current economic trends in equine practice are trends of weakness. Most practices, after a decade of double-digit growth, have migrated to survival mode within a few months. Understanding that all regions and disciplines are affected differently, using the Porter five forces model, we can identify changes that must be made in our business models first to survive and then to position ourselves to prosper when the recession ends. If we are to avoid long-term damage to our practices, we must use cost control and work efficiency in addition to price concessions. PMID:19945636

  6. Current economic trends in equine practice.

    PubMed

    Clark, Andrew R

    2009-12-01

    Current economic trends in equine practice are trends of weakness. Most practices, after a decade of double-digit growth, have migrated to survival mode within a few months. Understanding that all regions and disciplines are affected differently, using the Porter five forces model, we can identify changes that must be made in our business models first to survive and then to position ourselves to prosper when the recession ends. If we are to avoid long-term damage to our practices, we must use cost control and work efficiency in addition to price concessions.

  7. Modifying delinquent behavior: beginnings and current practices.

    PubMed

    Stumphauzer, J S

    1976-01-01

    The beginnings of behavior therapy with delinquents are traced to the early 1960's when a number of case studies and demonstration projects were first presented. Current practices are reviewed in more detail. In institutions for delinquents, many token economies have gradually developed; their shortcomings and results are discussed. In clinic settings, several individual and group techniques are reviewed as they are currently practiced. A major trend is seen as being away from institutional and traditional clinic behavior therapy. Direct community intervention is seen as the most parsimonious mode for modifying and preventing delinquent behavior, and several model programs are described.

  8. Percutaneous coronary intervention in the UK: recommendations for good practice 2015

    PubMed Central

    Banning, Adrian P; Baumbach, Andreas; Blackman, Dan; Curzen, Nick; Devadathan, Sen; Fraser, Douglas; Ludman, Peter; Norell, Micheal; Muir, Dougie; Nolan, James; Redwood, Simon

    2015-01-01

    Over the last 35 years, there has been dramatic progress in the technology and applicability of percutaneous techniques to treat obstructive coronary heart disease. Percutaneous coronary intervention (PCI) has a considerable evidence base and it is firmly established as the most common procedure used in the invasive treatment of patients with coronary heart disease in the UK. This set of guidelines aims to address specifically issues relating to PCI and not the growing subspecialty of structural heart disease intervention. It is not intended to provide a review of the entire evidence base for coronary intervention. The evidence base relating to PCI is extensively reviewed in international guidelines and the British Cardiovascular Intervention society endorses these guidelines and their updates. The guidelines presented here focus on issues pertinent to practice within the UK and set out a recommended template to ensure optimal delivery of patient care. PMID:26041756

  9. Current Practices in Resident Assistant Training

    ERIC Educational Resources Information Center

    Koch, Virginia Albaneso

    2016-01-01

    Developing resident assistant (RA) training is a challenge for most housing and residence life staff. Grounded in the author's doctoral research on the curricular design of RA training programs, this study summarizes current practices in three types of RA training programs--preservice training, in-service training, and academic courses--and…

  10. How Advertising History Helps Explain Current Practices.

    ERIC Educational Resources Information Center

    Lanfranco, Leonard W.

    Students majoring in advertising can benefit from a study of that field in its historical context because such study helps them to understand current practices and to foresee future developments. One model of teaching advertising history within a required course about advertising and society begins with some basic definitions of the advertising…

  11. Thymomas: Review of Current Clinical Practice

    PubMed Central

    Tomaszek, Sandra; Wigle, Dennis A.; Keshavjee, Shaf; Fischer, Stefan

    2010-01-01

    Thymomas are the most common tumors of the mediastinum. The introduction of multimodality treatment strategies, as well as novel approaches to the diagnosis of these tumors, has led to changes in the clinical management of thymomas. Here we review the literature for current clinical practice in the diagnosis, management, and treatment of thymomas. PMID:19463649

  12. CURRENT PRACTICES IN QSAR DEVELOPMENT AND APPLICATIONS

    EPA Science Inventory

    Current Practices in QSAR Development and Applications

    Although it is commonly assumed that the structure and properties of a single chemical determines its activity in a particular biological system, it is only through study of how biological activity varies with changes...

  13. Preventing childhood obesity during infancy in UK primary care: a mixed-methods study of HCPs' knowledge, beliefs and practice

    PubMed Central

    2011-01-01

    Background There is a strong rationale for intervening in early childhood to prevent obesity. Over a quarter of infants gain weight more rapidly than desirable during the first six months of life putting them at greater risk of obesity in childhood. However, little is known about UK healthcare professionals' (HCPs) approach to primary prevention. This study explored obesity-related knowledge of UK HCPs and the beliefs and current practice of general practitioners (GPs) and practice nurses in relation to identifying infants at risk of developing childhood obesity. Method Survey of UK HCPs (GPs, practice nurses, health visitors, nursery, community and children's nurses). HCPs (n = 116) rated their confidence in providing infant feeding advice and completed the Obesity Risk Knowledge Scale (ORK-10). Semi-structured interviews with a sub-set of 12 GPs and 6 practice nurses were audio recorded, taped and transcribed verbatim. Thematic analysis was applied using an interpretative, inductive approach. Results GPs were less confident about giving advice about infant feeding than health visitors (p = 0.001) and nursery nurses (p = 0.009) but more knowledgeable about the health risks of obesity (p < 0.001) than nurses (p = 0.009). HCPs who were consulted more often about feeding were less knowledgeable about the risks associated with obesity (r = -0.34, n = 114, p < 0.001). There was no relationship between HCPs' ratings of confidence in their advice and their knowledge of the obesity risk. Six main themes emerged from the interviews: 1) Attribution of childhood obesity to family environment, 2) Infant feeding advice as the health visitor's role, 3) Professional reliance on anecdotal or experiential knowledge about infant feeding, 4) Difficulties with recognition of, or lack of concern for, infants "at risk" of becoming obese, 5) Prioritising relationship with parent over best practice in infant feeding and 6) Lack of shared understanding for dealing with early years

  14. Current loop signal conditioning: Practical applications

    NASA Technical Reports Server (NTRS)

    Anderson, Karl F.

    1995-01-01

    This paper describes a variety of practical application circuits based on the current loop signal conditioning paradigm. Equations defining the circuit response are also provided. The constant current loop is a fundamental signal conditioning circuit concept that can be implemented in a variety of configurations for resistance-based transducers, such as strain gages and resistance temperature detectors. The circuit features signal conditioning outputs which are unaffected by extremely large variations in lead wire resistance, direct current frequency response, and inherent linearity with respect to resistance change. Sensitivity of this circuit is double that of a Wheatstone bridge circuit. Electrical output is zero for resistance change equals zero. The same excitation and output sense wires can serve multiple transducers. More application arrangements are possible with constant current loop signal conditioning than with the Wheatstone bridge.

  15. Investigation into the dosage form attributes of currently UK licensed cardiovascular and Parkinson's disease drug products.

    PubMed

    Hanning, S M; Muhamed, J; Orlu-Gul, M

    2015-02-01

    Globally, there is a continuous rise in the older population (over 65 years), particularly in developed countries. As many diseases are age-related, older adults represent a highly heterogeneous cohort. This presents a major challenge for both the pharmaceutical industry and healthcare professionals. The purpose of this research was to attract attention towards the appropriateness of geriatric formulations by investigating the dosage form attributes of currently UK licensed cardiovascular and Parkinson's disease drug products. Medication available in the UK for cardiovascular disorders and Parkinson's disease were screened and the available formulations, packaging and patient information leaflets of these medicines were analysed, with the goal of raising awareness of the need to cater for elderly patients with increasing difficulty in managing their medication. It emerged that although cardiovascular disorders and Parkinson's disease are more prevalent in older people, many treatment options have not been optimised for this cohort. In particular, older patient centred dosage forms, specific dosing requirements, excipients, patient-friendly packaging and easy-to-follow patient information were highlighted as areas to be considered in order to optimise health outcomes in the ageing population.

  16. Investigation into the dosage form attributes of currently UK licensed cardiovascular and Parkinson's disease drug products.

    PubMed

    Hanning, S M; Muhamed, J; Orlu-Gul, M

    2015-02-01

    Globally, there is a continuous rise in the older population (over 65 years), particularly in developed countries. As many diseases are age-related, older adults represent a highly heterogeneous cohort. This presents a major challenge for both the pharmaceutical industry and healthcare professionals. The purpose of this research was to attract attention towards the appropriateness of geriatric formulations by investigating the dosage form attributes of currently UK licensed cardiovascular and Parkinson's disease drug products. Medication available in the UK for cardiovascular disorders and Parkinson's disease were screened and the available formulations, packaging and patient information leaflets of these medicines were analysed, with the goal of raising awareness of the need to cater for elderly patients with increasing difficulty in managing their medication. It emerged that although cardiovascular disorders and Parkinson's disease are more prevalent in older people, many treatment options have not been optimised for this cohort. In particular, older patient centred dosage forms, specific dosing requirements, excipients, patient-friendly packaging and easy-to-follow patient information were highlighted as areas to be considered in order to optimise health outcomes in the ageing population. PMID:25556052

  17. Anorexia nervosa: review of current treatment practices.

    PubMed

    Rockwell, W J; Ellinwood, E H; Dougherty, G G; Brodie, H K

    1982-09-01

    The etiology of anorexia nervosa has defied elucidation for over 100 years and no systematic treatment has yet been developed for the illness. We have reviewed some current findings that relate to both neuroendocrinologic and psychologic defects. Review of current treatment practices reveals that a variety of approaches are used, alone or in combination. Special attention is directed to the rationale for the use of certain neuropharmacologic agents that influence eating behavior. We advocate a flexible, multimodal approach to treatment of this illness, the understanding of which is still in its early stage.

  18. Training in clinical forensic medicine in the UK--perceptions of current regulatory standards.

    PubMed

    Stark, Margaret M; Norfolk, Guy A

    2011-08-01

    As clinical forensic medicine (CFM) is not currently recognised as a speciality in the UK there are no nationally agreed mandatory standards for training forensic physicians in either general forensic (GFM) or sexual offence medicine (SOM). The General Medical Council (GMC), the medical regulator in the UK, has issued clear standards for training in all specialities recommending that "trainees must be supported to acquire the necessary skills and experience through induction, effective educational supervision, an appropriate workload and time to learn". In order to evaluate the current situation in the field of clinical forensic medicine, doctors who have recently (within the last two years) started working in the field "trainees" (n = 38), and trainers (n = 61) with responsibility for clinical and educational supervision of new trainees, were surveyed by questionnaire to gather their perceptions of how the relevant GMC standards are being met in initial on-the-job training. Telephone interviews were performed with eleven doctors working as clinical or medical directors to determine their views. It is clear that currently the quality of training in CFM is sub-standard and inconsistent and that the published standards, as to the minimum requirement for training that must be met by post-graduate medical and training providers at all levels, are not being met. The Faculty of Forensic and Legal Medicine (FFLM) needs to set explicit minimum standards which will comply with the regulator and work to pilot credentialing for forensic physicians. A number of recommendations are made for urgent FFLM development.

  19. Access with evidence development in the UK: past experience, current initiatives and future potential.

    PubMed

    Briggs, Andrew; Ritchie, Karen; Fenwick, Elisabeth; Chalkidou, Kalipso; Littlejohns, Peter

    2010-01-01

    Access with evidence development (AED) describes the general approach of linking some form of access to the healthcare market with the generation of additional evidence relating to the value of the healthcare intervention under evaluation, with an explicit aim of aiding future decision making. A number of health systems around the world are interested in the potential for such schemes. This article looks in detail at the potential for some form of AED in the UK, focusing on the two major decision-making bodies: the Scottish Medicines Consortium in Scotland and the National Institute for Health and Clinical Excellence in England and Wales. We consider past experience with these approaches and current initiatives that are exploring their potential, and speculate as to how these schemes might develop in the future.

  20. Current management of male‐to‐female gender identity disorder in the UK

    PubMed Central

    Tugnet, Nicola; Goddard, Jonathan Charles; Vickery, Richard M; Khoosal, Deenesh; Terry, Tim R

    2007-01-01

    Gender identity disorder (GID), or transsexualism as it is more commonly known, is a highly complex clinical entity. Although the exact aetiology of GID is unknown, several environmental, genetic and anatomical theories have been described. The diagnosis of GID can be a difficult process but is established currently using standards of care as defined by the Harry Benjamin International Gender Dysphoria Association. Patients go through extensive psychiatric assessment, including the Real Life Experience, which entails living in the desired gender role 24 h a day for a minimum period of 12 months. The majority of GID patients will eventually go on to have gender realignment surgery, which includes feminising genitoplasty. The clinical features, diagnostic approach and management of male‐to‐female GID in the UK are reviewed, including the behavioural, psychological and surgical aspects. PMID:17916872

  1. The Current Use of Online Services in U.K. Academic Libraries.

    ERIC Educational Resources Information Center

    Foster, Allan; Akeroyd, John

    This update of a survey taken by the authors in April 1978 on the use of online services in British academic libraries (Online Review; v3 n2 p195-204 1979) concentrates on the following areas: (1) general pattern of use; (2) current arguments for charging users for online services; (3) current academic library practice on charging; (4) specific…

  2. Music Therapy in School Settings: Current Practice.

    PubMed

    Smith; Hairston

    1999-01-01

    The practice of music therapy in school settings was the focus of this study. Survey forms were mailed to 244 NAMT members who indicated school setting as their place of employment. A total of 190 forms were received, 138 of which fit the qualifications for inclusion and were included in the data summaries. Greater numbers of respondents lived in Texas (21), New York (17), and Michigan (11), and were employed full-time (60&percent;). Employers were more typically school systems (53&percent;) for the highest percentage of full-time respondents (80&percent;), and self-employers (25&percent;) for the highest percentage of part-time respondents (80&percent;). A considerably higher percentage of time was spent each week in direct service delivery (62&percent;) than in consultation (13&percent;), travel (18&percent;), documentation (11&percent;), or preparation (14&percent;). Over 40&percent; of the respondents had been music therapists for more than 8 years, but not necessarily in their current positions. Almost 40&percent; needed a valid teaching certificate for employment, while over 50&percent; currently held one. Respondents most frequently worked with persons who were developmentally disabled (80&percent;). The impact of employer and the inclusion movement on professional practice issues was discussed, as were possible trends in the practice of music therapy in school settings.

  3. Assessing governance theory and practice in health-care organizations: a survey of UK hospices.

    PubMed

    Chambers, Naomi; Benson, Lawrence; Boyd, Alan; Girling, Jeff

    2012-05-01

    This paper sets out a theoretical framework for analyzing board governance, and describes an empirical study of corporate governance practices in a subset of non-profit organizations (hospices in the UK). It examines how practices in hospice governance compare with what is known about effective board working. We found that key strengths of hospice boards included a strong focus on the mission and the finances of the organizations, and common weaknesses included a lack of involvement in strategic matters and a lack of confidence, and some nervousness about challenging the organization on the quality of clinical care. Finally, the paper offers suggestions for theoretical development particularly in relation to board governance in non-profit organizations. It develops an engagement theory for boards which comprises a triadic proposition of high challenge, high support and strong grip. PMID:22673698

  4. Assessing governance theory and practice in health-care organizations: a survey of UK hospices.

    PubMed

    Chambers, Naomi; Benson, Lawrence; Boyd, Alan; Girling, Jeff

    2012-05-01

    This paper sets out a theoretical framework for analyzing board governance, and describes an empirical study of corporate governance practices in a subset of non-profit organizations (hospices in the UK). It examines how practices in hospice governance compare with what is known about effective board working. We found that key strengths of hospice boards included a strong focus on the mission and the finances of the organizations, and common weaknesses included a lack of involvement in strategic matters and a lack of confidence, and some nervousness about challenging the organization on the quality of clinical care. Finally, the paper offers suggestions for theoretical development particularly in relation to board governance in non-profit organizations. It develops an engagement theory for boards which comprises a triadic proposition of high challenge, high support and strong grip.

  5. "Does RE Work?" An Analysis of the Aims, Practices and Models of Effectiveness of Religious Education in the UK

    ERIC Educational Resources Information Center

    Lundie, David

    2010-01-01

    Possibly the largest qualitative study in RE policy and practice in many years, the AHRC/ESRC Religion and Society project "Does RE work? An analysis of the aims, practices and models of effectiveness in religious education in the UK", headed by the University of Glasgow, seeks to map the complex processes of curriculum formation as experienced in…

  6. A survey of surgical draping practices in small-animal practice in the UK.

    PubMed

    Delisser, P J; Sinnett, D E; Parsons, K J; Friend, E J

    2012-09-29

    Veterinary practices in the United Kingdom were surveyed to compare their surgical draping practices with Royal College of Veterinary Surgeons (RCVS) accreditation tier and other surgery-related factors. Using descriptive statistics and logistic or ordinal regression analysis (where appropriate), the relationships between draping material and accreditation tier and other surgery-related factors were assessed. Procedures were categorised as short or long. Two hundred and sixty-nine surveys were completed. Reusable drapes were used in 66 per cent of practices. Antibiotics were administered routinely in 38 per cent of short and 93 per cent of long procedures. Practices accredited as a Veterinary Hospital (VH) were 6.3-7.2 (short and long surgeries, respectively) times more likely to use disposable drapes, when compared with non-accredited practices. Use of dedicated surgical attire, draping the whole animal/table, and routine antibiotic usage were also positively correlated with disposable drape usage. Fifty-one per cent of practices rated infection rate as most important when choosing drape material. 'Best practice' techniques are associated with lower importance given to infection rate, and higher importance given to financial cost, when choosing drape material. Disposable drape use correlates with RCVS accreditation and with other aspects of surgical technique. Importance ratings awarded correlate with best practice procedures. Clinical relevance 'Best practice' draping procedures, that are not governed by RCVS accreditation scheme, are also more frequently performed in accredited VHs.

  7. Qualitative study of factors associated with antimicrobial usage in seven small animal veterinary practices in the UK.

    PubMed

    Mateus, Ana L P; Brodbelt, David C; Barber, Nick; Stärk, Katharina D C

    2014-11-01

    Responsible use of antimicrobials by veterinarians is essential to contain antimicrobial resistance in pathogens relevant to public health. Inappropriate antimicrobial use has been previously described in practice. However, there is scarce information on factors influencing antimicrobial usage in dogs and cats. We investigated intrinsic and extrinsic factors influencing decision-making of antimicrobial usage in first opinion small animal practices in the UK through the application of qualitative research methods. Semi-structured interviews were conducted with 21 veterinarians from seven veterinary first opinion practices in the UK in 2010. Topics investigated included: a) criteria used for selection of antimicrobials, b) influences by colleagues, c) influences by clients, d) pet characteristics, e) sources of knowledge, f) awareness of guidelines and g) protocols implemented in practice that may affect antimicrobial usage by veterinarians. Hypothetical scenarios selected to assess appropriateness of antimicrobial usage were: a) vomiting in a Yorkshire Terrier due to dietary indiscretion, b) deep pyoderma in a Shar-Pei, c) Feline Lower Urinary Tract disease in an 7 year-old male neutered cat and d) neutering of a 6-months dog. Interviews were recorded and transcribed by the interviewer. Thematic analysis was used to analyse content of transcribed interviews. Data management and analysis was conducted with qualitative analysis software NVivo8 (QSR International Pty Ltd). Antimicrobial usage by participants was influenced by factors other than clinical evidence and scientific knowledge. Intrinsic factors included veterinarian's preference of substances and previous experience. Extrinsic factors influencing antimicrobial selection were; perceived efficacy, ease of administration of formulations, perceived compliance, willingness and ability to treat by pet owners, and animal characteristics. Cost of therapy was only perceived as an influential factor in low, mixed

  8. Faculty Development in Teaching and Learning: The UK Framework and Current Debates

    ERIC Educational Resources Information Center

    Hibbert, Paul; Semler, Mirko

    2016-01-01

    Following the publication of a recent report, commissioned by the Higher Education Academy (HEA) and conducted by Staff and Educational Developers Association, this short paper considers the HEA UK Professional Standards Framework in the UK Higher Education Sector, in the context of recent and continuing debates about how best to support faculty…

  9. A Comparison of Spectacles Purchased Online and in UK Optometry Practice

    PubMed Central

    Alderson, Alison J.; Green, Alison; Whitaker, David; Scally, Andrew J.; Elliott, David B.

    2016-01-01

    ABSTRACT Purpose To compare spectacles bought online with spectacles from optometry practices. Methods Thirty-three participants consisting of single vision spectacle wearers with either a low (N = 12, mean age 34 ± 14 years) or high prescription (N = 11, mean age 28 ± 9 years) and 10 presbyopic participants (mean age 59 ± 4 years) wearing progressive addition lenses (PALs) purchased 154 pairs of spectacles online and 154 from UK optometry practices. The spectacles were compared via participant-reported preference, acceptability, and safety; the assessment of lens, frame, and fit quality; and the accuracy of the lens prescriptions to international standard ISO 21987:2009. Results Participants preferred the practice spectacles (median ranking 4th, IQR 1–6) more than online (6th, IQR 4–8; Mann-Whitney U = 7345, p < 0.001) and practice PALs (median ranking 2nd, IQR 1–4) were particularly preferred (online 6.5th, IQR 4–9, Mann-Whitney U = 455, p < 0.001). Of those deemed unacceptable and unsafe, significantly more were bought online (unacceptable: online 43/154 vs. practice 15/154, Fisher’s exact p = 0.0001; unsafe: online 14/154 vs. practice 5/154, Fisher’s exact p = 0.03). Conclusions Participants preferred spectacles from optometry practice rather than those bought online, despite lens quality and prescription accuracy being similar. A greater number of online spectacles were deemed unsafe or unacceptable because of poor spectacle frame fit, poor cosmetic appearance, and inaccurate optical centration. This seems particularly pertinent to PAL lenses, which are known to increase falls risk. Recommendations are made to improve both forms of spectacle provision. PMID:27536974

  10. Informed consent for epidural analgesia in labour: a survey of UK practice.

    PubMed

    Middle, J V; Wee, M Y K

    2009-02-01

    Anaesthetists are legally obliged to obtain informed consent before performing regional analgesia in labour. A postal survey of consultant-led UK anaesthetic units was performed in September 2007 to assess practice regarding obtaining informed consent before inserting an epidural, and documentation of the risks discussed. The response rate was 72% (161/223). There was great variation between units regarding which risks women were informed about and the likely incidence of that risk. One hundred and twenty-three respondents out of 157 providing an epidural service (78%) supported a national standardised information card endorsed by the Obstetric Anaesthetists' Association, with all the benefits and risks stated, to be shown to all women before consenting to an epidural in labour.

  11. Randomised trial of two approaches to screening for atrial fibrillation in UK general practice.

    PubMed Central

    Morgan, Stephen; Mant, David

    2002-01-01

    majority (53/65 [82%]) atrial fibrillation had been previously recorded somewhere on their medical record. If the nurse used any irregularity of the pulse as the screening criterion, the sensitivity of screening was 91% and the specificity was 74%; sensitivity fell to 54% but specificity increased to 98% if the criterion used was continuous irregularity. CONCLUSIONS: Nurse-led screening for atrial fibrillation in UK general practice is both feasible and effective and will identify a substantial number of patients who could benefit from antithrombotic therapy. Although the majority of patients detected at first screening could be identified by careful scrutiny of medical records, review of record summaries was insufficient in the practices involved in this study and screening may be a more cost-effective option. PMID:12014534

  12. The current epidemiology of pertussis in the developed world: UK and West Germany.

    PubMed

    Miller, E; Farrington, C P

    1988-01-01

    The existence of well established national reporting systems for monitoring pertussis incidence and vaccine uptake in the United Kingdom has allowed the epidemiology of whooping cough and the impact of vaccination to be studied in detail. The increase in pertussis morbidity that followed the decline in vaccine uptake in recent years confirms the continuing need for mass vaccination in a developed country. There is also evidence that pertussis may be responsible for many more deaths than official mortality statistics show. A national study of vaccine efficacy demonstrated over 80% protection against clinical disease during the first 5 years after vaccination. However, there is evidence that the current whole cell vaccine may protect less well against infection with agglutinogen serotype 3 than type 2 organisms which supports the view that both these antigens should be included in acellular vaccines to achieve good protection. In West Germany, unlike the UK, there are no national statistics on pertussis incidence, no national vaccination policy and no figures for vaccine uptake. Local studies have shown that vaccination rates are low and that pertussis is prevalent, particularly in the 2-4 year age-group, which is typical of a country with low uptake; similarly serotype 2 predominates. PMID:3273623

  13. Aphasia: Current Concepts in Theory and Practice

    PubMed Central

    Tippett, Donna C.; Niparko, John K.; Hillis, Argye E.

    2014-01-01

    Recent advances in neuroimaging contribute to a new insights regarding brain-behavior relationships and expand understanding of the functional neuroanatomy of language. Modern concepts of the functional neuroanatomy of language invoke rich and complex models of language comprehension and expression, such as dual stream networks. Increasingly, aphasia is seen as a disruption of cognitive processes underlying language. Rehabilitation of aphasia incorporates evidence based and person-centered approaches. Novel techniques, such as methods of delivering cortical brain stimulation to modulate cortical excitability, such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation, are just beginning to be explored. In this review, we discuss the historical context of the foundations of neuroscientific approaches to language. We sample the emergent theoretical models of the neural substrates of language and cognitive processes underlying aphasia that contribute to more refined and nuanced concepts of language. Current concepts of aphasia rehabilitation are reviewed, including the promising role of cortical stimulation as an adjunct to behavioral therapy and changes in therapeutic approaches based on principles of neuroplasticity and evidence-based/person-centered practice to optimize functional outcomes. PMID:24904925

  14. Aphasia: Current Concepts in Theory and Practice.

    PubMed

    Tippett, Donna C; Niparko, John K; Hillis, Argye E

    2014-01-01

    Recent advances in neuroimaging contribute to a new insights regarding brain-behavior relationships and expand understanding of the functional neuroanatomy of language. Modern concepts of the functional neuroanatomy of language invoke rich and complex models of language comprehension and expression, such as dual stream networks. Increasingly, aphasia is seen as a disruption of cognitive processes underlying language. Rehabilitation of aphasia incorporates evidence based and person-centered approaches. Novel techniques, such as methods of delivering cortical brain stimulation to modulate cortical excitability, such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation, are just beginning to be explored. In this review, we discuss the historical context of the foundations of neuroscientific approaches to language. We sample the emergent theoretical models of the neural substrates of language and cognitive processes underlying aphasia that contribute to more refined and nuanced concepts of language. Current concepts of aphasia rehabilitation are reviewed, including the promising role of cortical stimulation as an adjunct to behavioral therapy and changes in therapeutic approaches based on principles of neuroplasticity and evidence-based/person-centered practice to optimize functional outcomes.

  15. Current CFD Practices in Launch Vehicle Applications

    NASA Technical Reports Server (NTRS)

    Kwak, Dochan; Kiris, Cetin

    2012-01-01

    The quest for sustained space exploration will require the development of advanced launch vehicles, and efficient and reliable operating systems. Development of launch vehicles via test-fail-fix approach is very expensive and time consuming. For decision making, modeling and simulation (M&S) has played increasingly important roles in many aspects of launch vehicle development. It is therefore essential to develop and maintain most advanced M&S capability. More specifically computational fluid dynamics (CFD) has been providing critical data for developing launch vehicles complementing expensive testing. During the past three decades CFD capability has increased remarkably along with advances in computer hardware and computing technology. However, most of the fundamental CFD capability in launch vehicle applications is derived from the past advances. Specific gaps in the solution procedures are being filled primarily through "piggy backed" efforts.on various projects while solving today's problems. Therefore, some of the advanced capabilities are not readily available for various new tasks, and mission-support problems are often analyzed using ad hoc approaches. The current report is intended to present our view on state-of-the-art (SOA) in CFD and its shortcomings in support of space transport vehicle development. Best practices in solving current issues will be discussed using examples from ascending launch vehicles. Some of the pacing will be discussed in conjunction with these examples.

  16. Rotator cuff rehabilitation: current theories and practice.

    PubMed

    Osborne, Jeffrey D; Gowda, Ashok L; Wiater, Brett; Wiater, J Michael

    2016-01-01

    A fully functioning, painless shoulder joint is essential to maintain a healthy, normal quality of life. Disease of the rotator cuff tendons (RCTs) is a common issue that affects the population, increasing with age, and can lead to significant disability and social and health costs. RCT injuries can affect younger, healthy patients and the elderly alike, and may be the result of trauma or occur as a result of chronic degeneration. They can be acutely painful, limited to certain activities or completely asymptomatic and incidental findings. A wide variety of treatment options exists ranging from conservative local and systemic pain modalities, to surgical fixation. Regardless of management ultimately chosen, physiotherapy of the RCT, rotator cuff muscles and surrounding shoulder girdle plays an essential role in proper treatment. Length of treatment, types of therapy and timing may vary if therapy is definitive care or part of a postoperative protocol. Allowing time for adequate RCT healing must always be considered when implementing ROM and strengthening after surgery. With current rehabilitation methods, patients with all spectrums of RCT pathology can improve their function, pain and quality of life. This manuscript reviews current theories and practice involving rehabilitation for RCT injuries.

  17. Globalisation and Education: A Review of Conflicting Perspectives and their Effect on Policy and Professional Practice in the UK

    ERIC Educational Resources Information Center

    Kelly, Anthony

    2009-01-01

    Many disparate groups have written about the effects of globalisation on education. Some have promoted its benefits; others have warned against its ill-effects. This paper is an attempt at coalescing and juxtaposing the respective arguments as they relate to schooling policy and practice in the UK. The growing international pressures of…

  18. Distribution of natural disturbance due to wave and tidal bed currents around the UK

    NASA Astrophysics Data System (ADS)

    Bricheno, Lucy M.; Wolf, Judith; Aldridge, John

    2015-10-01

    The UK continental shelf experiences large tidal ranges and winter storm events, which can both generate strong near-bed currents. The regular tidal bottom currents from tides plus wind driven 'benthic storms' (dominated by wave-driven oscillatory currents in shallow water) are a major source of disturbance to benthic communities, particularly in shallow waters. We aim to identify and map the relative impact of the tides and storm events on the shallower parts of the North West European continental shelf. A 10-year simulation of waves, tides and surges on the continental shelf was performed. The shelf model was validated against current meter observations and the Centre for Environmental, Fisheries and Aquaculture Science (CEFAS) network of SmartBuoys. Next, the model performance was assessed against seabed lander data from two sites in the Southern North Sea; one in deep water and another shallow water site at Sea Palling, and a third in Liverpool Bay. Both waves and currents are well simulated at the offshore Southern North Sea site. A large storm event was also well captured, though the model tends to underpredict bottom orbital velocity. Poorer results were achieved at the Sea Palling site, thought to be due to an overly deep model water depth, and missing wave-current interactions. In Liverpool Bay tides were well modelled and good correlations (average R2=0.89) are observed for significant wave height, with acceptable values (average R2=0.79) for bottom orbital velocity. Using the full 10-year dataset, return periods can be calculated for extreme waves and currents. Mapping these return periods presents a spatial picture of extreme bed disturbance, highlighting the importance of rare wave disturbances (e.g. with a return period of 1 in 10 years). Annual maximum currents change little in their magnitude and distribution from year to year, with mean speeds around 0.04 m s-1, and maximums exceeding 3 m s-1. Wave conditions however are widely variable throughout

  19. Module Technology: Current Practice and Issues (Presentation)

    SciTech Connect

    Wohlgemuth, J.

    2010-10-05

    PV modules must provide mechanical support for the cells, protect the world from the voltages inside, protect the cells, diodes and interconnects from the weather outside, couple as much light as possible into the PV cells and minimize the temperature increase of the cells. The package must continue to serve these functions for at least 25 years as that is the typical module warranty period today. Furthermore the package must do all this for as low a cost as possible since the key to large scale PV growth is a reduction in cost while retaining excellent module reliability and durability. This paper will review current module construction practices for both crystalline silicon and thin film PV with emphasis on explaining why the present designs and materials have been selected. Possible long term issues with today's designs and materials will be discussed. Several proposed solutions to these issues will be presented, highlighting the research efforts that will be necessary in order to verify that they can cost effectively solve the identified issues.

  20. Prepared for practice? Law teaching and assessment in UK medical schools.

    PubMed

    Preston-Shoot, Michael; McKimm, Judy

    2010-11-01

    A revised core curriculum for medical ethics and law in UK medical schools has been published. The General Medical Council requires medical graduates to understand law and ethics and behave in accordance with ethical and legal principles. A parallel policy agenda emphasises accountability, the development of professionalism and patient safety. Given the renewed focus on teaching and learning law alongside medical ethics and the development of professional identity, this survey aimed to identify how medical schools are responding to the preparation of medical students for practice in the future. Questions were asked about the location, content and methods of teaching and assessment of law in undergraduate medical education. Examples of course documentation were requested to illustrate the approaches being taken. A 76% response rate was achieved. Most responding schools integrate law teaching with medical ethics, emphasising both the acquisition of knowledge and its application in a clinical context. Teaching, learning and assessment of law in clinical attachments is much less formalised than that in non-clinical education. Coverage of recommended topic areas varies, raising questions about the degree to which students can embed their knowledge and skills in actual practice. More positively, teaching does not rely on single individuals and clear descriptions were offered for problem-based and small group case-based learning. Further research is required to explore whether there are optimum ways of ensuring that legal knowledge, and skills in its use, form part of the development of professionalism among doctors in training.

  1. Helminth egg excretion with regard to age, gender and management practices on UK Thoroughbred studs.

    PubMed

    Relf, V E; Morgan, E R; Hodgkinson, J E; Matthews, J B

    2013-04-01

    Few studies have described the combined effect of age, gender, management and control programmes on helminth prevalence and egg shedding in grazing equines. Here, fecal samples collected from 1221 Thoroughbred horses, residing at 22 studs in the UK, were analysed. The distribution of strongyle eggs amongst individuals in relation to age, gender and management practices was investigated. Fecal worm egg counts (FWECs), described as the number of eggs per gramme (epg) of feces, were determined using a modification of the salt flotation method. The FWEC prevalence (mean%) of strongyles, Parascaris equorum, tapeworm spp. and Strongyloides westeri was 56, 9, 4 and 8%, respectively. Strongyle, P. equorum, tapeworm spp. and S. westeri infections were detected on 22 (100%), 11 (50%), 9 (41%) and 8 (36%) of studs, respectively. Within all age and gender categories, strongyle FWECs were highly over-dispersed (arithmetic mean = 95 epg, aggregation parameter k=0·111) amongst horses. Animal age, last anthelmintic type administered and management practices (for example, group rotation on grazing) most strongly influenced strongyle prevalence and level of egg shedding (P < 0·05). Overall, 11% of equines (range: 234-2565 epg) were responsible for excreting 80% of the strongyle eggs detected on FWEC analysis. The results confirm that the judicious application of targeted treatments has potential to control equine strongyle populations by protecting individual horses from high burdens, whilst promoting refugia for anthelmintic susceptible genotypes.

  2. 21 CFR 1271.150 - Current good tissue practice requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Current good tissue practice requirements. 1271... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.150 Current good tissue practice requirements. (a) General. This subpart D and subpart C of this part...

  3. 21 CFR 1271.150 - Current good tissue practice requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Current good tissue practice requirements. 1271... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.150 Current good tissue practice requirements. (a) General. This subpart D and subpart C of this part...

  4. 21 CFR 1271.150 - Current good tissue practice requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Current good tissue practice requirements. 1271... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.150 Current good tissue practice requirements. (a) General. This subpart D and subpart C of this part...

  5. 21 CFR 225.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic...

  6. 21 CFR 110.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria...

  7. 21 CFR 225.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic...

  8. 21 CFR 110.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria...

  9. 21 CFR 226.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115,...

  10. 21 CFR 225.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic...

  11. 21 CFR 225.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic...

  12. 21 CFR 110.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria...

  13. 21 CFR 225.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic...

  14. 21 CFR 110.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria...

  15. 21 CFR 226.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115,...

  16. 21 CFR 226.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115,...

  17. 21 CFR 110.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria...

  18. 21 CFR 226.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115,...

  19. 21 CFR 226.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115,...

  20. Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study

    PubMed Central

    Greenhalgh, Trisha; Russell, Jill; Myall, Michelle

    2011-01-01

    Objective To describe, explore, and compare organisational routines for repeat prescribing in general practice to identify contributors and barriers to safety and quality. Design Ethnographic case study. Setting Four urban UK general practices with diverse organisational characteristics using electronic patient records that supported semi-automation of repeat prescribing. Participants 395 hours of ethnographic observation of staff (25 doctors, 16 nurses, 4 healthcare assistants, 6 managers, and 56 reception or administrative staff), and 28 documents and other artefacts relating to repeat prescribing locally and nationally. Main outcome measures Potential threats to patient safety and characteristics of good practice. Methods Observation of how doctors, receptionists, and other administrative staff contributed to, and collaborated on, the repeat prescribing routine. Analysis included mapping prescribing routines, building a rich description of organisational practices, and drawing these together through narrative synthesis. This was informed by a sociological model of how organisational routines shape and are shaped by information and communications technologies. Results Repeat prescribing was a complex, technology-supported social practice requiring collaboration between clinical and administrative staff, with important implications for patient safety. More than half of requests for repeat prescriptions were classed as “exceptions” by receptionists (most commonly because the drug, dose, or timing differed from what was on the electronic repeat list). They managed these exceptions by making situated judgments that enabled them (sometimes but not always) to bridge the gap between the idealised assumptions about tasks, roles, and interactions that were built into the electronic patient record and formal protocols, and the actual repeat prescribing routine as it played out in practice. This work was creative and demanded both explicit and tacit knowledge

  1. Arts on prescription: a review of practice in the U.K.

    PubMed

    Bungay, Hilary; Clift, Stephen

    2010-11-01

    The current levels of psychosocial distress in society are significant, as evidenced by the number of prescribed antidepressants and the numbers of working days lost as a result of stress and anxiety. There is a growing body of evidence that active involvement in creative activities provides a wide range of benefits, including the promotion of well-being, quality of life, health and social capital. In the U.K. there are currently a number of projects operating that offer Arts on Prescription for people experiencing mental health problems and social isolation. The purpose of such schemes is not to replace conventional therapies but rather to act as an adjunct, helping people in their recovery through creativity and increasing social engagement. Although the schemes are varied in their approaches and settings, the common theme is that there is a referral process and creative activities take place in the community facilitated by artists rather than therapists. This paper explores whether such schemes can be part of the solution to the current challenge of mental ill-health, and looks at the evidence supporting the value of such schemes which may influence government, funders and healthcare professionals to implement Arts on Prescription more widely.

  2. Current management practices and interventions prioritised as part of a nationwide mastitis control plan

    PubMed Central

    Bradley, A. J.; Breen, J. E.; Hudson, C. D.; Green, M. J.

    2016-01-01

    The objectives of this study were to report performance and management data taken from a sample of UK dairy farms that have participated in the Agriculture and Horticulture Development Board Dairy Mastitis Control Plan (DMCP) and to identify important mastitis prevention practices that are not currently widely implemented. A total of 234 UK dairy herds were included in the study from which farm management and udder health data were collected. Herds were grouped according to their mastitis epidemiology and could be classed as (i) environmental dry period (EDP) (i.e. environmental pathogen with majority of infections being acquired during the dry period), (ii) environmental lactation (EL), (iii) contagious dry period (CDP) or (iv) contagious lactation (CL). The results of this study showed that many mastitis-related management practices that are generally considered to be important were not widely performed. A better understanding of those practices not widely adopted by UK dairy farmers at present may aid practitioners in identifying and overcoming potential barriers to improved mastitis control. PMID:26966249

  3. Preparticipation medical evaluation in professional sport in the UK: theory or practice?

    PubMed Central

    Fuller, C W; Ojelade, E O; Taylor, A

    2007-01-01

    Objective To determine the level of pre‐employment, pre‐season, and post‐injury medical evaluation of players undertaken within UK professional team sports. Design A postal, whole population survey. Setting Elite professional sports teams in England. Population Six groups comprising the following clubs: professional football (Premiership, 15 of 20; Championship, 22 of 24), rugby union (Premiership, 9 of 12; Division 1, 11 of 14), rugby league (Super League, 6 of 11) and cricket (County, 12 of 18). Main outcome measures Number (percentage) of clubs recording players' medical history and undertaking medical examinations of players' cardiovascular, respiratory, neurological, and musculoskeletal systems at pre‐employment, pre‐season and post‐injury. Results The overall response to the survey was 74%, with a range from 55% to 92% among groups. Almost 90% of football (Premiership and Championship) and rugby union (Premiership) clubs took a pre‐employment history of players' general health, cardiovascular, respiratory, neurological, and musculoskeletal systems, but fewer than 50% of cricket and rugby union (Division 1) clubs recorded a history. The majority of football (Premiership and Championship) and rugby union (Premiership) clubs implemented both cardiovascular and musculoskeletal examinations of players before employment. Fewer than 25% of clubs in any of the groups implemented neurological examinations of players at pre‐employment, although 100% of rugby union (Premiership) and rugby league clubs implemented neurological testing during pre‐season. Conclusions None of the sports implemented best practice guidelines for the preparticipation evaluation of players at all stages of their employment. Departures from best practice guidelines and differences in practices between clubs within the same sport leave club physicians vulnerable if their players sustain injuries or ill health conditions that could have been identified and avoided through the

  4. General practice education in Australia. Current issues.

    PubMed

    Sturmberg, Joachim; Heard, Sam

    2004-05-01

    General practice education is rapidly changing. Medical students now have exposure to general practice at most year levels, vocational training has been opened to competition, and continuing professional development is a mandatory requirement for maintenance of Health Insurance Commission recognition, and increasingly for state registration. This article outlines the foundations for, and challenge to, building a framework for quality general practice education in Australia. PMID:15227866

  5. Current Capabilities, Requirements and a Proposed Strategy for Interdependency Analysis in the UK

    NASA Astrophysics Data System (ADS)

    Bloomfield, Robin; Chozos, Nick; Salako, Kizito

    The UK government recently commissioned a research study to identify the state-of-the-art in Critical Infrastructure modelling and analysis, and the government/industry requirements for such tools and services. This study (Cetifs) concluded with a strategy aiming to bridge the gaps between the capabilities and requirements, which would establish interdependency analysis as a commercially viable service in the near future. This paper presents the findings of this study that was carried out by CSR, City University London, Adelard LLP, a safety/security consultancy and Cranfield University, defense academy of the UK.

  6. Pupil Vulnerability and School Exclusion: Developing Responsive Pastoral Policies and Practices in Secondary Education in the UK

    ERIC Educational Resources Information Center

    Tucker, Stanley

    2013-01-01

    How to best support pupils who are considered to be in danger of temporary or permanent exclusion from secondary school is an issue that is currently exercising policy makers, school managers and teachers in the UK. Using primary research data gained from interviews with secondary pupils, school managers and behaviour support staff in a group of…

  7. Technology and Special Needs Provision in the UK: Is Current Law Satisfactory?

    ERIC Educational Resources Information Center

    Kariyawasam, Rohan

    2007-01-01

    Recently, the government has issued legislation on disability discrimination (the UK "Disability Discrimination Act" 2005) that is silent on the issue of access to technology for those adults and minors with special needs/disabilities either in the classroom or out of the classroom. At the same time, commercial legislation from Europe drives…

  8. Does current provision of undergraduate education prepare UK medical students in ENT? A systematic literature review

    PubMed Central

    Ferguson, Gary R; Bacila, Irina A; Swamy, Meenakshi

    2016-01-01

    Objective To systematically identify and analyse all published literature relating to the provision of undergraduate education for preparedness in ear, nose and throat (ENT) surgery, as perceived by medical students and clinicians in the UK. Design Systematic literature review. Data sources 5 major databases were searched: MEDLINE, EMBASE, ERIC, Cochrane and Web of Science. The literature search was conducted from February to April 2015. Eligibility criteria for selecting studies Primary research or studies that report on the provision of undergraduate education for preparedness in ENT, from the perspective of medical students and clinicians in the UK. The timescale of searches was limited from 1999 onwards (ie, the past 15 years). Data extraction The literature search was conducted by 2 independent reviewers. Search terms used involved the combination and variation of 5 key concepts, namely: medical student, clinician, ENT, undergraduate medical education and UK. A data extraction form was designed for and used in this study, based on guidelines provided by the UK National Health Service (NHS) Centre for Reviews and Dissemination. Textual narrative synthesis was used for data analysis. Results A total of 7 studies were included in the final review. 4 main themes were identified: confidence in managing patients, teaching delivery, student assessment and duration of rotations. A consistent finding in this review was that the majority of final year medical students and junior doctors did not feel adequately prepared to practise ENT. Important factors influencing preparedness in ENT included the duration of clinical rotations, the opportunity for hands-on learning and formal assessment. Conclusions The findings of this review suggest the need for further development of the ENT undergraduate curricula across the UK. However, there is insufficient evidence from which to draw strong conclusions; this in itself is beneficial as it highlights a gap in the existing

  9. Osteoporosis and venous thromboembolism: a retrospective cohort study in the UK General Practice Research Database

    PubMed Central

    Cooper, C.; Meyer, O.; Speirs, C.; Deltour, N.; Reginster, J. Y.

    2009-01-01

    Summary In a retrospective cohort study using the General Practice Research Database (GPRD), there was a greater association of venous thromboembolism (VTE) in osteoporotic than in non-osteoporotic female patients. No greater association was shown in treated patients with strontium ranelate or alendronate compared to untreated osteoporotic female patients. Introduction We explored the risk of VTE in usual practice in osteoporotic and non-osteoporotic women with and without anti-osteoporotic treatment. Methods A retrospective study was conducted using the GPRD in the UK. The cohorts consisted of untreated osteoporotic women (N = 11,546), osteoporotic women treated with alendronate (N = 20,084), or strontium ranelate (N = 2,408), and a sample of non-osteoporotic women (N = 115,009). Cohorts were compared using a Cox proportional hazards regression model. Results There was a significantly increased relative risk for VTE in untreated osteoporotic women versus non-osteoporotic women (annual incidence 5.6 and 3.2 per 1,000 patient–years, respectively; relative risk 1.75 [95% confidence interval (CI), 1.09–1.84]). Results were confirmed using adjusted models. The annual incidences of VTE in osteoporotic patients treated with strontium ranelate and alendronate were 7.0 and 7.2 per 1,000 patient–years, respectively, with no significant difference between untreated and treated patients whatever the treatment. Adjusted hazard ratios for treated versus untreated osteoporotic women were 1.09 (95% CI, 0.60–2.01) for strontium ranelate and 0.92 (95% CI, 0.63–1.33) for alendronate. Conclusion This study shows a greater association of VTE in osteoporotic compared to non-osteoporotic patients, but does not show any greater association in treated patients with strontium ranelate or alendronate compared to untreated osteoporotic patients. PMID:19806285

  10. 21 CFR 129.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the... manufacturing practice to assure that bottled drinking water is safe and that it has been processed,...

  11. 21 CFR 129.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the... manufacturing practice to assure that bottled drinking water is safe and that it has been processed,...

  12. 21 CFR 129.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the... manufacturing practice to assure that bottled drinking water is safe and that it has been processed,...

  13. 21 CFR 129.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the... manufacturing practice to assure that bottled drinking water is safe and that it has been processed,...

  14. 21 CFR 129.1 - Current good manufacturing practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the... manufacturing practice to assure that bottled drinking water is safe and that it has been processed,...

  15. Clinical practice and the UK Human Rights Act 1998: protecting individual rights in the interest of the wider community.

    PubMed

    Thomson, S M; Pitman, D; Mossialos, E

    2001-01-01

    Health professionals have expressed concern that the UK Human Rights Act 1988, which came into force in 2000, may threaten their autonomy in clinical practice/decision-making and resource allocation by health authorities. Although healthcare-related cases have so far been slow to emerge under the Act, it seems clear that in clinical practice the transition from duty to legal obligation will involve a degree of change for health professionals, in attitude if not in behaviour. With regard to resource allocation, it appears that the UK courts are likely to consider challenges to health authorities' decisions in a way that takes into account the need to set priorities, so long as these decisions do not discriminate unfairly and can be shown to have been made in the best interest of the wider community.

