Toward a New Industrial America.

ERIC Educational Resources Information Center

Berger, Suzanne; And Others

1989-01-01

Summarizes the positive and negative sides of American industrial practices determined by the Commission on Industrial Productivity at the Massachusetts Institute of Technology. Describes five imperatives recommended by the commission based on its study of current weakness and best practices in American industry. (YP)

Organizational Culture as Determinant of Knowledge Sharing Practices of Teachers Working in Higher Education Sector

ERIC Educational Resources Information Center

Areekkuzhiyil, Santhosh

2016-01-01

The current study aims to explore the influence of organisational culture on the knowledge sharing practices of teachers working in higher education sector. The study hypothesized the impact of various aspects of organisational culture on the knowledge sharing practices of teachers working in higher education sector. The data required for the…

Standards of Practice in Continuing Education: A Status Study. Research Report: CCEU Project for the Development of Standards and Criteria for Good Practice in Continuing Education.

ERIC Educational Resources Information Center

House, Richard M.

A major purpose of this study was to determine the attitudes toward standards of practice and the nature and scope of standards of practice as they currently exist in governmental agencies, professional associations and licensing agencies, business and industry, health-related organizations, and colleges and universities. A second purpose was to…

In-service inspection methods for graphite-epoxy structures on commercial transport aircraft

NASA Technical Reports Server (NTRS)

Phelps, M. L.

1981-01-01

In-service inspection methods for graphite-epoxy composite structures on commercial transport aircraft are determined. Graphite/epoxy structures, service incurred defects, current inspection practices and concerns of the airline and manufacturers, and other related information were determind by survey. Based on this information, applicable inspection nondestructive inspection methods are evaluated and inspection techniques determined. Technology is developed primarily in eddy current inspection.

The role of MRI in musculoskeletal practice: a clinical perspective

PubMed Central

Dean Deyle, Gail

2011-01-01

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

Current trends in nursing theories.

PubMed

Im, Eun-Ok; Chang, Sun Ju

2012-06-01

To explore current trends in nursing theories through an integrated literature review. The literature related to nursing theories during the past 10 years was searched through multiple databases and reviewed to determine themes reflecting current trends in nursing theories. The trends can be categorized into six themes: (a) foci on specifics; (b) coexistence of various types of theories; (c) close links to research; (d) international collaborative works; (e) integration to practice; and (f) selective evolution. We need to make our continuous efforts to link research and practice to theories, to identify specifics of our theories, to develop diverse types of theories, and to conduct international collaborative works. Our paper gives implications for future theoretical development in diverse clinical areas of nursing research and practice. © 2012 Sigma Theta Tau International.

Teacher Behavioral Process Criteria Grading Practices and the Effect on Student Achievement in English and Mathematics

ERIC Educational Resources Information Center

Kahney, Jon

2017-01-01

Teacher grading practices commonly do not align with the grading practices recommended by leading grading authorities in the field of education. The experts advocate for grades to be determined solely from measures of product criteria that represent a students current level of knowledge and what they can do. Most teachers, however, still use a mix…

Perceived determinants of cardiovascular risk management in primary care: disconnections between patient behaviours, practice organisation and healthcare system.

PubMed

Huntink, E; Wensing, M; Klomp, M A; van Lieshout, J

2015-12-15

Although conditions for high quality cardiovascular risk management in primary care in the Netherlands are favourable, there still remains a gap between practice guideline recommendations and practice. The aim of the current study was to identify determinants of cardiovascular primary care in the Netherlands. We performed a qualitative study, using semi-structured interviews with healthcare professionals and patients with established cardiovascular diseases or at high cardiovascular risk. A framework analysis was used to cluster the determinants into seven domains: 1) guideline factors, 2) individual healthcare professional factors, 3) patient factors, 4) professional interaction, 5) incentives and recourses, 6) mandate, authority and accountability, and 7) social, political and legal factors. Twelve healthcare professionals and 16 patients were interviewed. Healthcare professionals and patients mentioned a variety of factors concerning all seven domains. Determinants of practice according to the health care professionals were related to communication between healthcare professionals, patients' lack of knowledge and self-management, time management, market mechanisms in the Dutch healthcare system and motivational interviewing skills of healthcare professionals. Patients mentioned determinants related to their knowledge of risk factors for cardiovascular diseases, medication adherence and self-management as key determinants. A key finding is the mismatch between healthcare professionals' and patients' views on patient's knowledge and self-management. Perceived determinants of cardiovascular risk management were mainly related to patient behaviors and (but only for health professionals) to the healthcare system. Though health care professionals and patients agree upon the importance of patients' knowledge and self-management, their judgment of the current state of knowledge and self-management is entirely different.

Conducting Child Assessments. Technical Report.

ERIC Educational Resources Information Center

McLean, Mary

This report discusses assessment procedures for young children who are culturally and linguistically diverse and describes three practices that the authors feel should be added to the currently recommended DEC practices. In the first place, professionals should gather information prior to assessment to determine whether a child should be referred…

State of the Art of Current Practices for Transit Transfers.