  16. Impact of omalizumab on treatment of severe allergic asthma in UK clinical practice: a UK multicentre observational study (the APEX II study)

    PubMed Central

    Niven, Robert M; Saralaya, Dinesh; Chaudhuri, Rekha; Masoli, Matthew; Clifton, Ian; Mansur, Adel H; Hacking, Victoria; McLain-Smith, Susan; Menzies-Gow, Andrew

    2016-01-01

    Objective To describe the impact of omalizumab on asthma management in patients treated as part of normal clinical practice in the UK National Health Service (NHS). Design A non-interventional, mixed methodology study, combining retrospective and prospective data collection for 12 months pre-omalizumab and post-omalizumab initiation, respectively. Setting Data were collected in 22 UK NHS centres, including specialist centres and district general hospitals in the UK. Participants 258 adult patients (aged ≥16 years; 65% women) with severe persistent allergic asthma treated with omalizumab were recruited, of whom 218 (84.5%) completed the study. Primary and secondary outcome measures The primary outcome measure was change in mean daily dose of oral corticosteroids (OCS) between the 12-month pre-omalizumab and post-omalizumab initiation periods. A priori secondary outcome measures included response to treatment, changes in OCS dosing, asthma exacerbations, lung function, employment/education, patient-reported outcomes and hospital resource utilisation. Results The response rate to omalizumab at 16 weeks was 82.4%. Comparing pre-omalizumab and post-omalizumab periods, the mean (95% CIs) daily dose of OCS decreased by 1.61 (−2.41 to −0.80) mg/patient/day (p<0.001) and hospital exacerbations decreased by 0.97 (−1.19 to −0.75) exacerbations/patient (p<0.001). Compared with baseline, lung function, assessed by percentage of forced expiratory volume in 1 s, improved by 4.5 (2.7 to 6.3)% at 16 weeks (p<0.001; maintained at 12 months) and patient quality of life (Asthma Quality of Life Questionnaire) improved by 1.38 (1.18 to 1.58) points at 16 weeks (p<0.001, maintained at 12 months). 21/162 patients with complete employment data gained employment and 6 patients lost employment in the 12-month post-omalizumab period. The mean number of A&E visits, inpatient hospitalisations, outpatient visits (excluding for omalizumab) and number of bed days

  17. [Suicide prevention - current practice and theory].

    PubMed

    Pohlmeier, H

    1979-02-01

    The present situation of suicide prevention is portrayed by an historical outline, and the description of the practice and the theoretical foundations. It is established that suicide prevention was intensified after 1948 through the fundamental practical and theoretical works of Erwin Ringel. The present situation is characterized by the fact that after the initial recovery of desperate persons as patients for medicine, the defamation of the suicidal act by society could be avoided in another manner than by merely classifying it as a sickness. Increasing interest is being granted to political and other suicides who depict suicide as a possibility of mankind. The practical application of suicide prevention consists in the organization of rest-centres, the interdisciplinary participation of various professional groups and the application of various medical, psychological and social therapies. The theoretical foundation includes the theories of early and present psychoanalysis, social science and theoretical learn-oriented psychology. This formation and this global view of suicide prevention-practice and theory today, allow us to draw the conclusion that every physician, psychologist, social worker or other human being who comes into contact with desperate persons applies the most effective suicide prevention when he behaves in a straight forward manner, and is interested unreservedly in a candid, unforced way in the psychic and social conflict situation of the other, allthewhile respecting that person's freedom. PMID:371243

  18. Inter-professional work based learning within an MSc in Advanced Practice: lessons from one UK higher education programme.

    PubMed

    Gaskell, Lynne; Beaton, Susan

    2010-09-01

    This paper will describe the implementation of inter-professional work based education (IPE) in one postgraduate Advanced Practitioner programme in the UK. The concept of Advanced Practice has developed as a response of a number of drivers including change in junior doctor training; government policy and increasing demands on the central government funded UK health service (the NHS). The programme was commissioned by the then greater Manchester Strategic Health Authority (now NHS North West) to meet service needs. The educational philosophy underpinning the MSc Advanced Practice (health and social care) provided by the University of Salford is IPE linked to work based learning. The process of work based learning (WBL) and inter-professional learning underpinning the programme will be discussed in relation to feedback from university staff, Advanced Practitioner (AP) students and employer feedback taken from programme and module evaluations. We argue that IPE at this level facilitates a greater understanding of the connectivity between professionals working in the health care system in the UK; a better understanding of the skills and knowledge base of colleagues; more inter-professional working and appropriate referrals in the work place. This has raised the profile of Advanced Practice (AP) in the region and ultimately resulted in better patient care with more effective and efficient use of resources (Acton Shapiro, 2006, 2008).

  19. Landscape of current and emerging cell therapy clinical trials in the UK: current status, comparison to global trends and future perspectives.

    PubMed

    Bisson, Isabelle; Green, Emma; Sharpe, Michaela; Herbert, Chris; Hyllner, Johan; Mount, Natalie

    2015-01-01

    Cell Therapy Clinical Trial and Preclinical Research databases have been established by the Cell Therapy Catapult to document current and future cell therapy clinical trials in the UK. We identified 41 ongoing trials in April 2014, an increase of seven trials from April 2013. In addition, we identified 45 late-stage preclinical research projects. The majority of the clinical trials are early phase, primarily led by academic groups. The leading therapeutic areas are cancer, cardiology and neurology. The trends in the UK are also seen globally. As the field matures, more later phase and commercial studies will emerge and the challenges will likely evolve into how to manufacture sufficient cell quantities, manage complex logistics for multi-center trials and control cost.

  20. Plastics processing: statistics, current practices, and evaluation.

    PubMed

    Cooke, F

    1993-11-01

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

  1. Population based epidemiology of ankle sprains attending accident and emergency units in the West Midlands of England, and a survey of UK practice for severe ankle sprains

    PubMed Central

    Bridgman, S; Clement, D; Downing, A; Walley, G; Phair, I; Maffulli, N

    2003-01-01

    Objectives: To estimate the incidence of ankle sprains and severe ankle sprains attending accident and emergency (A&E) units; to describe current practice for severe ankle sprains in A&E units in the United Kingdom. Methods: Crude age and sex specific incidence rates were calculated for four health districts from cases ascertained from data on seven A&E clinical information systems. Case records of patients with ankle sprains at an A&E unit in another health district were audited and the proportion of severe ankle sprains calculated. UK A&E units were surveyed about their usual treatment of patients with severe ankle sprains. Results: The estimate of the crude incidence rate of ankle sprains was a minimum of 52.7 per 10 000, rising to 60.9 (95% CI 59.4 to 62.4) when figures were adjusted for the proportion of patients without a diagnostic code (13.7%). There were important age-sex differences with unadjusted rates observed from 127.8 per 10 000 (CI 115.5 to 140.0) in girls aged 10–14 years to 8.2 (CI 4.2 to 12.3) in men aged 70–74 years. As 14% of ankle sprains attending A&E were classed as severe, this would equate to 42 000 severe ankle sprains per year in the UK. In the UK wide survey, there was a response rate of 79% (211 of 266). Among the responders, Tubigrip was used routinely in 55%, below knee casts in 3%, and braces in 2%. Boots were not used routinely in any unit. Conclusion: While there is considerable variation in severe ankle sprain management in UK A&E units, most are treated with the minimal mechanical support of Tubigrip. PMID:14623833

  2. What does standard rehabilitation practice after total hip replacement in the UK entail? results of a mixed methods study

    PubMed Central

    2013-01-01

    Background There is evidence of prolonged poor function in patients following total hip replacement (THR). Studies of progressive resistance training (PRT) interventions to improve function are often compared to ‘standard’ practice which is not well defined. This study aimed to investigate ‘standard’ rehabilitation care in the UK after total hip replacement (THR) as well as determine whether PRT was part of ‘standard’ care. Methods After ethical approval, questionnaire item development about rehabilitation practice was guided by a focus group interview (after informed consent) with physiotherapists (n = 4; >5 years post-qualification) who regularly treated THR patients. An online questionnaire investigating the exercises prescribed and rehabilitation practice following THR was developed and sent to physiotherapists working in hospitals in the UK. The survey was performed from January to May 2011. The survey results were analysed (frequency (%) of responses) focusing on the exercises the physiotherapists considered important, as well as their use of PRT in prescribed regimes. Results 106 responses were obtained from physiotherapists in the UK. The survey respondents considered that the most important muscles to target in all phases of rehabilitation were the hip abductors (62.2%), followed by the quadriceps (16.9%), and other muscles (21%). Exercise type prescribed revealed no consensus, with weight bearing (42%), functional (45%) and Bed-based/Bridging/Postural exercises (13%) favoured. 83.7% were able to define the basis of progressive resistance training (PRT), but only 33% prescribed it. Conclusions Standard physiotherapy rehabilitation in the UK after THR is variable, and appears to rarely include PRT. This may be a factor in prolonged poor function in some patients after this common operation. PMID:23496875

  3. Assessment and management of the communication difficulties of children with cerebral palsy: a UK survey of SLT practice

    PubMed Central

    Mary Watson, Rose; Pennington, Lindsay

    2015-01-01

    Background Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. Aims To describe the assessment and intervention practices of speech–language therapist (SLTs) in the UK in their management of communication difficulties associated with CP in childhood. Methods & Procedures An online survey of the assessments and interventions employed by UK SLTs working with children and young people with CP was conducted. The survey was publicized via NHS trusts, the Royal College of Speech and Language Therapists (RCSLT) and private practice associations using a variety of social media. The survey was open from 5 December 2011 to 30 January 2012. Outcomes & Results Two hundred and sixty-five UK SLTs who worked with children and young people with CP in England (n = 199), Wales (n = 13), Scotland (n = 36) and Northern Ireland (n = 17) completed the survey. SLTs reported using a wide variety of published, standardized tests, but most commonly reported assessing oromotor function, speech, receptive and expressive language, and communication skills by observation or using assessment schedules they had developed themselves. The most highly prioritized areas for intervention were: dysphagia, alternative and augmentative (AAC)/interaction and receptive language. SLTs reported using a wide variety of techniques to address difficulties in speech, language and communication. Some interventions used have no supporting evidence. Many SLTs felt unable to estimate the hours of therapy per year children and young people with CP and communication disorders received from their service. Conclusions & Implications The assessment and management of communication difficulties associated with CP in childhood varies widely in the

  4. The current provision of community-based teaching in UK medical schools: an online survey and systematic review

    PubMed Central

    Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

    2014-01-01

    Objective To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. Design and data sources An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Study selection Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Results Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors’ knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Conclusions Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for ‘Tomorrow's Doctors’, a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. Strengths and limitations of this study This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed

  5. A theoretical and practical test of geographical profiling with serial vehicle theft in a U.K. context.

    PubMed

    Tonkin, Matthew; Woodhams, Jessica; Bond, John W; Loe, Trudy

    2010-01-01

    Geographical profiling is an investigative methodology sometimes employed by the police to predict the residence of an unknown offender from the locations of his/her crimes. The validity of geographical profiling, however, has not been fully explored for certain crime types. This study, therefore, presents a preliminary test of the potential for geographical profiling with a sample of 145 serial vehicle thieves from the U.K. The behavioural assumptions underlying geographical profiling (distance decay and domocentricity) are tested and a simple practical test of profiling using the spatial mean is presented. There is evidence for distance decay but not domocentricity among the spatial behaviour of car thieves from the U.K. A degree of success was achieved when applying the spatial mean on a case-by-case basis. The level of success varied, however, and neither series length in days nor number of crimes could account for the variation. The findings question previously held assumptions regarding geographical profiling and have potential theoretical and practical implications for the study and investigation of vehicle theft in the U.K.

  6. UK and Italian EIA systems: A comparative study on management practice and performance in the construction industry

    SciTech Connect

    Bassi, Andrea; Howard, Robert; Geneletti, Davide; Ferrari, Simone

    2012-04-15

    This study evaluates and contrasts the management practice and the performance that characterise Environmental Impact Assessments (EIA) in Italy and in the UK. The methodology relies on the investigation of six carefully selected case studies, critically reviewed by referring to EIA and project design information, as well as collecting the opinion of key project participants. The study focuses on the construction industry and on specific key sectors like infrastructure for transport and renewable energy and commercial and tourism development. A main term of reference for the analyses has been established by critically reviewing international literature so as to outline common good practice, requirements for the enhancement of sustainability principles and typically incurred drawbacks. The proposed approach enhances transfer of knowledge and of experiences between the analyzed contexts and allows the provision of guidelines for practitioners. Distinctive differences between the UK and the Italian EIA systems have been detected for pivotal phases and elements of EIA, like screening, scoping, analysis of alternatives and of potential impacts, definition of mitigation strategies, review, decision making, public participation and follow up. - Highlights: Black-Right-Pointing-Pointer The Italian and the UK Environmental Impact Assessment systems are compared. Black-Right-Pointing-Pointer The research is centred on the construction industry. Black-Right-Pointing-Pointer Issues and shortcomings are analysed by investigating six case studies. Black-Right-Pointing-Pointer Integration of EIA with sustainability principles is appraised. Black-Right-Pointing-Pointer General guidelines are provided to assist practitioners in the two national contexts.

  7. 21 CFR 120.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 120.5 Current good manufacturing practice. Part 110 of this chapter applies in...

  8. 21 CFR 113.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Current good manufacturing practice. 113.5 Section 113.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10,...

  9. 21 CFR 120.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 120.5 Current good manufacturing practice. Part 110 of this chapter applies in...

  10. 21 CFR 120.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 120.5 Current good manufacturing practice. Part 110 of this chapter applies in...

  11. 21 CFR 120.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 120.5 Current good manufacturing practice. Part 110 of this chapter applies in...

  12. 21 CFR 113.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 113.5 Section 113.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10,...

  13. 21 CFR 120.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 120.5 Current good manufacturing practice. Part 110 of this chapter applies in...

  14. 21 CFR 113.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Current good manufacturing practice. 113.5 Section 113.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10,...

  15. 21 CFR 113.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Current good manufacturing practice. 113.5 Section 113.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10,...

  16. 21 CFR 113.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Current good manufacturing practice. 113.5 Section 113.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10,...

  17. Geography: A Portrait of Current Practice in Scottish Secondary Schools

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2008

    2008-01-01

    "Geography--a portrait of current practice" in Scottish secondary schools is one of a developing series of publications by Her Majesty's Inspectorate of Education (HMIE), designed to reflect current good practice in subjects and aspects of Scottish education and identify areas for further improvement. The portrait series is a new initiative by…

  18. At the crossroads of anthropology and epidemiology: current research in cultural psychiatry in the UK.

    PubMed

    Dein, Simon; Bhui, Kamaldeep Singh

    2013-12-01

    Cultural psychiatry research in the UK comprises a broad range of diverse methodologies, academic disciplines, and subject areas. Methodologies range from epidemiological to anthropological/ethnographic to health services research; mixed methods research is becoming increasingly popular, as are public health and health promotional topics. After briefly outlining the history of cultural psychiatry in the UK we will discuss contemporary research. Prominent themes include: the epidemiology of schizophrenia among Africans/Afro-Caribbeans, migration and mental health, racism and mental health, cultural identity, pathways to care, explanatory models of mental illness, cultural competence, and the subjective experiences of healthcare provision among specific ethnic groups such as Bangladeshis and Pakistanis. Another strand of research that is attracting increasing academic attention focuses upon the relationship between religion, spirituality, and mental health, in particular, the phenomenology of religious experience and its mental health ramifications, as well as recent work examining the complex links between theology and psychiatry. The paper ends by appraising the contributions of British cultural psychiatrists to the discipline of cultural psychiatry and suggesting promising areas for future research.

  19. At the crossroads of anthropology and epidemiology: Current research in cultural psychiatry in the UK

    PubMed Central

    Bhui, Kamaldeep Singh

    2013-01-01

    Cultural psychiatry research in the UK comprises a broad range of diverse methodologies, academic disciplines, and subject areas. Methodologies range from epidemiological to anthropological/ethnographic to health services research; mixed methods research is becoming increasingly popular, as are public health and health promotional topics. After briefly outlining the history of cultural psychiatry in the UK we will discuss contemporary research. Prominent themes include: the epidemiology of schizophrenia among Africans/Afro-Caribbeans, migration and mental health, racism and mental health, cultural identity, pathways to care, explanatory models of mental illness, cultural competence, and the subjective experiences of healthcare provision among specific ethnic groups such as Bangladeshis and Pakistanis. Another strand of research that is attracting increasing academic attention focuses upon the relationship between religion, spirituality, and mental health, in particular, the phenomenology of religious experience and its mental health ramifications, as well as recent work examining the complex links between theology and psychiatry. The paper ends by appraising the contributions of British cultural psychiatrists to the discipline of cultural psychiatry and suggesting promising areas for future research. PMID:24114263

  20. Antimicrobial Stewardship from Policy to Practice: Experiences from UK Antimicrobial Pharmacists.

    PubMed

    Gilchrist, Mark; Wade, Paul; Ashiru-Oredope, Diane; Howard, Philip; Sneddon, Jacqueline; Whitney, Laura; Wickens, Hayley

    2015-09-01

    Antimicrobial stewardship in the UK has evolved dramatically in the last 15 years. Factors driving this include initial central funding for specialist pharmacists and mandatory reductions in healthcare-associated infections (particularly Clostridium difficile infection). More recently, the introduction of national stewardship guidelines, and an increased focus on stewardship as part of the UK five-year antimicrobial resistance strategy, have accelerated and embedded developments. Antimicrobial pharmacists have been instrumental in effecting changes at an organizational and national level. This article describes the evolution of the antimicrobial pharmacist role, its impact, the progress toward the actions listed in the five-year resistance strategy, and novel emerging areas in stewardship in the UK.

  1. VOC Control: Current practices and future trends

    SciTech Connect

    Moretti, E.C.; Mukhopadhyay, N. )

    1993-07-01

    One of the most formidable challenges posed by the Clean Air Act Amendments of 1990 (CAAA) is the search for efficient and economical control strategies for volatile organic compounds (VOCs). VOCs are precursors to ground-level ozone, a major component in the formation of smog. Under the CAAA, thousands of currently unregulated sources will be required to reduce or eliminate VOC emissions. In addition, sources that are currently regulated may seek to evaluate alternative VOC control strategies to meet stricter regulatory requirements such as the maximum achievable control technology (MACT) requirements in Title III of the CAAA. Because of the increasing attention being given to VOC control, the American Institute of Chemical Engineers' (AIChE) Center for Waste Reduction Technologies (CWRT) initiated a study of VOC control technologies and regulatory initiatives. A key objective of the project was to identify and describe existing VOC control technologies and air regulations, as well as emerging technologies and forthcoming regulations. That work is the basis for this article.

  2. PSYCHOLOGICAL ASSESSMENT FOR BARIATRIC SURGERY: CURRENT PRACTICES

    PubMed Central

    FLORES, Carolina Aita

    2014-01-01

    Introduction The prevalence of obesity on a global scale has alarmed health institutions, the general population and professionals involved in its treatment. Bariatric surgery has emerged as an effective and lasting alternative for weight reduction and improved general health. In this context and as part of a multidisciplinary team, psychologists are responsible for the preoperative psychological assessment of bariatric candidates. Aim To investigate how psychological assessments are occurring, including the identification of utilized resources; factors that are addressed; the duration of the process; existing protocols; and to evaluate the importance of this practice. Method A systematic review of national and international literature, through PubMed and Scielo's databases, using "psychological assessment", "obesity" and "surgery", as keywords. Conclusion There is an agreement about the main factors that should be investigated during the preoperative assessment, as well as the main contraindications for the surgical procedure. The importance of the psychological assessment is well established in the field of bariatric surgery. However, this area needs a standard protocol to guide the mental health professionals that deal with bariatric patients. PMID:25409969

  3. UK nurses are needed overseas.

    PubMed

    2016-09-28

    Could UK nurse volunteers working overseas be instrumental in reducing healthcare inequalities? João Marçal-Grilo, writing in Nursing Older People, is adamant that UK-trained nurses have the potential to eradicate poverty worldwide and should be offered opportunities to volunteer abroad and practise alongside colleagues in low and middle-income countries. Not only will this have a positive effect on older adults who are affected by a lack of qualified staff working in developing countries, UK-trained nurses can gain new skills that can benefit nursing practice in the UK. The article provides examples of current voluntary projects in older person care taking place in Sri Lanka and Nepal. PMID:27682572

  4. UK nurses are needed overseas.

    PubMed

    2016-09-28

    Could UK nurse volunteers working overseas be instrumental in reducing healthcare inequalities? João Marçal-Grilo, writing in Nursing Older People, is adamant that UK-trained nurses have the potential to eradicate poverty worldwide and should be offered opportunities to volunteer abroad and practise alongside colleagues in low and middle-income countries. Not only will this have a positive effect on older adults who are affected by a lack of qualified staff working in developing countries, UK-trained nurses can gain new skills that can benefit nursing practice in the UK. The article provides examples of current voluntary projects in older person care taking place in Sri Lanka and Nepal.

  5. Miniature bioreactors: current practices and future opportunities

    PubMed Central

    Betts, Jonathan I; Baganz, Frank

    2006-01-01

    This review focuses on the emerging field of miniature bioreactors (MBRs), and examines the way in which they are used to speed up many areas of bioprocessing. MBRs aim to achieve this acceleration as a result of their inherent high-throughput capability, which results from their ability to perform many cell cultivations in parallel. There are several applications for MBRs, ranging from media development and strain improvement to process optimisation. The potential of MBRs for use in these applications will be explained in detail in this review. MBRs are currently based on several existing bioreactor platforms such as shaken devices, stirred-tank reactors and bubble columns. This review will present the advantages and disadvantages of each design together with an appraisal of prototype and commercialised devices developed for parallel operation. Finally we will discuss how MBRs can be used in conjunction with automated robotic systems and other miniature process units to deliver a fully-integrated, high-throughput (HT) solution for cell cultivation process development. PMID:16725043

  6. Verbal autopsy: current practices and challenges.

    PubMed Central

    Soleman, Nadia; Chandramohan, Daniel; Shibuya, Kenji

    2006-01-01

    Cause-of-death data derived from verbal autopsy (VA) are increasingly used for health planning, priority setting, monitoring and evaluation in countries with incomplete or no vital registration systems. In some regions of the world it is the only method available to obtain estimates on the distribution of causes of death. Currently, the VA method is routinely used at over 35 sites, mainly in Africa and Asia. In this paper, we present an overview of the VA process and the results of a review of VA tools and operating procedures used at demographic surveillance sites and sample vital registration systems. We asked for information from 36 field sites about field-operating procedures and reviewed 18 verbal autopsy questionnaires and 10 cause-of-death lists used in 13 countries. The format and content of VA questionnaires, field-operating procedures, cause-of-death lists and the procedures to derive causes of death from VA process varied substantially among sites. We discuss the consequences of using varied methods and conclude that the VA tools and procedures must be standardized and reliable in order to make accurate national and international comparisons of VA data. We also highlight further steps needed in the development of a standard VA process. PMID:16583084

  7. Using Applied Behaviour Analysis as Standard Practice in a UK Special Needs School

    ERIC Educational Resources Information Center

    Foran, Denise; Hoerger, Marguerite; Philpott, Hannah; Jones, Elin Walker; Hughes, J. Carl; Morgan, Jonathan

    2015-01-01

    This article describes how applied behaviour analysis can be implemented effectively and affordably in a maintained special needs school in the UK. Behaviour analysts collaborate with classroom teachers to provide early intensive behaviour education for young children with autism spectrum disorders (ASD), and function based behavioural…

  8. Middle Managers in UK Higher Education Conceptualising Experiences in Support of Reflective Practice

    ERIC Educational Resources Information Center

    Birds, Rachel

    2014-01-01

    This paper examines the role of reflexivity in supporting middle managers in understanding and facilitating large-scale change management projects in their organisations. Utilising an example from a UK university, it is argued that the development of a conceptual model to fit local circumstances enables deeper understanding and better informed…

  9. An Empirical Study of Internet Usage and Difficulties among Medical Practice Management in the UK.

    ERIC Educational Resources Information Center

    Howcroft, Debra; Mitev, Nathalie

    2000-01-01

    Considers the use of information technology in the UK (United Kingdom) National Health Service (NHS) as the government pledges to connect every doctor or general practitioner to the NHS's information superhighway by the year 2002. Uses a case study to social and technical considerations surrounding this issue. (Author/LRW)

  10. The Creative Countryside: Policy and Practice in the UK Rural Cultural Economy

    ERIC Educational Resources Information Center

    Bell, David; Jayne, Mark

    2010-01-01

    This paper explores emerging policymaking and research into rural creative industries, drawing on a case study from the county of Shropshire in the UK. It begins with a critique of existing creative industries policy, which is argued to focus almost exclusively on the urban as the site of creative work. The paper highlights an emerging body of…

  11. The Search for next Practice: A UK Approach to Innovation in Schools

    ERIC Educational Resources Information Center

    Hannon, Valerie

    2009-01-01

    In 2002, the Labor Government in the UK established an Innovation Unit, within government, to support practitioner-led innovation in schools. Two considerations led to this action. First, there was an increasing sense that amidst the plethora of national strategies and change programs, an important element was in danger of being lost: the…

  12. Politics, Policies and Practice: Assessing the Impact of Sexual Harassment Policies in UK Universities

    ERIC Educational Resources Information Center

    Thomas, Alison M.

    2004-01-01

    Since sexual harassment was first named and identified as an obstacle to women's equality in the mid 1970s, concern about both its prevalence and its damaging effects has resulted in the widespread introduction of anti-harassment policies in UK universities, as in other work and educational settings. The study reported here sought to assess the…

  13. Policy Enactments in the UK Secondary School: Examining Policy, Practice and School Positioning

    ERIC Educational Resources Information Center

    Braun, Annette; Maguire, Meg; Ball, Stephen J.

    2010-01-01

    This paper presents a first attempt in an ongoing research study of the policy environments in four UK secondary schools to examine policy enactment, where "enactment" refers to an understanding that policies are interpreted and "translated" by diverse policy actors in the school environment, rather than simply implemented. The paper is divided…

  14. Recruiting Teachers Online: Marketing Strategies and Information Dissemination Practices of UK-Based Agencies

    ERIC Educational Resources Information Center

    de Villiers, Rian; Books, Sue

    2009-01-01

    A review of the websites of 43 UK-based agencies that are recruiting teachers in South Africa and other countries finds that important information about what to expect often is missing. An analysis of the marketing strategies shows that agencies overall are promising schools thorough vetting of candidates and low fees, are promising prospective…

  15. Telehealth: current practices and future directions

    NASA Astrophysics Data System (ADS)

    David, Yadin B.

    1996-02-01

    When we review the positive impact that the integration of ostensibly independent patient-care services have on the efficient management of quality care, education, and collaborative research, it is not surprising that telehealth deployment is on the rise. The forces that drive this phenomenon include: the need to manage the entire disease episode; the desire for wider geographically-distributed quality health care; the escalation of customer expectations; globalization of healthcare and its support services; an increase in patient and provider convenience; and the acceptance of the present technological community. At the Telehealth Center at the Texas Children's Hospital, current classifications of clinical applications are listed: (1) initial urgent evaluation of patients, (2) triage decisions and pretransfer arrangements, (3) medical and surgical follow-up and medication review, (4) consultation for primary care encounters, (5) real-time subspecialty care consultation and planning, (6) management of chronic diseases and conditions, (7) extended diagnostic work-ups, (8) review of diagnostic images, and (9) preventive medicine and patient education. The delivery of such services is associated with challenges and opportunities. As we move forward from limited data processing to an integrated communication system, from centralized main frame functions to personalized and location-independent workstations, and from hospitals to clinics and homecare, an increase in the minimum features provided by the equipment and the communication systems must accompany the widening variety of clinical applications. Future expansion of telehealth systems stands to revolutionize the delivery of services to the benefits of providers' networks, our economy, and patients through integration.

  16. The current status of diabetes professional educational standards and competencies in the UK--a position statement from the Diabetes UK Healthcare Professional Education Competency Framework Task and Finish Group.

    PubMed

    Walsh, N; George, S; Priest, L; Deakin, T; Vanterpool, G; Karet, B; Simmons, D

    2011-12-01

    Diabetes is a significant health concern, both in the UK and globally. Management can be complex, often requiring high levels of knowledge and skills in order to provide high-quality and safe care. The provision of good, safe, quality care lies within the foundations of healthcare education, continuing professional development and evidence-based practice, which are inseparable and part of a continuum during the career of any health professional. Sound education provides the launch pad for effective clinical management and positive patient experiences. This position paper reviews and discusses work undertaken by a Working Group under the auspices of Diabetes UK with the remit of considering all health professional educational issues for people delivering care to people with diabetes. This work has scoped the availability of education for those within the healthcare system who may directly or indirectly encounter people with diabetes and reviews alignment to existing competency frameworks within the UK's National Health Service.

  17. The impact of persistence with bisphosphonates on health resource utilization and fracture risk in the UK: a study of patient records from the UK Clinical Practice Research Datalink

    PubMed Central

    Ferguson, Samara; Feudjo Tepie, Maurille; Taylor, Andrew; Roddam, Andrew; Critchlow, Cathy; Iqbal, Mazhar; Spangler, Leslie

    2015-01-01

    Abstract Rationale, aims and objectives Clinical trial data suggest that patients who have received bisphosphonates continue to benefit from them after discontinuation. However, data from real‐world clinical practice are inconclusive. We assessed the impact of persistence and discontinuation on health resource utilization (HRU) and fracture rate in women who were prescribed oral bisphosphonates. Method The study used data from the UK Clinical Practice Research Datalink. Women aged 50 years or older with a first prescription of oral bisphosphonate therapy between January 2000 and December 2007 were included. Multivariate modelling compared rate ratios for fracture and HRU between patients who had discontinued medication (shorter persistence group) and patients who took their medication for longer (longer persistence group). The interactions of elapsed time (measured as 6‐month intervals) with HRU and with fracture rate for all patients within paired groups were also assessed. Results Overall, 36 320 patients were included. Pairwise comparisons showed that HRU and fracture rates were lower in longer persistence groups than in shorter persistence groups. Analysis by 6‐month interval showed that, across all patients in persistence group pairs, HRU significantly increased for each additional 6 months elapsed; trends towards increased risk of fracture were also seen. Conclusion In contrast to results from clinical trials, in this patient population the protective effect of oral bisphosphonates after discontinuation was not sufficient to reduce HRU and fracture rates to the levels that would be seen if patients had continued on therapy. Reducing the rate of treatment discontinuation may decrease the burden that osteoporosis places on both patients and health care systems. PMID:26279458

  18. Unequal to the task: deprivation, health and UK general practice at the millennium.

    PubMed Central

    Beale, N

    2001-01-01

    The NHS is over 50 years old, but health inequalities remain prevalent in the United Kingdom (UK). Material deprivation may be less apparent; however, social deprivation is becoming worse while the markers of socioeconomic disadvantage remain unsatisfactory. Health is an even more elusive concept; nevertheless, the evidence for an increasing association between deprivation, poor health, and early death is overwhelming. Equally unavoidable is the impact of this social degradation on UK primary care. Service industries have deserted deprived communities but, on the whole, GPs struggle on. Denied the supplementary resources they deserve they become disenchanted, too exhausted to convert incentives into rewards. Clear-headed strategic thinking from the top brass is overdue. PMID:11407055

  19. Developing best practice for fungal specimen management: audit of UK microbiology laboratories.

    PubMed

    Lasseter, G; Palmer, M; Morgan, J; Watts, J; Yoxall, H; Kibbler, C; McNulty, C

    2011-01-01

    This study represents an audit of microbiology laboratories in the UK to ascertain whether they are aware of, or follow, the Health Protection Agency (HPA) National Standard Methods Standard Operating Procedure (NSM SOP) for the investigation of dermatological specimens for superficial mycoses, or use a locally adapted version. A questionnaire audit was distributed to 179 NHS microbiology laboratories throughout England, Wales, Scotland and Northern Ireland. The NSM SOP was followed by 92% of laboratories for the microscopy of dermatological samples; light microscopy/ KOH digestion was used by 63% and fluorescence microscopy/KOH digestion by 29% of laboratories. Preliminary reports post-microscopy were issued by 98% of laboratories, with 93% issuing reports within 48 hours. Adherence to the NSM SOP guidelines for culture was low; only 34% of laboratories incubated microscopy-negative specimens for the recommended 14 days, while approximately 60% incubated microscopy-positive specimens for 21 days. The culture medium recommended by the NSM SOP was used in 82% of laboratories. Comments were added to culture reports by 51% of laboratories; most were added manually and comments varied between laboratories. Nail samples were the most common sample received from primary care, followed by skin and hair. These results show no significant difference in the rate of microscopy positives versus culture positives. Microscopy and culture are the easiest and cheapest methods available to UK laboratories for the investigation of suspected superficial fungal infections. Although most laboratories included in this audit claimed to follow the NSM SOP for microscopy and culture, these results show that the techniques used vary throughout the UK. To maximise the service provided to primary care, UK laboratories should use standardise methods based on the NSM SOP.

  20. Crystallization screening: the influence of history on current practice.

    PubMed

    Luft, Joseph R; Newman, Janet; Snell, Edward H

    2014-07-01

    While crystallization historically predates crystallography, it is a critical step for the crystallographic process. The rich history of crystallization and how that history influences current practices is described. The tremendous impact of crystallization screens on the field is discussed.

  1. Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

    PubMed Central

    Aird, Edwin GA; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia AD; Thomas, Russell AS; Venables, Karen; Thwaites, David I

    2015-01-01

    Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed. PMID:26329469

  2. Sustainable practices in medicinal chemistry: current state and future directions.

    PubMed

    Bryan, Marian C; Dillon, Barry; Hamann, Lawrence G; Hughes, Gregory J; Kopach, Michael E; Peterson, Emily A; Pourashraf, Mehrnaz; Raheem, Izzat; Richardson, Paul; Richter, Daniel; Sneddon, Helen F

    2013-08-01

    The medicinal chemistry subgroup of the American Chemical Society's Green Chemistry Institute Pharmaceutical Roundtable (ACS GCI PR) offers a perspective on the current state of environmentally sustainable practices in medicinal chemistry with the aim of sharing best practices more widely and highlighting some potential future developments.

  3. 21 CFR 123.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Current good manufacturing practice. 123.5 Section 123.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities,...

  4. 21 CFR 123.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 123.5 Section 123.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities,...

  5. 21 CFR 123.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Current good manufacturing practice. 123.5 Section 123.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities,...

  6. 21 CFR 123.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Current good manufacturing practice. 123.5 Section 123.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities,...

  7. 21 CFR 123.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Current good manufacturing practice. 123.5 Section 123.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities,...

  8. Current Practices in the Delivery of Undergraduate Exercise Physiology Content

    ERIC Educational Resources Information Center

    Fisher, Michele M.

    2013-01-01

    The purpose of this study was to identify current practices for the delivery of exercise physiology content at the undergraduate level. An anonymous 22-item survey was sent to instructors of exercise physiology to collect information concerning the structure of course offerings and instructional practices. One hundred ten instructors responded to…

  9. Evaluating Teaching: A Guide to Current Thinking and Best Practice.

    ERIC Educational Resources Information Center

    Stronge, James, Ed.

    This guide presents current research and thinking about teacher evaluation and combines that research with practice. Chapters contain illustrations and examples to make a research-practice connection and present a comprehensive approach to designing, implementing, and monitoring quality teacher-evaluation systems. Chapters include: (1) "Improving…

  10. A summarized discussion of current good manufacturing practice regulations.

    PubMed

    Allen, Loyd V

    2013-01-01

    In light of recent events and discussions of compounding pharmacy, it is important to discuss and understand the purpose of good manufacturing practices. This article provides a summary of the current Good Manufacturing Practice Regulations which were established by the U.S. Food and Drug Administration. PMID:24046937

  11. A summarized discussion of current good manufacturing practice regulations.

    PubMed

    Allen, Loyd V

    2013-01-01

    In light of recent events and discussions of compounding pharmacy, it is important to discuss and understand the purpose of good manufacturing practices. This article provides a summary of the current Good Manufacturing Practice Regulations which were established by the U.S. Food and Drug Administration.

  12. Improving prescribing practice in psychiatry: the experience of the Prescribing Observatory for Mental Health (POMH-UK).

    PubMed

    Barnes, Thomas R E; Paton, Carol

    2011-08-01

    Data from the UK Prescribing Observatory for Mental Health (POMH-UK) suggest that while positive change in prescribing practice can be achieved with focused, audit-based, quality improvement programmes (QIPs) that include feedback of benchmarked performance data and customized change interventions, the time frame for progress is long and improvement generally modest. Improvement may be seen between the baseline audit and re-audit, but supplementary audits conducted in subsequent years can show incremental, sustained improvement in clinical services that have been consistently involved. Audit invariably reveals a marked variation across and within healthcare organizations in the level of compliance with evidence-based clinical practice standards. Additional work has identified various impediments to behavioural change. Some are common to all QIPs, such as the incomplete dissemination of audit results throughout participating organizations and variable uptake of change interventions. Others are specific to particular QIPs, depending on the prescribing issue addressed. For example, in a QIP targeting biochemical monitoring of lithium treatment, the major barrier was the complexity of clinical care arrangements, including multiple interfaces between clinical and laboratory services, which were often not directly or wholly under the control of clinical teams. In this QIP there was little improvement in overall performance against the clinical standards in the total national sample between baseline and re-audit.

  13. Preliminary Evidence That Yoga Practice Progressively Improves Mood and Decreases Stress in a Sample of UK Prisoners

    PubMed Central

    Bilderbeck, Amy C.; Brazil, Inti A.; Farias, Miguel

    2015-01-01

    Objectives. In the first randomized controlled trial of yoga on UK prisoners, we previously showed that yoga practice was associated with improved mental wellbeing and cognition. Here, we aimed to assess how class attendance, self-practice, and demographic factors were related to outcome amongst prisoners enrolled in the 10-week yoga intervention. Methods. The data of 55 participants (52 male, 3 female) who completed a 10-week yoga course were analysed. Changes in pre- and postyoga measures of affect, perceived stress, and psychological symptoms were entered into linear regression analyses with bias-corrected and accelerated bootstrap confidence intervals. Class attendance, self-practice, demographic variables, and baseline psychometric variables were included as regressors. Results. Participants who attended more yoga classes and those who engaged in frequent (5 times or more) self-practice reported significantly greater decreases in perceived stress. Decreases in negative affect were also significantly related to high frequency self-practice and greater class attendance at a near-significant level. Age was positively correlated with yoga class attendance, and higher levels of education were associated with greater decreases in negative affect. Conclusions. Our results suggest that there may be progressive beneficial effects of yoga within prison populations and point to subpopulations who may benefit the most from this practice. PMID:26294928

  14. 21 CFR 114.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Current good manufacturing practice. 114.5 Section 114.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good...

  15. 21 CFR 114.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Current good manufacturing practice. 114.5 Section 114.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good...

  16. 21 CFR 114.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Current good manufacturing practice. 114.5 Section 114.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good...

  17. 21 CFR 114.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 114.5 Section 114.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good...

  18. 21 CFR 114.5 - Current good manufacturing practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 2 2013-04-01 2013-04-01 false Current good manufacturing practice. 114.5 Section 114.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good...

  19. Inclusion Classrooms and Teachers: A Survey of Current Practices

    ERIC Educational Resources Information Center

    Kilanowski-Press, Lisa; Foote, Chandra J.; Rinaldo, Vince J.

    2010-01-01

    This study investigates the current state of inclusion practices in general education classrooms via survey of 71 inclusion teachers currently serving as special educators across the state of New York. Specifically, small group instruction, co-teaching, one-to-one instruction, and planning support are explored in relationship to class size, number…

  20. The UK immunisation schedule: changes to vaccine policy and practice in 2013/14

    PubMed Central

    Hassounah, Sondus

    2015-01-01

    Summary Vaccination programmes are implemented either as new vaccines become available or evidence about them accumulates, or in response to specific situations. In the United Kingdom, development and implementation of the national immunisation programme is centrally coordinated and funded by the Department of Health on behalf of England, Wales, Scotland and Northern Ireland. A number of significant changes were made to the UK immunisation schedule for 2013/2014. Three new vaccines were introduced: intranasal influenza and oral rotavirus for children and subcutaneous shingles for older adults. To ensure protection against meningococcal C infection into adulthood, there has been a change to the schedule for meningitis C vaccination. The temporary pertussis vaccination programme for pregnant women, set up in response to an increase in the number of cases of pertussis particularly among young babies, has been extended until further notice. Furthermore, in response to large outbreaks of measles in south Wales and other parts of the UK, a national measles, mumps and rubella catch-up campaign specifically targeted at unvaccinated children aged 10–16 years was launched to ensure that all children and young people have received two doses of measles, mumps and rubella vaccine. This review describes the rationale behind these policy changes. PMID:25973215

  1. The UK immunisation schedule: changes to vaccine policy and practice in 2013/14.

    PubMed

    Atchison, Christina J; Hassounah, Sondus

    2015-04-01

    Vaccination programmes are implemented either as new vaccines become available or evidence about them accumulates, or in response to specific situations. In the United Kingdom, development and implementation of the national immunisation programme is centrally coordinated and funded by the Department of Health on behalf of England, Wales, Scotland and Northern Ireland. A number of significant changes were made to the UK immunisation schedule for 2013/2014. Three new vaccines were introduced: intranasal influenza and oral rotavirus for children and subcutaneous shingles for older adults. To ensure protection against meningococcal C infection into adulthood, there has been a change to the schedule for meningitis C vaccination. The temporary pertussis vaccination programme for pregnant women, set up in response to an increase in the number of cases of pertussis particularly among young babies, has been extended until further notice. Furthermore, in response to large outbreaks of measles in south Wales and other parts of the UK, a national measles, mumps and rubella catch-up campaign specifically targeted at unvaccinated children aged 10-16 years was launched to ensure that all children and young people have received two doses of measles, mumps and rubella vaccine. This review describes the rationale behind these policy changes.

  2. The Working Practices and Clinical Experiences of Paediatric Speech and Language Therapists: A National UK Survey

    ERIC Educational Resources Information Center

    Pring, Tim; Flood, Emma; Dodd, Barbara; Joffe, Victoria

    2012-01-01

    Background: The majority of speech and language therapists (SLTs) work with children who have speech, language and communication needs. There is limited information about their working practices and clinical experience and their views of how changes to healthcare may impact upon their practice. Aims: To investigate the working practices and…

  3. Restricted Creativity: Advertising Agency Work Practices in the U.S., Canada and the UK.

    ERIC Educational Resources Information Center

    West, Douglas

    1993-01-01

    The extent to which relationships and work practices within advertising agencies differ in the United States, Canada, and the United Kingdom and degree of similarity to practices of artists were examined. Responses from Senior Creative Directors at 303 agencies suggested that work practices did not differ significantly but were limited in efforts…

  4. The Current State of Sustainability in Bioscience Laboratories: A Statistical Examination of a UK Tertiary Institute

    ERIC Educational Resources Information Center

    Wright, Hazel A.; Ironside, Joseph E.; Gwynn-Jones, Dylan

    2008-01-01

    Purpose: This study aims to identify the current barriers to sustainability in the bioscience laboratory setting and to determine which mechanisms are likely to increase sustainable behaviours in this specialised environment. Design/methodology/approach: The study gathers qualitative data from a sample of laboratory researchers presently…

  5. Cefixime-resistant Neisseria gonorrhoeae in the UK: a time to reflect on practice and recommendations.

    PubMed

    Forsyth, S; Penney, P; Rooney, G

    2011-05-01

    A 40-year-old man who has sex with men (MSM) with urethral gonorrhoea failed to respond to treatment with 400 mg cefixime orally. Laboratory isolation of the post-treatment strain showed a minimum inhibitory concentration of ≥0.25 mg/L, which is a level of tolerance to cefixime that has not been previously documented in the UK. This case illustrates the importance of assessing all patients after treatment for gonorrhoea so that treatment failure and antibiotic resistance can be identified. It is vital that gonorrhoea culture continues to be attempted from all infected individuals to enable accurate diagnosis and antibiotic sensitivities. We also recommend that laboratories test for cefixime sensitivity routinely, given that it is one of the most commonly prescribed treatments for gonorrhoea.

  6. Endocannabinoid system modulator use in everyday clinical practice in the UK and Spain.

    PubMed

    García-Merino, Antonio

    2013-02-01

    Spasticity is a disabling complication of multiple sclerosis. Some commonly used oral medications include baclofen, tizanidine, anticonvulsants and benzodiazepines, but their benefits are modest. Sativex® (GW Pharmaceuticals PLC, Porton Down, UK; Laboratorios Almirall, SA, Barcelona, Spain) is a unique cannabinoid-based medicine with two main active ingredients; 9-δ-tetrahydrocannabinol, which acts mainly on cannabinoid 1 receptors in the CNS and plays a key role in the modulation of spasticity and spasms, and cannabidiol, which has different properties, including minimization of the psychoactivity associated with 9-δ-tetrahydrocannabinol. Sativex is indicated for symptomatic improvement in adult patients with moderate-to-severe multiple sclerosis-related spasticity who have not responded adequately to other first- or second-line antispasticity medications, and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial of therapy. Over the past couple of years, Sativex has been approved for use in a number of European countries and ongoing postmarketing studies are evaluating the possible risks associated with Sativex treatment by systematically collecting all suspected adverse reactions that occur in patients from the start of treatment. Interim data from the UK as well as Spanish Sativex safety registries confirm that clinical benefit is maintained over the longer term despite the expected trend for deterioration owing to disease progression. Even after more than 2 years of use, no new safety/tolerability signals have emerged with Sativex, including no evidence of driving impairment and no relevant incidence of falls or other adverse events of concern, such as psychiatric or nervous system events. Sativex appears to be a well-tolerated and useful add-on therapy in patients who have not achieved an adequate response with traditional antispastic agents. PMID:23369054

  7. UK prescribing practices as proxy markers of unmet need in allergic rhinitis: a retrospective observational study.

    PubMed

    Price, David B; Scadding, Glenis; Bachert, Claus; Saleh, Hesham; Nasser, Shuaib; Carter, Victoria; von Ziegenweidt, Julie; Durieux, Alice M S; Ryan, Dermot

    2016-01-01

    Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20% of SAR and >37% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and >50% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies. PMID:27334893

  8. UK prescribing practices as proxy markers of unmet need in allergic rhinitis: a retrospective observational study

    PubMed Central

    Price, David B; Scadding, Glenis; Bachert, Claus; Saleh, Hesham; Nasser, Shuaib; Carter, Victoria; von Ziegenweidt, Julie; Durieux, Alice M S; Ryan, Dermot

    2016-01-01

    Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20% of SAR and >37% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and >50% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies. PMID:27334893

  9. Modelling study to estimate the health burden of foodborne diseases: cases, general practice consultations and hospitalisations in the UK, 2009

    PubMed Central

    Larose, Tricia L; Adak, Goutam K; Evans, Meirion R; Tam, Clarence C

    2016-01-01

    Objective To generate estimates of the burden of UK-acquired foodborne disease accounting for uncertainty. Design A modelling study combining data from national public health surveillance systems for laboratory-confirmed infectious intestinal disease (IID) and outbreaks of foodborne disease and 2 prospective, population-based studies of IID in the community. The underlying data sets covered the time period 1993–2008. We used Monte Carlo simulation and a Bayesian approach, using a systematic review to generate Bayesian priors. We calculated point estimates with 95% credible intervals (CrI). Setting UK, 2009. Outcome measures Pathogen-specific estimates of the number of cases, general practice (GP) consultations and hospitalisations for foodborne disease in the UK in 2009. Results Bayesian approaches gave slightly more conservative estimates of overall health burden (∼511 000 cases vs 566 000 cases). Campylobacter is the most common foodborne pathogen, causing 280 400 (95% CrI 182 503–435 693) food-related cases and 38 860 (95% CrI 27 160–55 610) GP consultations annually. Despite this, there are only around 562 (95% CrI 189–1330) food-related hospital admissions due to Campylobacter, reflecting relatively low disease severity. Salmonella causes the largest number of hospitalisations, an estimated 2490 admissions (95% CrI 607–9631), closely followed by Escherichia coli O157 with 2233 admissions (95% CrI 170–32 159). Other common causes of foodborne disease include Clostridium perfringens, with an estimated 79 570 cases annually (95% CrI 30 700–211 298) and norovirus with 74 100 cases (95% CrI 61 150–89 660). Other viruses and protozoa ranked much lower as causes of foodborne disease. Conclusions The 3 models yielded similar estimates of the burden of foodborne illness in the UK and show that continued reductions in Campylobacter, Salmonella, E. coli O157, C. perfringens and norovirus are needed to mitigate the impact of

  10. Practical Support from Fathers and Grandmothers Is Associated with Lower Levels of Breastfeeding in the UK Millennium Cohort Study

    PubMed Central

    2015-01-01

    Mothers face trade-offs between infant care and subsistence/economic activities. In traditional populations, allomothers such as fathers and grandmothers support mothers with young infants, allowing them to reduce labour activities and focus on breastfeeding. Similarly, the positive impact of social support on breastfeeding has been highlighted in developed populations. However, these studies have generally focused on emotional support from fathers, peers and healthcare professionals. Given the availability of formula milk in developed populations, an evolutionary anthropological perspective highlights that practical support, unlike emotional support, may have negative associations with breastfeeding by enabling substitution of maternal care. Other kin, mainly grandmothers, may also be important allomothers influencing maternal breastfeeding levels. Here we explore the associations between different types of social support mothers receive from fathers/grandmothers and breastfeeding in the UK Millennium Cohort Study. We find frequent grandmother contact and father’s parenting involvement are both associated with lower levels of breastfeeding, suggesting a negative relationship between practical support and breastfeeding. In contrast, father presence, potentially capturing emotional support, is associated with greater breastfeeding initiation. Our findings suggest that practical support and emotional support functions differently, and practical support may not encourage breastfeeding in developed populations. PMID:26192993

  11. Survey of UK Speech and Language Therapists' Assessment and Treatment Practices for People with Progressive Dysarthria

    ERIC Educational Resources Information Center

    Collis, Jessica; Bloch, Steven

    2012-01-01

    Background: Dysarthria knowledge is predominantly impairment-based. As a result, speech and language therapists (SLTs) have traditionally adopted impairment-focused management practices. However, guidance for best practice suggests that SLTs should consider the client holistically, including the impact of dysarthria beyond the impairment. Aims: To…

  12. Access to complementary medicine in general practice: survey in one UK health authority.

    PubMed

    Wearn, A M; Greenfield, S M

    1998-09-01

    Complementary therapy (CT) has become increasingly popular with the general public and interest from the health professions has been rising. There has been no study focusing on the pattern of availability of CT within urban and inner-city general practice. We aimed to describe the prevalence and pattern of access to complementary therapy in this setting, identifying the characteristics of practices offering CT and the perceived barriers to service provision. We sent a postal questionnaire to all 254 general practices on the Birmingham Family Health Services Authority list. Practices were asked whether they offered any access to CTs, how services were organized and which therapies were available and to identify any barriers to provision. 175 practices (68.9%) responded. Half of the practices offered access to CT. Of these, half offered an in-house service, usually provided by the doctor (81.8%). Of GPs practising therapies themselves, 58% began in or after 1990. Seventeen separate therapies were offered, most commonly acupuncture, osteopathy, chiropractic, hypnotherapy and homoeopathy. Practices significantly more likely to offer access to CT were of larger list size and training or teaching practices. They were equally likely to be fundholders or non-fundholders. Practices offering an in-house service tended to be fundholding, training and of larger list size. Finance was perceived as the major barrier. In the area studied, many patients now have some access to CT within primary care, often within their own practice. In the main, therapies offered are the 'medically acceptable face' of complementary medicine.

  13. Contemporary chiropractic practice in the UK: a field study of a chiropractor and his patients in a suburban chiropractic clinic

    PubMed Central

    2013-01-01

    Background Two recent surveys of chiropractors in Great Britain suggest that there are discrepancies between chiropractic practice as defined in regulatory guidelines and day-to-day chiropractic clinical practice and there is in general a paucity of information regarding the characteristics of contemporary chiropractic practice in the United Kingdom. This field study describes the daily practice of a contemporary British UK-trained chiropractor. Methods The fieldwork took place during the spring and summer of 2008 when the author spent one day per week observing consultations and interviewing patients in a chiropractic clinic. The chiropractor was subjected to interviews on two occasions. The author also registered as a patient. Field notes were taken by the author, interviews were recorded and the transcripts were corrected and analysed by the author. Results A total of 25 patients took part in the study. The interaction that took place between patients and staff in reception could be considered as a prelude to consultation facilitating the transformation from individual to patient and back to individual. Coupled with the continuous physical contact between the chiropractor and each patient there was a substantial amount of verbal and non-verbal communication throughout treatment visits. The patients presented with predominantly musculo-skeletal pain and the majority had consulted the chiropractor as a result of recommendations from others in their close social environment. The majority of the interviewed patients had either an inaccurate or at best rudimentary understanding of the mechanisms of chiropractic treatment. A few of the interviewed patients indicated that they had at first experienced concerns about the nature of chiropractic treatment or getting undressed. The author was able to gain some insight into how the chiropractor's experiences, opinions and beliefs had shaped his approach to chiropractic treatment and how this formed the basis of his clinical

  14. The stewardship model: current viability for genetic biobank practice development.

    PubMed

    Williams, Pamela Holtzclaw; Schepp, Karen; McGrath, Barbara; Mitchell, Pamela

    2010-01-01

    The "stewardship model" of ethics relationships is a conceptual framework initially proposed by Jeffers in Advances in Nursing Science, 24(2), 2001. It conceptualized ethical responsibilities in the practice of systematic collection and storage of biospecimens in biobanks for future healthcare genetic research. Since the article's publication 8 years ago, genetic biobanks have grown in number around the world and discernible biobank relational conceptualizations were published. Nursing leadership adopted competency standards for all genetic nursing practices. The involvement of nurses has increased and is projected for further significant increase as biobank practices emerge from research into clinical care settings. This assessment of current viability of this previously established stewardship model offers fresh insights to existing and future nursing research and practice. The purpose of this article was to analyze the original stewardship model's components, the relational parties, and characteristics; by contrasting those with proposed conceptualizations and existing biobank practices developed subsequent to its publication. The model's current viability and theoretical development status are assessed for its ability to support a future nursing evidence base for best practices. Proposals for the model's expansion are suggested.

  15. Narrative, Poststructuralism, and Social Justice: Current Practices in Narrative Therapy

    ERIC Educational Resources Information Center

    Combs, Gene; Freedman, Jill

    2012-01-01

    This paper is a review of current practice in narrative therapy with a focus on how it is attractive and useful for therapists who wish to work for social justice. The authors describe narrative therapy's roots in poststructuralist philosophy and social science. They illustrate its major theoretical constructs, including the "narrative metaphor,"…

  16. Reaching First Year College Students: Current Practices in Instructional Programs

    ERIC Educational Resources Information Center

    Boyd-Byrnes, Mary Kate; McDermott, Dona

    2006-01-01

    In light of the new emphasis on information literacy, this research updates previous studies and explores current practices in first year library instruction and programming. Academic librarians are reaching out to freshmen seminar programs, first year orientations, Introduction to College courses, and English composition courses to integrate…

  17. Serving Wounded Warriors: Current Practices in Postsecondary Education

    ERIC Educational Resources Information Center

    Vance, Mary Lee; Miller, Wayne K., II

    2009-01-01

    From September to October 2009 the Association on Higher Education and Disabilities (AHEAD) invited anonymous voluntary responses from 2,500 members and affiliates to complete a 29-question online survey on current practices in postsecondary education for serving veterans with disabilities (wounded warriors). Two hundred and thirty seven complete…

  18. Crystallization screening: the influence of history on current practice

    PubMed Central

    Luft, Joseph R.; Newman, Janet; Snell, Edward H.

    2014-01-01

    While crystallization historically predates crystallography, it is a critical step for the crystallographic process. The rich history of crystallization and how that history influences current practices is described. The tremendous impact of crystallization screens on the field is discussed. PMID:25005076

  19. Exploring Current Arts Practice in Kindergartens and Preparatory Classrooms

    ERIC Educational Resources Information Center

    Garvis, Susanne

    2012-01-01

    The arts are an important area of development for young children in their early years. By engaging with arts activities, young children are able to use their senses to explore the world. This paper reports on current arts practice in two kindergartens and two preparatory classrooms in Queensland, Australia. All sites are located in neighbouring…

  20. The Legal Implications of Student Use of Social Networking Sites in the UK and US: Current Concerns and Lessons for the Future

    ERIC Educational Resources Information Center

    Davies, Mark R.; Lee, Barbara A.

    2008-01-01

    This paper provides a comparative snapshot of the current state of the law in the US and UK with respect to potential liability of university and college students for use (and misuse) of social networking sites. It reviews the limited case law on this topic, highlights the differences in the two nations' laws of defamation and the various possible…

  1. Does the current regulation of assisted reproductive techniques in the UK safeguard animal welfare?

    PubMed Central

    Campbell, Madeleine L.H.

    2016-01-01

    Reproductive medicine is one of the fastest-developing fields of veterinary medicine, Regulation of veterinary assisted reproductive technologies (ARTs) is currently divided between the Animals (Scientific Procedures) Act (1986); the Veterinary Surgeons Act 1966, and the Animal Welfare Act (2006). None of those pieces of legislation was purpose designed to protect the welfare of animals undergoing ARTs, either directly or by determining which veterinary ART procedures may or may not be performed. Consequently, due to the lack of reference to such procedures, the welfare protection aims of the legislation are sometimes ambiguous. It is therefore difficult to ascertain whether the aims of the legislation are being fulfilled, but, in the opinion of this author, the legislation is anyway inadequate in scope, most particularly because it fails to provide a reporting function. It is unclear whether all or any veterinary ART procedures being undertaken on post-natal animals are associated with suffering. Some ARTs may cause discomfort, stress or pain: study or review of the welfare effects of these would be valuable. Any future review of the legislation regulating veterinary ARTs, be that an overall review or a review of one of the relevant statutes (for example the VSA), should take into account the interface between research and clinical medicine; the potentially welfare-compromising gaps between the Acts; the need to introduce reporting functions in order to build an evidence base, and the issue of veterinary specialisation and whether specialised techniques should be carried out only by those with specialist post-graduate qualifications. PMID:26973381

  2. Diagnosis, Management and Assessment of Adults with Joint Hypermobility Syndrome: A UK-Wide Survey of Physiotherapy Practice.

    PubMed

    Palmer, Shea; Cramp, Fiona; Lewis, Rachel; Muhammad, Shahid; Clark, Emma

    2015-06-01

    Joint hypermobility syndrome (JHS) is a heritable disorder associated with excessive joint range of motion and pain in the absence of inflammatory joint disease. It is a relatively common cause of musculoskeletal pain but is generally understood to be under-recognized and poorly managed in clinical practice. The present study therefore aimed to identify how JHS is diagnosed, managed and assessed in routine physiotherapy practice. A survey tool was developed from similar physiotherapy surveys of musculoskeletal practice, a review of the literature, and consultation with researchers and clinicians. Paper copies of the final survey were sent to 201 randomly selected secondary care organizations across the UK and an electronic version was advertised through physiotherapy professional networks. A total of 66 responses (80% women) were received from physiotherapists, with a wide range of clinical experience. Only 32% of respondents reported that they had received formal training in JHS management. The Brighton diagnostic criteria for JHS were not often used (only 31% of respondents). The stated aims of physiotherapy and the specific interventions employed seem well matched, with a focus on advice, education, exercise and self-management. Although pain relief was not reported as a high priority in terms of treatment aims, pain was most often assessed as an outcome, suggesting a mismatch between what clinicians aim to achieve and what they measure. The results suggest that reported management strategies are broadly appropriate to long-term musculoskeletal conditions but additional training specific to JHS may be required, particularly in diagnosis and assessment.

  3. The impact of pay-for-performance on professional boundaries in UK general practice: an ethnographic study.

    PubMed

    Grant, Suzanne; Huby, Guro; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw; Guthrie, Bruce

    2009-03-01

    The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact of the new contract and the financial incentives contained within it on professional boundaries in UK general practice. The distribution of clinical and administrative work has changed significantly and there has been a new concentration of authority, with QOF decision making and monitoring being led by an internal QOF team of clinical and managerial staff who make the major practice-level decisions about QOF, monitor progress against targets, and intervene to resolve areas or indicators at risk of missing targets. General practitioners and nurses, however, appear to have accommodated these changes by re-creating long established narratives on professional boundaries and clinical hierarchies. This paper is concerned with the impact of these new arrangements on existing clinical hierarchies.

  4. Good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) in the UK: a consensus statement.

    PubMed

    Patel, Sanjay; Abrahamson, Ed; Goldring, Stephen; Green, Helen; Wickens, Hayley; Laundy, Matt

    2015-02-01

    There is compelling evidence to support the rationale for managing children on intravenous antimicrobial therapy at home whenever possible, including parent and patient satisfaction, psychological well-being, return to school/employment, reductions in healthcare-associated infection and cost savings. As a joint collaboration between the BSAC and the British Paediatric Allergy, Immunity and Infection Group, we have developed good practice recommendations to highlight good clinical practice and governance within paediatric outpatient parenteral antibiotic therapy (p-OPAT) services across the UK. These guidelines provide a practical approach for safely delivering a p-OPAT service in both secondary care and tertiary care settings, in terms of the roles and responsibilities of members of the p-OPAT team, the structure required to deliver the service, identifying patients and pathologies that are suitable for p-OPAT, ensuring appropriate vascular access, antimicrobial choice and delivery and the clinical governance aspects of delivering a p-OPAT service. The process of writing a business case to support the introduction of a p-OPAT service is also addressed.

  5. Soft governance, restratification and the 2004 general medical services contract: the case of UK primary care organisations and general practice teams.

    PubMed

    Grant, Suzanne; Ring, Adele; Gabbay, Mark; Guthrie, Bruce; McLean, Gary; Mair, Frances S; Watt, Graham; Heaney, David; O'Donnell, Catherine

    2015-01-01

    In the UK National Health Service, primary care organisation (PCO) managers have traditionally relied on the soft leadership of general practitioners based on professional self-regulation rather than direct managerial control. The 2004 general medical services contract (nGMS) represented a significant break from this arrangement by introducing new performance management mechanisms for PCO managers to measure and improve general practice work. This article examines the impact of nGMS on the governance of UK general practice by PCO managers through a qualitative analysis of data from an empirical study in four UK PCOs and eight general practices, drawing on Hood's four-part governance framework. Two hybrids emerged: (i) PCO managers emphasised a hybrid of oversight, competition (comptrol) and peer-based mutuality by granting increased support, guidance and autonomy to compliant practices; and (ii) practices emphasised a broad acceptance of increased PCO oversight of clinical work that incorporated a restratified elite of general practice clinical peers at both PCO and practice levels. Given the increased international focus on the quality, safety and efficiency in primary care, a key issue for PCOs and practices will be to achieve an effective, contextually appropriate balance between the counterposing governance mechanisms of peer-led mutuality and externally led comptrol.

  6. Soft governance, restratification and the 2004 general medical services contract: the case of UK primary care organisations and general practice teams.

    PubMed

    Grant, Suzanne; Ring, Adele; Gabbay, Mark; Guthrie, Bruce; McLean, Gary; Mair, Frances S; Watt, Graham; Heaney, David; O'Donnell, Catherine

    2015-01-01

    In the UK National Health Service, primary care organisation (PCO) managers have traditionally relied on the soft leadership of general practitioners based on professional self-regulation rather than direct managerial control. The 2004 general medical services contract (nGMS) represented a significant break from this arrangement by introducing new performance management mechanisms for PCO managers to measure and improve general practice work. This article examines the impact of nGMS on the governance of UK general practice by PCO managers through a qualitative analysis of data from an empirical study in four UK PCOs and eight general practices, drawing on Hood's four-part governance framework. Two hybrids emerged: (i) PCO managers emphasised a hybrid of oversight, competition (comptrol) and peer-based mutuality by granting increased support, guidance and autonomy to compliant practices; and (ii) practices emphasised a broad acceptance of increased PCO oversight of clinical work that incorporated a restratified elite of general practice clinical peers at both PCO and practice levels. Given the increased international focus on the quality, safety and efficiency in primary care, a key issue for PCOs and practices will be to achieve an effective, contextually appropriate balance between the counterposing governance mechanisms of peer-led mutuality and externally led comptrol. PMID:25601063

  7. Naturalness as an ethical stance: idea(l)s and practices of care in western herbal medicine in the UK.

    PubMed

    Nissen, Nina

    2015-01-01

    An association of non-biomedical healthcare with appeals to nature and naturalness, and an invocation of a rhetoric of gentleness, goodness, purity and moral power has been noted previously, and some scholars argue that nature has taken on a meaning broadly opposed to the rational scientific order of modernity. Drawing on an ethnographic study of women's practice and use of western herbal medicine (WHM) in the UK, the intertwining of the perceived naturalness of WHM with distinct care practices points to a further avenue for exploration. To examine patients' and herbalists' discourses of the naturalness of WHM and associated idea(l)s and practices of care, understandings of nature and a feminist ethics of care are utilized as analytical frameworks. The analysis presented suggests that, through WHM, patients and herbalists become embedded in a complex spatio-temporal wholeness and web of care that intertwines past, present and future, self and others, and local and global concerns. In the emerging 'ordinary ethics of care', naturalness constitutes a sign of goodness and of a shared humanity within the organic world, while care, underpinned by idea(l)s of natural and holistic care practices, links human and non-human others. Thus, the naturalness of WHM, as perceived by some patients and herbalists, engages and blends with a continually unfolding field of relationships in the lifeworld(s), where care practices, caring relations and collective wellbeing may constitute an ethical stance that raises deeper questions about the significance of relationality, the values of care/caring and the mutual involvement of nature and human being(s). PMID:26001272

  8. Naturalness as an ethical stance: idea(l)s and practices of care in western herbal medicine in the UK.

    PubMed

    Nissen, Nina

    2015-01-01

    An association of non-biomedical healthcare with appeals to nature and naturalness, and an invocation of a rhetoric of gentleness, goodness, purity and moral power has been noted previously, and some scholars argue that nature has taken on a meaning broadly opposed to the rational scientific order of modernity. Drawing on an ethnographic study of women's practice and use of western herbal medicine (WHM) in the UK, the intertwining of the perceived naturalness of WHM with distinct care practices points to a further avenue for exploration. To examine patients' and herbalists' discourses of the naturalness of WHM and associated idea(l)s and practices of care, understandings of nature and a feminist ethics of care are utilized as analytical frameworks. The analysis presented suggests that, through WHM, patients and herbalists become embedded in a complex spatio-temporal wholeness and web of care that intertwines past, present and future, self and others, and local and global concerns. In the emerging 'ordinary ethics of care', naturalness constitutes a sign of goodness and of a shared humanity within the organic world, while care, underpinned by idea(l)s of natural and holistic care practices, links human and non-human others. Thus, the naturalness of WHM, as perceived by some patients and herbalists, engages and blends with a continually unfolding field of relationships in the lifeworld(s), where care practices, caring relations and collective wellbeing may constitute an ethical stance that raises deeper questions about the significance of relationality, the values of care/caring and the mutual involvement of nature and human being(s).

  9. Practices used for recommending sickness certification by general practitioners: a conversation analytic study of UK primary care consultations.

    PubMed

    Wheat, Hannah C; Barnes, Rebecca K; Byng, Richard

    2015-02-01

    Existing research indicates that many patients and doctors find the process of negotiating sickness certification for time off work to be a difficult one. This study examined how patients and general practitioners (GPs) managed these negotiations in a sample of UK primary care consultations. The study made use of an existing dataset of audio-recorded consultations between 13 GPs and 506 unselected adult patients in five general practices in London. Forty-nine consultations included discussions for both initial and repeat sickness certification across a wide range of conditions. Here we report our findings on doctor practices for recommending, as opposed to patient practices for advocating for, sickness certification (n = 26 cases). All cases were transcribed in detail and analysed using conversation analytic methods. Four main communication practices were observed: (1) declarative statements of need for sickness certification; (2) 'do you need' offers for sickness certification; (3) 'do you want' offers for sickness certification; and (4) conditional 'If X, Y' offers for sickness certification. These different communication practices indexed doctor agency, doctor endorsement and patient entitlement to varying degrees. In the main, recommendations to patients presenting with biomedical problems or a repeat occurrence of a psychosocial problem displayed stronger doctor endorsement and patient entitlement. Contrastingly, recommendations to patients presenting with new psychosocial and biopsychosocial problems, displayed weaker endorsement and patient entitlement. This study offers new evidence to support the Parsonian argument that becoming sick involves entering a social role with special rights and obligations. Through documenting doctors' orientations to their gatekeeping role as well as patients' orientations to differential rights vis à vis legitimacy, we demonstrate the contrasting stances of doctors in situ when giving sick notes for biomedical problems as

  10. Multicentre prospective survey of SeHCAT provision and practice in the UK

    PubMed Central

    Peacock, Janet; Coker, Bolaji; McMillan, Viktoria; Ofuya, Mercy; Lewis, Cornelius; Keevil, Stephen; Logan, Robert; McLaughlin, John; Reid, Fiona

    2016-01-01

    Objective A clinical diagnosis of bile acid malabsorption (BAM) can be confirmed using SeHCAT (tauroselcholic (75selenium) acid), a radiolabelled synthetic bile acid. However, while BAM can be the cause of chronic diarrhoea, it is often overlooked as a potential diagnosis. Therefore, we investigated the use of SeHCAT for diagnosis of BAM in UK hospitals. Design A multicentre survey was conducted capturing centre and patient-level information detailing patient care-pathways, clinical history, SeHCAT results, treatment with bile acid sequestrants (BAS), and follow-up in clinics. Eligible data from 38 centres and 1036 patients were entered into a validated management system. Results SeHCAT protocol varied between centres, with no standardised patient positioning, and differing referral systems. Surveyed patients had a mean age of 50 years and predominantly women (65%). The mean SeHCAT retention score for all patients was 19% (95% CI 17.8% to 20.3%). However, this differed with suspected BAM type: type 1: 9% (95% CI 6.3% to 11.4%), type 2: 21% (95% CI 19.2% to 23.0%) and type 3: 22% (95% CI 19.6% to 24.2%). Centre-defined ‘abnormal’ and ‘borderline’ results represented over 50% of the survey population. BAS treatment was prescribed to only 73% of patients with abnormal results. Conclusions The study identified a lack of consistent cut-off/threshold values, with differing centre criteria for defining an ‘abnormal’ SeHCAT result. BAS prescription was not related in a simple way to the SeHCAT result, nor to the centre-defined result, highlighting a lack of clear patient care-pathways. There is a clear need for a future diagnostic accuracy study and a better understanding of optimal management pathways. PMID:27252882

  11. Calcium channel blockers and cancer: a risk analysis using the UK Clinical Practice Research Datalink (CPRD)

    PubMed Central

    Grimaldi-Bensouda, Lamiae; Klungel, Olaf; Kurz, Xavier; de Groot, Mark C H; Maciel Afonso, Ana S; de Bruin, Marie L; Reynolds, Robert; Rossignol, Michel

    2016-01-01

    Objective The evidence of an association between calcium channel blockers (CCBs) and cancer is conflicting. The objective of the present study was to evaluate the risk of cancer (all, breast, prostate and colon cancers) in association with exposure to CCB. Methods This is a population-based cohort study in patients exposed to CCBs from across the UK, using two comparison cohorts: (1) patients with no exposure to CCB (non-CCB) matched on age and gender and (2) unmatched patients unexposed to CCB and at least one other antihypertensive (AHT) prescription. Cancer incidence rates computed in the exposed and the two unexposed groups were compared using HRs and 95% CIs obtained from multivariate Cox regression analyses. Results Overall, 150 750, 557 931 and 156 966 patients were included, respectively, in the CCB, non-CCB and AHT cohorts. Crude cancer incidence rates per 1000 person-years were 16.51, 15.75 and 10.62 for the three cohorts, respectively. Adjusted HRs (CI) for all cancers comparing CCB, non-CCB and AHT cohorts were 0.88 (0.86 to 0.89) and 1.01 (0.98 to 1.04), respectively. Compared to the AHT cohort, adjusted HRs (CI) for breast, prostate and colon cancer for the CCB cohort were 0.95 (0.87 to 1.04), 1.07 (0.98 to 1.16) and 0.89 (0.81 to 0.98), respectively. Analyses by duration of exposure to CCB did not show excess risk. Conclusions This large population-based study provides strong evidence that CCB use is not associated with an increased risk of cancer. The analyses yielded robust results across all types of cancer and different durations of exposure to CCBs. PMID:26747033

  12. Pressure ulcer prevention and care: a survey of current practice.

    PubMed

    Sharp, C; Burr, G; Broadbent, M; Cummins, M; Casey, H; Merriman, A

    2000-12-01

    The incidence and management of pressure ulcers in hospitalised patients is an ongoing concern for nurses. Efforts to prevent pressure ulcer development are plagued with inconsistencies and a general lack of best practice guidelines. Establishing current practice approaches to the assessment, prevention and management of pressure ulcers is a necessary first step in the implementation of evidence-based/best practice guidelines. Anecdotal evidence suggested a range of different approaches were being used in a Sydney metropolitan area health service (AHS) to assess patients to identify those at risk, to prevent pressure ulcers and to treat existing ulcers. A collaborative research project was undertaken to examine current practice and to explore the apparent clinical variance. It involved the distribution of a questionnaire to registered nurses working within the AHS (n = 2113) and a review of nursing policy documents in the various hospitals in the health service area. While the overall response rate was satisfactory (40%) many of the returned questionnaires were incomplete. Only 21% (n = 444) of the questionnaires were deemed suitable for analysis. The findings highlight a range of inconsistencies within and across nursing practice domains. Nurses generally do not use a tool to assess pressure ulcer risk potential, but rely on a range of practice procedures and risk indicators to determine risk potential of developing pressure ulcers. Repositioning patients is the most common approach used in an attempt to prevent the development of pressure ulcers, but additional measures are diverse. Most nurses seem to be familiar with modern wound dressings such as hydrocolloids, foams and alginates in the treatment of second and third stage ulceration. However, the care provided by some nurses reflects an adherence to outdated practices, including the use of water filled gloves, povidone iodine and gauze packing.

  13. The safe practice of CT coronary angiography in adult patients in UK imaging departments.

    PubMed

    Harden, S P; Bull, R K; Bury, R W; Castellano, E A; Clayton, B; Hamilton, M C K; Morgan-Hughes, G J; O'Regan, D; Padley, S P G; Roditi, G H; Roobottom, C A; Stirrup, J; Nicol, E D

    2016-08-01

    Computed tomography coronary angiography is increasingly used in imaging departments in the investigation of patients with chest pain and suspected coronary artery disease. Due to the routine use of heart rate controlling medication and the potential for very high radiation doses during these scans, there is a need for guidance on best practice for departments performing this examination, so the patient can be assured of a good quality scan and outcome in a safe environment. This article is a summary of the document on 'Standards of practice of computed tomography coronary angiography (CTCA) in adult patients' published by the Royal College of Radiologists (RCR) in December 2014.

  14. Digitally Controllable Current Amplifier and Current Conveyors in Practical Application of Controllable Frequency Filter

    NASA Astrophysics Data System (ADS)

    Polak, Josef; Jerabek, Jan; Langhammer, Lukas; Sotner, Roman; Dvorak, Jan; Panek, David

    2016-07-01

    This paper presents the simulations results in comparison with the measured results of the practical realization of the multifunctional second order frequency filter with a Digitally Adjustable Current Amplifier (DACA) and two Dual-Output Controllable Current Conveyors (CCCII +/-). This filter is designed for use in current mode. The filter was designed of the single input multiple outputs (SIMO) type, therefore it has only one input and three outputs with individual filtering functions. DACA element used in a newly proposed circuit is present in form of an integrated chip and the current conveyors are implemented using the Universal Current Conveyor (UCC) chip with designation UCC-N1B. Proposed frequency filter enables independent control of the pole frequency using parameters of two current conveyors and also independent control of the quality factor by change of a current gain of DACA.

  15. Health and Safety in Practical Science in Schools: A UK Perspective 2, Using Model Risk Assessments

    ERIC Educational Resources Information Center

    Borrows, Peter

    2008-01-01

    The previous article in this series explained the difference between hazard and risk. If the risk is too high, steps must be taken to reduce it to a sufficiently low level by adopting suitable protective control measures. If a practical activity in a science lesson has some risk associated with it then one way of reducing the risk might be to…

  16. "Cascades, Torrents & Drowning" in Information: Seeking Help in the Contemporary General Practitioner Practice in the UK

    ERIC Educational Resources Information Center

    Holley, Debbie; Santos, Patricia; Cook, John; Kerr, Micky

    2016-01-01

    This paper responds to the Alpine Rendez-Vous "crisis" in technology-enhanced learning. It takes a contested area of policy as well as a rapid change in the National Health Service, and documents the responses to "information overload" by a group of general practitioners practices in the North of England. Located between the…

  17. Nature and Quality of Antipsychotic Prescribing Practice in UK Psychiatry of Intellectual Disability Services

    ERIC Educational Resources Information Center

    Paton, C.; Flynn, A.; Shingleton-Smith, A.; McIntyre, S.; Bhaumik, S.; Rasmussen, J.; Hardy, S.; Barnes, T.

    2011-01-01

    Background: Antipsychotics are perceived to be over-used in the management of behavioural problems in people with an intellectual disability (ID). Published guidelines have set good practice standards for the use of these drugs for behavioural indications. We sought to identify the range of indications for which antipsychotic drugs are prescribed…

  18. E-portfolios and personalized learning: research in practice with two dyslexic learners in UK higher education.

    PubMed

    Hughes, Julie; Herrington, Margaret; McDonald, Tess; Rhodes, Amy

    2011-02-01

    This paper analyses the use of an e-portfolio system in contributing to the personalized learning of two dyslexic learners at the University of Wolverhampton, UK. The rationale for this research rests at the intersection of generic findings from e-portfolio (and wider e-learning) research and the still challenging project in higher education (HE) of creating inclusive curricula. A qualitative, ethnographic approach was employed in a piece of collaborative research between academic staff and dyslexic learners. Two retrospective learner narratives were constructed and then reviewed by all co-authors in terms of the 'personalized fit' which they allowed with dyslexic thinking, learning and writing experience. The findings suggest a potential refinement of the general pedagogical claims about e-portfolio-based learning when considering dyslexic learners and thence the value of an enhanced prioritization of e-portfolio learning practices within inclusive HE curricula. The review and analysis also allow a 'critical' discussion of the practical and theoretical issues arising within this work.

  19. Rewards for Inventors: A Review of Current Practice in UK Universities.

    ERIC Educational Resources Information Center

    Handscombe, R. D.

    1996-01-01

    Since the British government began allowing universities to exploit the products of their research, universities have developed cash reward systems for inventors. For many researchers, job satisfaction and peer recognition appear more important than monetary rewards. The money is often reinvested in further research. (SK)

  20. Test result communication in primary care: a survey of current practice

    PubMed Central

    Litchfield, Ian; Bentham, Louise; Lilford, Richard; McManus, Richard J; Hill, Ann; Greenfield, Sheila

    2015-01-01

    Background The number of blood tests ordered in primary care continues to increase and the timely and appropriate communication of results remains essential. However, the testing and result communication process includes a number of participants in a variety of settings and is both complicated to manage and vulnerable to human error. In the UK, guidelines for the process are absent and research in this area is surprisingly scarce; so before we can begin to address potential areas of weakness there is a need to more precisely understand the strengths and weaknesses of current systems used by general practices and testing facilities. Methods We conducted a telephone survey of practices across England to determine the methods of managing the testing and result communication process. In order to gain insight into the perspectives from staff at a large hospital laboratory we conducted paired interviews with senior managers, which we used to inform a service blueprint demonstrating the interaction between practices and laboratories and identifying potential sources of delay and failure. Results Staff at 80% of practices reported that the default method for communicating normal results required patients to telephone the practice and 40% of practices required that patients also call for abnormal results. Over 80% had no fail-safe system for ensuring that results had been returned to the practice from laboratories; practices would otherwise only be aware that results were missing or delayed when patients requested results. Persistent sources of missing results were identified by laboratory staff and included sample handling, misidentification of samples and the inefficient system for collating and resending misdirected results. Conclusions The success of the current system relies on patients both to retrieve results and in so doing alert staff to missing and delayed results. Practices appear slow to adopt available technological solutions despite their potential for

  1. Kidney Failure and Liver Allocation: Current Practices and Potential Improvements.

    PubMed

    Saxena, Varun; Lai, Jennifer C

    2015-09-01

    In February 2002, the United Network for Organ Sharing implemented a system for prioritizing candidates for liver transplantation that was based on the risk of 90-day mortality as determined by the Model for End-Stage Liver Disease (MELD) score. As the MELD score is driven in part by serum creatinine as a marker of kidney function, the prevalence of kidney dysfunction and failure in patients with end-stage liver disease at the time of listing and at transplantation has steadily risen. In this review, we discuss current practices in liver transplantation in patients with kidney dysfunction focusing briefly on the decision to perform simultaneous liver-kidney transplantation. We then discuss pitfalls to the current practices of liver transplantation in patients with kidney dysfunction. We conclude by discussing potential improvements to current practices including the use of the MELD-Na score, alternatives to creatinine and creatinine-based equation for estimating kidney function, and the use of intraoperative kidney replacement therapy during liver transplantation.

  2. Recovery from mental illness as an emergent concept and practice in Australia and the UK.

    PubMed

    Ramon, Shulamit; Healy, Bill; Renouf, Noel

    2007-03-01

    The language of recovery is now widely used in mental health policy, services, and research. Yet the term has disparate antecedents, and is used in a variety of ways. Some of the history of the use of the term recovery is surveyed, with particular attention to the new meaning of the term, especially as identified by service users, supported and taken up to various degrees by research and in the professional literature. Policy and practice in two countries--Australia and the United Kingdom--are examined to determine the manner and extent to which the concept of recovery is evident. In its new meaning, the concept of recovery has the potential to bring about profound and needed changes in mental health theory and practice. It is being taken up differently in different settings. It is clear that--at least in Australia and the United Kingdom--there are promising new recovery models and practices that support recovery, but the widespread use of recovery language is not enough to ensure that the core principles of the recovery model are implemented. PMID:17472085

  3. Recovery from mental illness as an emergent concept and practice in Australia and the UK.

    PubMed

    Ramon, Shulamit; Healy, Bill; Renouf, Noel

    2007-03-01

    The language of recovery is now widely used in mental health policy, services, and research. Yet the term has disparate antecedents, and is used in a variety of ways. Some of the history of the use of the term recovery is surveyed, with particular attention to the new meaning of the term, especially as identified by service users, supported and taken up to various degrees by research and in the professional literature. Policy and practice in two countries--Australia and the United Kingdom--are examined to determine the manner and extent to which the concept of recovery is evident. In its new meaning, the concept of recovery has the potential to bring about profound and needed changes in mental health theory and practice. It is being taken up differently in different settings. It is clear that--at least in Australia and the United Kingdom--there are promising new recovery models and practices that support recovery, but the widespread use of recovery language is not enough to ensure that the core principles of the recovery model are implemented.

  4. Current issues in dental practice management. Part 1. The importance of shared values.

    PubMed

    Newsome, Philip R H

    2003-04-01

    There can be few who would argue with the notion that the nature of dental practice in the United Kingdom has changed dramatically over the last couple of decades. A variety of factors, including new clinical techniques, growing consumerism, a much greater awareness of health-related and well-being issues in the public at large, as well as a marked deregulation within the dental profession, the development of vocational training and recently mandatory lifelong learning, the growing number of females working in the profession, and an increasing reluctance of young dentists to finance dental practices have all combined to create an environment which has enabled and encouraged a move away from traditional forms of dental care delivery. Instead, there has been considerable growth in independently-funded practice and a commensurate growth in the number of practices operating under a corporate body umbrella of one form or another. Currently there are 27 corporate bodies registered with the General Dental Council (GDC) with the likelihood of more in the future given the proposed GDC review. This will no doubt take into consideration European law, under which the restriction within the Dentist's Act on the number of corporate bodies is likely to be untenable. Although they still have only a small share of the dental market--with 4% of all dentists in the UK in 1999--they have expanded rapidly from a small base. The data available at the time the paper was written indicate that the global total of fees earned from dentistry in the UK in the financial year 2001/2002 was almost 3 billion Pounds, of which 1.9 billion Pounds (64%) came from NHS fees and 1.1 billion Pounds (36%) from private fees. Of this 1.9 billion Pounds received in NHS fees in 2001/2002, 0.55 billion Pounds were paid by patients who were not exempt from charges, bringing the total amount actually paid out of patients' pockets for dental treatment to 1.65 billion Pounds. Compare these figures with 1996

  5. Nutritional supplement practices in UK junior national track and field athletes

    PubMed Central

    Nieper, A

    2005-01-01

    Methods: The nutritional supplementation practices of 32 national track and field athletes competing at the 2004 World Junior Championships were studied using an anonymous questionnaire. Information was sought on the prevalence and type of supplement used, the reasons for use, knowledge of supplements, and sources of information. Results: Use of supplements was widespread with 62% of respondents declaring supplement use. Prevalence in female athletes (75%) was higher than in males (55%) but was not statistically significant. No differences were found for age, training volume, or type of event. Seventeen different supplements were taken, with each athlete using an average of 2.4 products, multivitamins and minerals being the most popular. Reasons for using supplements were for health (45%), to enhance the immune system (40%), and to improve performance (25%). Of all respondents 48% believed they had an average knowledge of supplements, but three quarters felt that they required further information. Those not using supplements were more likely to think supplements were associated with health risks than those taking them (p = 0.03). Most athletes (72%) have access to a sports dietician but underutilise this resource. Coaches (65%) had the greatest influence on supplementation practices, with doctors (25%) and sports dieticians (30%) being less important. Conclusions: Supplementation practices were widespread among the population studied. The findings of this investigation could be used to enable the sports dietician and physician to identify common misconceptions held by adolescent athletes regarding nutritional supplements and to implement educational programs, which should include members of the non-medical support team. PMID:16118303

  6. Thromboprophylaxis following cast immobilisation for lower limb injuries--survey of current practice in United Kingdom.

    PubMed

    Batra, Sameer; Kurup, Harish; Gul, Arif; Andrew, J G

    2006-09-01

    The risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) is well documented in patients following cast immobilisation for injuries of lower extremities. There are no generally accepted approaches to preventing this complication and hence there remains substantial practice variation amongst surgeons regarding the use of anticoagulation measures. The present survey was conducted to investigate the current chemothromboprophylaxis practice among UK orthopaedic departments for patients immobilised with plasters for lower extremity injuries and establish any variations in practice. A telephone questionnaire survey was conducted on junior doctors (Senior House Officers and Registrars) in orthopaedic departments of 70 randomly selected hospitals in United Kingdom. This survey assessed the thromboprophylaxis practice for lower limb injuries in plaster casts. Our results show substantial variation amongst British orthopaedic surgeons in the use of chemothromboprophylaxis measures. Sixty-two percent of the departments do not use any DVT prophylaxis in this group of trauma. Furthermore, only 11.4% of the departments performed risk stratification on their patients. Ninety-nine percent of the respondents were unaware of any existing guidelines in this regard. Although the incidence of DVT in patients in plaster for lower extremity injuries is low compared to the Hip/Knee arthroplasty group, this is not insignificant. Both over and under treatment with thromboprophylaxis can have implications in terms of side effects and costs. One possible solution is to use risk stratification to identify individuals who are likely to benefit from prophylaxis. There is a substantial variation and inconsistency in practice among orthopaedic departments in United Kingdom due to a lack of clinical guidelines in this group of trauma and it remains underused even in high-risk group.

  7. Evaluation of an interprofessional practice placement in a UK in-patient palliative care unit.

    PubMed

    Dando, Nicholas; d'Avray, Lynda; Colman, Jane; Hoy, Andrew; Todd, Jennifer

    2012-03-01

    This paper reports on undergraduate students' evaluation of a new hospice-based interprofessional practice placement (IPP) that took place in the voluntary sector from 2008 to 2009. Ward-based interprofessional training has been successfully demonstrated in a range of clinical environments. However, the multidisciplinary setting within a hospice in-patient unit offered a new opportunity for interprofessional learning. The development and delivery of the IPP initiative is described, whereby multidisciplinary groups of 12 students provided hands-on care for a selected group of patients, under the supervision of trained health care professionals. The placement was positively evaluated and students reported an increased understanding of both their own role and that of other professionals in the team. The evaluation also suggests that additional learning opportunities were provided by the in-patient palliative care unit. The results of this evaluation suggest that the in-patient unit of a hospice caring for patients with life-limiting illness provides a suitable environment to demonstrate and learn about interprofessional practice.

  8. Principles of Lifeworld Led Public Health Practice in the UK and Sweden: Reducing Health Inequalities

    PubMed Central

    Hemingway, Ann; Norton, Liz; Aarts, Clara

    2015-01-01

    The purpose of this paper is to consider the role of the lifeworld perspective in reducing inequalities in health and we explain how the public health practitioner can use this perspective to address public health issues with individuals and groups. We offer ideas for public health actions that are based on and deal with the lifeworld context of individual people or families. Each of the dimensions of the lifeworld temporality, spatiality, intersubjectivity, embodiment and mood are outlined and their significance explained in relation to health inequalities. Suggestions for action to reduce health inequalities are made and overall principles of lifeworld led public health practice are proposed by way of conclusion. The principles comprise understanding the community members' lifeworld view, understanding their view of their potential, offering resources and facilitating empowerment, and sharing lifeworld case studies and lobbying to influence local and national policy in relation to both the individual and communities. PMID:25642346

  9. Current clinical practices in stroke rehabilitation: regional pilot survey.

    PubMed

    Natarajan, Pradeep; Oelschlager, Ashley; Agah, Arvin; Pohl, Patricia S; Ahmad, S Omar; Liu, Wen

    2008-01-01

    This study was aimed at understanding the current physical and occupational therapy practices in stroke rehabilitation in the Midwest. The insights gained from this pilot study will be used in a future study aimed at understanding stroke rehabilitation practices across the nation. Researchers and clinicians in the field of stroke rehabilitation were interviewed, and past studies in the literature were analyzed. Through these activities, we developed a 37-item questionnaire that was sent to occupational and physical therapists practicing in Kansas and Missouri who focus on the care of people who have had a stroke (n = 320). A total of 107 respondents returned a com pleted questionnaire, which gives a response rate of about 36%. The majority of respondents had more than 12 years of experience treating patients with stroke. Consensus of 70% or more was found for 80% of the items. The preferred approaches for the rehabilitation of people who have had a stroke are the Bobath and Brunnstrom methods, which are being used by 93% and 85% of the physical and occupational therapists, respectively. Even though some variability existed in certain parts of the survey, in general clinicians agreed on different treatment approaches in issues dealing with muscle tone, weakness, and limited range of motion in stroke rehabilitation. Some newer treatment approaches that have been proven to be effective are practiced only by a minority of clinicians. The uncertainty among clinicians in some sections of the survey reveals that more evidence on clinical approaches is needed to ensure efficacious treatments.

  10. Current clinical practices in stroke rehabilitation: regional pilot survey.

    PubMed

    Natarajan, Pradeep; Oelschlager, Ashley; Agah, Arvin; Pohl, Patricia S; Ahmad, S Omar; Liu, Wen

    2008-01-01

    This study was aimed at understanding the current physical and occupational therapy practices in stroke rehabilitation in the Midwest. The insights gained from this pilot study will be used in a future study aimed at understanding stroke rehabilitation practices across the nation. Researchers and clinicians in the field of stroke rehabilitation were interviewed, and past studies in the literature were analyzed. Through these activities, we developed a 37-item questionnaire that was sent to occupational and physical therapists practicing in Kansas and Missouri who focus on the care of people who have had a stroke (n = 320). A total of 107 respondents returned a com pleted questionnaire, which gives a response rate of about 36%. The majority of respondents had more than 12 years of experience treating patients with stroke. Consensus of 70% or more was found for 80% of the items. The preferred approaches for the rehabilitation of people who have had a stroke are the Bobath and Brunnstrom methods, which are being used by 93% and 85% of the physical and occupational therapists, respectively. Even though some variability existed in certain parts of the survey, in general clinicians agreed on different treatment approaches in issues dealing with muscle tone, weakness, and limited range of motion in stroke rehabilitation. Some newer treatment approaches that have been proven to be effective are practiced only by a minority of clinicians. The uncertainty among clinicians in some sections of the survey reveals that more evidence on clinical approaches is needed to ensure efficacious treatments. PMID:19009470

  11. Current practices of the child neurologist in managing sports concussion.

    PubMed

    Broshek, Donna K; Samples, Hillary; Beard, Jennifer; Goodkin, Howard P

    2014-01-01

    Given the 2010 position statement issued by the American Academy of Neurology that neurologists be consulted on return-to-play decisions following a concussion, we surveyed members of the Child Neurology Society to asses clinical practice management of concussion among child neurologists. Among the 239 respondents, the majority continued to rely on the American Academy of Neurology's 1997 Practice Parameter to guide their decision-making process. Although the 2008 consensus statement from the Third International Conference on Concussion in Sport (Zurich Guidelines) is currently considered the most up-to-date guideline, few respondents relied exclusively on this guideline. More respondents who completed continuing medical education on concussion reported making clinical decisions based on the Zurich guidelines. The finding that child neurologists who completed continuing medical education had a greater familiarity with the more recently proposed consensus-based concussion guidelines supports the development of additional education in sports concussion at all levels of child neurology training.

  12. Survey of the use of whole blood in current blood transfusion practice.

    PubMed

    MacLennan, S; Murphy, M F

    2001-12-01

    Limited use of whole blood has continued despite a general move to blood component therapy in recent years. This paper describes the results of a questionnaire survey which was distributed to haematologists in charge of blood banks in England and North Wales to ascertain how much and for which indications whole blood was being requested. There was a 58% response rate. More than 90% of hospitals that responded had not requested whole blood during the last 12 months. Indications for the use of whole blood were primarily in paediatric practice, mostly for neonatal exchange transfusion or paediatric surgery (cardiac or craniofacial). Infrequent use in adult practice was for "major bleeding" when whole blood was available, and in cardiac surgery, when post-operative bleeding was unresponsive to standard replacement therapy. The evidence for the use of whole blood in preference to component therapy in the massive transfusion setting was reviewed, and no compelling evidence was found for its routine use for this indication. It is worth noting that, as currently supplied in the UK, "whole blood" is not strictly "whole" as the leucocyte-depletion process removes platelets. PMID:11843887

  13. The clinical skills resource: a review of current practice.

    PubMed

    du Boulay, C; Medway, C

    1999-03-01

    This review is based on the findings of the Southampton Clinical Skills Project, which was a needs assessment and feasibility study to consider the development of a multiprofessional Clinical Skills Resource at Southampton. The project spanned a period of 18 months and used a range of methods of data collection, including visits to 12 clinical skills facilities in the UK. Most existing clinical skills centres have developed in response to changing healthcare policy, curricular initiatives and increasing emphasis on the quality of assessments and competencies. There is also increasing recognition that clinicians are no longer able to teach effectively all skills to students in the traditional ways, and that clinical skills training and assessment, particularly for undergraduates, is an area of deficiency. The potential scope of clinical skills centres is broad and encompasses not only clinical and communication skills but medical informatics, computer assisted learning, multiprofessional learning and assessment. Skills centres can also promote self directed and lifelong learning methods. The planning of skills centres involves a variety of stakeholders and users, including undergraduates, postgraduates, acute and community Trusts, Postgraduate Deans and medical schools. A successful skills centre needs to be flexible in its design, integral to the curriculum and relevant to educational and training requirements. This requires planning, organization and resources. Different organizational models can be used, depending on local factors. The management of skills centres involves consideration of issues such as security, safety, supervision of learners and staff development, informed by a network of experts and everyday users. The development of skills centres should include ongoing educational evaluation of outcomes and educational research. The use of a clinical skills centre has potential benefits for staff and students, including the provision of a safe environment

  14. Survey of the frequency and perceived stressfulness of ethical dilemmas encountered in UK veterinary practice.

    PubMed

    Batchelor, C E M; McKeegan, D E F

    2012-01-01

    The scale of the ethical challenges faced by veterinary surgeons and their perceived stressful consequences were investigated via a short questionnaire, completed by 58 practising veterinary surgeons. Respondents were asked to report how frequently they faced ethical dilemmas, and to rate on a simple numerical scale (zero to 10) how stressful they found three common scenarios. Fifty seven per cent of respondents reported that they faced one to two dilemmas per week, while 34 per cent stated they typically faced three to five dilemmas per week. The three scenarios provided were all rated as highly stressful with 'client wishing to continue treatment despite poor animal welfare' rated as the most stressful (median 9). The female veterinary surgeons gave two of the scenarios significantly higher stress ratings than the male veterinary surgeons. Stress ratings were not influenced by number of years in practice (which ranged from one to more than 25 years). The results show that veterinary surgeons regularly face ethical dilemmas and that they find these stressful. This has implications for the wellbeing of veterinary surgeons and supports the case for increased provision of training and support, especially for those who entered the profession before undergraduate ethics teaching was widely available. PMID:22084032

  15. Elective Single Embryo Transfer: an update to UK Best Practice Guidelines.

    PubMed

    Harbottle, Stephen; Hughes, Ciara; Cutting, Rachel; Roberts, Steve; Brison, Daniel

    2015-09-01

    A significant number of multiple pregnancies and births worldwide continue to occur following treatment with Assisted Reproductive Technologies (ARTs). Whilst efforts have been made to increase the proportion of elective single embryo transfer (eSET) cycles, the multiple pregnancy rate or MPR remains at a level that most consider unacceptable given the associated clinical risks to mothers and babies, and the additional costs associated with neonatal care of premature and low birth weight babies. Northern Europe, Australia and Japan have continued to lead the way in the adoption of eSET. Randomised controlled trials or RCTs, meta-analyses and economic analyses support the implementation of an eSET policy, particularly in light of recent advances in ARTs. This paper provides a review of current evidence and an update to the eSET guidelines first published by Cutting et al. (2008) intended to assist ART clinics in the implementation of an effective eSET policy.

  16. Elective Single Embryo Transfer: an update to UK Best Practice Guidelines.

    PubMed

    Harbottle, Stephen; Hughes, Ciara; Cutting, Rachel; Roberts, Steve; Brison, Daniel

    2015-09-01

    A significant number of multiple pregnancies and births worldwide continue to occur following treatment with Assisted Reproductive Technologies (ARTs). Whilst efforts have been made to increase the proportion of elective single embryo transfer (eSET) cycles, the multiple pregnancy rate or MPR remains at a level that most consider unacceptable given the associated clinical risks to mothers and babies, and the additional costs associated with neonatal care of premature and low birth weight babies. Northern Europe, Australia and Japan have continued to lead the way in the adoption of eSET. Randomised controlled trials or RCTs, meta-analyses and economic analyses support the implementation of an eSET policy, particularly in light of recent advances in ARTs. This paper provides a review of current evidence and an update to the eSET guidelines first published by Cutting et al. (2008) intended to assist ART clinics in the implementation of an effective eSET policy. PMID:26391438

  17. Three-year evaluation of best practice guidelines for nematode control on commercial sheep farms in the UK.

    PubMed

    Learmount, Jane; Stephens, Nathalie; Boughtflower, Valerie; Barrecheguren, Alba; Rickell, Kayleigh; Massei, Giovanna; Taylor, Mike

    2016-08-15

    Anthelmintics are commonly used on the majority of UK commercial sheep farms to reduce major economic losses associated with parasitic diseases. With increasing anthelmintic resistance worldwide, several countries have produced evidence-based, best practice guidelines with an example being the UK's Sustainable Control of Parasites in Sheep (SCOPS) initiative. In 2012, a pilot study demonstrated that SCOPS-managed farms used fewer anthelmintic treatments than traditionally managed farms, with no impact on lamb productivity and worm burden. Building on these results, we collected data for three consecutive years (2012-2014) with the following aims: (1) To compare the effects of traditional and SCOPS-based parasite management on lamb productivity and worm burden; (2) To evaluate the effect of region and farm type on lamb productivity and worm burden; (3) To compare the frequency and patterns of use of anthelmintic treatment on traditional and SCOPS-managed farms. The study was carried out on 16 farms located in the North east and the South west of England and Wales. Lamb productivity was assessed by quantifying birth, mid-season and finish weights and calculating daily live-weight gains and time to finish in a cohort of 40-50 lambs on each farm. Five annual faecal egg counts were carried out on each farm to assess worm burden. No differences in lamb productivity and worm burdens were found between farms that adopted SCOPS guidelines and traditional farms across the three years. However, mean infection levels increased for both the SCOPS and the traditional groups. Lamb production was not significantly different for farm type and region but the effect of region on infection was significant. For both ewes and lambs, SCOPS farms carried out significantly fewer anthelmintic treatments per year, and used fewer anthelmintic doses/animal than traditional farms. The data suggest a trend to increasing use of anthelmintics in ewes on traditional but not on the SCOPS farms and a

  18. 76 FR 47593 - Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-05

    ... Manufacturing Practice for Positron Emission Tomography Drugs; Availability AGENCY: Food and Drug Administration... a guidance for small business entities entitled ``PET Drugs--Current Good Manufacturing Practice... entitled ``PET Drugs--Current Good Manufacturing Practice (CGMP); Small Entity Compliance Guide.''...

  19. Are We Ready? The Construct of Subjective Cognitive Impairment and its Utilization in Clinical Practice: A Preliminary UK-Based Service Evaluation.

    PubMed

    Jenkins, Amy; Tales, Andrea; Tree, Jeremy; Bayer, Antony

    2015-09-24

    Extensive research on the concept of mild cognitive impairment (MCI) as a potential prodromal stage of dementia has highlighted the likelihood that abnormalities in information processing occur at even earlier stages in the disease process with research increasingly focused on the relatively new concept of subjective cognitive impairment (SCI). An individual with SCI will experience cognitive impairment solely on a subjective level, which is in contrast to an individual with MCI who will also experience cognitive impairment at an objective level. SCI is believed to be a risk factor for development of MCI. This qualitative service evaluation aimed to determine how much is known about SCI and how it is currently managed in specialist clinical practice in the UK. An email-based questionnaire containing a vignette of an individual presenting with SCI was distributed to 112 memory clinics requesting information on their most likely approach to such an individual. The 21% response rate evinces potential time pressure within clinical services that may preclude research participation and/or a lack of issue salience at present. However, the data from those who responded provide an important insight into 'where we are now' in relation to this issue. Analysis revealed main themes associated with SCI, namely the factors that influence what action is taken when an individual presents and what further investigations are performed, the multiplicity of potential outcomes experienced, and the barriers clinicians may face. The findings highlight the need for a coherent and consistent framework in relation to the management of SCI. PMID:26445273

  20. Are We Ready? The Construct of Subjective Cognitive Impairment and its Utilization in Clinical Practice: A Preliminary UK-Based Service Evaluation.

    PubMed

    Jenkins, Amy; Tales, Andrea; Tree, Jeremy; Bayer, Antony

    2015-09-24

    Extensive research on the concept of mild cognitive impairment (MCI) as a potential prodromal stage of dementia has highlighted the likelihood that abnormalities in information processing occur at even earlier stages in the disease process with research increasingly focused on the relatively new concept of subjective cognitive impairment (SCI). An individual with SCI will experience cognitive impairment solely on a subjective level, which is in contrast to an individual with MCI who will also experience cognitive impairment at an objective level. SCI is believed to be a risk factor for development of MCI. This qualitative service evaluation aimed to determine how much is known about SCI and how it is currently managed in specialist clinical practice in the UK. An email-based questionnaire containing a vignette of an individual presenting with SCI was distributed to 112 memory clinics requesting information on their most likely approach to such an individual. The 21% response rate evinces potential time pressure within clinical services that may preclude research participation and/or a lack of issue salience at present. However, the data from those who responded provide an important insight into 'where we are now' in relation to this issue. Analysis revealed main themes associated with SCI, namely the factors that influence what action is taken when an individual presents and what further investigations are performed, the multiplicity of potential outcomes experienced, and the barriers clinicians may face. The findings highlight the need for a coherent and consistent framework in relation to the management of SCI.

  1. Championing mental health at work: emerging practice from innovative projects in the UK.

    PubMed

    Robinson, Mark; Tilford, Sylvia; Branney, Peter; Kinsella, Karina

    2014-09-01

    This paper examines the value of participatory approaches within interventions aimed at promoting mental health and wellbeing in the workplace. Specifically the paper explores data from the thematic evaluation of the Mental Health and Employment project strand within the Altogether Better programme being implemented in England in the Yorkshire and Humber region, which was funded through the BIG Lottery and aimed to empower people across the region to lead better lives. The evaluation combined a systematic evidence review with semi-structured interviews across mental health and employment projects. Drawing on both evaluation elements, the paper examines the potential of workplace-based 'business champions' to facilitate organizational culture change within enterprises within a deprived regional socio-economic environment. First, the paper identifies key policy drivers for interventions around mental health and employment, summarizes evidence review findings and describes the range of activities within three projects. The role of the 'business champion' emerged as crucial to these interventions and therefore, secondly, the paper examines how champions' potential to make a difference depends on the work settings and their existing roles, skills and motivation. In particular, champions can proactively coordinate project strands, embed the project, encourage participation, raise awareness, encourage changes to work procedures and strengthen networks and partnerships. The paper explores how these processes can facilitate changes in organizational culture. Challenges of implementation are identified, including achieving leverage with senior management, handover of ownership to fellow employees, assessing impact and sustainability. Finally, implications for policy and practice are discussed, and conclusions drawn concerning the roles of champions within different workplace environments. PMID:23300189

  2. Championing mental health at work: emerging practice from innovative projects in the UK.

    PubMed

    Robinson, Mark; Tilford, Sylvia; Branney, Peter; Kinsella, Karina

    2014-09-01

    This paper examines the value of participatory approaches within interventions aimed at promoting mental health and wellbeing in the workplace. Specifically the paper explores data from the thematic evaluation of the Mental Health and Employment project strand within the Altogether Better programme being implemented in England in the Yorkshire and Humber region, which was funded through the BIG Lottery and aimed to empower people across the region to lead better lives. The evaluation combined a systematic evidence review with semi-structured interviews across mental health and employment projects. Drawing on both evaluation elements, the paper examines the potential of workplace-based 'business champions' to facilitate organizational culture change within enterprises within a deprived regional socio-economic environment. First, the paper identifies key policy drivers for interventions around mental health and employment, summarizes evidence review findings and describes the range of activities within three projects. The role of the 'business champion' emerged as crucial to these interventions and therefore, secondly, the paper examines how champions' potential to make a difference depends on the work settings and their existing roles, skills and motivation. In particular, champions can proactively coordinate project strands, embed the project, encourage participation, raise awareness, encourage changes to work procedures and strengthen networks and partnerships. The paper explores how these processes can facilitate changes in organizational culture. Challenges of implementation are identified, including achieving leverage with senior management, handover of ownership to fellow employees, assessing impact and sustainability. Finally, implications for policy and practice are discussed, and conclusions drawn concerning the roles of champions within different workplace environments.

  3. Current laboratory practices in the diagnosis and management of haemophilia: a global assessment.

    PubMed

    Kitchen, S; Signer-Romero, K; Key, N S

    2015-07-01

    Haemophilia management is complicated by the extreme variability in laboratory practices. Lack of consistency or comparability in testing makes it difficult to establish diagnostic criteria or disease severity, and complicates response assessment. A global survey was conducted to document current practices. A 35-min survey was completed by 30 laboratory scientists in each of seven countries (France, Germany, Italy, Japan, Spain, UK, USA; 210 in total); results were weighted by average country testing volume in haemophilia. Eighty-three per cent of participants reported participation in a Quality Assurance scheme. Ninety per cent reported using clotting tests in haemophilia A and 88% in haemophilia B (55% and 53% frequent use respectively). Sixty-eight per cent reported chromogenic assays were used in haemophilia A, with only 23% reporting frequent use, compared to only 11% reporting any use in haemophilia B. Twenty-nine separate activated partial thromboplastin time (aPTT) reagents were reported for haemophilia A and 27 aPTT reagents were reported for haemophilia B, with one-quarter or less obtaining reagents or kits from any single manufacturer. Fifty-four per cent run a calibration curve with every factor VIII (FVIII) assay. The mean number of plasma dilutions varied from 2 to 4 for FVIII assays and from 1 to 3 for FIX assays. Results indicate very low consistency in materials and practices used to test for factor activity in haemophilia. A number of responses suggest that some laboratory scientists' understanding of best practices or guidelines in haemophilia could be improved. More education and broader understanding is recommended regarding assay types, assay components, test material and instrument features and capabilities.

  4. The challenge of risk characterization: current practice and future directions.

    PubMed Central

    Gray, G M; Cohen, J T; Graham, J D

    1993-01-01

    Risk characterization is perhaps the most important part of risk assessment. As currently practiced, risk characterizations do not convey the degree of uncertainty in a risk estimate to risk managers, Congress, the press, and the public. Here, we use a framework put forth by an ad hoc study group of industry and government scientists and academics to critique the risk characterizations contained in two risks assessments of gasoline vapor. After discussing the strengths and weaknesses of each assessment's risk characterization, we detail an alternative approach that conveys estimates in the form of a probability distribution. The distributional approach can make use of all relevant scientific data and knowledge, including alternative data sets and all plausible mechanistic theories of carcinogenesis. As a result, this approach facilitates better public health decisions than current risk characterization procedures. We discuss methodological issues, as well as strengths and weaknesses of the distributional approach. PMID:8020444

  5. Autopsy in Islam and current practice in Arab Muslim countries.

    PubMed

    Mohammed, Madadin; Kharoshah, Magdy A

    2014-03-01

    Autopsy, or post-mortem examination, is the dissection of a dead body. It is performed for many reasons. Attitudes toward dead bodies vary with religious beliefs and cultural and geographical backgrounds. We have carried out an extensive literature review to determine the Islamic view and current practice of Autopsy, in at least four Arab countries which published their experiences. Several research articles have studied the history of Islamic Autopsy as well as the current situation and legal debates about it. The overwhelming conclusion is that data is lacking. More must be published from Arabic Muslim countries and more research done to correct misconceptions. We also recommend more application of non-invasive Autopsy.

  6. Reconsidering sore throats. Part I: Problems with current clinical practice.

    PubMed Central

    McIsaac, W. J.; Goel, V.; Slaughter, P. M.; Parsons, G. W.; Woolnough, K. V.; Weir, P. T.; Ennet, J. R.

    1997-01-01

    OBJECTIVE: To provide evidence-based answers to clinical questions posed by family physicians about Group A streptococcus pharyngitis and to further understanding of why management is controversial. QUALITY OF EVIDENCE: Evidence from randomized trials was not found for most questions. The most critical information came from high-quality community prevalence studies and criterion standard studies of physician clinical judgement. MAIN FINDINGS: Expert recommendations for physician management are not likely to help prevent rheumatic fever, as most people with sore throats do not seek medical care. Current clinical practices result in overuse of antibiotics because accuracy of clinical judgment is limited. CONCLUSIONS: Costs associated with visits for upper respiratory infections as well as increasing antibiotic resistance necessitate reconsidering the current clinical approach. An alternative management strategy is presented in part 2. PMID:9116520

  7. Supporting pre-registration students in practice: A review of current ICT use.

    PubMed

    Ward, Rod; Moule, Pam

    2007-01-01

    It is unclear how current healthcare students based in the United Kingdom (UK) use information and communication technology (ICT) to support their learning and care delivery in practice environments. This position reflects the dearth of current empirical evidence that needs development in this rapidly changing field. Using focus group interviews involving 16 students from nursing and the allied health professions, to reflect the interprofessional nature of healthcare education, this research explored how students employ technology in placement settings. The students drew on networked resources for personal learning and gave examples of use to meet patient and user needs. Technology also provided a vehicle for communication with the University, though use was complicated by a number of issues. Access to computers and the Internet whilst in placement environments proved problematic for some, with the culture not seeming to support ICT use. Lack of time, attitudes towards computers and ICT skills also affected student engagement. These findings provide information to guide the development of ICT use in placement settings. PMID:16624450

  8. Endocrinopathies: The current and changing perspectives in anesthesia practice.

    PubMed

    Bajwa, Sukhminder Jit Singh; Kaur, Gurpreet

    2015-01-01

    The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesia practice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesia practice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer. PMID:26180760

  9. Endocrinopathies: The current and changing perspectives in anesthesia practice

    PubMed Central

    Bajwa, Sukhminder Jit Singh; Kaur, Gurpreet

    2015-01-01

    The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesia practice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesia practice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer. PMID:26180760

  10. Assessing the options for local government to use legal approaches to combat obesity in the UK: putting theory into practice.

    PubMed

    Mitchell, C; Cowburn, G; Foster, C

    2011-08-01

    The law is recognized as a powerful tool to address some of the structural determinants of chronic disease, including 'obesogenic' environments which are a major factor in the increasing prevalence of obesity worldwide. However, it is often local - as opposed to national - government that has responsibility for an environment, including the built environment, and their role in reducing obesity using law remains relatively unexplored. With the English government shifting emphasis for improvement of public health from central to local government, this paper reviews the potential for regulatory action by local government to reduce obesity. We took a novel approach to assess the evidence and to identify legal options for implementation by local government: conducting reviews of literature, media reports and case law. Our results provide a clear rational for regulatory intervention that encourages a real choice of behaviour. They highlight strategic legal areas for reduction of obesity through restriction of traffic and promotion of active travel, promotion of access to healthy food and construction of a sustainable and active environment. Importantly, we identify current legal mechanisms for adoption by UK local government including the use of planning, licensing and transport legislation to develop local obesity prevention policy.

  11. Depersonalised doctors: a cross-sectional study of 564 doctors, 760 consultations and 1876 patient reports in UK general practice

    PubMed Central

    Orton, Christopher; Pereira Gray, Denis

    2012-01-01

    Objectives The objectives of this study were to assess burnout in a sample of general practitioners (GPs), to determine factors associated with depersonalisation and to investigate its impact on doctors' consultations with patients. Design Cross-sectional, postal survey of GPs using the Maslach Burnout Inventory (MBI). Patient survey and tape-recording of consultations for a subsample of respondents stratified by their MBI scores, gender and duration of General Medical Council registration. Setting UK general practice. Participants GPs within NHS Essex. Primary and secondary outcome measures Scores on MBI subscales (depersonalisation, emotional exhaustion, personal accomplishment); scores on Doctors' Interpersonal Skills Questionnaire and patient-centredness scores attributed to tape-recorded consultations by independent observers. Results In the postal survey, 564/789 (71%) GPs completed the MBI. High levels of emotional exhaustion (261/564 doctors, 46%) and depersonalisation (237 doctors, 42%) and low levels of personal accomplishment (190 doctors, 34%) were reported. Depersonalisation scores were related to characteristics of the doctor and the practice. Male doctors reported significantly higher (p<0.001) depersonalisation than female doctors. Doctors registered with the General Medical Council under 20 years had significantly higher (p=0.005) depersonalisation scores than those registered for longer. Doctors in group practices had significantly higher (p=0.001) depersonalisation scores than single-handed practitioners. Thirty-eight doctors agreed to complete the patient survey (n=1876 patients) and audio-record consultations (n=760 consultations). Depersonalised doctors were significantly more likely (p=0.03) to consult with patients who reported seeing their ‘usual doctor’. There were no significant associations between doctors' depersonalisation and their patient-rated interpersonal skills or observed patient-centredness. Conclusions This is the

  12. Research Reproducibility in Geosciences: Current Landscape, Practices and Perspectives

    NASA Astrophysics Data System (ADS)

    Yan, An

    2016-04-01

    Reproducibility of research can gauge the validity of its findings. Yet currently we lack understanding of how much of a problem research reproducibility is in geosciences. We developed an online survey on faculty and graduate students in geosciences, and received 136 responses from research institutions and universities in Americas, Asia, Europe and other parts of the world. This survey examined (1) the current state of research reproducibility in geosciences by asking researchers' experiences with unsuccessful replication work, and what obstacles that lead to their replication failures; (2) the current reproducibility practices in community by asking what efforts researchers made to try to reproduce other's work and make their own work reproducible, and what the underlying factors that contribute to irreproducibility are; (3) the perspectives on reproducibility by collecting researcher's thoughts and opinions on this issue. The survey result indicated that nearly 80% of respondents who had ever reproduced a published study had failed at least one time in reproducing. Only one third of the respondents received helpful feedbacks when they contacted the authors of a published study for data, code, or other information. The primary factors that lead to unsuccessful replication attempts are insufficient details of instructions in published literature, and inaccessibility of data, code and tools needed in the study. Our findings suggest a remarkable lack of research reproducibility in geoscience. Changing the incentive mechanism in academia, as well as developing policies and tools that facilitate open data and code sharing are the promising ways for geosciences community to alleviate this reproducibility problem.

  13. Infant care practices related to sudden infant death syndrome in South Asian and White British families in the UK.

    PubMed

    Ball, Helen L; Moya, Eduardo; Fairley, Lesley; Westman, Janette; Oddie, Sam; Wright, John

    2012-01-01

    In the UK, infants of South Asian parents have a lower rate of sudden infant death syndrome (SIDS) than White British infants. Infant care and life style behaviours are strongly associated with SIDS risk. This paper describes and explores variability in infant care between White British and South Asian families (of Bangladeshi, Indian or Pakistani origin) in Bradford, UK (the vast majority of which were Pakistani) and identifies areas for targeted SIDS intervention. A cross-sectional telephone interview study was conducted involving 2560 families with 2- to 4-month-old singleton infants enrolled in the Born in Bradford cohort study. Outcome measures were prevalence of self-reported practices in infant sleeping environment, sharing sleep surfaces, breast feeding, use of dummy or pacifier, and life style behaviours. We found that, compared with White British infants, Pakistani infants were more likely to: sleep in an adult bed (OR = 8.48 [95% CI 2.92, 24.63]); be positioned on their side for sleep (OR = 4.42 [2.85, 6.86]); have a pillow in their sleep environment (OR = 9.85 [6.39, 15.19]); sleep under a duvet (OR = 3.24 [2.39, 4.40]); be swaddled for sleep (OR = 1.49 [1.13, 1.97]); ever bed-share (OR = 2.13 [1.59, 2.86]); regularly bed-share (OR = 3.57 [2.23, 5.72]); ever been breast-fed (OR = 2.00 [1.58, 2.53]); and breast-fed for 8+ weeks (OR = 1.65 [1.31, 2.07]). Additionally, Pakistani infants were less likely to: sleep in a room alone (OR = 0.05 [0.03, 0.09]); use feet-to-foot position (OR = 0.36 [0.26, 0.50]); sleep with a soft toy (OR = 0.52 [0.40, 0.68]); use an infant sleeping bag (OR = 0.20 [0.16, 0.26]); ever sofa-share (OR = 0.22 [0.15, 0.34]); be receiving solid foods (OR = 0.22 [0.17, 0.30]); or use a dummy at night (OR = 0.40 [0.33, 0.50]). Pakistani infants were also less likely to be exposed to maternal smoking (OR = 0.07 [0.04, 0.12]) and to alcohol consumption by either parent. No difference was found in the prevalence of prone sleeping (OR = 1

  14. Understanding flucloxacillin prescribing trends and treatment non-response in UK primary care: a Clinical Practice Research Datalink (CPRD) study

    PubMed Central

    Francis, Nick A.; Hood, Kerenza; Lyons, Ronan; Butler, Christopher C.

    2016-01-01

    Objectives The volume of prescribed antibiotics is associated with antimicrobial resistance and, unlike most other antibiotic classes, flucloxacillin prescribing has increased. We aimed to describe UK primary care flucloxacillin prescribing and factors associated with subsequent antibiotic prescribing as a proxy for non-response. Patients and methods Clinical Practice Research Datalink patients with acute prescriptions for oral flucloxacillin between January 2004 and December 2013, prescription details, associated Read codes and patient demographics were identified. Monthly prescribing rates were plotted and logistic regression identified factors associated with having a subsequent antibiotic prescription within 28 days. Results 3 031 179 acute prescriptions for 1 667 431 patients were included. Average monthly prescription rates increased from 4.74 prescriptions per 1000 patient-months in 2004 to 5.74 (increase of 21.1%) in 2013. The highest prescribing rates and the largest increases in rates were seen in older adults (70+ years), but the overall increase in prescribing was not accounted for by an ageing population. Prescribing 500 mg tablets/capsules rather than 250 mg became more common. Children were frequently prescribed low doses and small volumes (5 day course) and prescribing declined for children, including for impetigo. Only 4.2% of new prescriptions involved co-prescription of another antibiotic. Age (<5 and ≥60 years), diagnosis of ‘cellulitis or abscess’ or no associated code, and 500 mg dose were associated with a subsequent antibiotic prescription, which occurred after 17.6% of first prescriptions. Conclusions There is a need to understand better the reasons for increased prescribing of flucloxacillin in primary care, optimal dosing (and the need to co-prescribe other antibiotics) and the reasons why one in five patients are prescribed a further antibiotic within 4 weeks. PMID:27090629

  15. GPs' views on the practice of physician-assisted suicide and their role in proposed UK legalisation: a qualitative study

    PubMed Central

    Hussain, Tariq; White, Patrick

    2009-01-01

    Background A bill to legalise assisted dying in the UK has been proposed in Parliament's House of Lords three times since 2003. The House of Lords Select Committee concluded in 2005 that ‘the few attempts to understand the basis of doctors' views have shown equivocal data varying over time’. Fresh research was recommended to gain a fuller understanding of health sector views. Aim To examine GPs' views of the practice of physician-assisted suicide as defined by the 2005/2006 House of Lords (Joffe) Bill and views of their role in the proposed legislation; and to explore the influences determining GPs' views on physician-assisted suicide. Design of study Qualitative interview study. Setting Primary care in South London, England. Method Semi-structured interviews with GPs were conducted by a lead interviewer and analysed in a search for themes, using the framework approach. Results Thirteen GPs were interviewed. GPs who had not personally witnessed terminal suffering that could justify assisted dying were against the legislation. Some GPs felt their personal religious views, which regarded assisted dying as morally wrong, could not be the basis of a generalisable medical ethic for others. GPs who had witnessed a person's suffering that, in their opinion, justified physician-assisted suicide were in favour of legislative change. Some GPs felt a specialist referral pathway to provide assisted dying would help to ensure proper standards were met. Conclusion GPs' views on physician-assisted suicide ranged from support to opposition, depending principally on their interpretation of their experience of patients' suffering at the end of life. The goal to lessen suffering of the terminally ill, and apprehensions about patients being harmed, were common to both groups. Respect for autonomy and the right of self-determination versus the need to protect vulnerable people from the potential for harm from social coercion were the dominant themes. PMID:19861029

  16. Challenges and Issues in the Evaluation of Teaching Quality: How Does it Affect Teachers' Professional Practice? A UK Perspective.

    PubMed

    Warman, Sheena M

    2015-01-01

    Evaluation of the quality of higher education is undertaken for the purposes of ensuring accountability, accreditation, and improvement, all of which are highly relevant to veterinary teaching institutions in the current economic climate. If evaluation is to drive change, it needs to be able to influence teaching practice. This article reviews the literature relating to evaluation of teaching quality in higher education with a particular focus on teachers' professional practice. Student evaluation and peer observation of teaching are discussed as examples of widely used evaluation processes. These approaches clearly have the potential to influence teachers' practice. Institutions should strive to ensure the development of a supportive culture that prioritizes teaching quality while being aware of any potential consequences related to cost, faculty time, or negative emotional responses that might result from the use of different evaluation methods.

  17. Spurious claims for health-care products: an experimental approach to evaluating current UK legislation and its implementation.

    PubMed

    Rose, Leslie B; Posadzki, Paul; Ernst, Edzard

    2012-01-01

    The lay media, and especially the Internet, contain many misleading claims for health products which have previously been inadequately regulated by consumer law. This was an experimental interventional survey within a consumer health-care setting. Three health products were chosen on the basis of being widely available on the UK market and having no available evidence of effectiveness. Twelve volunteers submitted 39 complaints to Consumer Direct (UK portal for the regulator Trading Standards) regarding false health claims, and 36 complaints were followed up for a maximum of 4.8 months. The mean time from submission of complaints to Consumer Direct to acknowledgement by the relevant Trading Standards office was 13 days. There were no responses from Trading Standards for 22% of complaints. At the end of the study one supplier had amended their website following Trading Standards advice, but did not stop all health claims. Another stopped advertising their product on the Internet and the third continued the health claims unchanged. EU directive 2005/29/EC is largely ineffective in preventing misleading health claims for consumer products in the UK. PMID:22403120

  18. The emergence of thanatology and current practice in death education.

    PubMed

    Fonseca, Luciana Mascarenhas; Testoni, Ines

    Thanatology is a recent field that contemplates death studies and employs an interdisciplinary approach to practice. This science emerged in a historical context marked by intense social, economic, and political changes that contributed to the concept of death being excluded from social life. This literature review aims to outline the history and evolution ofthanatology in Western society, delineating the contextual circumstances that led to its origin and drawing special attention to current works on death education. In our post-modern society, the call for studies in the field of thanatology appears to be increasing. However, although there have been significant contributions and promising research is underway, there are still many questions to be answered.

  19. REVIEW OF CURRENT PRACTICE IN CHARACTERIZATION AND MONITORING

    SciTech Connect

    M.A.Ebadian, Ph.D.

    2001-01-01

    Characterization and monitoring are important parts of environmental remediation of contaminated sites by the Department of Energy--Office of Environmental Management (DOE-EM). The actual remediation process often cannot begin or even be planned until characterization is complete. Monitoring is essential to verify the progress of remediation and of the waste stream. However, some contaminated sites are difficult, costly, or have a high exposure risk to personnel to characterize or monitor using the baseline technology or current practice. Therefore, development of new characterization and monitoring technologies is time-critical to remediate these sites. The main task of the Characterization, Monitoring, and Sensor Technology Crosscutting Program (CMST-CP) is to develop and deploy innovative characterization and monitoring technologies that improve performance and reduce personnel exposure, cost, and detection limits. However, to evaluate different proposals for new technologies to decide which ones to develop or deploy, it is necessary to compare their cost and performance to the baseline technology. The goal of this project is to facilitate the direct comparison of new technologies to the baseline technology by documenting the current practices for site characterization and monitoring at DOE sites and by presenting the information in an easy-to-use, concise database. The database will assist the CMST-CP and others in evaluating or designing new technologies by identifying the baseline technologies and describing their performance and cost. The purpose of this document is to report on the completion of this project and to describe the database. Section 2.0 describes the data assessment methodology. Section 3.0 presents the database and serves as a user manual. Section 4.0 lists the references used for each baseline technology in the database. The full references can be found in the Appendix.

  20. 76 FR 38399 - Assessing the Current Research, Policy, and Practice Environment in Public Health Genomics

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-30

    ... Practice Environment in Public Health Genomics AGENCY: Centers for Disease Control and Prevention (CDC..., and other information helpful to assess the current research, policy, and practice environment...

  1. Current status in outpatient parenteral antimicrobial therapy: a practical view.

    PubMed

    Candel, Francisco Javier; Julián-Jiménez, Agustin; González-Del Castillo, Juan

    2016-04-01

    Outpatient parenteral antimicrobial therapy (OPAT) programs are a current and widely spread trend in clinical practice because of it's a cost-effective option, it's associated with a greater comfort for the patient, a lower risk of nosocomial complications and an important cost saving for the health care system. OPAT is used for treating a wide range of infections, including skin and soft tissue infections, osteoarticular infections, bacteraemia, endocarditis and complex intra-abdominal and urinary tract infections, even in presence of multiresistant microorganisms. Correct choice of antimicrobial agent and adequate patient selection are crucial for reaching therapeutic success and avoiding readmissions, treatment prolongation or treatment-related toxicity. The optimal antimicrobial for OPAT must be highly effective, have a long half-life and an adequate spectrum of action. Ceftriaxone and teicoplanin are currently the most prescribed antibiotics for OPAT, though daptomycin and ertapenem are also on the rise, due to their high efficiency, safety and wide spectrum of action. Antibiotics that are stable at room temperature can be administered through a continuous perfusion, though self-administration is preferable although it requires training of the patient or the caregiver. Factors that are most frequently associated with OPAT failure include advanced age, recent hospitalization and isolation of multiresistant microorganisms. PMID:27014770

  2. Fish quarantine: current practices in public zoos and aquaria.

    PubMed

    Hadfield, Catherine A; Clayton, Leigh A

    2011-12-01

    The primary goal of quarantine is to reduce the risk of introducing infectious diseases into established collections. Fish quarantine is inherently complex because of the variety of species, environmental requirements, and facilities. To examine current practices, questionnaires were submitted to 60 public zoos and aquaria, predominantly in North America. Questions reviewed system type (closed, flow-through), quarantine length, diagnostics, treatments, and cleaning and disinfection. Forty-two of the 60 institutions responded. Most institutions had separate quarantine protocols for freshwater teleosts, marine teleosts, and elasmobranchs. Ninety-five percent of institutions had a minimum quarantine period of 30 days or more. Sixty-four percent of institutions used isolated areas for some or all of their fish quarantine. Twenty-five percent had designated fish quarantine staff. All institutions used regular visual examinations to assess animal health. Fifty-four percent of the institutions carried out routine hands-on diagnostics on some fish; this was more common for elasmobranchs than teleosts. All institutions carried out necropsies on mortalities. Fifteen percent of institutions performed histopathology on almost all fresh mortalities; 54% percent performed histopathology on less than 10% of mortalities. Prophylactic treatments were common in closed systems, in particular, formalin immersion for teleosts, freshwater dips and copper sulfate immersion for marine teleosts, and praziquantel immersion for marine teleosts and elasmobranchs. Institutions using dips generally did so at the start or end of quarantine. Fenbendazole- and praziquantel-medicated foods were used commonly in teleosts, but dosages varied greatly. Cleaning and disinfection of systems and equipment increased in response to known pathogens. These results can be used to compare and discuss fish quarantine practices at display facilities in order to improve quarantine success.

  3. Is dosimetry still a necessity in current dental practice?

    PubMed

    Reddy, S S; Rakesh, N; Chauhan, Pallavi; Clint, Joseph Ben; Sharma, Shivani

    2015-12-01

    Today, dentists have a wide range of imaging modalities to choose from, the film based techniques, digital techniques, and the recent introduction of 3D volumetric or cone beam computed tomography (CBCT). The inherent design features of the new generation dental x-ray equipment has significantly improved over the years with no evidence of substandard x-ray units in operation. In dental facilities radiological workload is comparatively low, newer radiation equipments and accessories follow safety guidelines and employ better radiation protection measures for the patient and the operator. Dentists' knowledge and expertise in radiation protection measures is good, enabling them to carry out riskfree radiation procedures in their practice. Therefore, the present study is aimed at assessing the need for dosimeters in current dental scenario. 'Is there currently a significant risk from dental radiography to merit the use of personal dosimetery in dental practice. 'Dental health professionals (Oral radiologists) and radiographic assistants of fourteen dental colleges in Karnataka state participated in this questionnaire study. The questionnaire consisted of the following questions--the make, type, year of manufacture of radiographic machines used in their setup, number of radiographs made per day in the institution, type of receptors used, number of personnel at risk for radiation exposure, radiation protection measures used, regular monitoring by personal dosimeters, equivalent dosage readings for the past 12 months and whether the reading of thermoluminescent dosimeters (TLD) for any personnel had exceeded the recommended exposure value in the last 3 years. Dosimetry records of the radiology staff in the last three years shows doses no more than 1.50 mSv per year. The various institutions' dose (person mSv) was in the range of 3.70 mSv-3.90 mSv. Personal monitoring for Dentists can be omitted in the dental colleges since the estimated dose of oral radiologists

  4. Robin sequence: A European survey on current practice patterns.

    PubMed

    van Lieshout, Manouk J S; Joosten, Koen F M; Mathijssen, Irene M J; Koudstaal, Maarten J; Hoeve, Hans L J; van der Schroeff, Marc P; Wolvius, Eppo B

    2015-10-01

    To provide an overview of current practice patterns with regard to Robin sequence (RS) patients in Europe, a survey was conducted among European clinicians. This online survey consisted of different sections assessing characteristics of the respondent and clinic, definition, diagnosis, treatment, and follow-up. In total, surveys from 101 different European clinics were included in the analysis, and 56 different RS definitions were returned. The majority (72%) of the respondents used a sleep study system to determine the severity of the airway obstruction. A total of 63% used flexible endoscopy and 16% used rigid endoscopy in the diagnostic process. Treatment of the airway obstruction differed considerably between the different countries. Prone positioning for mild airway obstruction was the treatment modality used most often (63%). When prone positioning was not successful, a nasopharyngeal airway was used (62%). Surgical therapies varied considerably among countries. For severe obstruction, mandibular distraction was performed most frequently. Three-quarters of the respondents noted the presence of catch-up growth in their patient population. This first European survey study on definition and management of RS shows that there are considerable differences within Europe. Therefore, we would encourage the establishment of national (and international) guidelines to optimize RS patient care. PMID:26315273

  5. Pharmacological treatment of hypertrophic cardiomyopathy: current practice and novel perspectives.

    PubMed

    Ammirati, Enrico; Contri, Rachele; Coppini, Raffaele; Cecchi, Franco; Frigerio, Maria; Olivotto, Iacopo

    2016-09-01

    Hypertrophic cardiomyopathy (HCM) is entering a phase of intense translational research that holds promise for major advances in disease-specific pharmacological therapy. For over 50 years, however, HCM has largely remained an orphan disease, and patients are still treated with old drugs developed for other conditions. While judicious use of the available armamentarium may control the clinical manifestations of HCM in most patients, specific experience is required in challenging situations, including deciding when not to treat. The present review revisits the time-honoured therapies available for HCM, in a practical perspective reflecting real-world scenarios. Specific agents are presented with doses, titration strategies, pros and cons. Peculiar HCM dilemmas such as treatment of dynamic outflow obstruction, heart failure caused by end-stage progression and prevention of atrial fibrillation and ventricular arrhythmias are assessed. In the near future, the field of HCM drug therapy will rapidly expand, based on ongoing efforts. Approaches such as myocardial metabolic modulation, late sodium current inhibition and allosteric myosin inhibition have moved from pre-clinical to clinical research, and reflect a surge of scientific as well as economic interest by academia and industry alike. These exciting developments, and their implications for future research, are discussed. PMID:27109894

  6. Preparation of intravenous cholesterol tracer using current good manufacturing practices.

    PubMed

    Lin, Xiaobo; Ma, Lina; Racette, Susan B; Swaney, William P; Ostlund, Richard E

    2015-12-01

    Studies of human reverse cholesterol transport require intravenous infusion of cholesterol tracers. Because insoluble lipids may pose risk and because it is desirable to have consistent doses of defined composition available over many months, we investigated the manufacture of cholesterol tracer under current good manufacturing practice (CGMP) conditions appropriate for phase 1 investigation. Cholesterol tracer was prepared by sterile admixture of unlabeled cholesterol or cholesterol-d7 in ethanol with 20% Intralipid(®). The resulting material was filtered through a 1.2 micron particulate filter, stored at 4°C, and tested at time 0, 1.5, 3, 6, and 9 months for sterility, pyrogenicity, autoxidation, and particle size and aggregation. The limiting factor for stability was a rise in thiobarbituric acid-reacting substances of 9.6-fold over 9 months (P < 0.01). The emulsion was stable with the Z-average intensity-weighted mean droplet diameter remaining at 60 nm over 23 months. The zeta potential (a measure of negative surface charge protecting from aggregation) was unchanged at -36.2. Rapid cholesterol pool size was 25.3 ± 1.3 g. Intravenous cholesterol tracer was stable at 4°C for 9 months postproduction. CGMP manufacturing methods can be achieved in the academic setting and need to be considered for critical components of future metabolic studies.

  7. The current status of targeted radiotherapy in clinical practice.

    PubMed

    Gaze, M N

    1996-10-01

    Biologically targeted radiotherapy in clinical practice requires a molecule which has a relative specificity for tumour tissue--the missile--coupled to a radionuclide with appropriate physical characteristics--the warhead. When administered to a patient this combination should result in selective irradiation of the target tumour cells with relative sparing of normal tissues. Simple ions and small molecules which follow physiological pathways as either the natural substrates or analogues form the best examples of biological targeting. Clinically valuable results are seen with, for instance, iodine uptake by normal and malignant thyroid cells, incorporation of the calci-mimetic element strontium in areas of increased bone metabolism and accumulation of the catecholamine analogue meta-iodobenzylguanidine in neuroblastoma. The use of monoclonal antibodies as targeting vehicles has not proved to be a panacea, yet some patients with lymphoma, hepatoma and ovarian carcinoma have obtained benefit. Current clinical studies in targeted radiotherapy focus on the integration of radionuclide treatment with conventional treatments, and the optimization of such combined approaches. The development of modifications to offset the limitations inherent in the use of crude antibodies also offers an opportunity for improved clinical outcomes.

  8. Targeted temperature management: Current evidence and practices in critical care.

    PubMed

    Saigal, Saurabh; Sharma, Jai Prakash; Dhurwe, Ritika; Kumar, Sanjay; Gurjar, Mohan

    2015-09-01

    Targeted temperature management (TTM) in today's modern era, especially in intensive care units represents a promising multifaceted therapy for a variety of conditions. Though hypothermia is being used since Hippocratic era, the renewed interest of late has been since early 21(st) century. There have been multiple advancements in this field and varieties of cooling devices are available at present. TTM requires careful titration of its depth, duration and rewarming as it is associated with side-effects. The purpose of this review is to find out the best evidence-based clinical practice criteria of therapeutic hypothermia in critical care settings. TTM is an unique therapeutic modality for salvaging neurological tissue viability in critically ill patients viz. Post-cardiac arrest, traumatic brain injury (TBI), meningitis, acute liver failure and stroke. TTM is standard of care in post-cardiac arrest situations; there has been a lot of controversy of late regarding temperature ranges to be used for the same. In patients with TBI, it reduces intracranial pressure, but has not shown any favorable neurologic outcome. Hypothermia is generally accepted treatment for hypoxic ischemic encephalopathy in newborns. The current available technology to induce and maintain hypothermia allows for precise temperature control. Future studies should focus on optimizing hypothermic treatment to full benefit of our patients and its application in other clinical scenarios. PMID:26430341

  9. Guide to clinical practice guidelines: the current state of play

    PubMed Central

    Kredo, Tamara; Bernhardsson, Susanne; Machingaidze, Shingai; Young, Taryn; Louw, Quinette; Ochodo, Eleanor; Grimmer, Karen

    2016-01-01

    Introduction Extensive research has been undertaken over the last 30 years on the methods underpinning clinical practice guidelines (CPGs), including their development, updating, reporting, tailoring for specific purposes, implementation and evaluation. This has resulted in an increasing number of terms, tools and acronyms. Over time, CPGs have shifted from opinion-based to evidence-informed, including increasingly sophisticated methodologies and implementation strategies, and thus keeping abreast of evolution in this field of research can be challenging. Methods This article collates findings from an extensive document search, to provide a guide describing standards, methods and systems reported in the current CPG methodology and implementation literature. This guide is targeted at those working in health care quality and safety and responsible for either commissioning, researching or delivering health care. It is presented in a way that can be updated as the field expands. Conclusion CPG development and implementation have attracted the most international interest and activity, whilst CPG updating, adopting (with or without contextualization), adapting and impact evaluation are less well addressed. PMID:26796486

  10. Computational structures technology at Grumman: Current practice/future needs

    NASA Astrophysics Data System (ADS)

    Pifko, Allan B.; Eidinoff, Harvey

    1992-05-01

    The current practice for the design analysis of new airframe structural systems is to construct a master finite element model of the vehicle in order to develop internal load distributions. The inputs to this model include the geometry which is taken directly from CADAM and CATIA structural layout and aerodynamic loads and mass distribution computer models. This master model is sufficiently detailed to define major load paths and for the computation of dynamic mode shapes and structural frequencies, but not detailed enough to define local stress gradients and notch stresses. This master model is then used to perform structural optimization studies that will provide minimum weights for major structural members. The post-processed output from the master model, load, stress, and strain analysis is then used by structural analysts to perform detailed stress analysis of local regions in order to design local structure with all its required details. This local analysis consists of hand stress analysis and life prediction analysis with the assistance of manuals, design charts, computer stress and structural life analysis and sometimes finite element or boundary element analysis. The resulting design is verified by fatigue tests.

  11. Computational structures technology at Grumman: Current practice/future needs

    NASA Technical Reports Server (NTRS)

    Pifko, Allan B.; Eidinoff, Harvey

    1992-01-01

    The current practice for the design analysis of new airframe structural systems is to construct a master finite element model of the vehicle in order to develop internal load distributions. The inputs to this model include the geometry which is taken directly from CADAM and CATIA structural layout and aerodynamic loads and mass distribution computer models. This master model is sufficiently detailed to define major load paths and for the computation of dynamic mode shapes and structural frequencies, but not detailed enough to define local stress gradients and notch stresses. This master model is then used to perform structural optimization studies that will provide minimum weights for major structural members. The post-processed output from the master model, load, stress, and strain analysis is then used by structural analysts to perform detailed stress analysis of local regions in order to design local structure with all its required details. This local analysis consists of hand stress analysis and life prediction analysis with the assistance of manuals, design charts, computer stress and structural life analysis and sometimes finite element or boundary element analysis. The resulting design is verified by fatigue tests.

  12. Preparation of intravenous cholesterol tracer using current good manufacturing practices.

    PubMed

    Lin, Xiaobo; Ma, Lina; Racette, Susan B; Swaney, William P; Ostlund, Richard E

    2015-12-01

    Studies of human reverse cholesterol transport require intravenous infusion of cholesterol tracers. Because insoluble lipids may pose risk and because it is desirable to have consistent doses of defined composition available over many months, we investigated the manufacture of cholesterol tracer under current good manufacturing practice (CGMP) conditions appropriate for phase 1 investigation. Cholesterol tracer was prepared by sterile admixture of unlabeled cholesterol or cholesterol-d7 in ethanol with 20% Intralipid(®). The resulting material was filtered through a 1.2 micron particulate filter, stored at 4°C, and tested at time 0, 1.5, 3, 6, and 9 months for sterility, pyrogenicity, autoxidation, and particle size and aggregation. The limiting factor for stability was a rise in thiobarbituric acid-reacting substances of 9.6-fold over 9 months (P < 0.01). The emulsion was stable with the Z-average intensity-weighted mean droplet diameter remaining at 60 nm over 23 months. The zeta potential (a measure of negative surface charge protecting from aggregation) was unchanged at -36.2. Rapid cholesterol pool size was 25.3 ± 1.3 g. Intravenous cholesterol tracer was stable at 4°C for 9 months postproduction. CGMP manufacturing methods can be achieved in the academic setting and need to be considered for critical components of future metabolic studies. PMID:26416797

  13. Current safety practices in nano-research laboratories in China.

    PubMed

    Zhang, Can; Zhang, Jing; Wang, Guoyu

    2014-06-01

    China has become a key player in the global nanotechnology field, however, no surveys have specifically examined safety practices in the Chinese nano-laboratories in depth. This study reports results of a survey of 300 professionals who work in research laboratories that handle nanomaterials in China. We recruited participants at three major nano-research laboratories (which carry out research in diverse fields such as chemistry, material science, and biology) and the nano-chemistry session of the national meeting of the Chinese Chemical Society. Results show that almost all nano-research laboratories surveyed had general safety regulations, whereas less than one third of respondents reported having nanospecific safety rules. General safety measures were in place in most surveyed nano-research laboratories, while nanospecific protective measures existed or were implemented less frequently. Several factors reported from the scientific literature including nanotoxicology knowledge gaps, technical limitations on estimating nano-exposure, and the lack of nano-occupational safety legislation may contribute to the current state of affairs. With these factors in mind and embracing the precautionary principle, we suggest strengthening or providing nanosafety training (including raising risk awareness) and establishing nanosafety guidelines in China, to better protect personnel in the nano-workplace.

  14. No More "Personal Notes"? Data Protection Policy and Practice in Higher Education Counselling Services in the UK

    ERIC Educational Resources Information Center

    Jenkins, Peter; Potter, Steve

    2007-01-01

    The introduction of the Data Protection Act 1998 has presented significant challenges to counselling recording, through its detailed requirements for the processing of personal data. The impact of these changes on recording in Higher Education counselling services in the UK is explored, using responses from an electronic survey of universities and…

  15. Interpreting Personal Development Planning (PDP): A Policy and Professional Practice Story of Higher Education in the UK

    ERIC Educational Resources Information Center

    Hilsdon, John

    2012-01-01

    It is claimed that Personal Development Planning (PDP) is the only approach to learning in UK higher education that has been actively encouraged through a policy. This paper reviews the background to the development of PDP as policy, under conditions described as the "new moral economy", and the impact of these conditions on contemporary…

  16. Changing Concepts of Equity in Transforming UK Higher Education: Implications for Future Pedagogies and Practices in Global Higher Education

    ERIC Educational Resources Information Center

    David, Miriam E.

    2011-01-01

    This paper is about changing concepts of equity in UK higher education. In particular, it charts the moves from concepts about gender equality as about women's education as a key issue in twentieth century higher education to questions of men's education in the twenty-first century. These changing concepts of equity are linked to wider social and…

  17. European Standards for Quality Assurance and Institutional Practices of Student Assessment in the UK, the Netherlands and the Czech Republic

    ERIC Educational Resources Information Center

    Kohoutek, Jan

    2014-01-01

    This article analyses the student assessment procedures of 12 universities in the UK, the Netherlands and the Czech Republic with respect to their alignment with the European standards and guidelines on the quality of assessing higher education students (European Standards and Guidelines for Quality Assurance [ESG] 1.3). Based on qualitative…

  18. Conceptualizing the Transition from Education to Work as Vocational Practice: Lessons from the UK's Creative and Cultural Sector

    ERIC Educational Resources Information Center

    Guile, David

    2009-01-01

    The paper argues that: (1) the demise of "occupational" and "internal" and the spread of "external" labour markets in growth areas of UK economy such as the creative and cultural sector, coupled with the massification of higher education which has created a new type of post-degree "vocational need", means that the transition from education to work…

  19. 21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What is current good manufacturing practice for... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION TOMOGRAPHY DRUGS (Eff. 12-12-2011) General Provisions § 212.2 What is current good manufacturing practice...

  20. 21 CFR 210.1 - Status of current good manufacturing practice regulations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice...

  1. 21 CFR 210.1 - Status of current good manufacturing practice regulations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice...

  2. 21 CFR 210.1 - Status of current good manufacturing practice regulations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice...

  3. 21 CFR 210.1 - Status of current good manufacturing practice regulations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice...

  4. 21 CFR 210.1 - Status of current good manufacturing practice regulations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice...

  5. 21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false What is current good manufacturing practice for... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION TOMOGRAPHY DRUGS General Provisions § 212.2 What is current good manufacturing practice for PET...

  6. Use and husbandry of captive European starlings (Sturnus vulgaris) in scientific research: a review of current practice.

    PubMed

    Asher, Lucy; Bateson, Melissa

    2008-04-01

    We reviewed the use of captive European starlings (Sturnus vulgaris) in scientific research published between 2000 and 2004. We estimated the numbers of birds used and documented their origin and the range of husbandry regimes employed with the aim of comparing current practice with the new European guidelines for husbandry of laboratory animals. Over the five-year period, 106 primary articles report the use of an estimated total of 2490 captive starlings. The majority of birds were caught from the wild either as adults or fledglings, and only 3% were hand-reared from chicks. There was considerable variation in husbandry. In the majority of cases, standards fell below those currently recommended as best practice in the UK and cited in new European guidelines. The median volume of home cages employed was 0.42 m3 (0.13-5.1 m3, interquartile range), whereas current recommendations suggest a minimum of 1.0 m3 for a singly-housed bird. The median volume of space allowed per bird was 0.13 m3/bird (0.08-1.05 m3/bird, Q1-Q3), whereas current recommendations suggest a minimum of 0.33 m3/bird. Only 27% of the articles mentioned providing any form of environmental enrichment for birds in their home cages. We recommend that more research be conducted into the welfare of starlings to inform legislation and guidelines, and thus maximize the welfare of captive animals. PMID:18435870

  7. Preoperative fasting: current practice and areas for improvement.

    PubMed

    Falconer, R; Skouras, C; Carter, T; Greenway, L; Paisley, A M

    2014-03-01

    Preoperative fasting aims to increase patient safety by reducing the risk of adverse events during general anaesthesia. However, prolonged fasting may be associated with dehydration, hypoglycaemia and electrolyte imbalance as well as patient discomfort. We aimed to examine compliance with the current best practice guidelines in a large surgical unit and to identify areas for improvement. Adult patients undergoing elective and emergency general, orthopaedic, gynaecology and vascular surgery procedures in the Royal Infirmary of Edinburgh were surveyed over a 3-month period commencing November 2011. A standardised questionnaire was used to collect information on the duration of preoperative fasting and the advice administered by medical and nursing staff. 292 patients were included. Median fast from solids was 13.5 h for elective patients (IQR 11.5-16) and 17.38 h for emergency patients (IQR 13.68-28.5 h). Similarly, the median fast from fluids was 9.36 h for elective patients (IQR 5.38-12.75 h) and 12.97 h for emergency patients (IQR 8.5-16.22 h). The instructions that elective patients received contributed to prolonged fasting times. The median fast for elective patients fully compliant with fasting advice would be 10 h for solids (IQR 8.75-12 h) and 6.25 h (IQR 3.83-9.25 h) for clear fluids. Elective patients fasted for longer than recommended confirming that clinical practice is slow to change. The use of universal fasting instructions and patient choice are factors that unnecessarily prolong preoperative fasting, which however appears to be multifactorial. Service improvement by abbreviation of the observed fasting periods will rely on targeted staff education and effective clinical communication by provision of written information for both elective and emergency surgical patients. The routine use of preoperative nutritional supplements may need to be re-examined when further evidence is available.

  8. Improving Knowledge of General Dental Practitioners on Antibiotic Prescribing by Raising Awareness of the Faculty of General Dental Practice (UK) Guidelines

    PubMed Central

    Zahabiyoun, Sana; Sahabi, Mahasti; Kharazi, Mohammad Javad

    2015-01-01

    Objectives: Cases of antimicrobial resistance are increasing, partly due to inappropriate prescribing practices by dentists. The purpose of this study was to investigate the prescribing practices and knowledge of dentists with regards to antibiotics. Moreover, this study aimed to determine whether the prescriptions comply with the recommended guidelines and whether clinical audit can alter the prescribing practices of dentists leading to better use of antibiotics in the dental service. Materials and Methods: A clinical audit (before/after non-controlled trial) was carried out in two dental clinics in the northeast of England. Retrospective data were collected from 30 antibiotic prescriptions, analysed and compared with the recommended guidelines. Data collected included age and gender of patients, type of prescribed antibiotics and their dosage, frequency and duration, clinical condition and reason for prescribing. The principles of appropriate prescribing based on guidance by the Faculty of General Dental Practice in the United Kingdom (UK), FGDP, were discussed with the dental clinicians. Following this, prospective data were collected and similarly managed. Pre and post audit data were then compared. Changes were tested for significance using McNemar’s test and P value<0.05 was considered statistically significant. Results: After intervention, data revealed that antibiotic prescribing practices of dentists improved, as there was an increase in the percentage of prescriptions that were in accordance with the FGDP (UK) guidelines. Conclusion: In view of the limited data collected, this study concludes that there are inappropriate antibiotic prescribing practices amongst general dental practitioners and that clinical audit can address this situation, leading to a more rational use of antibiotics in dental practice. PMID:26622268

  9. Current Status of Nuclear Medicine Practice in the Middle East.

    PubMed

    Paez, Diana; Becic, Tarik; Bhonsle, Uday; Jalilian, Amir R; Nuñez-Miller, Rodolfo; Osso, Joao Alberto

    2016-07-01

    availability of (68)Ge-(68)Ga generators is increasing and studies involving prostate-specific membrane antigen or DOTA-chelated peptides or both are performed in at least seven countries. Although therapeutic radionuclide agents are mostly imported from outside the region, this does not limit the availability of therapies with (90)Y, (153)Sm, (177)Lu, (131)I, (188)Re, and (89)Sr. Nevertheless, therapies based on alpha particle emitters are still largely not available in the region and are currently only available in Israel and Turkey. Regarding human resources, according to the data provided there are 1157 NM physicians, 1953 technologists, 586 medical physicists, and 173 radiopharmacists or radiochemists in the region. Approximately half of all available human resources are accounted for by Turkey. The region has great potential for expanding the applications of NM; this becomes especially important in view of the high prevalence of non-communicable diseases. Further increasing awareness of the clinical applications of NM in healthcare and strengthening technical and human capacities including the establishment of training programs for all professionals and disciplines in the field are recognized as key components in advancing the practice of NM in the Middle East. PMID:27237437

  10. Current Status of Nuclear Medicine Practice in the Middle East.

    PubMed

    Paez, Diana; Becic, Tarik; Bhonsle, Uday; Jalilian, Amir R; Nuñez-Miller, Rodolfo; Osso, Joao Alberto

    2016-07-01

    availability of (68)Ge-(68)Ga generators is increasing and studies involving prostate-specific membrane antigen or DOTA-chelated peptides or both are performed in at least seven countries. Although therapeutic radionuclide agents are mostly imported from outside the region, this does not limit the availability of therapies with (90)Y, (153)Sm, (177)Lu, (131)I, (188)Re, and (89)Sr. Nevertheless, therapies based on alpha particle emitters are still largely not available in the region and are currently only available in Israel and Turkey. Regarding human resources, according to the data provided there are 1157 NM physicians, 1953 technologists, 586 medical physicists, and 173 radiopharmacists or radiochemists in the region. Approximately half of all available human resources are accounted for by Turkey. The region has great potential for expanding the applications of NM; this becomes especially important in view of the high prevalence of non-communicable diseases. Further increasing awareness of the clinical applications of NM in healthcare and strengthening technical and human capacities including the establishment of training programs for all professionals and disciplines in the field are recognized as key components in advancing the practice of NM in the Middle East.

  11. Cardiovascular pharmacogenomics; state of current knowledge and implementation in practice.

    PubMed

    Shahabi, Payman; Dubé, Marie-Pierre

    2015-04-01

    Pharmacogenomics (PGx) is the science that examines how an individual's genetic make-up affects the safety and efficacy of therapeutic drugs. PGx of response to cardiovascular (CV) medications is of the most successfully translated branches of PGx into the clinical workout. However, the clinical implementation of PGx of CV drugs is yet far beyond the growth of our understanding of the role of genetics in drug therapy. A considerable amount of efforts have been devoted by the regulatory agents like the food and drug administration (FDA) as well as the expert-based networks such as the Clinical Pharmacogenetics Implementation Consortium (CPIC) to overcome the existing barriers. This has been done, at least in part, for some of the most widely prescribed CV drugs, including clopidogrel, warfarin and simvastatin for which the PGx knowledge have been satisfactorily robust to provoke the CPIC to issue the guidelines for these drugs and the FDA to update the drugs' labeling, both strongly recommended the use of genotype-guided dosing for these medications, provided that the genetic data are available. For other drugs, however, studies have produced contradictory results and further large and well-designed clinical trials are required to expand and confirm the clinical utility of their PGx data. This review paper presents the current state of knowledge in the field of PGx of CV medications and describes the facilities assisting to the translation of PGx data into the clinical practice. Afterward, the existing body of PGx literature of the most-commonly used CV medications is comprehensively discussed.

  12. Ethnic specific recommendations in clinical practice guidelines: a first exploratory comparison between guidelines from the USA, Canada, the UK, and the Netherlands

    PubMed Central

    Manna, D; Bruijnzeels, M; Mokkink, H; Berg, M

    2003-01-01

    Objectives: To investigate whether clinical practice guidelines in different countries take ethnic differences between patients into consideration and to assess the scientific foundation of such ethnic specific recommendations. Design: Analysis of the primary care sections of clinical practice guidelines. Setting: Primary care practice guidelines for type 2 diabetes mellitus, hypertension, and asthma developed in the USA, Canada, the UK, and the Netherlands. Main outcome measures: Enumeration of the ethnic specific information and recommendations in the guidelines, and the scientific basis and strength of this evidence. Results: Different guidelines do address ethnic differences between patients, but to a varying extent. The USA guidelines contained the most ethnic specific statements and the Dutch guidelines the least. Most ethnic specific statements were backed by scientific evidence, usually arising from descriptive studies or narrative reviews. Conclusion: The attention given to ethnic differences between patients in clinical guidelines varies between countries. Guideline developers should be aware of the potential problems of ignoring differences in ethnicity. PMID:14532367

  13. A UK general practice population cohort study investigating the association between lipid lowering drugs and 30-day mortality following medically attended acute respiratory illness

    PubMed Central

    Joshi, Roshni; Myles, Puja R.

    2016-01-01

    Background. Cholesterol lowering drugs HMG-CoA reductase inhibitors (statins) and PPARα activators (fibrates) have been shown to reduce host inflammation via non-disease specific immunomodulatory mechanisms. Recent studies suggest that commonly prescribed drugs in general practice, statins and fibrates, may be beneficial in influenza-like illness related mortality. This retrospective cohort study examines the association between two lipid lowering drugs, statins and fibrates, and all-cause 30-day mortality following a medically attended acute respiratory illness (MAARI). Methods. Primary care patient data were retrospectively extracted from the UK Clinical Practice Research Datalink (CPRD) database. The sample comprised 201,179 adults aged 30 years or older experiencing a MAARI episode. Patient exposure to statins or fibrates was coded as separate dichotomous variables and deemed current if the most recent GP prescription was issued in the 30 days prior to MAARI diagnosis. Multivariable logistic regression and Cox regression were used for analyses. Adjustment was carried out for chronic lung disease, heart failure, metformin and glitazones, comorbidity burden, socio-demographic and lifestyle variables such as smoking status and body mass index (BMI). Statistical interaction tests were carried out to check for effect modification by gender, body mass index, smoking status and comorbidity. Results. A total of 1,096 (5%) patients died within the 30-day follow up period. Of this group, 213 (19.4%) were statin users and 4 (0.4%) were fibrate users. After adjustment, a significant 35% reduction in odds [adj OR; 0.65 (95% CI [0.52–0.80])] and a 33% reduction in the hazard [adj HR: 0.67 (95% CI [0.55–0.83])] of all-cause 30-day mortality following MAARI was observed in statin users. A significant effect modification by comorbidity burden was observed for the association between statin use and MAARI-related mortality. Fibrate use was associated with a non

  14. A UK general practice population cohort study investigating the association between lipid lowering drugs and 30-day mortality following medically attended acute respiratory illness.

    PubMed

    Joshi, Roshni; Venkatesan, Sudhir; Myles, Puja R

    2016-01-01

    Background. Cholesterol lowering drugs HMG-CoA reductase inhibitors (statins) and PPARα activators (fibrates) have been shown to reduce host inflammation via non-disease specific immunomodulatory mechanisms. Recent studies suggest that commonly prescribed drugs in general practice, statins and fibrates, may be beneficial in influenza-like illness related mortality. This retrospective cohort study examines the association between two lipid lowering drugs, statins and fibrates, and all-cause 30-day mortality following a medically attended acute respiratory illness (MAARI). Methods. Primary care patient data were retrospectively extracted from the UK Clinical Practice Research Datalink (CPRD) database. The sample comprised 201,179 adults aged 30 years or older experiencing a MAARI episode. Patient exposure to statins or fibrates was coded as separate dichotomous variables and deemed current if the most recent GP prescription was issued in the 30 days prior to MAARI diagnosis. Multivariable logistic regression and Cox regression were used for analyses. Adjustment was carried out for chronic lung disease, heart failure, metformin and glitazones, comorbidity burden, socio-demographic and lifestyle variables such as smoking status and body mass index (BMI). Statistical interaction tests were carried out to check for effect modification by gender, body mass index, smoking status and comorbidity. Results. A total of 1,096 (5%) patients died within the 30-day follow up period. Of this group, 213 (19.4%) were statin users and 4 (0.4%) were fibrate users. After adjustment, a significant 35% reduction in odds [adj OR; 0.65 (95% CI [0.52-0.80])] and a 33% reduction in the hazard [adj HR: 0.67 (95% CI [0.55-0.83])] of all-cause 30-day mortality following MAARI was observed in statin users. A significant effect modification by comorbidity burden was observed for the association between statin use and MAARI-related mortality. Fibrate use was associated with a non

  15. Critical thinking, nurse education and universities: some thoughts on current issues and implications for nursing practice.

    PubMed

    Morrall, Peter; Goodman, Benny

    2013-09-01

    When in the latter part of the 20th century nurse 'training' in the UK left the old schools of nursing (based within the health delivery system) and entered universities, the promise was not just a change of focus from training to education but an embracement of 'higher' education. Specifically, nurses were to be exposed to the demands of thinking rather than just doing - and critical thinking at that. However, despite a history of critical perspectives informing nursing theory, that promise may be turning sour. The insidious saturation of the university system in bureaucracy and managerialism has, we argue, undermined critical thinking. A major funding restructuring of higher education in the UK, coinciding with public concern about the state of nursing practice, is undermining further the viability of critical thinking in nursing and potentially the acceptability of university education for nurses. Nevertheless, while critical thinking in universities has decayed, there is no obvious educational alternative that can provide this core attribute, one that is even more necessary to understand health and promote competent nursing practice in an increasingly complex and globalising world. We propose that nurse academics and their colleagues from many other academic and professional disciplines engage in collegiate 'moral action' to re-establish critical thinking in UK universities.

  16. Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework

    PubMed Central

    Kontopantelis, Evangelos; Buchan, Iain; Reeves, David; Checkland, Kath; Doran, Tim

    2013-01-01

    Objectives To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. Design Retrospective longitudinal study. Setting Data for 2007–2008 to 2010–2011, extracted from the clinical computer systems of general practices in England. Participants All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice. Main outcome measures Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement. Results Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels). Conclusions Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system. PMID:23913774

  17. Evaluation of Research. A Selection of Current Practices.

    ERIC Educational Resources Information Center

    Gibbons, Michael; Georghiou, Luke

    This report is based on selected surveys of research practices used in eight countries (Canada, France, Germany, Japan, The Netherlands, Sweden, the United Kingdom and the United States). It is designed as a technical approach to help both scientists and decision makers unfamiliar with these procedures to define the most relevant practices in…

  18. Child Abuse: Principles and Implications of Current Pediatric Practice.

    ERIC Educational Resources Information Center

    Newberger, Eli H.; Hyde, James N., Jr.

    This paper summarizes data and experience with child abuse pertinent to child health practice. It goal is to foster sound and rational medical management. Because of the complex origins of child abuse, however, and of the institutional and social changes which shall have to accompany excellent practice if child abuse is effectively to be treated…

  19. Physician-assisted suicide: a review of the literature concerning practical and clinical implications for UK doctors

    PubMed Central

    Hicks, Madelyn Hsiao-Rei

    2006-01-01

    Background A bill to legalize physician-assisted suicide in the UK recently made significant progress in the British House of Lords and will be reintroduced in the future. Until now there has been little discussion of the clinical implications of physician-assisted suicide for the UK. This paper describes problematical issues that became apparent from a review of the medical and psychiatric literature as to the potential effects of legalized physician-assisted suicide. Discussion Most deaths by physician-assisted suicide are likely to occur for the illness of cancer and in the elderly. GPs will deal with most requests for assisted suicide. The UK is likely to have proportionately more PAS deaths than Oregon due to the bill's wider application to individuals with more severe physical disabilities. Evidence from other countries has shown that coercion and unconscious motivations on the part of patients and doctors in the form of transference and countertransference contribute to the misapplication of physician-assisted suicide. Depression influences requests for hastened death in terminally ill patients, but is often under-recognized or dismissed by doctors, some of whom proceed with assisted death anyway. Psychiatric evaluations, though helpful, do not solve these problems. Safeguards that are incorporated into physician-assisted suicide criteria probably decrease but do not prevent its misapplication. Summary The UK is likely to face significant clinical problems arising from physician-assisted suicide if it is legalized. Terminally ill patients with mental illness, especially depression, are particularly vulnerable to the misapplication of physician-assisted suicide despite guidelines and safeguards. PMID:16792812

  20. Current state of medical device nomenclature and taxonomy systems in the UK: spotlight on GMDN and SNOMED CT

    PubMed Central

    White, Judith; Carolan-Rees, Grace

    2013-01-01

    A standardised terminology for describing medical devices can enable safe and unambiguous exchange of information. Proposed changes to EU-wide medical devices regulations mandate the use of such a system. This article reviews two important classification systems for medical devices in the UK. The Global Medical Device Nomenclature (GMDN) provides a classification system specifically for medical devices and diagnostics, and facilitates data exchange between manufacturers and regulators. SNOMED CT is the terminology of choice in the NHS for communicating, sharing and storing information about patients’ healthcare episodes. Harmonisation of GMDN and SNOMED CT will encourage use of single terminology throughout the lifetime of a device; from regulatory approval through clinical use and post-marketing surveillance. Manufacturers will be required to register medical devices with a European device database (Eudamed) and to fit certain devices with a Unique Device Identifier; both are efforts to improve transparency and traceability of medical devices. Successful implementation of these elements depends on having a consistent nomenclature for medical devices. PMID:23885299

  1. 21 CFR 1271.150 - Current good tissue practice requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... implemented for reproductive HCT/Ps described in § 1271.10 and regulated solely under section 361 of the... manufacturing practice regulations in parts 210 and 211 of this chapter and the quality system regulations...

  2. 21 CFR 1271.150 - Current good tissue practice requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... implemented for reproductive HCT/Ps described in § 1271.10 and regulated solely under section 361 of the... manufacturing practice regulations in parts 210 and 211 of this chapter and the quality system regulations...

  3. Promising Practices and Programs: Current Efforts and Future Directions

    ERIC Educational Resources Information Center

    Crisp, Gloria

    2016-01-01

    The final chapter of the issue provides a synthesis of the first eight chapters, offers conclusions and recommendations, and considers future directions regarding practices and programs with promise for high impact at community colleges around the country.

  4. Current Perspectives on Pronunciation. Practices Anchored in Theory.

    ERIC Educational Resources Information Center

    Morley, Joan, Ed.

    A collection of essays on pronunciation instruction theory and practice includes: "Teaching Pronunciation as Communication" (Marianne Celce-Murcia); "Learner Variables and Prepronunciation Considerations in Teaching Pronunciation" (Rita Wong); "Pronunciation and Listening Comprehension" (Judy B. Gilbert); "Pronunciation Tutorials for Nonnative…

  5. Forensic Occupational Therapy in Canada: The Current State of Practice.

    PubMed

    Chui, Adora L Y; Wong, Chantal Isabelle; Maraj, Sara A; Fry, Danielle; Jecker, Justine; Jung, Bonny

    2016-09-01

    Although occupational therapists have been practicing in forensic settings for many years, there is a paucity of literature regarding the nature of this practice in Canada. The purpose of this study was to describe the practices of Canadian occupational therapists in forensic mental health. An online survey was designed based on the Canadian Practice Process Framework. Following purposive and snowball sampling, responses were analysed with descriptive statistics and content analysis. Twenty-seven clinicians responded (56% response rate). Respondents indicated commonalities in workplaces, client caseloads and practice challenges. The outstanding need in Canada to demonstrate client outcomes through the use of evaluation instruments reflects those practice gaps identified internationally. Education, advocacy and research are critical areas for the development of Canadian forensic occupational therapy. Although findings heavily reflect one provincial context and may not be generalizable to nonhospital settings, a number of priority areas were identified. Future efforts should clarify the role of forensic occupational therapy to stakeholders, and validate their contributions through research that evaluates intervention efficacy and meaningful outcomes. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Nutritional knowledge of UK coaches.

    PubMed

    Cockburn, Emma; Fortune, Alistair; Briggs, Marc; Rumbold, Penny

    2014-04-10

    Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC) level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163) completed a sports nutrition questionnaire to identify: (a) if they provided nutritional advice; (b) their level of sport nutrition knowledge; and (c) factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%), even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05). Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p < 0.05). In conclusion, UK sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice.

  7. Current clinical practice guidelines in atrial fibrillation: a review.

    PubMed

    Galvez-Olortegui, José Kelvin; Álvarez-Vargas, Mayita Lizbeth; Galvez-Olortegui, Tomas Vladimir; Godoy-Palomino, Armando; Camacho-Saavedra, Luis

    2016-01-14

    The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in atrial fibrillation. This is the second in a series of articles of review, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Among all clinical practice guidelines, we selected the American, Canadian and NICE (National Institute for Health and Care Excellence) guidelines. We used the AGREE (Appraisal of Guidelines for Research and Evaluation) II instrument for the assessment. In general, the guidelines obtained the lowest score in the applicability domain (mean 36.1%); while the highest score was for clarity of presentation (mean 93.5%). The lowest percentage was found in the editorial independence domain (Canadian guideline) and the highest of all scores in the applicability domain (NICE guideline). Regarding global quality, the NICE guideline obtained the AGREE II instrument best scores, followed by the American guideline, both recommended for use without modifications.

  8. Current clinical practice guidelines in atrial fibrillation: a review.

    PubMed

    Galvez-Olortegui, José Kelvin; Álvarez-Vargas, Mayita Lizbeth; Galvez-Olortegui, Tomas Vladimir; Godoy-Palomino, Armando; Camacho-Saavedra, Luis

    2016-01-01

    The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in atrial fibrillation. This is the second in a series of articles of review, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Among all clinical practice guidelines, we selected the American, Canadian and NICE (National Institute for Health and Care Excellence) guidelines. We used the AGREE (Appraisal of Guidelines for Research and Evaluation) II instrument for the assessment. In general, the guidelines obtained the lowest score in the applicability domain (mean 36.1%); while the highest score was for clarity of presentation (mean 93.5%). The lowest percentage was found in the editorial independence domain (Canadian guideline) and the highest of all scores in the applicability domain (NICE guideline). Regarding global quality, the NICE guideline obtained the AGREE II instrument best scores, followed by the American guideline, both recommended for use without modifications. PMID:26939036

  9. Primary care consultation rates among people with and without severe mental illness: a UK cohort study using the Clinical Practice Research Datalink

    PubMed Central

    Kontopantelis, Evangelos; Olier, Ivan; Planner, Claire; Reeves, David; Ashcroft, Darren M; Gask, Linda; Doran, Tim; Reilly, Siobhan

    2015-01-01

    Objectives Little is known about service utilisation by patients with severe mental illness (SMI) in UK primary care. We examined their consultation rate patterns and whether they were impacted by the introduction of the Quality and Outcomes Framework (QOF), in 2004. Design Retrospective cohort study using individual patient data collected from 2000 to 2012. Setting 627 general practices contributing to the Clinical Practice Research Datalink, a large UK primary care database. Participants SMI cases (346 551) matched to 5 individuals without SMI (1 732 755) on age, gender and general practice. Outcome measures Consultation rates were calculated for both groups, across 3 types: face-to-face (primary outcome), telephone and other (not only consultations but including administrative tasks). Poisson regression analyses were used to identify predictors of consultation rates and calculate adjusted consultation rates. Interrupted time-series analysis was used to quantify the effect of the QOF. Results Over the study period, face-to-face consultations in primary care remained relatively stable in the matched control group (between 4.5 and 4.9 per annum) but increased for people with SMI (8.8–10.9). Women and older patients consulted more frequently in the SMI and the matched control groups, across all 3 consultation types. Following the introduction of the QOF, there was an increase in the annual trend of face-to-face consultation for people with SMI (average increase of 0.19 consultations per patient per year, 95% CI 0.02 to 0.36), which was not observed for the control group (estimates across groups statistically different, p=0.022). Conclusions The introduction of the QOF was associated with increases in the frequency of monitoring and in the average number of reported comorbidities for patients with SMI. This suggests that the QOF scheme successfully incentivised practices to improve their monitoring of the mental and physical health of this group of patients

  10. Chemical Aspects of General Anesthesia: Part II. Current Practices

    ERIC Educational Resources Information Center

    Brunsvold, Robert; Ostercamp, Daryl L.

    2006-01-01

    The basics of balanced general anesthesia developed since 1956 and the update on existing practices of intravenous induction anesthetics and inhalational anesthetics are discussed. Some of the progressive anesthetics discussed are propofol instead of barbiturate such as thiopental or methohexital, inhalational anesthetic halothane,…

  11. Current Juvenile Corrections Professional Development Practices and Future Directions

    ERIC Educational Resources Information Center

    Gagnon, Joseph C.; Houchins, David E.; Murphy, Kristin M.

    2012-01-01

    Personnel in juvenile corrections (JC) work with students who have challenging academic, behavioral, and mental health needs. The complexity of the JC setting requires personnel to be highly skilled in effective practices to meet the demands of their job. Unfortunately, juvenile correctional personnel are neglected as an important link in the…

  12. Family Counseling in Malaysia: Current Issues and Practices

    ERIC Educational Resources Information Center

    Noor, Norhayati Mohd.

    2014-01-01

    The study is carried out to explore the issues and practices in family counselling among the family counsellors at few counseling centres in Malaysia. Qualitative approach of single case embedded units was used for the study. Data collection was done using in-depth interview, observation and document analysis with 12 family counsellors. The data…

  13. Current Neonatal Resuscitation Practices among Paediatricians in Gujarat, India

    PubMed Central

    Bansal, Satvik C.; Nimbalkar, Archana S.; Patel, Dipen V.; Sethi, Ankur R.; Phatak, Ajay G.; Nimbalkar, Somashekhar M.

    2014-01-01

    Aim. We assessed neonatal resuscitation practices among paediatricians in Gujarat. Methods. Cross-sectional survey of 23 questions based on guidelines of Neonatal Resuscitation Program (NRP) and Navjaat Shishu Suraksha Karyakram (NSSK) was conducted using web-based tool. Questionnaire was developed and consensually validated by three neonatologists. Results. Total of 142 (21.2%) of 669 paediatricians of Gujarat, India, whose e-mail addresses were available, attempted the survey and, from them, 126 were eligible. Of these, 74 (58.7%) were trained in neonatal resuscitation. Neonatal Intensive Care Unit with mechanical ventilation facilities was available for 54% of respondents. Eighty-eight (69.8%) reported correct knowledge and practice regarding effective bag and mask ventilation (BMV) and chest compressions. Knowledge and practice about continuous positive airway pressure use in delivery room were reported in 18.3% and 30.2% reported use of room air for BMV during resuscitation. Suctioning oral cavity before delivery in meconium stained liquor was reported by 27.8% and 38.1% cut the cord after a minute of birth. Paediatricians with NRP training used appropriate method of tracheal suction in cases of nonvigorous newborns than those who were not trained. Conclusions. Contemporary knowledge about neonatal resuscitative practices in paediatricians is lacking and requires improvement. Web-based tools provided low response in this survey. PMID:24688549

  14. Current Practices and Procedures in the Use of Substitute Teachers.

    ERIC Educational Resources Information Center

    Rose, Terry L.; And Others

    This report provides statistics on employment, evaluation, and training practices and procedures of American public school substitute teachers. A questionnaire was mailed to the directors of substitute teachers in 401 randomly selected school districts. Usable information was returned by 259 school systems (64.6 percent) in 49 states and the…

  15. Preoperative Planning in Orthopaedic Surgery. Current Practice and Evolving Applications.

    PubMed

    Atesok, Kivanc; Galos, David; Jazrawi, Laith M; Egol, Kenneth A

    2015-12-01

    Preoperative planning is an essential prerequisite for the success of orthopaedic procedures. Traditionally, the exercise has involved the written down, step by step "blueprint" of the surgical procedure. Preoperative planning of the technical aspects of the orthopaedic procedure has been performed on hardcopy radiographs using various methods such as copying the radiographic image on tracing papers to practice the planned interventions. This method has become less practical due to variability in radiographic magnification and increasing implementation of digital imaging systems. Advances in technology along with recognition of the importance of surgical safety protocols resulted in widespread changes in orthopaedic preoperative planning approaches. Nowadays, perioperative "briefings" have gained particular importance and novel planning methods have started to integrate into orthopaedic practice. These methods include using software that enables surgeons to perform preoperative planning on digital radiographs and to construct 3D digital models or prototypes of various orthopaedic pathologies from a patient's CT scans to practice preoperatively. Evidence-to-date suggests that preoperative planning and briefings are effective means of favorably influencing the outcomes of orthopaedic procedures.

  16. SOME CURRENT REGULATIONS AND PRACTICES IN APPROVING DOCTORAL DISSERTATIONS.

    ERIC Educational Resources Information Center

    ROGERS, ROBERT W.

    SIXTY-FIVE U.S. INSTITUTIONS WITH PH.D. PROGRAMS IN ENGLISH AS OF 1960 RESPONDED TO A SURVEY OF REGULATIONS AND PRACTICES FOR APPROVING DOCTORAL DISSERTATIONS. A BRIEF TABULATION OF RESULTS REVEALS HOW MANY READERS ARE USED FOR EACH DISSERTATION, WHETHER THIS NUMBER IS A REQUIREMENT OF THE GRADUATE SCHOOL OR THE ENGLISH DEPARTMENT, AND WHAT DEGREE…

  17. Current marketing practices in the nursing home sector.

    PubMed

    Calhoun, Judith G; Banaszak-Holl, Jane; Hearld, Larry R

    2006-01-01

    Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function. PMID:16770906

  18. Alien knowledge: preparing student midwives for learning about infant feeding--education practice at a UK university.

    PubMed

    Angell, Catherine; Taylor, Alison M

    2013-11-01

    Infant feeding education forms a key element in undergraduate midwifery education in the UK. Students must be prepared to provide women with support and information to make appropriate health choices for themselves and their infants. However, student midwives may already have developed opinions about infant feeding prior to commencing a midwifery education programme. The education literature suggests that existing attitudes may present a barrier to learning for some students. This particularly applies to learning in relation to sensitive or emotionally laden subjects. A review of the literature was undertaken to identify potential teaching approaches which might help students to overcome barriers to learning. Following this the evidence was utilised at a UK university to develop activities which prepare student midwives for effective learning around infant feeding. Students enrolled in the midwifery education programme were introduced to a number of activities aimed at encouraging them to accommodate unfamiliar ideas or 'alien knowledge'. These included placing students in situations which challenged their ideas, as well as engaging in group discussions and reflective exercises. The impact of these educational interventions was identified through formative and summative assessment, and through evaluation of the teaching strategy at the end of the programme. This demonstrated that, amongst those students with previously negative attitudes towards infant feeding, there was a move towards more positive attitudes and a greater confidence in providing evidence based information to parents.

  19. Diagnostic Testing at UK Universities: An E-Mail Survey

    ERIC Educational Resources Information Center

    Gillard, Jonathan; Levi, Margaret; Wilson, Robert

    2010-01-01

    In July 2009, an e-mail survey was sent to various UK universities to gain information regarding current practices concerning mathematics diagnostic testing, and to provide an update from the review "Diagnostic Testing for Mathematics" published by the LTSN MathsTEAM Project in 2003. A total of 38 university departments were contacted and the…

  20. Personal Trainer Demographics, Current Practice Trends and Common Trainee Injuries

    PubMed Central

    Waryasz, Gregory R.; Daniels, Alan H.; Gil, Joseph A.; Suric, Vladimir; Eberson, Craig P.

    2016-01-01

    Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness. PMID:27761219

  1. Core competencies for UK occupational health nurses: a Delphi study

    PubMed Central

    Demou, E.; Kiran, S.; Gaffney, M.; Stevenson, M.; Macdonald, E. B.

    2016-01-01

    Background Occupational health nurses (OHNs) play a pivotal role in the delivery of occupational health (OH) services. Specific competency guidance has been developed in a number of countries, including the UK. While it is acknowledged that UK OHN practice has evolved in recent years, there has been no formal research to capture these developments to ensure that training and curricula remain up-to-date and reflect current practice. Aims To identify current priorities among UK OHNs of the competencies required for OH practice. Methods A modified Delphi study undertaken among representative OHN networks in the UK. This formed part of a larger study including UK and international occupational physicians. The study was conducted in two rounds using a questionnaire based on available guidance on training competencies for OH practice, the published literature, expert panel reviews and conference discussions. Results Consensus among OHNs was high with 7 out of the 12 domains scoring 100% in rating. ‘Good clinical care’ was the principal domain ranked most important, followed by ‘general principles of assessment & management of occupational hazards to health’. ‘Research methods’ and ‘teaching & educational supervision’ were considered least important. Conclusions This study has established UK OHNs’ current priorities on the competencies required for OH practice. The timing of this paper is opportune with the formal launch of the Faculty of Occupational Health Nursing planned in 2018 and should inform the development of competency requirements as part of the Faculty’s goals for standard setting in OHN education and training. PMID:27492470

  2. What evidence is there for a delay in diagnostic coding of RA in UK general practice records? An observational study of free text

    PubMed Central

    Ford, Elizabeth; Carroll, John; Smith, Helen; Davies, Kevin; Koeling, Rob; Petersen, Irene; Rait, Greta; Cassell, Jackie

    2016-01-01

    Objectives Much research with electronic health records (EHRs) uses coded or structured data only; important information captured in the free text remains unused. One dimension of EHR data quality assessment is ‘currency’ or timeliness, that is, data are representative of the patient state at the time of measurement. We explored the use of free text in UK general practice patient records to evaluate delays in recording of rheumatoid arthritis (RA) diagnosis. We also aimed to locate and quantify disease and diagnostic information recorded only in text. Setting UK general practice patient records from the Clinical Practice Research Datalink. Participants 294 individuals with incident diagnosis of RA between 2005 and 2008; 204 women and 85 men, median age 63 years. Primary and secondary outcome measures Assessment of (1) quantity and timing of text entries for disease-modifying antirheumatic drugs (DMARDs) as a proxy for the RA disease code, and (2) quantity, location and timing of free text information relating to RA onset and diagnosis. Results Inflammatory markers, pain and DMARDs were the most common categories of disease information in text prior to RA diagnostic code; 10–37% of patients had such information only in text. Read codes associated with RA-related text included correspondence, general consultation and arthritis codes. 64 patients (22%) had DMARD text entries >14 days prior to RA code; these patients had more and earlier referrals to rheumatology, tests, swelling, pain and DMARD prescriptions, suggestive of an earlier implicit diagnosis than was recorded by the diagnostic code. Conclusions RA-related symptoms, tests, referrals and prescriptions were recorded in free text with 22% of patients showing strong evidence of delay in coding of diagnosis. Researchers using EHRs may need to mitigate for delayed codes by incorporating text into their case-ascertainment strategies. Natural language processing techniques have the capability to do this at

  3. Current Student Assessment Practices of High School Band Directors

    ERIC Educational Resources Information Center

    LaCognata, John P.

    2010-01-01

    Measurement and assessment are becoming increasingly important to all music educators. The purpose of this study was to investigate the following questions: 1) in what specific ways are current high school band directors assessing students in their ensemble classes; 2) what are high school band directors' attitudes toward the assessment process;…

  4. Early and Current Reading and Spelling Practices of Gifted Spellers.

    ERIC Educational Resources Information Center

    Olson, Mary W.; And Others

    1989-01-01

    Studies spelling bee finalists' early and current reading and spelling experiences. Finds that gifted spellers show an early interest in language arts activities, pass through developmental stages far earlier than normal children, and rely on visual memory strategies, word meanings, and saying/writing words to master orthography. (RS)

  5. Reflection of Constructivist Theories in Current Educational Practice

    ERIC Educational Resources Information Center

    Juvova, Alena; Chudy, Stefan; Neumeister, Pavel; Plischke, Jitka; Kvintova, Jana

    2015-01-01

    In this overview study, we would like to present the basic constructivist approaches that have affected or influenced the current concept of education. The teacher-student interaction is reflected by personality, psychological traits, attitudes and cultural capital of the participants of the educational process as well as the teacher's effort to…

  6. A Preliminary Investigation of Current Practices in American Youth Theatres.

    ERIC Educational Resources Information Center

    Regan, F. Scott

    1983-01-01

    Summarizes results of a survey of youth theatres on (1) theatre goals; (2) staff training and courses offered; (3) organization and funds; and (4) teachers' knowledge of actor training, child and adolescent psychology, playwriting trends in children's theatre, and current theoretical writings. (PD)

  7. The current status of behavioral psychotherapy: theory and practice.

    PubMed

    Marks, I M

    1976-03-01

    Behavioral psychotherapy has become one of the definitive treatments available for the relief of psychiatric suffering. Although hardly a panacea for all ills, the behavioral approach is the treatment of choice for certain selected problems. Behavioral methods make their contribution in the context of general psychiatric management and often must be used in conjunction with other treatment. The theoretical and practical aspects of behavioral psychotherapy have changed a great deal over the past few years and continue to evolve rapidly. Although useful molecular theories are emerging to guide the discipline, no global theory is likely to be satisfactory in the foreseeable future.

  8. Post-arthroscopy septic arthritis: Current data and practical recommendations.

    PubMed

    Bauer, T; Boisrenoult, P; Jenny, J Y

    2015-12-01

    Septic arthritis develops after less than 1% of all arthroscopy procedures. The clinical symptoms may resemble those seen after uncomplicated arthroscopy, raising diagnostic challenges. The diagnosis rests on emergent joint aspiration with microscopic smear examination and prolonged culturing on specific media. Urgent therapeutic measures must be taken, including abundant arthroscopic lavage, synovectomy, and the concomitant administration of two effective antibiotics for at least 6 weeks. Preservation of implants or transplants is increasingly accepted, and repeated joint lavage is a component of the treatment strategy. After knee arthroscopy, infection is the most common complication; most cases occur after cruciate ligament reconstruction, and staphylococci are the predominant causative organisms. Emergent synovectomy with transplant preservation and appropriate antibiotic therapy ensures eradication of the infection in 85% of cases, with no adverse effect on final functional outcomes. After shoulder arthroscopy, infection is 10 times less common than neurological complications and occurs mainly after rotator cuff repair procedures; the diagnosis may be difficult and delayed if Propionibacterium acnes is the causative organism. The update presented here is based on both a literature review and a practice survey. The findings have been used to develop practical recommendations aimed at improving the management of post-arthroscopy infections, which are exceedingly rare but can induce devastating functional impairments. PMID:26412207

  9. Current Neonatal Skin Care Practices in Four African Sites.

    PubMed

    Amare, Yared; Shamba, Donat D; Manzi, Fatuma; Bee, Margaret H; Omotara, Babatunji A; Iganus, Ruth B; Adejuyigbe, Ebunoluwa A; Odebiyi, Adetanwa L; Skordis-Worrall, Jolene; Hill, Zelee E

    2015-12-01

    Data for this study on skin care practices and emollient use in four African sites were collected using in-depth interviews, focus-group discussions and observations. Respondents were mothers, grandmothers, fathers, health workers, birth attendants and people selling skin-care products. Analysis included content and framework analyses.Emollient use was a normative practice in all sites, with frequent application from an early age in most sites. There were variations in the type of emollients used, but reasons for use were similar and included improving the skin, keeping the baby warm, softening/strengthening the joints/bones, shaping the baby, ensuring flexibility and encouraging growth and weight gain. Factors that influenced emollient choice varied and included social pressure, cost, availability and deep-rooted traditional norms. Massage associated with application was strong and potentially damaging to the skin in some sites.Given the widespread use of emollients, the repeated exposure of newborns in the first month of life and the potential impact of emollients on mortality, trials such as those that have been conducted in Asia are needed in a range of African settings.

  10. Post-arthroscopy septic arthritis: Current data and practical recommendations.

    PubMed

    Bauer, T; Boisrenoult, P; Jenny, J Y

    2015-12-01

    Septic arthritis develops after less than 1% of all arthroscopy procedures. The clinical symptoms may resemble those seen after uncomplicated arthroscopy, raising diagnostic challenges. The diagnosis rests on emergent joint aspiration with microscopic smear examination and prolonged culturing on specific media. Urgent therapeutic measures must be taken, including abundant arthroscopic lavage, synovectomy, and the concomitant administration of two effective antibiotics for at least 6 weeks. Preservation of implants or transplants is increasingly accepted, and repeated joint lavage is a component of the treatment strategy. After knee arthroscopy, infection is the most common complication; most cases occur after cruciate ligament reconstruction, and staphylococci are the predominant causative organisms. Emergent synovectomy with transplant preservation and appropriate antibiotic therapy ensures eradication of the infection in 85% of cases, with no adverse effect on final functional outcomes. After shoulder arthroscopy, infection is 10 times less common than neurological complications and occurs mainly after rotator cuff repair procedures; the diagnosis may be difficult and delayed if Propionibacterium acnes is the causative organism. The update presented here is based on both a literature review and a practice survey. The findings have been used to develop practical recommendations aimed at improving the management of post-arthroscopy infections, which are exceedingly rare but can induce devastating functional impairments.

  11. A critique of current practice: ten foundational guidelines for autoethnographers.

    PubMed

    Tolich, Martin

    2010-12-01

    Any research is potentially compromised when researchers address ethical issues retrospectively rather than by anticipating these issues. In this regard, creative analytical practices (CAP) autoethnography has endemic problems. In Part 1 of this article, I detail a case study of an autoethnography in which journal reviewers insisted that an author gain retrospective informed consent from the 23 persons documented in an autoethnography. Yet the journal reviewers' insistence failed to go one step further-acknowledging that a conflict of interest develops when gaining consent retrospectively. In Part 2, I contrast three leading autoethnographers' justifications for not gaining informed consent with the Position Statement on Qualitative Research developed by successive Congresses of Qualitative Inquiry. In Part 3, I identify resources available for autoethnographers, including ethical issues present when researchers use autoethnography to heal themselves, violating the internal confidentiality of relational others. In Part 4, I question if autoethnography is research and, like journalism, exempt from formal ethics review. Throughout the article, 10 foundational ethical considerations for autoethnographers are developed, taking autoethnographers beyond procedural ethics and providing tools for their ethics in practice. PMID:20660368

  12. Credentialing in radiology: Current practice and future challenges

    PubMed Central

    Youssef, Adam; McCoubrie, Paul

    2016-01-01

    Radiology has changed significantly in recent years. The volume of work has increased dramatically as has its complexity. Future radiologists need an adequate training and expertise in conventional practice as well as new techniques. This comes at a time when other stakeholders outside of radiology are voicing their own concerns. The rightly justified increasing focus on patient safety has placed even more emphasis on the demonstration of competent practice by all health care professionals. Credentialing has been put forward as a way to ensure a doctor is competent in specific areas. Credentialing may be an alien concept to many radiology trainees but moves are afoot in the United Kingdom to bring it to the forefront of its postgraduate medical training. Credentialing began in 20th century North America where it was linked to the process of privileging. It subsequently garnered a strong patient safety focus and has become a part of the international healthcare agenda. Not everyone agrees with credentialing, it has many criticisms including the risk of speciality “turf wars” and the stifling of medical excellence to name just a couple. Is credentialing in radiology here to stay or will it pass by quietly? This paper reviews the global credentialing movement and discusses how this may impact on future radiology training, using the United Kingdom as its case example. PMID:27247716

  13. Credentialing in radiology: Current practice and future challenges.

    PubMed

    Youssef, Adam; McCoubrie, Paul

    2016-05-28

    Radiology has changed significantly in recent years. The volume of work has increased dramatically as has its complexity. Future radiologists need an adequate training and expertise in conventional practice as well as new techniques. This comes at a time when other stakeholders outside of radiology are voicing their own concerns. The rightly justified increasing focus on patient safety has placed even more emphasis on the demonstration of competent practice by all health care professionals. Credentialing has been put forward as a way to ensure a doctor is competent in specific areas. Credentialing may be an alien concept to many radiology trainees but moves are afoot in the United Kingdom to bring it to the forefront of its postgraduate medical training. Credentialing began in 20(th) century North America where it was linked to the process of privileging. It subsequently garnered a strong patient safety focus and has become a part of the international healthcare agenda. Not everyone agrees with credentialing, it has many criticisms including the risk of speciality "turf wars" and the stifling of medical excellence to name just a couple. Is credentialing in radiology here to stay or will it pass by quietly? This paper reviews the global credentialing movement and discusses how this may impact on future radiology training, using the United Kingdom as its case example. PMID:27247716

  14. A critique of current practice: ten foundational guidelines for autoethnographers.

    PubMed

    Tolich, Martin

    2010-12-01

    Any research is potentially compromised when researchers address ethical issues retrospectively rather than by anticipating these issues. In this regard, creative analytical practices (CAP) autoethnography has endemic problems. In Part 1 of this article, I detail a case study of an autoethnography in which journal reviewers insisted that an author gain retrospective informed consent from the 23 persons documented in an autoethnography. Yet the journal reviewers' insistence failed to go one step further-acknowledging that a conflict of interest develops when gaining consent retrospectively. In Part 2, I contrast three leading autoethnographers' justifications for not gaining informed consent with the Position Statement on Qualitative Research developed by successive Congresses of Qualitative Inquiry. In Part 3, I identify resources available for autoethnographers, including ethical issues present when researchers use autoethnography to heal themselves, violating the internal confidentiality of relational others. In Part 4, I question if autoethnography is research and, like journalism, exempt from formal ethics review. Throughout the article, 10 foundational ethical considerations for autoethnographers are developed, taking autoethnographers beyond procedural ethics and providing tools for their ethics in practice.

  15. The current health of the signing Deaf community in the UK compared with the general population: a cross-sectional study

    PubMed Central

    Emond, Alan; Ridd, Matthew; Sutherland, Hilary; Allsop, Lorna; Alexander, Andrew; Kyle, Jim

    2015-01-01

    Objectives To assess the current health of the Deaf community in the UK and compare with the general population. Design A quota sample of adult Deaf British Sign Language (BSL) users underwent a health assessment and interview in 2012–2013. Comparative data were obtained from the Health Survey for England (HSE) 2011 and the Quality Outcomes Framework (QOF) 2012. Setting Participants completed a structured interview and health assessment at seven Bupa centres across the UK, supported in BSL by Deaf advisers and interpreters. Participants 298 Deaf people, 20–82 years old, 47% male, with 12% from ethnic minorities. Main outcome measures Self–reported health conditions, medication usage, tobacco and alcohol consumption; measured blood pressure (BP), body mass index, fasting blood sugar and lipid profile. Results Rates of obesity in the Deaf sample were high, especially in those over 65 years, and 48% were in a high risk group for serious illness. High BP readings were obtained in 37% of Deaf people (21% in HSE): 29% were unaware of this (6% in HSE). Only 42% of Deaf people being treated for hypertension had adequate control, compared with 62% of the general population. Deaf people with self-reported cardiovascular disease (CVD) were significantly less than the general population. One-third of Deaf participants had total cholesterol >5 mmol/L but although control rates were high compared with HSE, treatment rates for self-reported CVD were half the general population rate. Eleven per cent of Deaf participants had blood sugar at prediabetic or diabetic levels, and 77% of those at prediabetic levels were unaware of it. Deaf respondents self-reported more depression (31% of women, 14% of men), but less smoking (8%) and alcohol intake (2–8 units/week). Conclusions Deaf people's health is poorer than that of the general population, with probable underdiagnosis and undertreatment of chronic conditions putting them at risk of preventable ill health. PMID:25619200

  16. Biomarkers in inflammatory bowel disease: current practices and recent advances.

    PubMed

    Iskandar, Heba N; Ciorba, Matthew A

    2012-04-01

    Crohn's disease and ulcerative colitis represent the two main forms of the idiopathic chronic inflammatory bowel diseases (IBD). Currently available blood and stool based biomarkers provide reproducible, quantitative tools that can complement clinical assessment to aid clinicians in IBD diagnosis and management. C-reactive protein and fecal based leukocyte markers can help the clinician distinguish IBD from noninflammatory diarrhea and assess disease activity. The ability to differentiate between forms of IBD and predict risk for disease complications is specific to serologic tests including antibodies against Saccharomyces cerevisiae and perinuclear antineutrophil cytoplasmic proteins. Advances in genomic, proteomic, and metabolomic array based technologies are facilitating the development of new biomarkers for IBD. The discovery of novel biomarkers, which can correlate with mucosal healing or predict long-term disease course has the potential to significantly improve patient care. This article reviews the uses and limitations of currently available biomarkers and highlights recent advances in IBD biomarker discovery. PMID:22424434

  17. [Cervical cancer screening in Switzerland - current practice and future challenges].

    PubMed

    Untiet, Sarah; Schmidt, Nicole; Low, Nicola; Petignat, Patrick

    2013-04-01

    At the beginning of the 20th Century, cervical cancer was the leading cause of death from cancer in women. A marked decline in cervical cancer has been observed since the 1960s, in parallel with the introduction of the Papanicolau (Pap) test as a cytological screening method. Today, Pap smear screening is still the most widely used tool for cervical cancer prevention. Testing for human papillomavirus (HPV) in cervical specimens or a combination of Pap and HPV testing are also now available. In this article we compare current guidelines for cervical cancer screening in Switzerland with those in other European countries. In view of the opportunities offered by HPV testing and, since 2008, HPV vaccination, current guidelines for cervical cancer screening should be updated. Both the choice of screening tests and general organization of cervical cancer screening should be reviewed.

  18. Management of Nasopharyngeal Carcinoma: Current Practice and Future Perspective.

    PubMed

    Lee, Anne W M; Ma, Brigette B Y; Ng, Wai Tong; Chan, Anthony T C

    2015-10-10

    Nasopharyngeal carcinoma of the undifferentiated subtype is endemic to southern China, and patient prognosis has improved significantly over the past three decades because of advances in disease management, diagnostic imaging, radiotherapy technology, and broader application of systemic therapy. Despite the excellent local control with modern radiotherapy, distant failure remains a key challenge. Advances in molecular technology have helped to decipher the molecular pathogenesis of nasopharyngeal carcinoma as well as its etiologic association with the Epstein-Barr virus. This in turn has led to the discovery of novel biomarkers and drug targets, rendering this cancer site a current focus for new drug development. This article reviews and appraises the key literature on the current management of nasopharyngeal carcinoma and future directions in clinical research.

  19. Practical Application of Eddy Currents Generated by Wind

    NASA Astrophysics Data System (ADS)

    Dirba, I.; Kleperis, J.

    2011-06-01

    When a conductive material is subjected to time-varying magnetic fluxes, eddy (Foucault) currents are generated in it and magnetic field of opposite polarity as the applied one arises. Due to the internal resistance of the conductive material, the eddy currents will be dissipated into heat (Joule heating). Conventional domestic water heaters utilize gas burners or electric resistance heating elements to heat the water in the tank and substantial part of the energy to use for it is wasted. In this paper the origin of electromagnetic induction heat generated by wind turbine in special heat exchange camera connected to water boiler is discussed and material evaluation performed using mathematical modelling (comparing the 2D finite element model with analytical and numerical calculation results).

  20. The uses of helium and xenon in current clinical practice.

    PubMed

    Harris, P D; Barnes, R

    2008-03-01

    The noble gases have always been an enigma. Discovered late in the history of chemistry and in seemingly small quantities in our atmosphere, they are some of the most unreactive elements known. However, despite being extremely inert, the noble gases (helium, neon, argon, krypton, xenon and radon) have found diverse and ever expanding applications in medicine. Of all of them, the gases that have found the greatest number of uses in the field of anaesthesia and related specialties are helium and xenon. This review focuses on the history of the discovery of both gases, their unique physicochemical properties and describes their uses in clinical practice with particular emphasis on those applicable to anaesthesia. PMID:18289236

  1. Comparison of current and past surgical smoke control practices.

    PubMed

    Edwards, Ben E; Reiman, Robert E

    2012-03-01

    In 2010, we teamed with AORN to repeat a simple web-based survey on surgical smoke control practices first conducted in 2007. This survey of AORN members assessed the level of compliance with established surgical smoke control measures (ie, use of wall suction with an in-line particulate filter, use of a smoke evacuator, use of an N95 or other National Institute for Occupational Safety and Health-approved respirator) in various medical specialties and facilities throughout North America, as well as the extent to which compliance rates may have changed since 2007. Survey responses indicate that while the use of wall suction as a control measure has increased for nearly all procedures, progress in the adoption of other control measures has been mixed, with improvement for some procedures, no change for most procedures, and a decrease in compliance for a few procedures. PMID:22381553

  2. A practical demonstration in modelling diclofenac and propranolol river water concentrations using a GIS hydrology model in a rural UK catchment.

    PubMed

    Johnson, A C; Keller, V; Williams, R J; Young, A

    2007-03-01

    An existing GIS hydrology water quality model, LF2000-WQX, was applied to predict the concentrations of the pharmaceuticals diclofenac and propranalol in catchments. As a practical exercise the predominantly rural Tamar (UK) catchment was chosen. Consumption, excretion, and fate data were used to estimate the pharmaceutical input load for the model. The predicted concentrations throughout most of the catchment were 1 ng/L or less under low flow (90th percentile) conditions. However, at a few locations, downstream of small sewage treatment plants, concentrations above 25 ng/L were predicted. This exercise shows that it is relatively straightforward to predict the concentrations of new and emerging organic microcontaminants in real catchments using existing GIS hydrology water quality models. Further testing will be required to establish their accuracy.

  3. 78 FR 4307 - Current Good Manufacturing Practice Requirements for Combination Products

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Part 4 Current Good Manufacturing Practice... manufacturing practice (CGMP) requirements applicable to combination products. This rule is intended to promote... good manufacturing practice requirements apply to my combination product? (Sec. 4.3) E. How can...

  4. 21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... PET drugs? 212.2 Section 212.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... TOMOGRAPHY DRUGS General Provisions § 212.2 What is current good manufacturing practice for PET drugs? Current good manufacturing practice for PET drugs is the minimum requirements for the methods to be...

  5. 40 CFR 450.21 - Effluent limitations reflecting the best practicable technology currently available (BPT).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... stormwater volume and velocity to minimize soil erosion in order to minimize pollutant discharges; (2... limitations reflecting the best practicable technology currently available (BPT). Except as provided in 40 CFR... the best practicable control technology currently available (BPT). (a) Erosion and sediment...

  6. Knowledge of asthma guidelines: results of a UK General Practice Airways Group (GPIAG) web-based 'Test your Knowledge' quiz.

    PubMed

    Pinnock, Hilary; Holmes, Steve; Levy, Mark L; McArthur, Ruth; Small, Iain

    2010-06-01

    A web-based questionnaire, comprising 11 multiple choice questions, tested the knowledge of visitors to the General Practice Airways Group (GPIAG) online summary of the British Asthma guideline. On average, the 413 respondents answered less than half the questions correctly. GP scores were significantly lower than practice nurses. Improving clinicians' knowledge of asthma is a prerequisite for improving management.

  7. Current practices in fertility preservation in male cancer patients

    PubMed Central

    Osterberg, E. Charles; Ramasamy, Ranjith; Masson, Puneet; Brannigan, Robert E.

    2014-01-01

    The incidence of a cancer diagnosis in children and young adolescents is increasing. With better treatments, the number of young cancer survivors living through reproductive age is increasing. Fertility preservation of these men and women has become essential and needs to be discussed prior to the start of cancer treatment. Here we review the current guidelines for male oncofertility patients and highlight some of the important gonadotoxic effects of chemotherapy, radiotherapy and surgery. Options for fertility preservation are also discussed along with resources that should be made available to all patients. PMID:24669115

  8. A comparison of management practices, farmer-perceived disease incidence and winter housing on organic and non-organic dairy farms in the UK.

    PubMed

    Langford, Fritha M; Rutherford, Kenneth Md; Jack, Mhairi C; Sherwood, Lorna; Lawrence, Alistair B; Haskell, Marie J

    2009-02-01

    There have been increases in the number of organic dairy farms in the UK in recent years. However, there is little information on the impact of organic regulations on cow welfare. As part of a larger study, we aimed to investigate differences between organic and non-organic farms in management practices and winter housing quality. Forty organic and 40 non-organic farms throughout the UK were visited. Organic and non-organic farms were paired for housing type, and as far as possible for herd size, genetic merit and location. A detailed questionnaire covering key aspects of dairy management was carried out with each farmer. On a subset of twenty pairs, an assessment of the quality of the winter housing for both lactating and dry cows was undertaken, covering the parlour, bedding, loafing and feeding areas. Management practices and building conditions varied greatly within farm types and there was considerable overlap between organic and non-organic farms. Milk yield, level and composition of concentrate feed, management of heifers and calving, and use of 'alternative treatments' to prevent and treat mastitis differed between organic and non-organic farms. In all other respects there were no differences between farm types. Building dimensions per cow did not differ, even though organic recommendations advise greater space per cow than recommended for non-organic farms. The similarity between organic and non-organic farms in most respects indicates that cow housing and health, based on both the described management regimes and the farmers' perceptions of disease incidence, on organic dairy farms is neither compromised by the regulations, nor considerably better than on non-organic farms.

  9. Use of a multiple choice questionnaire to assess UK prescribing channels' knowledge of helminthology and best practice surrounding anthelmintic use in livestock and horses.

    PubMed

    Easton, Stephanie; Bartley, David J; Hotchkiss, Emily; Hodgkinson, Jane E; Pinchbeck, Gina L; Matthews, Jacqueline B

    2016-06-01

    Grazing livestock and equines are at risk of infection from a variety of helminths, for which the primary method of control has long been the use of anthelmintics. Anthelmintic resistance is now widespread in a number of helminth species across the globe so it is imperative that best practice control principles be adopted to delay the further spread of resistance. It is the responsibility of all who prescribe anthelmintics (in the UK, this being veterinarians, suitably qualified persons (SQPs) and pharmacists) to provide adequate information on best practice approaches to parasite control at the point of purchase. Poor uptake of best practice guidelines at farm level has been documented; this could be due to a lack of, or inappropriate, advice at the point of anthelmintics purchase. Therefore, the aim here was to evaluate levels of basic knowledge of helminthology, best practice guidelines and dispensing legislation among veterinarians and SQPs in the UK, through a Multiple Choice Question (MCQ) test, that was distributed online via targeted emails and social media sites. For each respondent, the percentage correct was determined (for the MCQ test overall and for subsections) and the results analysed initially using parametric and non-parametric statistics to compare differences between prescribing channels. The results showed that channels generally performed well; veterinarians achieved a mean total percentage correct of 79.7% (range 34.0-100%) and SQPs, a mean total percentage correct of 75.8% (range 38.5-100%) (p=0.051). The analysis indicated that veterinarians performed better in terms of knowledge of basic helminthology (p=0.001), whilst the SQP group performed better on legislation type questions (p=0.032). There was no significant difference in knowledge levels of best practice between the two channels. Multivariable linear regression analysis showed that veterinarians and those answering equine questions only performed significantly better than those

  10. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    PubMed Central

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-01-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided. PMID:26587391

  11. Somatic cell nuclear transfer cloning: practical applications and current legislation.

    PubMed

    Niemann, H; Lucas-Hahn, A

    2012-08-01

    Somatic cloning is emerging as a new biotechnology by which the opportunities arising from the advances in molecular genetics and genome analysis can be implemented in animal breeding. Significant improvements have been made in SCNT protocols in the past years which now allow to embarking on practical applications. The main areas of application of SCNT are: Reproductive cloning, therapeutic cloning and basic research. A great application potential of SCNT based cloning is the production of genetically modified (transgenic) animals. Somatic cell nuclear transfer based transgenic animal production has significant advances over the previously employed microinjection of foreign DNA into pronuclei of zygotes. This cell based transgenesis is compatible with gene targeting and allows both, the addition of a specific gene and the deletion of an endogenous gene. Efficient transgenic animal production provides numerous opportunities for agriculture and biomedicine. Regulatory agencies around the world have agreed that food derived from cloned animals and their offspring is safe and there is no scientific basis for questioning this. Commercial application of somatic cloning within the EU is via the Novel Food regulation EC No. 258/97. Somatic cloning raises novel questions regarding the ethical and moral status of animals and their welfare which has prompted a controversial discussion in Europe which has not yet been resolved.

  12. Overview of robotic colorectal surgery: Current and future practical developments

    PubMed Central

    Roy, Sudipta; Evans, Charles

    2016-01-01

    Minimal access surgery has revolutionised colorectal surgery by offering reduced morbidity and mortality over open surgery, while maintaining oncological and functional outcomes with the disadvantage of additional practical challenges. Robotic surgery aids the surgeon in overcoming these challenges. Uptake of robotic assistance has been relatively slow, mainly because of the high initial and ongoing costs of equipment but also because of limited evidence of improved patient outcomes. Advances in robotic colorectal surgery will aim to widen the scope of minimal access surgery to allow larger and more complex surgery through smaller access and natural orifices and also to make the technology more economical, allowing wider dispersal and uptake of robotic technology. Advances in robotic endoscopy will yield self-advancing endoscopes and a widening role for capsule endoscopy including the development of motile and steerable capsules able to deliver localised drug therapy and insufflation as well as being recharged from an extracorporeal power source to allow great longevity. Ultimately robotic technology may advance to the point where many conventional surgical interventions are no longer required. With respect to nanotechnology, surgery may eventually become obsolete. PMID:26981188

  13. Home enteral feeding: part 2 current issues in community practice.

    PubMed

    Fogg, Louisa

    2007-07-01

    Part 1 provided an overview of enteral tube feeding and management in the community. Due to the limited evidence base there are many aspects of the practical management of patients on home enteral tube feeding (HETF) that has as yet not been standardized, particularly around issues such as the type of syringes and water that should be used in HETF. There are also some areas where the guidelines are clear but difficult to apply in the community (such as with maximum feed 'hanging times') or where further guidance is required (such as for confirming the position of nasogastric tubes in patients on acid-reducing therapy). Finally, as NHS trusts look at further ways to save money, enteral feeding is being increasingly scrutinised and needs to be carefully managed, with the involvement of healthcare professionals who understand patient needs and the commercial HETF market. This article is based on personal views and local discussions about the issues in question and, until further research and national standards are available, are subject to local interpretation. PMID:17851308

  14. Lightning as a space-weather hazard: UK thunderstorm activity modulated by the passage of the heliospheric current sheet

    NASA Astrophysics Data System (ADS)

    Owens, M. J.; Scott, C. J.; Bennett, A. J.; Thomas, S. R.; Lockwood, M.; Harrison, R. G.; Lam, M. M.

    2015-11-01

    Lightning flash rates, RL, are modulated by corotating interaction regions (CIRs) and the polarity of the heliospheric magnetic field (HMF) in near-Earth space. As the HMF polarity reverses at the heliospheric current sheet (HCS), typically within a CIR, these phenomena are likely related. In this study, RL is found to be significantly enhanced at the HCS and at 27 days prior/after. The strength of the enhancement depends on the polarity of the HMF reversal at the HCS. Near-Earth solar and galactic energetic particle fluxes are also ordered by HMF polarity, though the variations qualitatively differ from RL, with the main increase occurring prior to the HCS crossing. Thus, the CIR effect on lightning is either the result of compression/amplification of the HMF (and its subsequent interaction with the terrestrial system) or that energetic particle preconditioning of the Earth system prior to the HMF polarity change is central to solar wind lightning coupling mechanism.

  15. Inflammatory bowel disease imaging: Current practice and future directions

    PubMed Central

    Kilcoyne, Aoife; Kaplan, Jess L; Gee, Michael S

    2016-01-01

    The purpose of this paper is to evaluate the role of imaging in inflammatory bowel disease (IBD), including detection of extraluminal complications and extraintestinal manifestations of IBD, assessment of disease activity and treatment response, and discrimination of inflammatory from fibrotic strictures. IBD is a chronic idiopathic disease affecting the gastrointestinal tract that is comprised of two separate, but related intestinal disorders; Crohn’s disease and ulcerative colitis. The paper discusses, in detail the pros and cons of the different IBD imaging modalities that need to be considered in order to optimize the imaging and clinical evaluation of patients with IBD. Historically, IBD evaluation of the bowel has included imaging to assess the portions of the small bowel that are inaccessible to optical endoscopic visualization. This traditionally was performed using barium fluoroscopic techniques; however, cross-sectional imaging techniques (computed tomography and magnetic resonance imaging) are being increasingly utilized for IBD evaluation because they can simultaneously assess mural and extramural IBD manifestations. Recent advances in imaging technology, that continue to improve the ability of imaging to noninvasively follow disease activity and treatment response, are also discussed. This review article summarizes the current imaging approach in inflammatory bowel disease as well as the role of emerging imaging modalities. PMID:26811637

  16. [Parapneumonic pleural effusions and empyema in adults:current practice].

    PubMed

    Porcel, J M; Light, R W

    2009-11-01

    About 20% of hospitalized patients with bacterial pneumonia have an accompanying pleural effusion. Parapneumonic effusions (PPE) are associated with a considerable morbidity and mortality. The main decision in managing a patient with a PPE is whether to insert a chest tube (complicated PPE). Imaging (i.e., chest radiograph, ultrasound and computed tomography) and pleural fluid analysis (i.e., pH, glucose, lactate dehydrogenase, bacterial cults) provide essential information for patient management. Therefore, all PPEs should be aspirated for diagnostic purposes. This may require image-guidance if the effusion is small or heavily loculated. According to the current guidelines, any PPE that fulfills at least one of the following criteria should be drained: size > or = 1/2 of the hemithorax, loculations, pleural fluid pH < 7.20 (or alternatively pleural fluid glucose < 60 mg/dl), positive pleural fluid Gram stain or culture, or purulent appearance. The key components of the treatment of complicated PPE and empyema are the use of appropriate antibiotics, provision of nutritional support, and drainage of the pleural space by one of the following methods: therapeutic thoracentesis, tube thoracostomy, intrapleural fibrinolytics, thoracoscopy with breakdown of adhesions or thoracotomy with decortication. The routine use of intrapleural fibrinolytic therapy remains controversial. (c) 2009 Elsevier España, S.L. All rights reserved. PMID:19889319

  17. Stable isotope ratio analysis of breastfeeding and weaning practices of children from medieval Fishergate House York, UK.

    PubMed

    Burt, Nicole M

    2013-11-01

    Rib collagen of 51 juveniles and 11 adult females from the late medieval Fishergate House cemetery site (York, UK) were analyzed using nitrogen and carbon stable isotope ratio analysis to determine the weaning age for this population and to reconstruct diet. The juveniles' ages ranged from fetal to 5-6 years, while the females were of reproductive age. Previous researchers suggested that the children from Fishergate House might have been weaned later than the medieval British norm of 2 years, based on a mortality peak at 4-6 years of age. The results show weaning was complete by 2 years of age, agreeing with previous British weaning studies. The adult female δ(15) N values have a mean of 11.4‰ ± 1.1‰ and the δ(13) C values have a mean of -19.4‰ ± 0.4‰. These findings are consistent with previous isotopic studies of female diet in York during this period, though slightly lower. The weaned juvenile nitrogen values were found to be higher than the adult females (12.4‰ ± 1.0‰ for δ(15) N and -19.7‰ ± 0.5‰ for δ(13) C), which might indicate a dependence on higher trophic level proteins such as marine fish or pork. Marine fish is considered a high status food and children are considered low-status individuals at this time, making this a particularly interesting finding. Weaning does not appear to coincide with peak mortality, suggesting environment factors may be playing a larger role in child mortality at Fishergate House.

  18. A Comparative Review of Policy and Practice for Education for Sustainable Development/Education for Global Citizenship (ESD/GC) in Teacher Education across the Four Nations of the UK

    ERIC Educational Resources Information Center

    Bamber, Philip; Bullivant, Andrea; Glover, Alison; King, Betsy; McMcCann, Gerard

    2016-01-01

    The early 21st century has seen a period of extreme turbulence in education at all levels in the UK. Although education policy was administrated on a territorial basis before 1999, the 1998-1999 devolution settlement has amplified the complexity of education policy and practice across England, Wales, Scotland, and Northern Ireland. Through a…

  19. 21 CFR 210.2 - Applicability of current good manufacturing practice regulations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Applicability of current good manufacturing... AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.2 Applicability of current good...

  20. 21 CFR 210.2 - Applicability of current good manufacturing practice regulations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Applicability of current good manufacturing... AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.2 Applicability of current good...

  1. 21 CFR 210.2 - Applicability of current good manufacturing practice regulations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Applicability of current good manufacturing... AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.2 Applicability of current good...

  2. 21 CFR 210.2 - Applicability of current good manufacturing practice regulations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Applicability of current good manufacturing... AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.2 Applicability of current good...

  3. 21 CFR 210.2 - Applicability of current good manufacturing practice regulations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Applicability of current good manufacturing... AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.2 Applicability of current good...

  4. Are recommendations for psychological treatment of borderline personality disorder in current U.K. guidelines justified? Systematic review and subgroup analysis.

    PubMed

    Omar, Hussein; Tejerina-Arreal, Maria; Crawford, Mike J

    2014-08-01

    Current U.K. guidelines on the management of borderline personality disorder include specific recommendations about the duration of therapy and number of sessions per week that patients should be offered. However, very little research has been conducted to examine the impact of these aspects of treatment process on patient outcomes. We therefore undertook a systematic review to examine the impact of treatment duration, number of sessions per week and access group-based therapy on general mental health, depression, social functioning and deliberate self-harm. We identified 25 randomized trials for possible inclusion in the review. However, differences in outcome measures used meant that only 12 studies could be included in the analysis. Statistically significant reductions in self-harm and depression and improvement in social functioning were found for treatments that include more than one session per week and those that included group-based sessions but were not found for those that deliver in individual sessions or one or fewer sessions per week. Longer term outcomes of short-term interventions have not been examined. Further research is needed to examine the impact of shorter term interventions and to compare the effects of group-based versus individual therapies for people with borderline personality disorder.

  5. Authorship and publication practices in the social sciences: historical reflections on current practices.

    PubMed

    Bebeau, Muriel J; Monson, Verna

    2011-06-01

    An historical review of authorship definitions and publication practices that are embedded in directions to authors and in the codes of ethics in the fields of psychology, sociology, and education illuminates reasonable agreement and consistency across the fields with regard to (a) originality of the work submitted, (b) data sharing, (c) human participants' protection, and (d) conflict of interest disclosure. However, the role of the professional association in addressing violations of research or publication practices varies among these fields. Psychology and sociology provide active oversight with sanction authority. In education, the association assumes a more limited role: to develop and communicate standards to evoke voluntary compliance. With respect to authorship credit, each association's standards focus on criteria for inclusion as an author, other than on the author's ability to defend and willingness to take responsibility for the entire work. Discussions across a broad range of research disciplines beyond the social sciences would likely be beneficial. Whether improved standards will reduce either misattribution or perceptions of inappropriate attribution of credit within social science disciplines will likely depend on how well authorship issues are addressed in responsible conduct of research education (RCR), in research practice, and in each association's ongoing efforts to influence normative practice by specifying and clarifying best practices.

  6. Assessment and Management of the Communication Difficulties of Children with Cerebral Palsy: A UK Survey of SLT Practice

    ERIC Educational Resources Information Center

    Watson, Rose Mary; Pennington, Lindsay

    2015-01-01

    Background: Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. Aims:…

  7. Prevalence of supporting limb laminitis in a UK equine practice and referral hospital setting between 2005 and 2013: implications for future epidemiological studies.

    PubMed

    Wylie, C E; Newton, J R; Bathe, A P; Payne, R J

    2015-01-17

    The electronic patient records of all equine patients of Rossdales Equine Practice between January 1, 2005 and November 1, 2013 were reviewed to determine the number of cases of supporting limb laminitis (SLL) in a large equine practice and referral hospital setting in the UK and to discuss the implications for future epidemiological studies. The clinical notes were searched electronically for a combination of 'laminitis AND (contralateral OR supporting OR overload OR weight bearing)'. The prevalence of SLL within each identified denominator population and the corresponding 95% CI were calculated. SLL developed in nine horses, one donkey and one pony. Thoroughbreds were the most commonly affected breed (72.7 per cent, CI 46.4 to 99.1 per cent), aged 2-14 years (median six years), and only mares (n=9) and stallions (n=2) were represented. SLL was not restricted to horses that were non-weightbearing lame, it developed within 4-100 days after injury (median 14.5 days) and occurred most commonly in a forelimb (54.6 per cent, CI 25.1 to 84.0 per cent). During the same time frame, a total of 65,327 horses were registered with Rossdales Equine Practice, resulting in an overall practice prevalence of SLL of 0.02 per cent (CI 0.01 to 0.03 per cent). Future epidemiological studies to investigate risk factors for SLL prevention will, therefore, be a logistical challenge. PMID:25261271

  8. The Impact of Peer Mentoring on Levels of Student Wellbeing, Integration and Retention: A Controlled Comparative Evaluation of Residential Students in UK Higher Education

    ERIC Educational Resources Information Center

    Collings, R.; Swanson, V.; Watkins, R.

    2014-01-01

    Peer mentoring is becoming increasingly popular in UK higher education, however, there remains little good quality, theoretically driven and evaluative research. The current study aims to bridge the gap between theory, practice and evaluation by providing a controlled evaluation of a peer mentoring scheme within UK universities. 109 first year…

  9. Restraining good practice: Reviewing evidence of the effects of restraint from the perspective of service users and mental health professionals in the United Kingdom (UK).

    PubMed

    Cusack, P; McAndrew, S; Cusack, F; Warne, T

    2016-01-01

    Safeguarding, balancing the concept of risk with the need for public protection and its implication for the lives of individuals, is an important facet of contemporary mental health care. Integral to safeguarding is the protection of human rights; the right to live free from torture, inhuman, or degrading treatment, and having the right to liberty, security, respect, and privacy. Professionals are required to recognise all of these rights when delivering care to vulnerable people. In the United Kingdom (UK) there has been growing public concern regarding abusive practices in institutions, with a number of unacceptable methods of restraint being identified as a feature of care, particularly in mental health care. In keeping with the service user movement, and following a review of the literature, this paper discusses the evidence regarding restraint from the perspectives of service users and professionals within mental health services and considers the implications for future practice and research. In reviewing the literature, findings revealed that restraint can be a form of abuse, it's inappropriate use often being a consequence of fear, neglect, and lack of using de-escalation techniques. Using restraint in this way can have negative implications for the well-being of service users and mental health professionals alike. PMID:27067763

  10. Restraining good practice: Reviewing evidence of the effects of restraint from the perspective of service users and mental health professionals in the United Kingdom (UK).

    PubMed

    Cusack, P; McAndrew, S; Cusack, F; Warne, T

    2016-01-01

    Safeguarding, balancing the concept of risk with the need for public protection and its implication for the lives of individuals, is an important facet of contemporary mental health care. Integral to safeguarding is the protection of human rights; the right to live free from torture, inhuman, or degrading treatment, and having the right to liberty, security, respect, and privacy. Professionals are required to recognise all of these rights when delivering care to vulnerable people. In the United Kingdom (UK) there has been growing public concern regarding abusive practices in institutions, with a number of unacceptable methods of restraint being identified as a feature of care, particularly in mental health care. In keeping with the service user movement, and following a review of the literature, this paper discusses the evidence regarding restraint from the perspectives of service users and professionals within mental health services and considers the implications for future practice and research. In reviewing the literature, findings revealed that restraint can be a form of abuse, it's inappropriate use often being a consequence of fear, neglect, and lack of using de-escalation techniques. Using restraint in this way can have negative implications for the well-being of service users and mental health professionals alike.

  11. Evidence of a transnational arts and health practice methodology? A contextual framing for comparative community-based participatory arts practice in the UK and Mexico

    PubMed Central

    Raw, Anni; Mantecón, Ana Rosas

    2014-01-01

    Background This paper draws on new research exploring community-based, participatory arts practice in Northern England and Mexico City to discuss contextual influences on artists’ practice, and whether a common practice model can be identified. The international comparison is used to interrogate whether such a practice model is transnational, displaying shared characteristics that transcend contextual differences. Methods The study used multi-site ethnography to investigate the participatory practice of more than 40 artists. Participant observation and extended individual and group dialogues provided data on practice in a diverse range of art forms and settings, analysed using open coding and grounded theory principles. Results Findings locate differences in practitioners’ motivations, and perceptions of the work’s function; however, key similarities emerge across both sites, in practitioners’ workshop methodologies and crucially in their creative strategies for catalysing change. A model is presented distilling the key elements of a common practice methodology, found across the study and across art forms. Conclusions The discussion notes where divergences echo nationalities of contributors, drawing inferences about the level of influence of national context in this work, and concludes with the implications of these findings for potential international collaboration, to face challenges within the community arts and health sector globally. PMID:25729411

  12. Smothering in UK free-range flocks. Part 2: investigating correlations between disease, housing and management practices.

    PubMed

    Rayner, A C; Gill, R; Brass, D; Willings, T H; Bright, A

    2016-09-10

    Smothering, when birds group together in a way that results in death from suffocation, is a welfare and economic concern for the egg industry. This questionnaire-based study explored correlations between disease, housing, management practices and smothering on free-range farms. A binomial logistic regression approach was used to test whether question responses predicted occurrence of nest box smothers (NBS) and panic and recurring smothers (PSRS) on farms. Breed (P=0.008) and nest box manufacturer (P=0.014) predicted NBS. Breed and nest box design have been previously reported to affect nesting behaviour. The affect of nest box manufacturer found in this study may illustrate the effect of nest box design features or house layouts. Nest box manufacturer (P=0.009), feeding oyster grit or grain on the litter (P<0.001) and range use on a sunny day (P<0.001) also predicted PSRS. Implementing some management practices to encourage desirable behaviours (eg ranging) may contribute to smothering, whereas some management practices such as those aimed at occupying birds may be beneficial, illustrating the delicate balance of factors involved in free-range egg production. It is hoped that these results will stimulate further work exploring the suitability of housing design and management of laying hens in light of smothering. PMID:27353872

  13. Smothering in UK free-range flocks. Part 2: investigating correlations between disease, housing and management practices.

    PubMed

    Rayner, A C; Gill, R; Brass, D; Willings, T H; Bright, A

    2016-09-10

    Smothering, when birds group together in a way that results in death from suffocation, is a welfare and economic concern for the egg industry. This questionnaire-based study explored correlations between disease, housing, management practices and smothering on free-range farms. A binomial logistic regression approach was used to test whether question responses predicted occurrence of nest box smothers (NBS) and panic and recurring smothers (PSRS) on farms. Breed (P=0.008) and nest box manufacturer (P=0.014) predicted NBS. Breed and nest box design have been previously reported to affect nesting behaviour. The affect of nest box manufacturer found in this study may illustrate the effect of nest box design features or house layouts. Nest box manufacturer (P=0.009), feeding oyster grit or grain on the litter (P<0.001) and range use on a sunny day (P<0.001) also predicted PSRS. Implementing some management practices to encourage desirable behaviours (eg ranging) may contribute to smothering, whereas some management practices such as those aimed at occupying birds may be beneficial, illustrating the delicate balance of factors involved in free-range egg production. It is hoped that these results will stimulate further work exploring the suitability of housing design and management of laying hens in light of smothering.

  14. The 2015 Pregnancy Summit, London, UK.

    PubMed

    Johansson, Cherynne

    2016-01-01

    Pregnancy Summit, Cineworld, The O2, London, UK, 29 September to 1 October 2015 The 2015 Pregnancy Summit was held over 3 days from 29 September to 1 October at Cineworld, The O2, London, UK. The event brings together a multidisciplinary faculty of international researchers and clinicians to discuss both scientific and clinical aspects of pregnancy-related issues in an informal setting. The goal of the meeting was to provide delegates with an update of recent advances in management of pregnancy-related conditions, to present research data and to discuss the current attitudes and practices in relevant topics. An extensive range of topics were discussed, from preeclampsia and treatment of hypertension, to the psychological impact of termination of pregnancy and feticide. This report will summarize a selection of the lectures presented.

  15. Current Practices and Future Trends in Neuropathology Assessment for Developmental Neurotoxicity Testing

    EPA Science Inventory

    The continuing education course on "Developmental Neurotoxicity Testing" (DNT) was designed to communicate current practices for DNT neuropathology, describe promising innovations in quantitative analysis and non-invasive imaging, and facilitate a discussion among experienced neu...

  16. Current State of Environmental Education in Mexico: A Study on Practices, Audiences, Settings, and Topics

    ERIC Educational Resources Information Center

    Marcos-Iga, Jose; Shaw, William

    2011-01-01

    Environmental education in Mexico takes many forms and plays a wide variety of roles. Through an online survey, we addressed the need to present a wider picture on the current state of environmental education practices in Mexico: Who is engaging in environmental education practices, how important is it for their organization, who are they…

  17. The Practice of School Psychology in Quebec English Schools: Current Challenges and Opportunities

    ERIC Educational Resources Information Center

    Finn, Cindy A.

    2016-01-01

    In Quebec, school psychology is alive and well. This article outlines current challenges and opportunities related to the practice of psychology in Quebec English schools. Changes to the practice of psychology in Quebec over the last decade have had an impact on the delivery of psychological services in schools. Modifications of the admission…

  18. "Best Practices" in Teaching and Learning: Challenging Current Paradigms and Redefining Their Role in Education

    ERIC Educational Resources Information Center

    Munro, Carolin Rekar

    2005-01-01

    With pervasive and persistent changes affecting education, educators are called to challenge current paradigms about best practices in instructional design and delivery and redefine how they are integrated into the curriculum. The purpose of this article is to introduce a model designed to support the new paradigm for best practices in education.…

  19. Current Faculty Development Practices for Alternative Delivery Systems in Christian Higher Education Institutions: A Qualitative Study

    ERIC Educational Resources Information Center

    Yates, Steven Lowell

    2009-01-01

    This research study was an investigation of current faculty development practices for alternative delivery systems. Attention was given to faculty development in general as well as specific facets of faculty development for alternative delivery systems. Future or intended faculty development practices were pursued, along with factors that…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    The purpose of this study is to document current practices and understandings about globalization of gerontology education in the United States. Better understanding of aging requires international perspectives in global communities. However, little is known about how globalization of gerontology education is practiced in U.S. graduate-level…

  1. School Discipline in Public Education: A Brief Review of Current Practices

    ERIC Educational Resources Information Center

    Allman, Kirsten L.; Slate, John R.

    2011-01-01

    In this manuscript, we examined the literature regarding current disciplinary practices in American schools. Specifically, we discuss in-school suspension, out-of-school suspension, and disciplinary alternative education programs. Moreover, the issue of zero tolerance policies and their relationship with increased use of disciplinary practices is…

  2. Extensive Reading in EFL Classroom at Secondary Schools in Bangladesh: Current Practices and Future Possibilities

    ERIC Educational Resources Information Center

    Haider, Md. Zulfeqar; Akhter, Elina

    2012-01-01

    Extensive reading is being practiced in many EFL and ESL classrooms as an effective means for developing learners' reading as well as other related skills. This paper is based on a small-scale study that explores the current practices and future possibilities of using extensive reading in the EFL classrooms at the junior secondary schools in…

  3. Cervical Screening for Women with Learning Disability: Current Practice and Attitudes within Primary Care in Edinburgh

    ERIC Educational Resources Information Center

    Wood, Rachael; Douglas, Margaret

    2007-01-01

    This study aimed to evaluate current practice in, and to explore primary care professionals' views about, providing cervical screening to women with learning disability, in two areas of Edinburgh. A postal questionnaire was sent to all 24 GP practices in the project area: 20 responded. Seven respondents were invited to participate in follow up…

  4. Implementing EHRs: An Exploratory Study to Examine Current Practices in Migrating Physician Practice.

    PubMed

    Dolezel, Diane; Moczygemba, Jackie

    2015-01-01

    Implementation of electronic health record (EHR) systems in physician practices is challenging and complex. In the past, physicians had little incentive to move from paper-based records. With the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, Medicare and Medicaid incentive payments are now available for physicians who implement EHRs for meaningful use. The Office of the National Coordinator for Health Information Technology (ONC) has ample detail on clinical data needed for meaningful use in order to assess the quality of patient care. Details are lacking, however, on how much clinical data, if any, should be transferred from the old paper records during an EHR implementation project. The purpose of this exploratory study was to investigate and document the elements of longitudinal clinical data that are essential for inclusion in the EHR of physicians in a clinical practice setting, as reported by the office managers of the physicians in the study group. PMID:26807077

  5. Implementing EHRs: An Exploratory Study to Examine Current Practices in Migrating Physician Practice

    PubMed Central

    Dolezel, Diane; Moczygemba, Jackie

    2015-01-01

    Implementation of electronic health record (EHR) systems in physician practices is challenging and complex. In the past, physicians had little incentive to move from paper-based records. With the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, Medicare and Medicaid incentive payments are now available for physicians who implement EHRs for meaningful use. The Office of the National Coordinator for Health Information Technology (ONC) has ample detail on clinical data needed for meaningful use in order to assess the quality of patient care. Details are lacking, however, on how much clinical data, if any, should be transferred from the old paper records during an EHR implementation project. The purpose of this exploratory study was to investigate and document the elements of longitudinal clinical data that are essential for inclusion in the EHR of physicians in a clinical practice setting, as reported by the office managers of the physicians in the study group. PMID:26807077

  6. Feline transfusion practice in South Africa: current status and practical solutions.

    PubMed

    Dippenaar, T

    1999-09-01

    Blood transfusion therapy is often under-utilised in feline practice in South Africa. However, it is a technique that can be safely and effectively introduced in practice. Cats have naturally occurring allo-antibodies against the blood type that they lack, which makes blood typing, or alternatively cross-matching, essential before transfusions. Feline blood donors must be carefully selected, be disease free and should be sedated before blood collection. The preferred anticoagulant for feline blood collection is citrate-phosphate-dextrose-adenine. Blood can either be administered intravenously or into the medullary cavity, with the transfusion rate depending on the cat's hydration status and cardiac function. Transfusion reactions can be immediate or delayed and they are classified as immunological or non-immunological. Indications, methods and techniques to do feline blood transfusions in a safe and economical way are highlighted. PMID:10852686

  7. Enhancing social networks: a qualitative study of health and social care practice in UK mental health services.

    PubMed

    Webber, Martin; Reidy, Hannah; Ansari, David; Stevens, Martin; Morris, David

    2015-03-01

    People with severe mental health problems such as psychosis have access to less social capital, defined as resources within social networks, than members of the general population. However, a lack of theoretically and empirically informed models hampers the development of social interventions which seek to enhance an individual's social networks. This paper reports the findings of a qualitative study, which used ethnographic field methods in six sites in England to investigate how workers helped people recovering from psychosis to enhance their social networks. This study drew upon practice wisdom and lived experience to provide data for intervention modelling. Data were collected from 73 practitioners and 51 people who used their services in two phases. Data were selected and coded using a grounded theory approach to depict the key themes that appeared to underpin the generation of social capital within networks. Findings are presented in four over-arching themes - worker skills, attitudes and roles; connecting people processes; role of the agency; and barriers to network development. The sub-themes which were identified included worker attitudes; person-centred approach; equality of worker-individual relationship; goal setting; creating new networks and relationships; engagement through activities; practical support; existing relationships; the individual taking responsibility; identifying and overcoming barriers; and moving on. Themes were consistent with recovery models used within mental health services and will provide the basis for the development of an intervention model to enhance individuals' access to social capital within networks. PMID:25441461

  8. A comparative analysis of drug safety withdrawals in the UK and the US (1971-1992): implications for current regulatory thinking and policy.

    PubMed

    Abraham, John; Davis, Courtney

    2005-09-01

    By going beyond individual case studies and solely quantitative surveys, this paper systematically examines why there were over twice as many new prescription drugs withdrawn from the market on grounds of safety in the UK as there were in the US between 1971 and 1992. Drawing on interviews with regulators, industry scientists and others involved, and on regulatory data never before accessed outside governments and companies, five key hypotheses which might explain this difference in drug safety withdrawals are analysed. These are: (1) simply because the UK approved more new drugs than the US; (2) because of an industrial corporate strategy to seek approval of 'less safe' drugs in the UK earlier; (3) because British regulators were more vigilant at spotting post-marketing safety problems than their US counterparts; (4) because the slowness of the US in approving new drugs enabled regulators there to learn from, and avoid, safety problems that had already emerged in the UK or European market; and (5) because more stringent regulation in the US meant that they approved fewer unsafe drugs on to the market in the first place. It is concluded that the main explanation for fewer drug safety withdrawals in the US is that the regulatory agency there applied more stringent pre-market review and/or standards, which took longer than UK regulatory checks, but prevented unsafe drugs marketed in the UK from entering the US market. Contrary to the claims frequently made by the pharmaceutical industry and regulatory agencies on both sides of the Atlantic, these results imply that it is likely that acceleration of regulatory review times in the US and the UK since the early 1990s is compromising drug safety.

  9. Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

    PubMed Central

    Rim, Chai Hong; Seong, Jinsil

    2016-01-01

    In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy. PMID:27730805

  10. Current Practices of Elementary Instructional Coaches in a Northwest School District

    ERIC Educational Resources Information Center

    Sylvanus, Sonja

    2012-01-01

    This study examined the role of the literacy/instructional coach as perceived by the literacy/instructional coaches themselves. The study sought to reveal the current practices of literacy/instructional coaches in their efforts to support the work of classroom teachers. Currently, research in this area is extremely limited. The purpose of this…

  11. Improving Transitions to High School: A Review of Current Research and Practice

    ERIC Educational Resources Information Center

    Uvaas, Trina; McKevitt, Brian C.

    2013-01-01

    This article synthesizes the current research in the area of school transitions for all students from junior high to high school and the effect of the transitions on students. The authors discuss current common high school transition practices and make recommendations for high school transition programming. The authors present a case study…

  12. Current Status and Future Agenda for the Theory, Research, and Practice of Childhood Career Development

    ERIC Educational Resources Information Center

    Schultheiss, Donna E. Palladino

    2008-01-01

    This article reviews the current status and a future agenda for childhood career development theory, research, and practice. The fragmented nature of the current state of the literature is noted, and a call is made for a reexamination and reconsideration of the childhood developmental pathways of life's work. It is suggested that the study of…

  13. Recent advances in the utility and use of the General Practice Research Database as an example of a UK Primary Care Data resource.

    PubMed

    Williams, Tim; van Staa, Tjeerd; Puri, Shivani; Eaton, Susan

    2012-04-01

    Since its inception in the mid-1980s, the General Practice Research Database (GPRD) has undergone many changes but remains the largest validated and most utilised primary care database in the UK. Its use in pharmacoepidemiology stretches back many years with now over 800 original research papers. Administered by the Medicines and Healthcare products Regulatory Agency since 2001, the last 5 years have seen a rebuild of the database processing system enhancing access to the data, and a concomitant push towards broadening the applications of the database. New methodologies including real-world harm-benefit assessment, pharmacogenetic studies and pragmatic randomised controlled trials within the database are being implemented. A substantive and unique linkage program (using a trusted third party) has enabled access to secondary care data and disease-specific registry data as well as socio-economic data and death registration data. The utility of anonymised free text accessed in a safe and appropriate manner is being explored using simple and more complex techniques such as natural language processing.

  14. Use of a large general practice syndromic surveillance system to monitor the progress of the influenza A(H1N1) pandemic 2009 in the UK.

    PubMed

    Harcourt, S E; Smith, G E; Elliot, A J; Pebody, R; Charlett, A; Ibbotson, S; Regan, M; Hippisley-Cox, J

    2012-01-01

    The Health Protection Agency/QSurveillance national surveillance system utilizes QSurveillance®, a recently developed general practitioner database covering over 23 million people in the UK. We describe the spread of the first wave of the influenza A(H1N1) pandemic 2009 using data on consultations for influenza-like illness (ILI), respiratory illness and prescribing for influenza from 3400 contributing general practices. Daily data, provided from 27 April 2009 to 28 January 2010, were used to give a timely overview for those managing the pandemic nationally and locally. The first wave particularly affected London and the West Midlands with a peak in ILI in week 30. Children aged between 1 and 15 years had consistently high consultation rates for ILI. Daily ILI rates were used for modelling national weekly case estimates. The system enabled the 'real-time' monitoring of the pandemic to a small geographical area, linking morbidity and prescribing for influenza and other respiratory illnesses. PMID:21473803

  15. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice

    PubMed Central

    2011-01-01

    Background Psychological models predict behaviour in a wide range of settings. The aim of this study was to explore the usefulness of a range of psychological models to predict the health professional behaviour 'referral for lumbar spine x-ray in patients presenting with low back pain' by UK primary care physicians. Methods Psychological measures were collected by postal questionnaire survey from a random sample of primary care physicians in Scotland and north England. The outcome measures were clinical behaviour (referral rates for lumbar spine x-rays), behavioural simulation (lumbar spine x-ray referral decisions based upon scenarios), and behavioural intention (general intention to refer for lumbar spine x-rays in patients with low back pain). Explanatory variables were the constructs within the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Weinstein's Stage Model termed the Precaution Adoption Process (PAP), and knowledge. For each of the outcome measures, a generalised linear model was used to examine the predictive value of each theory individually. Linear regression was used for the intention and simulation outcomes, and negative binomial regression was used for the behaviour outcome. Following this 'theory level' analysis, a 'cross-theoretical construct' analysis was conducted to investigate the combined predictive value of all individual constructs across theories. Results Constructs from TPB, SCT, CS-SRM, and OLT predicted behaviour; however, the theoretical models did not fit the data well. When predicting behavioural simulation, the proportion of variance explained by individual theories was TPB 11.6%, SCT 12.1%, OLT 8.1%, and II 1.5% of the variance, and in the cross-theory analysis constructs from TPB, CS-SRM and II explained 16.5% of the variance in simulated behaviours. When predicting intention, the proportion of variance

  16. Chronic fatigue in general practice: is counselling as good as cognitive behaviour therapy? A UK randomised trial.

    PubMed Central

    Ridsdale, L; Godfrey, E; Chalder, T; Seed, P; King, M; Wallace, P; Wessely, S

    2001-01-01

    BACKGROUND: Fatigue is a common symptom for which patients consult their doctors in primary care. With usual medical management the majority of patients report that their symptoms persist and become chronic. There is little evidence for the effectiveness of any fatigue management in primary care. AIM: To compare the effectiveness of cognitive behaviour therapy (CBT) with counselling for patients with chronic fatigue and to describe satisfaction with care. DESIGN OF STUDY: Randomised trial with parallel group design. SETTING: Ten general practices located in London and the South Thames region of the United Kingdom recruited patients to the trial between 1996 and 1998. Patients came from a wide range of socioeconomic backgrounds and lived in urban, suburban, and rural areas. METHOD: Data were collected before randomisation, after treatment, and six months later. Patients were offered six sessions of up to one hour each of either CBT or counselling. Outcomes include: self-report of fatigue symptoms six months later, anxiety and depression, symptom attributions, social adjustment and patients' satisfaction with care. RESULTS: One hundred and sixty patients with chronic fatigue entered the trial, 45 (28%) met research criteria for chronic fatigue syndrome; 129 completed follow-up. All patients met Chalder et al's standard criteria for fatigue. Mean fatigue scores were 23 on entry (at baseline) and 15 at six months' follow-up. Sixty-one (47%) patients no longer met standard criteria for fatigue after six months. There was no significant difference in effect between the two therapies on fatigue (1.04 [95% CI = -1.7 to 3.7]), anxiety and depression or social adjustment outcomes for all patients and for the subgroup with chronic fatigue syndrome. Use of antidepressants and consultations with the doctor decreased after therapy but there were no differences between groups. CONCLUSION: Counselling and CBT were equivalent in effect for patients with chronic fatigue in primary

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

    PubMed Central

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

    2016-01-01

    The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students. PMID:27170810

  18. A congener-specific PCDD/F emissions inventory for the UK: do current estimates account for the measured atmospheric burden?

    PubMed

    Alcock, R E; Sweetman, A J; Jones, K C

    2001-04-01

    Considerable effort has been expended in the UK and elsewhere to quantify and rank PCDD/F primary sources and emissions to the environment, principally the atmosphere, so that cost-effective source reduction measures can be taken. Here, we predict a congener-specific emissions inventory for primary and secondary nondioxin-regulated sources to the UK atmosphere, estimated to have ranged from 3 to 22 kg in 1996. The inventory profile is dominated by OCDD (approximately 30-40%), 1,2,3,4,6,7,8-HpCDD (approximately 15-19%) and 1,2,3,4,6,7,8-HpCDF (approximately 14-19%). Congeners 2,3,4,7,8-PeCDF and 1,2,3,7,8-PeCDD dominate the sigmaTEQ composition. Mass balance modelling suggests that the predicted congener pattern in UK air (based on the emission inventory) is similar to observed measurements, with absolute concentrations being estimated within a factor of 2 for most congeners. Calculations taking into account atmospheric weathering processes and long range (advective) transport suggest that PCDD/F sources to ambient air are primarily ongoing and that atmospheric mixing will mask individual emission source profiles/identities. This supports measured evidence for the consistency of PCDD/F air profiles observed around the UK throughout the year.

  19. The current state of abortion law and practice in Northern Ireland.

    PubMed

    Daniels, Pauline; Campbell, Patricia; Clinton, Alison

    This paper reviews current abortion law and practice in Northern Ireland (NI). It explores the origins of NI's abortion law and its complexity in relation to current practice. It reviews issues relating to women seeking terminations in NI and Great Britain and reviews attempts by the Family Planning Association in NI to require the Department of Health, Social Services and Public Safety NI to clarify the current legal basis for termination of pregnancy and to provide guidance for health professionals engaged in this practice. The paper also discusses some of the issues surrounding abortion in NI and seeks to explain why this subject is causing controversy and debate, especially following a judicial review in February and Marie Stopes opening a termination service in Belfast.

  20. Monitoring entry-level practice: keeping the national council licensure examination for registered nurses current.

    PubMed

    Wendt, Anne; Kenny, Lorraine

    2007-01-01

    The National Council Licensure Examination for Registered Nurses assesses whether a candidate has the ability to provide safe and effective nursing care upon entry into practice. It is essential that this assessment be current and relevant to nursing practice. The authors discuss methods that are used to provide evidence to support the 2007 NCLEX-RN Test Plan and to maintain the currency of the examination. PMID:17496823

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

    SciTech Connect

    Hamlet, Jason R.; Keliiaa, Curtis M.

    2010-09-01

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

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

    PubMed

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

    2012-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  4. Provision of weight management advice for obese women during pregnancy: a survey of current practice and midwives' views on future approaches.

    PubMed

    Macleod, Maureen; Gregor, Amy; Barnett, Carol; Magee, Elizabeth; Thompson, Joyce; Anderson, Annie S

    2013-10-01

    A semi-structured, web-based questionnaire was developed to survey midwives (n = 241) employed by NHS Tayside, UK, to identify current practice and views on weight management of obese women during pregnancy and the puerperium. A total of 78 (32%) midwives submitted responses following email invitation. Most respondents (79%) reported always calculating women's body mass index (BMI) at booking, with 73% routinely explaining the BMI category. In terms of future practice for obese women, although few respondents (15%) currently offer personalised advice regarding weight management based on a woman's diet and physical activity levels, 77% of respondents thought such advice would be appropriate and 69% thought it could possibly be feasible to offer such advice. The respondents viewed weight management to be of importance and felt that universal advice is appropriate, but confidence in discussing weight management and knowledge of the subject was low. Strategies to improve midwife confidence and weight management services should include training, ongoing support and definition of the midwife's role within the multidisciplinary team to support practice in the future. PMID:22288981

  5. A cohort study of trends in the prevalence of pregestational diabetes in pregnancy recorded in UK general practice between 1995 and 2012

    PubMed Central

    Coton, Sonia J; Nazareth, Irwin; Petersen, Irene

    2016-01-01

    Objective To describe the characteristics of pregnant women with and without pregestational diabetes and to estimate the prevalence of pregestational diabetes in pregnant women recorded in a UK primary care database. Methods The data source for this study is The Health Improvement Network (THIN) primary care database. Pregnant women with and without diabetes aged 16 years and over were identified using diagnostic Read codes and prescriptions for antidiabetics from medical records. Data were examined on: age, body mass index (BMI), social deprivation, smoking, ethnicity and glycaemic control. The prevalence of pregestational diabetes was calculated by diabetes type and calendar year between 1995 and 2012. Results Data from 400 434 pregnancies suggests that women with pregestational diabetes were: older (median 29, 32 vs 29 years for type 1, type 2 and without diabetes, respectively), had higher BMI (median 25.0, 30.4 vs 23.9 k/m2 for type 1, type 2 and without diabetes, respectively) and were registered with a general practice for longer than pregnant women without diabetes. The prevalence of type 1 diabetes in pregnancy increased from 1.56 to 4.09 per 1000 pregnancies between 1995 and 2015. For type 2 diabetes the increase was from 2.34 to 5.09 per 1000 pregnancies between 1995 and 2008 followed by a more rapid increase to 10.62 per 1000 pregnancies by 2012. Conclusions Pregnant women with pregestational diabetes were older, had higher BMI and were registered for longer than women without diabetes. The prevalence of type 1 and type 2 diabetes increased in pregnancy. The prevalence of type 2 diabetes rose more rapidly with a marked increase after 2008. PMID:26810997

  6. Linking databases on perinatal health: a review of the literature and current practices in Europe

    PubMed Central

    Szamotulska, K.; Hindori-Mohangoo, A.D.; Blondel, B.; Macfarlane, A.J.; Dattani, N.; Barona, C.; Berrut, S.; Zile, I.; Wood, R.; Sakkeus, L.; Gissler, M.; Zeitlin, J.

    2016-01-01

    Background: International comparisons of perinatal health indicators are complicated by the heterogeneity of data sources on pregnancy, maternal and neonatal outcomes. Record linkage can extend the range of data items available and thus can improve the validity and quality of routine data. We sought to assess the extent to which data are linked routinely for perinatal health research and reporting. Methods: We conducted a systematic review of the literature by searching PubMed for perinatal health studies from 2001 to 2011 based on linkage of routine data (data collected continuously at various time intervals). We also surveyed European health monitoring professionals about use of linkage for national perinatal health surveillance. Results: 516 studies fit our inclusion criteria. Denmark, Finland, Norway and Sweden, the US and the UK contributed 76% of the publications; a further 29 countries contributed at least one publication. Most studies linked vital statistics, hospital records, medical birth registries and cohort data. Other sources were specific registers for: cancer (70), congenital anomalies (56), ART (19), census (19), health professionals (37), insurance (22) prescription (31), and level of education (18). Eighteen of 29 countries (62%) reported linking data for routine perinatal health monitoring. Conclusion: Research using linkage is concentrated in a few countries and is not widely practiced in Europe. Broader adoption of data linkage could yield substantial gains for perinatal health research and surveillance. PMID:26891058

  7. Examining Current Beliefs, Practices and Barriers about Technology Integration: A Case Study

    ERIC Educational Resources Information Center

    Hsu, Pi-Sui

    2016-01-01

    The purpose of this mixed-methods study was to examine the current beliefs, practices and barriers concerning technology integration of Kindergarten through Grade Six teachers in the midwestern United States. The three data collection methods were online surveys with 152 teachers as well as interviews and observations with 8 teachers. The findings…

  8. Survey of Current Practices in the Psychological Assessment of Limited-English-Proficiency Handicapped Children.

    ERIC Educational Resources Information Center

    Nuttall, Ena Vazquez

    1987-01-01

    Discusses current psychological and educational assessment practices used with elementary school limited-English proficiency (LEP) children, as revealed by a nationwide study of local education agencies (LEAs) (n=21) that had LEP handicapped children mainstreamed in bilingual education classrooms. Testing approaches most frequently used with LEP…

  9. 76 FR 39260 - Direct Investment Surveys: Alignment of Regulations With Current Practices

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

    ... Bureau of Economic Analysis 15 CFR Part 806 RIN 0691-AA78 Direct Investment Surveys: Alignment of Regulations With Current Practices AGENCY: Bureau of Economic Analysis, Commerce. ACTION: Final rule. SUMMARY: This final rule amends regulations of the Bureau of Economic Analysis (BEA) related to...

  10. 76 FR 19282 - Direct Investment Surveys: Alignment of Regulations With Current Practices

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-07

    ... Bureau of Economic Analysis 15 CFR Part 806 [Docket No. 110321207-1206-01 0691-AA78 Direct Investment Surveys: Alignment of Regulations With Current Practices AGENCY: Bureau of Economic Analysis, Commerce. ACTION: Notice of proposed rulemaking. SUMMARY: The Bureau of Economic Analysis (BEA) proposes to...

  11. Current Status of Evidence-Based Practice for Students with Intellectual Disability and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    West, Elizabeth A.; McCollow, Meaghan; Umbarger, Gardner; Kidwell, James; Cote, Debra L.

    2013-01-01

    The purpose of this paper is to provide a current look at the status of evidence-based practice (EBP) for students with intellectual disability and autism spectrum disorders. Specifically, this paper will (1) provide an introduction to the history and evolution of the use of levels of evidence, (2) discuss the importance of EBPs, (3) identify…

  12. Mentoring and New Teacher Induction in the United States: A Review and Analysis of Current Practices

    ERIC Educational Resources Information Center

    Bullough, Robert V., Jr.

    2012-01-01

    In this article, current practices were reviewed in mentoring and induction across three large states--New York, Texas, and California--and one small state, Utah. Patterns and trends are described in the United States, program results and evolving views of mentoring are discussed, gaps in the research literature are identified, and the future of…

  13. Interpersonal Relationships, Motivation, Engagement, and Achievement: Yields for Theory, Current Issues, and Educational Practice

    ERIC Educational Resources Information Center

    Martin, Andrew J.; Dowson, Martin

    2009-01-01

    In this review, we scope the role of interpersonal relationships in students' academic motivation, engagement, and achievement. We argue that achievement motivation theory, current issues, and educational practice can be conceptualized in relational terms. Influential theorizing, including attribution theory, expectancy-value theory, goal theory,…

  14. Current Trends in Malaysian Higher Education and the Effect on Education Policy and Practice: An Overview

    ERIC Educational Resources Information Center

    Grapragasem, Selvaraj; Krishnan, Anbalagan; Mansor, Azlin Norhaini

    2014-01-01

    Malaysia has evolved from a production-based to knowledge-based economy in order to stay relevant and compete in the global marketplace. Thus, the purpose of this article is to discuss current trends in Malaysian higher education and how these affect education policies and practices. Four main trends are discussed in this study: Globalization,…

  15. 40 CFR 450.21 - Effluent limitations reflecting the best practicable technology currently available (BPT).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... velocity within the site to minimize soil erosion; (2) Control stormwater discharges, including both peak... streambank erosion; (3) Minimize the amount of soil exposed during construction activity; (4) Minimize the... the best practicable technology currently available (BPT). Except as provided in 40 CFR 125.30...

  16. 40 CFR 450.21 - Effluent limitations reflecting the best practicable technology currently available (BPT).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... stormwater volume and velocity within the site to minimize soil erosion; (2) Control stormwater discharges... downstream channel and streambank erosion; (3) Minimize the amount of soil exposed during construction... limitations reflecting the best practicable technology currently available (BPT). Except as provided in 40...

  17. 40 CFR 450.21 - Effluent limitations reflecting the best practicable technology currently available (BPT).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... stormwater volume and velocity within the site to minimize soil erosion; (2) Control stormwater discharges... downstream channel and streambank erosion; (3) Minimize the amount of soil exposed during construction... limitations reflecting the best practicable technology currently available (BPT). Except as provided in 40...

  18. 40 CFR 450.21 - Effluent limitations reflecting the best practicable technology currently available (BPT).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... velocity within the site to minimize soil erosion; (2) Control stormwater discharges, including both peak... streambank erosion; (3) Minimize the amount of soil exposed during construction activity; (4) Minimize the... the best practicable technology currently available (BPT). Except as provided in 40 CFR 125.30...

  19. Current Literacy Skills, Practices, and Dispositions of Teachers: A Case Study

    ERIC Educational Resources Information Center

    Al Nassir, Mona N.

    2014-01-01

    This study seeks to address the current literacy skills, practices, and dispositions of teachers who educate students with significant disabilities. It sought to address two questions including how do teachers who educate students with significant disabilities design and implement literacy instruction, and how do teachers who educate students with…

  20. Vitamin D status of dairy cattle: Outcomes of current practices in the dairy industry

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The need for vitamin D supplementation of dairy cattle has been known for the better part of the last century and is well-appreciated by dairy producers and nutritionists. Whether current recommendations and practices for supplemental vitamin D are meeting the needs of dairy cattle, however, is not...

  1. Transforming nursing education: a review of current curricular practices in relation to Benner's latest work.

    PubMed

    Handwerker, Sarah M

    2012-01-01

    Current societal and healthcare system trends highlight the need to transform nursing education to prepare nurses capable of outstanding practice in the 21st century. Patricia Benner and colleagues urged nurse educators to transform their practice in the 2010 publication Educating Nurses, A Call to Radical Transformation. Frequently utilized pedagogical frameworks in nursing education include behaviorism and constructivism. Much of the structure and basis for instruction and evaluation can be found rooted in these philosophies. By first exploring both behaviorism and constructivism and then relating their use in nursing education to the call to transform, educators can be encourage to examine current practice and possibly modify aspects to include more rich experiential learning. PMID:23092804

  2. Experiences of non-UK-qualified doctors working within the UK regulatory framework: a qualitative study

    PubMed Central

    Slowther, A; Lewando Hundt, GA; Purkis, J; Taylor, R

    2012-01-01

    Objective To explore the experience of non-UK-qualified doctors in working within the regulatory framework of the General Medical Council (GMC) document Good Medical Practice. Design Individual interviews and focus groups. Setting United Kingdom. Participants Non-UK-qualified doctors who had registered with the GMC between 1 April 2006 and 31 March 2008, doctors attending training/induction programmes for non-UK-qualified doctors, and key informants involved in training and support for non-UK-qualified doctors. Main outcome measures Themes identified from analysis of interview and focus group transcripts. Results Information and support for non-UK qualified doctors who apply to register to work in the UK has little reference to the ethical and professional standards required of doctors working in the UK. Recognition of the ethical, legal and cultural context of UK healthcare occurs once doctors are working in practice. Non-UK qualified doctors reported clear differences in the ethical and legal framework for practising medicine between the UK and their country of qualification, particularly in the model of the doctor–patient relationship. The degree of support for non-UK-qualified doctors in dealing with ethical concerns is related to the type of post they work in. European doctors describe similar difficulties with working in an unfamiliar regulatory framework to their non-European colleagues. Conclusions Non-UK-qualified doctors experience a number of difficulties related to practising within a different ethical and professional regulatory framework. Provision of information and educational resources before registration, together with in-practice support would help to develop a more effective understanding of GMP and its implications for practice in the UK. PMID:22408082

  3. Articulating current service development practices: a qualitative analysis of eleven mental health projects

    PubMed Central

    2014-01-01

    Background The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Methods Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Results Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. Conclusions This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial. PMID:24438471

  4. Brief Intervention for Emergency Department Patients with Alcohol Misuse: Implications for Current Practice

    PubMed Central

    Woolard, Robert; Cherpitel, Cheryl; Kathleen, Thompson

    2011-01-01

    This article reviews studies and current practices of brief motivational intervention in the emergency department and identifies factors related to the effectiveness of brief intervention. Studies of brief intervention in the emergency department have had mixed results with most studies showing improvements in both intervention and control groups. Most report brief intervention reducing alcohol’s negative consequences without reducing consumption. Clinical practice is incorporating brief intervention as part of emergency treatment and further research is needed to determine the factors most responsible for the improvements noted in most studies. PMID:21886943

  5. Through the back door: nurse migration to the UK from Malawi and Nepal, a policy critique.

    PubMed

    Adhikari, Radha; Grigulis, Astrida

    2014-03-01

    The UK National Health Service has a long history of recruiting overseas nurses to meet nursing shortages in the UK. However, recruitment patterns regularly fluctuate in response to political and economic changes. Typically, the UK government gives little consideration of how these unstable recruitment practices affect overseas nurses. In this article, we present findings from two independent research studies from Malawi and Nepal, which aimed to examine how overseas nurses encountered and overcame the challenges linked to recent recruitment and migration restrictions. We show how current UK immigration policy has had a negative impact on overseas nurses' lives. It has led them to explore alternative entry routes into the UK, affecting both the quality of their working lives and their future decisions about whether to stay or return to their home country. We conclude that the shifting forces of nursing workforce demand and supply, leading to abrupt policy changes, have significant implications on overseas nurses' lives, and can leave nurses 'trapped' in the UK. We make recommendations for UK policy-makers to work with key stakeholders in nurse-sending countries to minimize the negative consequences of unstable nurse recruitment, and we highlight the benefits of promoting circular migration.

  6. Current practices and issues for placement of coal combustion by-products in mine settings

    SciTech Connect

    Hassett, D.J.; Daly, D.J.; Pflughoeft-Hassett, D.F.

    1999-07-01

    The placement of coal combustion by-products (CCBs) in mine settings is viewed quite differently by various stakeholders. A summary of key research on placement of CCBs in mine settings is presented. A limited survey of current practices for placement of CCBs in surface mine settings was performed by the Energy and Environmental Research Center (EERC), and the results are summarized. The survey provides a brief comparison of eastern and western practices as reported by appropriate state agencies. This document also discussed the importance and impact of valid scientific information and citizen groups on the perception of regulating entities that have responsibility for approving practices related to placement of CCBs in mine settings.

  7. Toilet training in primary care: current practice and recommendations from behavioral pediatrics.

    PubMed

    Polaha, Jodi; Warzak, William J; Dittmer-Mcmahon, Karen

    2002-12-01

    This article is the first to evaluate pediatricians' (1). current practices regarding recommendations for toilet training typically developing first-time learners and (2). opinions on an intensive procedure for rapid toilet training. Results of surveys obtained from 103 pediatricians indicate that physicians' recommendations lean toward a gradual, passive approach to toilet training with 72% endorsing "child interest" in the toilet as one of the top criteria children must exhibit before beginning training. Respondents had a somewhat unfavorable view of intensive toilet training for first-time learners with 29% endorsing the use of such a procedure, although in most cases without all of the components. It is recommended that some components of the intensive procedure could easily "fit" with physicians' current practices to increase toilet-training effectiveness within a shorter training interval. These recommendations, including compliance training as a part of teaching, increased fluid intake to promote toileting trials, and multiple training sits, are described.

  8. Large-Eddy Simulation: Current Capabilities, Recommended Practices, and Future Research

    NASA Technical Reports Server (NTRS)

    Georgiadis, Nicholas J.; Rizzetta, Donald P.; Fureby, Christer

    2009-01-01

    This paper presents the results of an activity by the Large Eddy Simulation (LES) Working Group of the AIAA Fluid Dynamics Technical Committee to (1) address the current capabilities of LES, (2) outline recommended practices and key considerations for using LES, and (3) identify future research needs to advance the capabilities and reliability of LES for analysis of turbulent flows. To address the current capabilities and future needs, a survey comprised of eleven questions was posed to LES Working Group members to assemble a broad range of perspectives on important topics related to LES. The responses to these survey questions are summarized with the intent not to be a comprehensive dictate on LES, but rather the perspective of one group on some important issues. A list of recommended practices is also provided, which does not treat all aspects of a LES, but provides guidance on some of the key areas that should be considered.

  9. Recovering the Lost "Métier" of Philosophy of Education? Reflections on Educational Thought, Policy and Practice in the UK and Farther Afield

    ERIC Educational Resources Information Center

    Hogan, Pádraig

    2015-01-01

    A Special Issue of the "Journal of Philosophy of Education" in November 2012 explored key aspects of the relationship between philosophy of education and educational policy in the UK. The contributions were generally critical of policy developments in recent decades, highlighting important shortcomings and arguing for more…

  10. LSAMO forum UK strategic plan.

    PubMed

    Richards, Julie

    2012-01-01

    Over the years, the LSA role and function have developed and strengthened significantly and it is crucial that this development continues in the new NHS. The biennial LSAMO UK conference which is entitled Future proofing supervision will launch the strategic plan for 2012-2015. It is essential that LSAMOs and supervisors of midwives (SoMs) look to the future to continue to maintain safety and protect the public, but within a modernised forward thinking framework. The forum will work collaboratively to encourage a greater consistency in the provision of supervision to ensure the standards set by the NMC for the LSAs and the supervision of midwives are met. Protecting the public and supporting safe midwifery practice will continue to be the driving principles behind the LSAMO UK forum's work plan. The specific challenges to LSAMOs will be to continue providing leadership and support and be pivotal in addressing the future significant challenges faced by the NHS throughout the UK.

  11. Current practices and guidelines for clinical next-generation sequencing oncology testing

    PubMed Central

    Strom, Samuel P.

    2016-01-01

    Next-generation sequencing (NGS) has been rapidly integrated into molecular pathology, dramatically increasing the breadth genomic of information available to oncologists and their patients. This review will explore the ways in which this new technology is currently applied to bolster care for patients with solid tumors and hematological malignancies, focusing on practices and guidelines for assessing the technical validity and clinical utility of DNA variants identified during clinical NGS oncology testing. PMID:27144058

  12. Toward a more materialistic medicine: the value of authentic materialism within current and future medical practice.

    PubMed

    Leder, Drew; Krucoff, Mitchell W

    2011-09-01

    Modern medicine is often accused by diverse critics of being "too materialistic" and therefore insufficiently holistic and effective. Yet, this critique can be misleading, dependent upon the ambiguous meanings of "materialism." The term can refer to the prevalence of financial concerns in driving medical practice. Alternatively, it can refer to "mechanistic materialism," the patient viewed as a body-machine. In each case, this article shows that this represents not authentic "materialism" at play, but a focus upon high-level abstractions. "Bottom-line" financial or diagnostic numbers can distract practitioners from the embodied needs of sick patients. In this sense, medical practice is not materialist enough. Through a series of clinical examples, this article explores how an authentic materialism would look in current and future practice. The article examines the use of prayer/comfort shawls at the bedside; hospitals and nursing homes redesigned as enriched healing environments; and a paradigmatic medical device--the implantable cardioverter defibrillator--as it might be presented to patients, in contrast to current practice.

  13. Evaluation of the status of canine hydrotherapy in the UK.

    PubMed

    Waining, M; Young, I S; Williams, S B

    2011-04-16

    To establish the current status of canine hydrotherapy in the UK and to ascertain information regarding the current use of hydrotherapy, a questionnaire was sent to 152 hydrotherapy centres throughout the UK, from which 89 responded. Hydrotherapy was found to be a rapidly growing business. Stand-alone centres were in existence; however, many centres were connected to other businesses, including boarding kennels and general practice veterinary surgeries. The dogs using the facility were mainly pedigree breeds, particularly labrador retrievers (30 per cent), and the most commonly encountered conditions were rupture of the cranial cruciate ligament (25 per cent), hip dysplasia (24 per cent) and osteoarthritis (18 per cent). The proportion of qualified versus unqualified staff varied between centres, highlighting a need for improved regulation of this aspect of the industry. However, all the dogs treated by the hydrotherapy centres surveyed were direct veterinary referrals, suggesting a good degree of professionalism in the field and a high regard for the benefits of hydrotherapy.

  14. Reversible stress and strain limits of the critical current of practical REBCO and BSCCO wires

    NASA Astrophysics Data System (ADS)

    Osamura, K.; Machiya, S.; Nishijima, G.

    2016-09-01

    Practical REBCO and BSCCO-2223 tape-shaped wires are now manufactured on an industrial scale. They are a typical composite material consisting of superconducting layer/filaments together with functional components. These functional components affect directly the stress and strain dependences of the critical current. When applying an external stress R, the critical current I c was measured. Then the external stress was reduced to R = 0 and the recovered critical current I cr was again measured. The tensile stress and strain dependences of both normalized critical currents divided by the original value, I c/I c0 and I cr/I c0 were investigated. In general I cr/I c0 recovered close to unity when the applied stress was low, but its recovering level decreased gradually with increasing applied stress. The definition of the reversible stress and strain limits was investigated and its validity was proved using the cyclic loading test. The original definition of reversible stress and strain limits of critical current relates to: (1) when releasing the applied stress and strain, the I c shall recover to the original value, and (2) when applying the cyclic stresses, the I c shall keep the original value. Here, as a practical definition for the reversible stress and strain limits, the tensile stress and strain at 99% recovery of I c have been proposed. On the other hand, it was made clear that the stress and strain at I c 95% retention are not valid for use commonly as a criterion of reversible stress and strain limits for both practical REBCO and BSCCO-2223 wires.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-04-25

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

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

    PubMed

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

    2016-04-25

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

  18. The Current Landscape of Transitions of Care Practice Models: A Scoping Review.

    PubMed

    Rochester-Eyeguokan, Charmaine D; Pincus, Kathleen J; Patel, Roshni S; Reitz, Shirley J

    2016-01-01

    Transitions of care (TOC) are a set of actions to ensure patient coordination and continuity of care as patients transfer between different locations or levels. During transitions associated with chronic or acute illness, vulnerable patients may be placed at risk with fragmented systems compromising their health and safety. In addition, poor care transitions also have an enormous impact on health care spending. The primary objective of this scoping review is to summarize the current landscape of practice models that deliver TOC services in the United States. The secondary objective is to use the information to characterize the current state of best practice models. A search of the PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, International Pharmaceutical Abstracts, National Center for Biotechnology Information at the U.S. National Library of Medicine, and Cochrane Library databases (January 1, 2000-April 13, 2015) for articles pertaining to TOC models, limited to U.S. studies published in the English language with human subjects, gleaned 1362 articles. An additional 26 articles were added from the gray literature. Articles meeting inclusion criteria underwent a second review and were categorized into four groups: background information, original TOC research articles not evaluating practice model interventions, original TOC research articles describing practice models, and systematic or Cochrane reviews. The reviewers met weekly to discuss the challenges and resolve disagreements regarding literature reviews with consensus before progressing. A total of 188 articles describing TOC practice models met the inclusion criteria. Despite the strengths of several quality TOC models, none satisfied all the components recommended by leading experts. Multimodal interventions by multidisciplinary teams appear to represent a best practice model for TOC to improve patient outcomes and reduce readmissions, but one size does not fit all

  19. Teaching Astronomy in UK Schools

    ERIC Educational Resources Information Center

    Roche, Paul; Roberts, Sarah; Newsam, Andy; Barclay, Charles

    2012-01-01

    This article attempts to summarise the good, bad and (occasionally) ugly aspects of teaching astronomy in UK schools. It covers the most common problems reported by teachers when asked about covering the astronomy/space topics in school. Particular focus is given to the GCSE Astronomy qualification offered by Edexcel (which is currently the…

  20. Evidence into Policy and Practice? Measuring the Progress of U.S. and U.K. Policies to Tackle Disparities and Inequalities in U.S. and U.K. Health and Health Care

    PubMed Central

    Exworthy, Mark; Bindman, Andrew; Davies, Huw; Washington, A Eugene

    2006-01-01

    Health policy in both the United States and the United Kingdom has recently shifted toward a much greater concern with disparities and inequalities in health and health care. As evidence for these disparities and inequalities mounts, the different approaches in each country present specific challenges for policy and practice. These differences are most apparent in the mechanisms by which the progress of such policies is measured. This article compares the United States' and United Kingdom's strategies to gauge the challenges for policymakers in order to inform policy and practice. A cross-national comparison of selected measurement mechanisms identifies lessons for policy and practice in both countries. PMID:16529569

  1. Evaluation of current surgeon practice for patients undergoing lumbar spinal fusion surgery in the United Kingdom

    PubMed Central

    Rushton, Alison; White, Louise; Heap, Alison; Heneghan, Nicola

    2015-01-01

    AIM: To ascertain current surgeon practice in the United Kingdom National Health Service for the management of patients undergoing lumbar spinal fusion surgery. METHODS: Descriptive survey methodology utilised an online questionnaire administered through SurveyMonkey. Eligible participants were all surgeons currently carrying out lumbar spinal fusion surgery in the National Health Service. Two previous surveys and a recent systematic review informed questions. Statistical analyses included responder characteristics and pre-planned descriptive analyses. Open question data were interpreted using thematic analysis. RESULTS: The response rate was 73.8%. Most surgeons (84%) were orthopaedic surgeons. Range of surgeon experience (1-15 years), number of operations performed in the previous 12 mo (4-250), and range of information used to predict outcome was broad. There was some consistency of practice: most patients were seen preoperatively; all surgeons ensured patients are mobile within 3 d of surgery; and there was agreement for the value of post-operative physiotherapy. However, there was considerable variability of practice: variability of protocols, duration of hospital stay, use of discharge criteria, frequency and timing of outpatient follow up, use of written patient information and outcome measures. Much variability was explained through patient-centred care, for example, 62% surgeons tailored functional advice to individual patients. CONCLUSION: Current United Kingdom surgeon practice for lumbar spinal fusion is described. The surgical procedure and patient population is diverse, and it is therefore understandable that management varies. It is evident that care should be patient-centred. However with high costs and documented patient dissatisfaction it is important that further research evaluates optimal management. PMID:26191495

  2. Determination of significance in Ecological Impact Assessment: Past change, current practice and future improvements

    SciTech Connect

    Briggs, Sam; Hudson, Malcolm D.

    2013-01-15

    Ecological Impact Assessment (EcIA) is an important tool for conservation and achieving sustainable development. 'Significant' impacts are those which disturb or alter the environment to a measurable degree. Significance is a crucial part of EcIA, our understanding of the concept in practice is vital if it is to be effective as a tool. This study employed three methods to assess how the determination of significance has changed through time, what current practice is, and what would lead to future improvements. Three data streams were collected: interviews with expert stakeholders, a review of 30 Environmental Statements and a broad-scale survey of the United Kingdom Institute of Ecology and Environmental Management (IEEM) members. The approach taken in the determination of significance has become more standardised and subjectivity has become constrained through a transparent framework. This has largely been driven by a set of guidelines produced by IEEM in 2006. The significance of impacts is now more clearly justified and the accuracy with which it is determined has improved. However, there are limitations to accuracy and effectiveness of the determination of significance. These are the quality of baseline survey data, our scientific understanding of ecological processes and the lack of monitoring and feedback of results. These in turn are restricted by the limited resources available in consultancies. The most notable recommendations for future practice are the implementation of monitoring and the publication of feedback, the creation of a central database for baseline survey data and the streamlining of guidance. - Highlights: Black-Right-Pointing-Pointer The assessment of significance has changed markedly through time. Black-Right-Pointing-Pointer The IEEM guidelines have driven a standardisation of practice. Black-Right-Pointing-Pointer Currently limited by quality of baseline data and scientific understanding. Black-Right-Pointing-Pointer Monitoring and

  3. Summary of current state nonpoint source control practices for forestry. Final report

    SciTech Connect

    Craig, J.; Parcher, M.A.; Wright, J.; Townsend, G.; Cannell, J.

    1993-08-01

    Forestry practices have been implicated by many states as a contributor to nonpoint source (NPS) pollution of streams, rivers, lakes, and other waterbodies. Many states, recognizing the forestry contribution to water pollution, have developed programs to address forestry NPS. The recent development of the Management Measures Guidance, as required by section 6217 of the Coastal Zone Reauthorization Amendments (CZARA), provided the motivation to develop a summary of the current state forestry NPS programs. The document provides a synopsis of the BMPs currently used by states to address the nonpoint source (NPS) impacts on water quality caused by forestry activities. Summaries of over 41 existing state BMP manuals or regulations that include BMPs are presented. The information presented in the document is intended to provide an increased understanding of the types of forestry activities commonly addressed in existing state NPS programs and to serve as a reference for the type and nature of BMPs included in current state BMP manuals.

  4. Mass Casualty Decontamination in the United States: An Online Survey of Current Practice.

    PubMed

    Power, Sarah; Symons, Charles; Carter, Holly; Jones, Emma; Amlôt, Richard; Larner, Joanne; Matar, Hazem; Chilcott, Robert P

    2016-01-01

    Mass casualty decontamination is a public health intervention that would be employed by emergency responders following a chemical, biological, or radiological incident. The decontamination of large numbers of casualties is currently most often performed with water to remove contaminants from the skin surface. An online survey was conducted to explore US fire departments' decontamination practices and their preparedness for responding to incidents involving mass casualty decontamination. Survey respondents were asked to provide details of various aspects of their decontamination procedures, including expected response times to reach casualties, disrobing procedures, approaches to decontamination, characteristics of the decontamination showering process, provision for special populations, and any actions taken following decontamination. The aim of the survey was to identify any differences in the way in which decontamination guidance is implemented across US states. Results revealed that, in line with current guidance, many US fire departments routinely use the "ladder-pipe system" for conducting rapid, gross decontamination of casualties. The survey revealed significant variability in ladder-pipe construction, such as the position and number of fire hoses used. There was also variability in decontamination characteristics, such as water temperature and water pressure, detergent use, and shower duration. The results presented here provide important insights into the ways in which implementation of decontamination guidance can vary between US states. These inconsistencies are thought to reflect established perceived best practices and local adaptation of response plans to address practical and logistical constraints. These outcomes highlight the need for evidence-based national guidelines for conducting mass casualty decontamination. PMID:27442794

  5. Mass Casualty Decontamination in the United States: An Online Survey of Current Practice.

    PubMed

    Power, Sarah; Symons, Charles; Carter, Holly; Jones, Emma; Amlôt, Richard; Larner, Joanne; Matar, Hazem; Chilcott, Robert P

    2016-01-01

    Mass casualty decontamination is a public health intervention that would be employed by emergency responders following a chemical, biological, or radiological incident. The decontamination of large numbers of casualties is currently most often performed with water to remove contaminants from the skin surface. An online survey was conducted to explore US fire departments' decontamination practices and their preparedness for responding to incidents involving mass casualty decontamination. Survey respondents were asked to provide details of various aspects of their decontamination procedures, including expected response times to reach casualties, disrobing procedures, approaches to decontamination, characteristics of the decontamination showering process, provision for special populations, and any actions taken following decontamination. The aim of the survey was to identify any differences in the way in which decontamination guidance is implemented across US states. Results revealed that, in line with current guidance, many US fire departments routinely use the "ladder-pipe system" for conducting rapid, gross decontamination of casualties. The survey revealed significant variability in ladder-pipe construction, such as the position and number of fire hoses used. There was also variability in decontamination characteristics, such as water temperature and water pressure, detergent use, and shower duration. The results presented here provide important insights into the ways in which implementation of decontamination guidance can vary between US states. These inconsistencies are thought to reflect established perceived best practices and local adaptation of response plans to address practical and logistical constraints. These outcomes highlight the need for evidence-based national guidelines for conducting mass casualty decontamination.

  6. Provision of cardiovascular genetic counseling services: current practice and future directions.

    PubMed

    Somers, Allyson E; Ware, Stephanie M; Collins, Kathleen; Jefferies, John L; He, Hua; Miller, Erin M

    2014-12-01

    Cardiovascular genetic counseling has emerged as a specialty critical to the care of patients with heritable cardiovascular disease. Current strategies to meet the growing demand are not clear. We sought to characterize practice patterns of cardiac genetic counseling by developing a novel survey distributed to the National Society of Genetic Counselors (NSGC) Listserv to assess clinical practice, cardiovascular training, and education. Descriptive statistics were used to summarize clinical practice; Fisher's exact test and the Cochran-Armitage trend test were used to compare the practice of cardiovascular genetic counselors (CVGCs) to those who did not identify cardiology as a specialty (non-CVGCs). A total of 153 individuals completed the survey. Of the 105 participants who reported seeing a cardiac genetics patient, 42 (40%) identified themselves as a CVGC. The most common conditions for which genetic counseling was provided were hypertrophic cardiomyopathy (HCM) (71% of participants), dilated cardiomyopathy (DCM) (61%), long QT syndrome (LQTS) (56%), and genetic syndromes with cardiovascular disease (55%). CVGCs were significantly more confident than non-CVGCs in providing genetic counseling for seven cardiovascular diseases (2.3 × 10(-6) ≤ p ≤ 0.021). Eighty-six percent of genetic counselors sought additional education related to cardiovascular genetics and listed online courses as the most desirable method of learning. These data suggest a growing interest in cardiovascular genetic counseling and need for additional training resources among the NSGC membership.

  7. The practicing physician's current perspective on therapeutic options in coronary artery disease

    PubMed Central

    Drenth, D.J.; Zijlstra, F.; Boonstra, P.W.

    2005-01-01

    Over the past decades the management of patients with stable as well as unstable manifestations of coronary artery disease has evolved in every aspect of routine clinical practice. Modern diagnostic modalities allow reliable and objective assessment of both the anatomical and functional consequences of the early as well as advanced stages of this disease, which remains one of the most important causes of morbidity and mortality worldwide. Pharmacological therapy now includes several classes of drugs with mortality benefits documented by randomised controlled trials. Surgical and percutaneous revascularisation techniques have shown rapid technical improvements and are now applicable in a wide range of clinical conditions. In this paper we will attempt to place the current status of the three therapeutic options for patients with coronary artery disease into perspective. It is important to realise that it is impossible to write a complete overview, a Pubmed search: 'PCI or drug therapy or surgery for coronary artery disease' results in 1,152,117 hits. Therefore, we have chosen the viewpoint of the practicing physician to synthesise this abundance of information in the context of modern clinical practice in a high volume cardiothoracic and cardiological practice. PMID:25696508

  8. Community Music: History and Current Practice, Its Constructions of "Community", Digital Turns and Future Soundings, an Arts and Humanities Research Council Research Review

    ERIC Educational Resources Information Center

    McKay, George; Higham, Ben

    2012-01-01

    The United Kingdom has been a pivotal national player within the development of community music practice. There are elements of cultural and debatably pedagogic innovations in community music. These have to date only partly been articulated and historicized within academic research. This report, funded by the UK's Arts and Humanities Research…

  9. Neonatal survival interventions in humanitarian emergencies: a survey of current practices and programs

    PubMed Central

    2012-01-01

    Background Neonatal deaths account for over 40% of all deaths in children younger than five years of age and neonatal mortality rates are highest in areas affected by humanitarian emergencies. Of the ten countries with the highest neonatal mortality rates globally, six are currently or recently affected by a humanitarian emergency. Yet, little is known about newborn care in crisis settings. Understanding current policies and practices for the care of newborns used by humanitarian aid organizations will inform efforts to improve care in these challenging settings. Methods Between August 18 and September 25, 2009, 56 respondents that work in humanitarian emergencies completed a web-based survey either in English or French. A snow ball sampling technique was used to identify organizations that provide health services during humanitarian emergencies to gather information on current practices for maternal and newborn care in these settings. Information was collected about continuum-of-care services for maternal, newborn and child health, referral services, training and capacity development, health information systems, policies and guidelines, and organizational priorities. Data were entered into MS Excel and frequencies and percentages were calculated. Results The majority of responding organizations reported implementing components of neonatal and maternal health interventions. However, multiple barriers exist in providing comprehensive care, including: funding shortages (63.3%), gaps in training (51.0%) and staff shortages and turnover (44.9%). Conclusions Neonatal care is provided by most of the responding humanitarian organizations; however, the quality, breadth and consistency of this care are limited. PMID:22824461

  10. UK national survey of enucleation, evisceration and orbital implant trends

    PubMed Central

    Viswanathan, P; Sagoo, Mandeep S; Olver, Jane M

    2007-01-01

    Aim To evaluate current clinical practice in the UK in the management of the anophthalmic socket; choice of enucleation, evisceration, type of orbital implant, wrap, motility pegging and complications. Methods All consultant ophthalmologists in the UK were surveyed by postal questionnaire. Questions included their practice subspecialty and number of enucleations and eviscerations performed in 2003. Specific questions addressed choice of implant, wrap, motility pegging and complications. Results 456/896 (51%) consultants responded, of which 162 (35%) had a specific interest in oculoplastics, lacrimal, orbits or oncology. Only 243/456 (53%) did enucleations or eviscerations. 92% inserted an orbital implant after primary enucleation, 69% after non‐endophthalmitis evisceration, whereas only 43% did so after evisceration for endophthalmitis (50% as a delayed procedure). 55% used porous orbital implants (porous polyethylene, hydroxyapatite or alumina) as their first choice and 42% used acrylic. Most implants inserted were spherical, sized 18–20 mm in diameter. 57% wrapped the implant after enucleation, using salvaged autogenous sclera (20%), donor sclera (28%) and synthetic Vicryl or Mersilene mesh (42%). A minority (7%) placed motility pegs in selected cases, usually as a secondary procedure. 14% of respondents reported implant exposure for each type of procedure and extrusion was reported by 4% after enucleation and 3% after evisceration. Conclusions This survey highlights contemporary anophthalmic socket practice in the UK. Most surgeons use porous orbital implants with a synthetic wrap after enucleation and only few perform motility pegging. PMID:17151061

  11. Current best practice in the management of hypertensive disorders in pregnancy.

    PubMed

    Townsend, Rosemary; O'Brien, Patrick; Khalil, Asma

    2016-01-01

    Preeclampsia is a potentially serious complication of pregnancy with increasing significance worldwide. Preeclampsia is the cause of 9%-26% of global maternal mortality and a significant proportion of preterm delivery, and maternal and neonatal morbidity. Incidence is increasing in keeping with the increase in obesity, maternal age, and women with medical comorbidities entering pregnancy. Recent developments in the understanding of the pathophysiology of preeclampsia have opened new avenues for prevention, screening, and management of this condition. In addition it is known that preeclampsia is a risk factor for cardiovascular disease in both the mother and the child and presents an opportunity for early preventative measures. New tools for early detection, prevention, and management of preeclampsia have the potential to revolutionize practice in the coming years. This review presents the current best practice in diagnosis and management of preeclampsia and the hypertensive disorders of pregnancy. PMID:27555797

  12. Current thinking in qualitative research: evidence-based practice, moral philosophies, and political struggle.

    PubMed

    Papadimitriou, Christina; Magasi, Susan; Frank, Gelya

    2012-01-01

    In this introduction to the special issue on current thinking in qualitative research and occupational therapy and science, the authors focus on the importance of rigorous qualitative research to inform occupational therapy practice. The authors chosen for this special issue reflect a "second generation of qualitative researchers" who are critical, theoretically sophisticated, methodologically productive, and politically relevant to show that working with disabled clients is political work. Three themes emerged across the articles included in this special issue: (1) recognizing and addressing social justice issues; (2) learning from clients' experiences; and (3) critically reframing occupational therapy's role. These themes can inform occupational therapy practice, research, and education to reflect a more client-centered and politically engaging approach.

  13. [Methodology for the development and update of practice guidelines: current state].

    PubMed

    Barrera-Cruz, Antonio; Viniegra-Osorio, Arturo; Valenzuela-Flores, Adriana Abigail; Torres-Arreola, Laura Pilar; Dávila-Torres, Javier

    2016-01-01

    The current scenario of health services in Mexico reveals as a priority the implementation of strategies that allow us to better respond to the needs and expectations of individuals and society as a whole, through the provision of efficient and effective alternatives for the prevention, diagnosis and treatment of diseases. In this context, clinical practice guidelines constitute an element of management in the health care system, whose objective is to establish a national bechmark for encouraging clinical and management decision making, based on recommendations from the best available evidence, in order to contribute to the quality and effectiveness of health care. The purpose of this document is to show the methodology used for the development and updating of clinical practice guidelines that the Instituto Mexicano del Seguro Social has developed in line with the sectorial model in order to serve the user of these guidelines.

  14. Current best practice in the management of hypertensive disorders in pregnancy

    PubMed Central

    Townsend, Rosemary; O’Brien, Patrick; Khalil, Asma

    2016-01-01

    Preeclampsia is a potentially serious complication of pregnancy with increasing significance worldwide. Preeclampsia is the cause of 9%–26% of global maternal mortality and a significant proportion of preterm delivery, and maternal and neonatal morbidity. Incidence is increasing in keeping with the increase in obesity, maternal age, and women with medical comorbidities entering pregnancy. Recent developments in the understanding of the pathophysiology of preeclampsia have opened new avenues for prevention, screening, and management of this condition. In addition it is known that preeclampsia is a risk factor for cardiovascular disease in both the mother and the child and presents an opportunity for early preventative measures. New tools for early detection, prevention, and management of preeclampsia have the potential to revolutionize practice in the coming years. This review presents the current best practice in diagnosis and management of preeclampsia and the hypertensive disorders of pregnancy. PMID:27555797

  15. UK Schools, CCTV and the Data Protection Act 1998

    ERIC Educational Resources Information Center

    Taylor, Emmeline

    2011-01-01

    The use of CCTV in schools is now commonplace in the UK. It is estimated that 85% of all UK secondary schools currently have CCTV systems in operation. The introduction of the Data Protection Act 1998 (DPA) (enacted in March 2000) meant that for the first time CCTV had direct legislation governing its use in the UK. This paper attempts to apply…

  16. Congruence of the current practices in Hymenoptera venom allergic patients in Poland with EAACI guidelines

    PubMed Central

    Cichocka-Jarosz, Ewa; Diwakar, Lavanya; Brzyski, Piotr; Tobiasz-Adamczyk, Beata; Lis, Grzegorz; Pietrzyk, Jacek J.

    2011-01-01

    Introduction Venom immunotherapy (VIT) practice is the definitive treatment for patients with potentially fatal allergic reactions to Hymenoptera stings. The aim is assesing compliance of VIT practice in Poland with the current European Academy of Allergy and Clinical Immunology (EAACI) guidance. Material and methods A multicentre study was carried out using a structured questionnaire which was sent by post to all VIT practitioners in Poland. Some questionnaire items were altered, in comparison to original version by adding additional answer options or alowing multiple answer option. The response rate was 100%. The obtained results were compared with the published EAACI guidelines. Results Twenty-six Polish centres took part in the survey. SSIgE and skin prick tests (SPT) are together used as the first line of investigation, whereas confirmatory intradermal tests (IDT) are applied in half of centres. Only a few centres measure baseline serum tryptase levels. The ultra-rush protocol is preferred. Antihistamine pre-medication is routinely practiced. A target dose equal to 100 µg is used in most centres. A 6-week interval between booster doses is the most frequent. Five years is considered as an optimal VIT duration. Before the VIT completion, SSIgE is evaluated in fifty percent of centres, whereas sting challenge is considered by half of responders. Conclusions There are some differences between current practice in Poland and the EAACI recommendations, indicating areas requiring better compliance. Comparision between Poland and the United Kingdom revealed that health service organization and health care funding may play a major role in the provision of allergy services. This may affect the extent to which international guidance may be applied in individual countries. It is worth considering conducting the same survey in other European countries. PMID:22291828

  17. Impacts of Russian biomass burning on UK air quality

    NASA Astrophysics Data System (ADS)

    Witham, Claire; Manning, Alistair

    Unusually high levels of PM 10 were observed in the UK in May 2006 and September 2002. This paper investigates the possible contribution of long-range transport of smoke from widespread agricultural burning and forest fires in western Russia to these air pollution episodes. The Lagrangian dispersion model NAME is run in both forwards and backwards modes to determine the transport and sources of the polluted air masses for the two incidents. Comparison of the model results to satellite data and ground observations from across Europe demonstrates good agreement for both the timing and magnitude of the episodes and suggests that fires in western Russia were the primary cause of both incidents. Secondary contributions to the 2006 episode may have come from European anthropogenic pollution and pollen released in northern Europe. The occurrence and timing of both pollution episodes were strongly controlled by the meteorological situation at the time. Scaling of model results to observations suggests that 0.5-0.7 Mtonnes of biomass per day could have been burnt during periods when winds reaching the UK were from the east. The newly reported 2006 episode means that Russian fires have affected UK air quality at least twice since 2000 and it is suggested that, without changes in current practice, such events are likely to occur again in the future with implications for UK and European air quality.

  18. The evolution of cognitive behavior therapy for schizophrenia: current practice and recent developments.

    PubMed

    Tai, Sara; Turkington, Douglas

    2009-09-01

    Cognitive behavior therapy (CBT) evolved from behavioral theory and developed to focus more on cognitive models that incorporated reappraisal of thinking errors and schema change strategies. This article will describe the key elements of CBT for schizophrenia and the current evidence of its efficacy and effectiveness. We conclude with a description of recent concepts that extend the theoretical basis of practice and expand the range of CBT strategies for use in schizophrenia. Mindfulness, meta-cognitive approaches, compassionate mind training, and method of levels are postulated as useful adjuncts for CBT with psychotic patients.

  19. Integrating HIV prevention into substance user treatment: current practices and challenges.

    PubMed

    Mitchell, Christopher G; Oltean, Anthony

    2007-01-01

    Despite well-organized prevention efforts, HIV continues to spread in the United States. Injection drug users (IDUs) and other substance users who engage in high-risk behaviors are at particularly high risk for contracting HIV. Substance abuse(dagger) counselors therefore are in a unique position to present HIV prevention messages to their clients. This article reports the results of a study that surveyed counselors in an urban setting (n = 116) to assess their knowledge of HIV, their current HIV prevention practices, and their attitudes about integrating HIV prevention more fully into their work. The article concludes with a discussion of the survey's limitations and its implications for training.

  20. Volumetric modulated arc therapy: a review of current literature and clinical use in practice

    PubMed Central

    Teoh, M; Clark, C H; Wood, K; Whitaker, S; Nisbet, A

    2011-01-01

    Volumetric modulated arc therapy (VMAT) is a novel radiation technique, which can achieve highly conformal dose distributions with improved target volume coverage and sparing of normal tissues compared with conventional radiotherapy techniques. VMAT also has the potential to offer additional advantages, such as reduced treatment delivery time compared with conventional static field intensity modulated radiotherapy (IMRT). The clinical worldwide use of VMAT is increasing significantly. Currently the majority of published data on VMAT are limited to planning and feasibility studies, although there is emerging clinical outcome data in several tumour sites. This article aims to discuss the current use of VMAT techniques in practice and review the available data from planning and clinical outcome studies in various tumour sites including prostate, pelvis (lower gastrointestinal, gynaecological), head and neck, thoracic, central nervous system, breast and other tumour sites. PMID:22011829

  1. Guidance on How to Move from Current Practice to Recommended Practice in Life Cycle Impact Assessment (UNEP/SETAC Life Cycle Initiative Publication)

    EPA Science Inventory

    The report provides guidance on how to move from current practice to recommended practice in Life Cycle Impact Assessment. It is composed of three complementary parts elaborated in the first task force (TFI) of the LCIA programme, with contribution of the other three task forces:

  2. Current practice in software development for computational neuroscience and how to improve it.

    PubMed

    Gewaltig, Marc-Oliver; Cannon, Robert

    2014-01-01

    Almost all research work in computational neuroscience involves software. As researchers try to understand ever more complex systems, there is a continual need for software with new capabilities. Because of the wide range of questions being investigated, new software is often developed rapidly by individuals or small groups. In these cases, it can be hard to demonstrate that the software gives the right results. Software developers are often open about the code they produce and willing to share it, but there is little appreciation among potential users of the great diversity of software development practices and end results, and how this affects the suitability of software tools for use in research projects. To help clarify these issues, we have reviewed a range of software tools and asked how the culture and practice of software development affects their validity and trustworthiness. We identified four key questions that can be used to categorize software projects and correlate them with the type of product that results. The first question addresses what is being produced. The other three concern why, how, and by whom the work is done. The answers to these questions show strong correlations with the nature of the software being produced, and its suitability for particular purposes. Based on our findings, we suggest ways in which current software development practice in computational neuroscience can be improved and propose checklists to help developers, reviewers, and scientists to assess the quality of software and whether particular pieces of software are ready for use in research.

  3. Sedation and analgesia for critically ill pediatric burn patients: the current state of practice.

    PubMed

    Singleton, Andrew; Preston, Robert J; Cochran, Amalia

    2015-01-01

    The objective of this study was to assess current practice patterns and attitudes toward pediatric sedation and analgesia in United States (US) burn centers for critically ill patients. Survey-based questionnaire was sent to 119 Directors at US burn centers that care for pediatric patients. Forty-one surveys (34%) were analyzed. 48.8% of responding centers mandate pediatric consultation for pediatric burn patients based on factors such as age and burn size. The most common sedation and analgesic agents used were midazolam, fentanyl, morphine, ketamine, and diphenhydramine. Written sedation policies exist at 63.4% of centers. 90.2% of centers employ scoring systems to guide agent titration. 60.9% of respondents practice sedation holidays "always" or "usually." 90.2% of centers perceive the medications they routinely use are "always" or "often" efficacious in pediatric sedation and analgesia. 53.7% of respondents reported the presence of withdrawal signs and symptoms in their patient population. The lack of consensus guidelines for sedation and analgesia delivery to pediatric intensive care unit patients results in practice variation. The majority of centers perceive their sedation and analgesia strategies to be efficacious despite the heavy reliance on propofol and midazolam, both of which have questionable safety profiles in critically ill children.

  4. Current Practice in Software Development for Computational Neuroscience and How to Improve It

    PubMed Central

    Gewaltig, Marc-Oliver; Cannon, Robert

    2014-01-01

    Almost all research work in computational neuroscience involves software. As researchers try to understand ever more complex systems, there is a continual need for software with new capabilities. Because of the wide range of questions being investigated, new software is often developed rapidly by individuals or small groups. In these cases, it can be hard to demonstrate that the software gives the right results. Software developers are often open about the code they produce and willing to share it, but there is little appreciation among potential users of the great diversity of software development practices and end results, and how this affects the suitability of software tools for use in research projects. To help clarify these issues, we have reviewed a range of software tools and asked how the culture and practice of software development affects their validity and trustworthiness. We identified four key questions that can be used to categorize software projects and correlate them with the type of product that results. The first question addresses what is being produced. The other three concern why, how, and by whom the work is done. The answers to these questions show strong correlations with the nature of the software being produced, and its suitability for particular purposes. Based on our findings, we suggest ways in which current software development practice in computational neuroscience can be improved and propose checklists to help developers, reviewers, and scientists to assess the quality of software and whether particular pieces of software are ready for use in research. PMID:24465191

  5. Field Measurements at River and Tidal Current Sites for Hydrokinetic Energy Development: Best Practices Manual

    SciTech Connect

    Neary, Vincent S; Gunawan, Budi

    2011-09-01

    In this report, existing data collection techniques and protocols for characterizing open channel flows are reviewed and refined to further address the needs of the MHK industry. The report provides an overview of the hydrodynamics of river and tidal channels, and the working principles of modern acoustic instrumentation, including best practices in remote sensing methods that can be applied to hydrokinetic energy site characterization. Emphasis is placed upon acoustic Doppler velocimeter (ADV) and acoustic-Doppler current profiler (ADCP) instruments, as these represent the most practical and economical tools for use in the MHK industry. Incorporating the best practices as found in the literature, including the parameters to be measured, the instruments to be deployed, the instrument deployment strategy, and data post-processing techniques. The data collected from this procedure aims to inform the hydro-mechanical design of MHK systems with respect to energy generation and structural loading, as well as provide reference hydrodynamics for environmental impact studies. The standard metrics and protocols defined herein can be utilized to guide field experiments with MHK systems.

  6. A Survey on Current Practice of Management of Early Onset Neonatal Sepsis.

    PubMed

    Dey, A C; Hossain, M I; Afroze, S; Dey, S K; Mannan, M A; Shahidullah, M

    2016-04-01

    It was a survey type of cross sectional study where the participants were from different teaching/referral hospital across the country and was done to gather information regarding current practice of management of neonatal sepsis among paediatricians and neonatologists and was conducted on the spot during a national conference of Bangladesh Perinatal Society in December 2013. Specialists in neonatology, paediatrics, and some other disciplines working in different institutes across the country were requested to respond. Out of 150 physicians, 92 (61.33%) were neonatologists. Physicians suspected early onset neonatal sepsis (EONS) when there is history suggestive of prolonged rupture of membrane (74.77%), prolonged labour (9.33%), chorioamnionitis (7.33%) and maternal fever (2%). Clinical sepsis is found commonly (53.33%) which is later proved by laboratory evidences such as Hb%, TC, DC PBF (peripheral blood film), C-reactive protein, chest X-ray etc. Injection Ampicillin and Gentamycin are still the first choice of antibiotics (61.3%). Preferred route was intravenous (95.3%). Antibiotics were given for 7-10 days by most of the physicians (48.77%). However there is lack of uniformity among the participants in regard to taking decision about antibiotics, the choice of first line and the subsequent options of antibiotics. So, neonatal sepsis is the most important cause of neonatal mortality in the community. Therefore a standard protocolized approach for diagnosis and management of Early Onset Neonatal Sepsis may prove critical which is currently not in practice uniformly. PMID:27277355

  7. Electronic submission of academic works: a survey of current editorial practices of radiologic journals.

    PubMed

    Jackson, G W; Davidson, H C; Wiggins, R H; Harnsberger, H R

    2001-06-01

    Computers are nearly ubiquitous in academic medicine, and authors create and compile much of their work in the electronic environment, yet the process of manuscript submission often fails to utilize the advantages of electronic communication. The purpose of this report is to review the submission policies of major academic journals in the field of radiology and assess current editorial practices relating to electronic submission of academic works. The authors surveyed 16 radiologic journals that are indexed in the Index Medicus and available in our medical center library. They compared the manuscript submission policies of these journals as outlined in recent issues of the journals and the corresponding worldwide web sites. The authors compared the journals on the following criteria: web site access to instructions; electronic submission of text, both with regard to initial submission and final submission of the approved document; text hardcopy requirements; word processing software restrictions; electronic submission of figures, figure hardcopy requirements; figure file format restrictions; and electronic submission media. Although the trend seems to be toward electronic submission, there currently is no clear-cut standard of practice. Because all of the journals that accept electronic documents also require a hardcopy, many of the advantages gained through electronic submission are nullified. In addition, many publishers only utilize electronic documents after a manuscript has been accepted, thus utilizing the benefits of digital information in the printing process but not in the actual submission and peer-review process.

  8. A Survey on Current Practice of Management of Early Onset Neonatal Sepsis.

    PubMed

    Dey, A C; Hossain, M I; Afroze, S; Dey, S K; Mannan, M A; Shahidullah, M

    2016-04-01

    It was a survey type of cross sectional study where the participants were from different teaching/referral hospital across the country and was done to gather information regarding current practice of management of neonatal sepsis among paediatricians and neonatologists and was conducted on the spot during a national conference of Bangladesh Perinatal Society in December 2013. Specialists in neonatology, paediatrics, and some other disciplines working in different institutes across the country were requested to respond. Out of 150 physicians, 92 (61.33%) were neonatologists. Physicians suspected early onset neonatal sepsis (EONS) when there is history suggestive of prolonged rupture of membrane (74.77%), prolonged labour (9.33%), chorioamnionitis (7.33%) and maternal fever (2%). Clinical sepsis is found commonly (53.33%) which is later proved by laboratory evidences such as Hb%, TC, DC PBF (peripheral blood film), C-reactive protein, chest X-ray etc. Injection Ampicillin and Gentamycin are still the first choice of antibiotics (61.3%). Preferred route was intravenous (95.3%). Antibiotics were given for 7-10 days by most of the physicians (48.77%). However there is lack of uniformity among the participants in regard to taking decision about antibiotics, the choice of first line and the subsequent options of antibiotics. So, neonatal sepsis is the most important cause of neonatal mortality in the community. Therefore a standard protocolized approach for diagnosis and management of Early Onset Neonatal Sepsis may prove critical which is currently not in practice uniformly.

  9. Improving medical students’ knowledge of genetic disease: a review of current and emerging pedagogical practices

    PubMed Central

    Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

    2015-01-01

    Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student’s critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics. PMID:26604852

  10. Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices.

    PubMed

    Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

    2015-01-01

    Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics. PMID:26604852

  11. Improving medical students' knowledge of genetic disease: a review of current and emerging pedagogical practices.

    PubMed

    Wolyniak, Michael J; Bemis, Lynne T; Prunuske, Amy J

    2015-01-01

    Genetics is an essential subject to be mastered by health professional students of all types. However, technological advances in genomics and recent pedagogical research have changed the way in which many medical training programs teach genetics to their students. These advances favor a more experience-based education focused primarily on developing student's critical thinking skills. In this review, we examine the current state of genetics education at both the preclinical and clinical levels and the ways in which medical and pedagogical research have guided reforms to current and emerging teaching practices in genetics. We discover exciting trends taking place in which genetics is integrated with other scientific disciplines both horizontally and vertically across medical curricula to emphasize training in scientific critical thinking skills among students via the evaluation of clinical evidence and consultation of online databases. These trends will produce future health professionals with the skills and confidence necessary to embrace the new tools of medical practice that have emerged from scientific advances in genetics, genomics, and bioinformatics.

  12. Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders in UK general practice: a retrospective cohort study

    PubMed Central

    2012-01-01

    Background Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders (PNDs) who are under the care of general practitioners (GPs) in the UK are not well understood. Methods Using a large electronic UK database, we identified all adults (age ≥ 18 years) with any GP encounters between 1 January 2006 - 31 December 2006 at which a diagnosis of PND was noted ("PND patients"). An age-and gender-matched comparison group also was constituted consisting of randomly selected patients with one or more GP encounters-but no mention of PNDs-during this period. Characteristics and patterns of healthcare utilization of patients in the two groups were then examined over the one-year study period. Results The study sample consisted of 31,688 patients with mention of PNDs and an equal number of matched comparators; mean age was 56 years, and 62% were women. The prevalence of various comorbidities was higher among patients in the PND group, including digestive disorders (31% vs. 17% for comparison group), circulatory disorders (29% vs. 22%), and depression (4% vs. 3%) (all p < 0.01). Receipt of prescriptions for pain-related pharmacotherapy also was higher among PND patients, including nonsteroidal anti-inflammatory drugs (56% of PND patients had one or more such prescriptions vs. only 22% in the comparison group), opioids (49% vs. 12%), tricyclic antidepressants (20% vs. 1%), and antiepileptics (12% vs. 1%) (all p < 0.01). PND patients also averaged significantly more GP visits (22.8 vs. 14.2) and referrals to specialists (2.8 vs. 1.4) over one year (both comparisons p < 0.01). Conclusions Patients with PNDs under the care of GPs in the UK have relatively high levels of use of healthcare services and pain-related pharmacotherapy. PMID:22394606

  13. Mechanism for the uniaxial strain dependence of the critical current in practical REBCO tapes

    NASA Astrophysics Data System (ADS)

    Osamura, Kozo; Machiya, Shutaro; Hampshire, Damian P.

    2016-06-01

    In order to elucidate the effect of uniaxial strain on the critical current of practical REBCO tapes (REBa2Cu3O7-d , RE = Y and Gd) fabricated by Superpower and SuNAM, two types of critical current measurements were carried out. In the first, the tape sample was attached directly to a universal testing machine and pulled under a tensile load. In the second, the tape was soldered to a Cu-Be springboard and then attached to the testing machine and then pushed or pulled in order to apply both tensile and compressive strains to the tape sample. An inverse parabolic behaviour was observed for the uniaxial strain dependence of the critical current of both tapes. Using synchrotron radiation, the local strain exerted on the REBCO layer was measured at room temperature under the conditions used for the two techniques for making I c measurements. On the basis of these room temperature data, the local strain exerted on the REBCO layer at 77 K was numerically evaluated. A one-dimensional chain model for current flow in the REBCO material with fractional lengths of A-domains and B-domains oriented along the uniaxial strain direction is proposed. The model can explain the parabolic strain behaviour of the critical current and shows that the strain at which the peak in I c occurs, is not only determined by pre-compression or pre-tension on the superconductor at the operating temperature, but also by the ratio of the fractional amounts of the two domains.

  14. Mechanism for the uniaxial strain dependence of the critical current in practical REBCO tapes

    NASA Astrophysics Data System (ADS)

    Osamura, Kozo; Machiya, Shutaro; Hampshire, Damian P.

    2016-06-01

    In order to elucidate the effect of uniaxial strain on the critical current of practical REBCO tapes (REBa2Cu3O7‑d , RE = Y and Gd) fabricated by Superpower and SuNAM, two types of critical current measurements were carried out. In the first, the tape sample was attached directly to a universal testing machine and pulled under a tensile load. In the second, the tape was soldered to a Cu–Be springboard and then attached to the testing machine and then pushed or pulled in order to apply both tensile and compressive strains to the tape sample. An inverse parabolic behaviour was observed for the uniaxial strain dependence of the critical current of both tapes. Using synchrotron radiation, the local strain exerted on the REBCO layer was measured at room temperature under the conditions used for the two techniques for making I c measurements. On the basis of these room temperature data, the local strain exerted on the REBCO layer at 77 K was numerically evaluated. A one-dimensional chain model for current flow in the REBCO material with fractional lengths of A-domains and B-domains oriented along the uniaxial strain direction is proposed. The model can explain the parabolic strain behaviour of the critical current and shows that the strain at which the peak in I c occurs, is not only determined by pre-compression or pre-tension on the superconductor at the operating temperature, but also by the ratio of the fractional amounts of the two domains.

  15. Practical experience in deploying and controlling the data sharing interoperability layer at the U.K. Land Open Systems Architecture (LOSA) field trials in October 2012

    NASA Astrophysics Data System (ADS)

    Bergamaschi, Flavio; Conway-Jones, Dave; Pearson, Gavin

    2013-05-01

    In October 2012 the UK MoD sponsored a multi-vendor field integration trial in support of its Land Open Systems Architecture (LOSA), an open, service based architecture for systems integration and interoperability which builds on the progress made with the Generic Vehicle Architecture (GVA, DefStan 23-09), Generic Base Architecture (GBA, DefStan 23-13) and the Generic Soldier Architecture (DefStan 23-12) programs. The aim of this trial was to experiment with a common data and power interoperability across and in support of the Soldier, Vehicles and Bases domains. This paper presents an overview of the field trial and discusses how the ITA Information Fabric, technology originated in the US and UK International Technology Alliance program, was extended to support the control of the data interoperability layer across various data bearers. This included: (a) interoperability and information sharing across multiple stove piped and legacy solutions; (b) command and control and bandwidth optimization of streamed data (e.g. video) over a peer-to-peer ad-hoc network across multiple domains- integration of disparate sensor systems; (c) integration with DDS based C2 systems.

  16. The Trouble with Triplets in Biodiversity Informatics: A Data-Driven Case against Current Identifier Practices

    PubMed Central

    Guralnick, Robert; Conlin, Tom; Deck, John; Stucky, Brian J.; Cellinese, Nico

    2014-01-01

    The biodiversity informatics community has discussed aspirations and approaches for assigning globally unique identifiers (GUIDs) to biocollections for nearly a decade. During that time, and despite misgivings, the de facto standard identifier has become the “Darwin Core Triplet”, which is a concatenation of values for institution code, collection code, and catalog number associated with biocollections material. Our aim is not to rehash the challenging discussions regarding which GUID system in theory best supports the biodiversity informatics use case of discovering and linking digital data across the Internet, but how well we can link those data together at this moment, utilizing the current identifier schemes that have already been deployed. We gathered Darwin Core Triplets from a subset of VertNet records, along with vertebrate records from GenBank and the Barcode of Life Data System, in order to determine how Darwin Core Triplets are deployed “in the wild”. We asked if those triplets follow the recommended structure and whether they provide an easy and unambiguous means to track from specimen records to genetic sequence records. We show that Darwin Core Triplets are often riddled with semantic and syntactic errors when deployed and curated in practice, despite specifications about how to construct them. Our results strongly suggest that Darwin Core Triplets that have not been carefully curated are not currently serving a useful role for relinking data. We briefly consider needed next steps to overcome current limitations. PMID:25470125

  17. UK Hazard Assessment for a Laki-type Volcanic Eruption

    NASA Astrophysics Data System (ADS)

    Witham, Claire; Felton, Chris; Daud, Sophie; Aspinall, Willy; Braban, Christine; Loughlin, Sue; Hort, Matthew; Schmidt, Anja; Vieno, Massimo

    2014-05-01

    Following the impacts of the Eyjafjallajokull eruption in 2010, two types of volcanic eruption have been added to the UK Government's National Risk Register for Civil Emergencies. One of these, a large gas-rich volcanic eruption, was identified as a high impact natural hazard, one of the three highest priority natural hazards faced by the UK. This eruption scenario is typified by the Laki eruption in Iceland in 1783-1784. The Civil Contingency Secretariat (CCS) of the UK's Cabinet Office, responsible for Civil Protection in the UK, has since been working on quantifying the risk and better understanding its potential impacts. This involves cross-cutting work across UK Government departments and the wider scientific community in order to identify the capabilities needed to respond to an effusive eruption, to exercise the response and develop increased resilience where possible. As part of its current work, CCS has been working closely with the UK Met Office and other UK agencies and academics (represented by the co-authors and others) to generate and assess the impacts of a 'reasonable worst case scenario', which can be used for decision making and preparation in advance of an eruption. Information from the literature and the findings of an expert elicitation have been synthesised to determine appropriate eruption source term parameters and associated uncertainties. This scenario is then being used to create a limited ensemble of model simulations of the dispersion and chemical conversion of the emissions of volcanic gases during such an eruption. The UK Met Office's NAME Lagrangian dispersion model and the Centre for Ecology and Hydrology's EMEP4UK Eulerian model are both being used. Modelling outputs will address the likelihood of near-surface concentrations of sulphur and halogen species being above specified health thresholds. Concentrations at aviation relevant altitudes will also be evaluated, as well as the effects of acid deposition of volcanic species on

  18. Multidose flurbiprofen 8.75 mg lozenges in the treatment of sore throat: a randomised, double-blind, placebo-controlled study in UK general practice centres.

    PubMed

    Blagden, M; Christian, J; Miller, K; Charlesworth, A

    2002-03-01

    The flurbiprofen 8.75 mg lozenge is a novel formulation that combines a demulcent effect with the analgesic activity of a non-steroidal anti-inflammatory drug. Previous controlled clinical studies have demonstrated the single- and multi-dose efficacy of these lozenges over placebo. The current study reflected the treatment of sore throat in general practice, investigating multiple dose efficacy where patients also had access to concomitant antibiotics and rescue medication. The efficacy of flurbiprofen 8.75 mg lozenge over placebo was confirmed: there was a significant difference in pain relief obtained from flurbiprofen 8.75 mg versus placebo, along with a significant reduction of difficulty in swallowing from the time of first assessment and significantly greater reductions in throat soreness and difficulty in swallowing throughout the study period. Additionally, significant benefit over placebo was demonstrated where concomitant antibiotic use was introduced, indicating that flurbiprofen 8.75 mg lozenges can be co-administered when antibiotic therapy is appropriate. No significant safety issues were identified. PMID:11926713

  19. Multidose flurbiprofen 8.75 mg lozenges in the treatment of sore throat: a randomised, double-blind, placebo-controlled study in UK general practice centres.

    PubMed

    Blagden, M; Christian, J; Miller, K; Charlesworth, A

    2002-03-01

    The flurbiprofen 8.75 mg lozenge is a novel formulation that combines a demulcent effect with the analgesic activity of a non-steroidal anti-inflammatory drug. Previous controlled clinical studies have demonstrated the single- and multi-dose efficacy of these lozenges over placebo. The current study reflected the treatment of sore throat in general practice, investigating multiple dose efficacy where patients also had access to concomitant antibiotics and rescue medication. The efficacy of flurbiprofen 8.75 mg lozenge over placebo was confirmed: there was a significant difference in pain relief obtained from flurbiprofen 8.75 mg versus placebo, along with a significant reduction of difficulty in swallowing from the time of first assessment and significantly greater reductions in throat soreness and difficulty in swallowing throughout the study period. Additionally, significant benefit over placebo was demonstrated where concomitant antibiotic use was introduced, indicating that flurbiprofen 8.75 mg lozenges can be co-administered when antibiotic therapy is appropriate. No significant safety issues were identified.

  20. 78 FR 22887 - Guidance for Industry on Non-Penicillin Beta-Lactam Drugs: A Current Good Manufacturing Practices...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... manufactured, and should have an independent air handling system. A draft version of this guidance was... practices regulation (21 CFR 10.115). The guidance represents the Agency's current thinking on...

  1. The current practice in the application of chemometrics for correlation of sensory and gas chromatographic data.

    PubMed

    Seisonen, Sirli; Vene, Kristel; Koppel, Kadri

    2016-11-01

    A lot of research has been conducted in correlating the sensory properties of food with different analytical measurements in recent years. Various statistical methods have been used in order to get the most reliable results and to create prediction models with high statistical performance. The current review summarises the latest practices in the field of correlating attributes from sensory analysis with volatile data obtained by gas chromatographic analysis. The review includes the origin of the data, different pre-processing and variable selection methods and finally statistical methods of analysis and validation. Partial least squares regression analysis appears as the most commonly used statistical method in the area. The main shortcomings were identified in the steps of pre-processing, variable selection and also validation of models that have not gained enough attention. As the association between volatiles and sensory perception is often nonlinear, future studies should test the application of different nonlinear techniques. PMID:27211679

  2. Continuing professional development in nursing in Australia: current awareness, practice and future directions.

    PubMed

    Katsikitis, Mary; McAllister, Margaret; Sharman, Rachael; Raith, Lisa; Faithfull-Byrne, Annette; Priaulx, Rae

    2013-08-01

    Australian nurses and midwives are expected to compile a professional development portfolio during their annual registration process. This study aimed to ascertain the current understanding, practice and future continuing professional development (CPD) needs of nurses and midwives employed in a regional area of Queensland, Australia. Perceived barriers and incentives for CPD were also measured. 289 public and private hospital nurses and midwives responded to the survey. Results showed that participants understood the new requirements, valued ongoing learning, preferred education to occur within work hours, and considered their workplaces as accepting of change. Approximately two-thirds of participants believed CPD should be shared between them and their employers. Barriers to undertaking CPD included understaffing, and the concern that CPD would interfere with time outside work. Organisational support positively influenced attitudes to CPD. This study highlights the importance of supportive management in encouraging their workforce to embrace ongoing learning and change. PMID:24099224

  3. Practical Framework for an Electron Beam Induced Current Technique Based on a Numerical Optimization Approach

    NASA Astrophysics Data System (ADS)

    Yamaguchi, Hideshi; Soeda, Takeshi

    2015-03-01

    A practical framework for an electron beam induced current (EBIC) technique has been established for conductive materials based on a numerical optimization approach. Although the conventional EBIC technique is useful for evaluating the distributions of dopants or crystal defects in semiconductor transistors, issues related to the reproducibility and quantitative capability of measurements using this technique persist. For instance, it is difficult to acquire high-quality EBIC images throughout continuous tests due to variation in operator skill or test environment. Recently, due to the evaluation of EBIC equipment performance and the numerical optimization of equipment items, the constant acquisition of high contrast images has become possible, improving the reproducibility as well as yield regardless of operator skill or test environment. The technique proposed herein is even more sensitive and quantitative than scanning probe microscopy, an imaging technique that can possibly damage the sample. The new technique is expected to benefit the electrical evaluation of fragile or soft materials along with LSI materials.

  4. Current practice of artificial insemination by donor in the United States.

    PubMed

    Curie-Cohen, M; Luttrell, L; Shapiro, S

    1979-03-15

    Of 711 physicians likely to perform artificial insemination by donor surveyed to determine their current practices, 471 responded, of whom 379 reported that they performed this procedure. They accounted for approximately 3576 births by this means in 1977. In addition to treating infertility, 26 per cent of these physicians used the procedure to prevent transmission of a genetic disease, and 10 per cent used if for single women. Donors of semen were primarily from universities, were only superficially screened for genetic diseases, and were then matched phenotypically to the recipient's husband. Most recipients were inseminated twice per cycle. Only 17 per cent of physicians used the same donor for a given recipient, and 32 per cent used multiple donors within a single cycle. Only 37 per cent kept records on children, and only 30 per cent on donors. The identity of donors usually was carefully guarded to ensure privacy and to avoid legal complications.

  5. Biodiversity in environmental assessment-current practice and tools for prediction

    SciTech Connect

    Gontier, Mikael . E-mail: gontier@kth.se; Balfors, Berit . E-mail: balfors@kth.se; Moertberg, Ulla . E-mail: mortberg@kth.se

    2006-04-15

    Habitat loss and fragmentation are major threats to biodiversity. Environmental impact assessment and strategic environmental assessment are essential instruments used in physical planning to address such problems. Yet there are no well-developed methods for quantifying and predicting impacts of fragmentation on biodiversity. In this study, a literature review was conducted on GIS-based ecological models that have potential as prediction tools for biodiversity assessment. Further, a review of environmental impact statements for road and railway projects from four European countries was performed, to study how impact prediction concerning biodiversity issues was addressed. The results of the study showed the existing gap between research in GIS-based ecological modelling and current practice in biodiversity assessment within environmental assessment.

  6. Modeling practical performance limits of photoelectrochemical water splitting based on the current state of materials research.

    PubMed

    Seitz, Linsey C; Chen, Zhebo; Forman, Arnold J; Pinaud, Blaise A; Benck, Jesse D; Jaramillo, Thomas F

    2014-05-01

    Photoelectrochemical (PEC) water splitting is a means to store solar energy in the form of hydrogen. Knowledge of practical limits for this process can help researchers assess their technology and guide future directions. We develop a model to quantify loss mechanisms in PEC water splitting based on the current state of materials research and calculate maximum solar-to-hydrogen (STH) conversion efficiencies along with associated optimal absorber band gaps. Various absorber configurations are modeled considering the major loss mechanisms in PEC devices. Quantitative sensitivity analyses for each loss mechanism and each absorber configuration show a profound impact of both on the resulting STH efficiencies, which can reach upwards of 25 % for the highest performance materials in a dual stacked configuration. Higher efficiencies could be reached as improved materials are developed. The results of the modeling also identify and quantify approaches that can improve system performance when working with imperfect materials.

  7. Meeting the needs of people in emergencies: a review of UK experiences and capability

    PubMed Central

    Eyre, A

    2008-01-01

    This article summarises the key findings of two research studies conducted for the UK Government in 2006–2007. The first was a literature review of evidence about provisions and interventions to meet the needs of people affected by ‘emergencies’ as defined within the Civil Contingencies Act (2004). Drawing on both historical and contemporary research and practice, the literature review presented an assessment of people's psychosocial needs after events such as natural disasters, terrorism, and other major incidents. Although some reference was made about the needs of and consequences on disaster workers responding to these events, the main emphasis was on those directly affected as bereaved people and/or injured survivors. The review offered best practice guidelines based on the most effective methods of humanitarian assistance in the immediate, short-term, and long-term aftermath of major emergencies. The second report was a follow-up study conducted in 2007. This was a piece of primary research focusing on the UK's current capability in humanitarian assistance in terms of the extent of planning, training, exercising, and experience relating to meeting people's needs in emergencies. A variety of methods were used to gather quantitative and qualitative evidence of the nature and status of such activity across the UK, including questionnaires, focus groups, and a review of literature and documentary evidence. The report included a number of good practice case studies and made recommendations for the development of best practice in humanitarian assistance within the UK. PMID:22460218

  8. Current Practices and Opportunities in a Resident Clinic Regarding the Care of Older Adults with Multimorbidity

    PubMed Central

    Schoenborn, Nancy L.; Boyd, Cynthia M.; McNabney, Matthew; Ray, Anushree; Cayea, Danelle

    2015-01-01

    OBJECTIVES Multimorbidity (≥2 chronic conditions) affects more than half of all older adults. The American Geriatrics Society developed and published guiding principles for the care of older adults with multimorbidity in 2012. Improved clinician training in caring for older adults with multimorbidity is needed, but it is not clear what opportunities arise within clinical encounters to apply the guiding principles or how clinicians at all stages of training currently practice in this area. This project aimed to characterize current practice and opportunities for improvement in an internal medicine residency clinic regarding the care of older adults with multimorbidity. DESIGN Qualitative content analysis of audio-recorded clinic visits. SETTING AND PARTICIPANTS Thirty clinic visits between 21 internal medicine residents and 30 of their primary care patients aged 65 and older with two or more chronic conditions were audio-recorded. Patients’ mean age was 73.6, and they had on average 3.7 chronic conditions and took 12.6 medications. MEASUREMENTS Transcripts of the audio-recorded visit discussions were analyzed using standard techniques of qualitative content analysis to describe the content and frequency of discussions in the clinic visits related to the five guiding principles: patient preferences, interpreting the evidence, prognosis, clinical feasibility, and optimizing therapies. RESULTS AND CONCLUSIONS All visits except one included discussions that were thematically related to at least one guiding principle, suggesting regular opportunities to apply the guiding principles in primary care encounters with internal medicine residents. Discussions related to some guiding principles occurred much more frequently than others. Patients presented a number of opportunities to incorporate the guiding principles that the residents missed, suggesting target areas for future educational interventions. PMID:26200347

  9. A survey of current practices and preferences for internal fixation of displaced olecranon fractures

    PubMed Central

    Wood, Thomas; Thomas, Katie; Farrokhyar, Forough; Ristevski, Bill; Bhandari, Mohit; Petrisor, Bradley

    2015-01-01

    Background Olecranon fractures represent 10% of upper extremity fractures. There is a growing body of literature to support the use of plate fixation for displaced olecranon fractures. The purpose of this survey was to gauge Canadian surgeons’ practices and preferences for internal fixation methods for displaced olecranon fractures. Methods Using an online survey tool, we administered a cross-sectional survey to examine current practice for fixation of displaced olecranon fractures. Results We received 256 completed surveys for a response rate of 31% (95% confidence interval [CI] 30.5–37.5%). The preferred treatment was tension band wiring (78.5%, 95% CI 73–83%) for simple displaced olecranon fractures (Mayo IIA) and plating (81%, 95% CI 75.5–85%) for displaced comminuted olecranon fractures (Mayo IIB). Fracture morphology with a mean impact of 3.31 (95% CI 3.17–3.45) and comminution with a mean impact of 3.34 (95% CI 3.21–3.46) were the 2 factors influencing surgeons’ choice of fixation method the most. The major deterrent to using tension band wiring for displaced comminuted fractures (Mayo IIB) was increased stability obtained with other methods described by 75% (95% CI 69–80%) of respondents. The major deterrent for using plating constructs for simple displaced fractures (Mayo IIA) was better outcomes with other methods. Hardware prominence was the most commonly perceived complication using either method of fixation: 77% (95% CI 71.4–81.7%) and 76.2% (95% CI 70.6–81.0%) for tension band wiring and plating, respectively. Conclusion Divergence exists with current literature and surgeon preference for fixation of displaced olecranon fractures. PMID:26204363

  10. Continuing education course #3: current practices and future trends in neuropathology assessment for developmental neurotoxicity testing.

    PubMed

    Bolon, Brad; Garman, Robert H; Gundersen, Hans Jørgen G; Allan Johnson, G; Kaufmann, Wolfgang; Krinke, Georg; Little, Peter B; Makris, Susan L; Mellon, R Daniel; Sulik, Kathleen K; Jensen, Karl

    2011-01-01

    The continuing education course on Developmental Neurotoxicity Testing (DNT) was designed to communicate current practices for DNT neuropathology, describe promising innovations in quantitative analysis and noninvasive imaging, and facilitate a discussion among experienced neuropathologists and regulatory scientists regarding suitable DNT practices. Conventional DNT neuropathology endpoints are qualitative histopathology and morphometric endpoints of particularly vulnerable sites (e.g., cerebral, cerebellar, or hippocampal thickness). Novel imaging and stereology measurements hold promise for automated analysis of factors that cannot be effectively examined in routinely processed specimens (e.g., cell numbers, fiber tract integrity). The panel recommended that dedicated DNT neuropathology data sets be acquired on a minimum of 8 sections (for qualitative assessment) or 3 sections (for quantitative linear and stereological analyses) using a small battery of stains to examine neurons and myelin. Where guidelines permit discretion, immersion fixation is acceptable for younger animals (postnatal day 22 or earlier), and peripheral nerves may be embedded in paraffin. Frequent concerns regarding DNT data sets include false-negative outcomes due to processing difficulties (e.g., lack of concordance among sections from different animals) and insensitive analytical endpoints (e.g., qualitative evaluation) as well as false-positive results arising from overinterpretation or misreading by inexperienced pathologists. PMID:21075916

  11. Coliform Bacteria Monitoring in Fish Systems: Current Practices in Public Aquaria.

    PubMed

    Culpepper, Erin E; Clayton, Leigh A; Hadfield, Catherine A; Arnold, Jill E; Bourbon, Holly M

    2016-06-01

    Public aquaria evaluate coliform indicator bacteria levels in fish systems, but the purpose of testing, testing methods, and management responses are not standardized, unlike with the coliform bacteria testing for marine mammal enclosures required by the U.S. Department of Agriculture. An online survey was sent to selected aquaria to document current testing and management practices in fish systems without marine mammals. The information collected included indicator bacteria species, the size and type of systems monitored, the primary purpose of testing, sampling frequency, test methods, the criteria for interpreting results, corrective actions, and management changes to limit human exposure. Of the 25 institutions to which surveys were sent, 19 (76%) responded. Fourteen reported testing for fecal indicator bacteria in fish systems. The most commonly tested indicator species were total (86%) and fecal (79%) coliform bacteria, which were detected by means of the membrane filtration method (64%). Multiple types and sizes of systems were tested, and the guidelines for testing and corrective actions were highly variable. Only three institutions performed additional tests to confirm the identification of indicator organisms. The results from this study can be used to compare bacterial monitoring practices and protocols in fish systems, as an aid to discussions relating to the accuracy and reliability of test results, and to help implement appropriate management responses. Received August 23, 2015; accepted December 29, 2015.

  12. Detection and location of leaks in district heating steam systems: Survey and review of current technology and practices

    SciTech Connect

    Kupperman, D.S.; Raptis, A.C.; Lanham, R.N.

    1992-03-01

    This report presents the results of a survey undertaken to identify and characterize current practices for detecting and locating leaks in district heating systems, particular steam systems. Currently used technology and practices are reviewed. In addition, the survey was used to gather information that may be important for the application of acoustic leak detection. A few examples of attempts to locate leaks in steam and hot water pipes by correlation of acoustic signals generated by the leaks are also discussed.

  13. Report to Congress: Summary Report of the Assessment of Current State Practices in Title XX Funded Day Care Programs.

    ERIC Educational Resources Information Center

    Administration for Children, Youth, and Families (DHHS), Washington, DC.

    In 1980 the federal government mandated that assistance be given states to conduct systematic assessment of current practices in Title XX funded day care programs and that a summary report of this assessment be provided to Congress. Assessment findings are given in this document. Overall, provider practices exceeded state licensing standards and…

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

    PubMed

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

    2015-05-01

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

  15. A practical solution in delineating thin conducting structures and suppression problem in direct current resistivity sounding

    NASA Astrophysics Data System (ADS)

    Sharma, Shashi Prakash; Biswas, Arkoprovo

    2013-08-01

    In hard rock areas, conventional apparent resistivity measurement using Schlumberger resistivity sounding fails to detect thin conducting structures (2-D and 3-D fractures filled with groundwater and mineral aggregate) concealed at a large depth. In the present study, an attempt is made to way-out the detection problem of deep seated thin conducting layer. It is proposed to study the apparent conductance simultaneously with resistivity sounding to detect such conductive zones qualitatively. Apparent conductance is defined as the magnitude of current flowing in the subsurface for a unit applied voltage through current electrodes. Even though such measurement is of qualitative importance, it gives extremely valuable information for the presence of conductive zones at depth in challenging hard rock terrain. It has been observed that apparent conductance increases significantly when groundwater bearing fractures and conductive bodies are encountered in the subsurface. Field data from different locations are presented to demonstrate the efficacy of such measurement. The measurement assists to the conventional resistivity sounding for successful prediction of groundwater zones at large depth in different hard rock areas and is of enormous importance. The approach is also used for possible solution of suppression problem in the DC resistivity sounding when intermediate layer is not reflected in the resistivity sounding curve. Finally, the approach can be used together with resistivity sounding to solve many practical problems.

  16. Heterotrophic plate count monitoring of treated drinking water in the UK: a useful operational tool.

    PubMed

    Sartory, David P

    2004-05-01

    The count of general or heterotrophic bacterial populations in treated drinking water in the UK has been undertaken since the 1880s. Counts of heterotrophic bacteria at 22 and 37 degrees C are used widely as part of an overall assessment of treated drinking water quality. There were no legislated standards for water quality in the UK until adoption of the first EU Directive in 1989. The UK has, however, never stipulated numerical standards or guidelines for heterotrophic bacteria, although their enumeration has long been part of the assessment of 'wholesome' water, on which advice regarding microbiological quality was given in a series of documents known as 'Report 71'. The current regulations stipulate only that there should be 'no abnormal change' in numbers normally associated with a given supply. This paper reviews the historical context regarding the enumeration, and interpretation of results, of heterotrophic bacteria from treated drinking water, and information regarding current practices by UK water suppliers. The appropriateness of using heterotrophic bacteria counts as an operational tool or as a health parameter is briefly discussed in the light of the UK experience.

  17. A review of current surgical practice in the operative treatment of proximal humeral fractures

    PubMed Central

    Jones, L. D.; Palmer, A. J. R.; Macnair, R. D.; Brewer, P. E.; Jayadev, C.; Wheelton, A. N.; Ball, D. E. J.; Nandra, R. S.; Aujla, R. S.; Sykes, A. E.; Carr, A. J.

    2016-01-01

    Objectives The PROximal Fracture of the Humerus: Evaluation by Randomisation (PROFHER) trial has recently demonstrated that surgery is non-superior to non-operative treatment in the management of displaced proximal humeral fractures. The objective of this study was to assess current surgical practice in the context of the PROFHER trial in terms of patient demographics, injury characteristics and the nature of the surgical treatment. Methods A total of ten consecutive patients undergoing surgery for the treatment of a proximal humeral fracture from each of 11 United Kingdom hospitals were retrospectively identified over a 15 month period between January 2014 and March 2015. Data gathered for the 110 patients included patient demographics, injury characteristics, mode of surgical fixation, the grade of operating surgeon and the cost of the surgical implants. Results A majority of the patients were female (66%, 73 of 110). The mean patient age was 62 years (range 18 to 89). A majority of patients met the inclusion criteria for the PROFHER trial (75%, 83 of 110). Plate fixation was the most common mode of surgery (68%, 75 patients), followed by intramedullary fixation (12%, 13 patients), reverse shoulder arthroplasty (10%, 11 patients) and hemiarthroplasty (7%, eight patients). The consultant was either the primary operating surgeon or supervising the operating surgeon in a large majority of cases (91%, 100 patients). Implant costs for plate fixation were significantly less than both hemiarthroplasty (p < 0.05) and reverse shoulder arthroplasty (p < 0.0001). Implant costs for intramedullary fixation were significantly less than plate fixation (p < 0.01), hemiarthroplasty (p < 0.0001) and reverse shoulder arthroplasty (p < 0.0001). Conclusions Our study has shown that the majority of a representative sample of patients currently undergoing surgical treatment for a proximal humeral fracture in these United Kingdom centres met the inclusion criteria for the PROFHER trial

  18. Solution-Focused Approaches in the Practice of UK Educational Psychologists: A Study of the Nature of Their Application and Evidence of Their Effectiveness

    ERIC Educational Resources Information Center

    Stobie, Ingeborg; Boyle, James; Woolfson, Lisa

    2005-01-01

    Solution-focused approaches are increasingly widely used in the practice of the applied educational psychologist (EP) (Ajmal and Rees, 2001; Durrant, 1993; Redpath and Harper, 1999; Rhodes and Ajmal, 1995). Based on a small-scale computer-mediated exploratory survey, this article examines the nature of such practice and investigates whether and…

  19. Training Needs of Nurses in Public Hospitals in Australia: Review of Current Practices and Future Research Agenda

    ERIC Educational Resources Information Center

    Carlisle, Joanna; Bhanugopan, Ramudu; Fish, Alan

    2011-01-01

    Purpose: This paper seeks to provide an overview of the concept of training needs analysis (TNA), current practice, models and the impact that training needs analysis currently has on nurses in public hospitals in Australia. Thus, the paper should aid future research in the area of TNA of nurses through helping researchers to clarify the…

  20. 78 FR 11611 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ..., and 211 RIN 0910-AG36 Current Good Manufacturing Practice and Hazard Analysis and Risk- Based... period for the information collection related to the proposed rule on ``Current Good Manufacturing... information collection provisions that are subject to review by the Office of Management and Budget...