DOT National Transportation Integrated Search

1981-07-01

The major objectives of the study are to: (1) describe and summarize the transfer policies currently in use on U.S. transit properties; (2) identify reasons why properties use or do not use particular transfer policies; (3) determine the consequences...

ICU nurses' oral-care practices and the current best evidence.

PubMed

DeKeyser Ganz, Freda; Fink, Naomi Farkash; Raanan, Ofra; Asher, Miriam; Bruttin, Madeline; Nun, Maureen Ben; Benbinishty, Julie

2009-01-01

The purpose of this study was to describe the oral-care practices of ICU nurses, to compare those practices with current evidence-based practice, and to determine if the use of evidence-based practice was associated with personal demographic or professional characteristics. A national survey of oral-care practices of ICU nurses was conducted using a convenience sample of 218 practicing ICU nurses in 2004-05. The survey instrument included questions about demographic and professional characteristics and a checklist of oral-care practices. Nurses rated their perceived level of priority concerning oral care on a scale from 0 to 100. A score was computed representing the sum of 14 items related to equipment, solutions, assessments, and techniques associated with the current best evidence. This score was then statistically analyzed using ANOVA to determine differences of EBP based on demographic and professional characteristics. The most commonly used equipment was gauze pads (84%), followed by tongue depressors (55%), and toothbrushes (34%). Chlorhexidine was the most common solution used (75%). Less than half (44%) reported brushing their patients' teeth. The majority performed an oral assessment before beginning oral care (71%); however, none could describe what assessment tool was used. Only 57% of nurses reported documenting their oral care. Nurses rated oral care of intubated patients with a priority of 67+/-27.1. Wide variations were noted within and between units in terms of which techniques, equipment, and solutions were used. No significant relationships were found between the use of an evidence-based protocol and demographic and professional characteristics or with the priority given to oral care. While nurses ranked oral care a high priority, many did not implement the latest evidence into their current practice. The level of research utilization was not related to personal or professional characteristics. Therefore attempts should be made to encourage all ICU nurses to introduce and use evidence-based, oral-care protocols. Practicing ICU nurses in this survey were often not adhering to the latest evidence-based practice and therefore need to be educated and encouraged to do so in order to improve patient care.

Current practices for evaluation of resonance disorders in North America.

PubMed

Stelck, Elizabeth Huebert; Boliek, Carol A; Hagler, Paul H; Rieger, Jana M

2011-02-01

Improving treatment outcomes for people with resonance problems (due to velopharyngeal disorders) is a priority for many speech-language pathologists (SLPs), but there exists a limited understanding of the practices SLPs are using to assess and monitor therapeutic effects in this population. The current study was designed to answer the following questions: (1) What are current clinical practices versus best practices for assessing resonance disorders, tracking therapeutic effects, and determining discharge criteria? (2) What assessment practices would SLPs prefer to use with clients who have resonance disorders? (3) What are barriers to SLPs' use of best practices? and (4) What effects do SLP demographics have on clinical practices? Thirty-eight SLPs, specializing in the treatment of resonance disorders, participated in the study. Responses were compared with best practice recommendations derived from the literature. Most clinicians were using low-tech assessment tools, often because they lacked access to high-tech tools. Demographics and training did not affect clinical assessment practices. There is a need to increase the availability of high-tech assessment tools to SLPs practicing in the area of resonance disorders, as consistent use of sophisticated assessment devices would exemplify contemporary thinking about the transfer of knowledge to practice in this area. © Thieme Medical Publishers.

Administrative Coaching Practices: Content, Personalization, and Support

ERIC Educational Resources Information Center

Hayashi, Christine A.

2016-01-01

This study surveys educators who have completed, or are in their second year of, an administrative coaching program that results in a California Clear Administrative Credential, also known as Tier II. The purpose of the study is to determine the perceptions of these educators regarding whether current practices in administrative coaching programs…

Quality Special Education Programs: The Role of Transformational Leadership

ERIC Educational Resources Information Center

Clinton, Demi

2013-01-01

The purpose of this quantitative study was to determine whether or not a relationship existed between principals who demonstrate transformational leadership traits and six different quality practices in their special education program. Effective principals must know and understand special education laws, practices, and current issues, but evidence…

The Customer Relationship Management in Terms of Business Practice in Slovakia

NASA Astrophysics Data System (ADS)

Urdziková, Jana; Jakábová, Martina; Saniuk, Sebastian

2012-12-01

The aim of the article is to present the results of the research on focus on the customer in relation to the use of customer relationship management in selected business subjects in Slovakia. The main goal of the research is the mapping of current state to ensure the principle of customer orientation and utilizing of CRM in organizations and industrial enterprises in Slovakia. This is the mapping of the current situation of that problem in practical conditions and determines potential opportunities for improvement.

48 CFR 30.202-7 - Determinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Impoverishment of practice: analysis of effects of economic discourses in home care case management practice.

PubMed

Ceci, Christine

2006-03-01

Home care is a health sector under increasing pressure. Demand is often said to be outstripping capacity, with constant change and retrenchment distinguishing features of the current context. This paper takes a reading of the current conditions of home care using data gathered during a field study of home care case management practices conducted in 2004. As economic discourses become increasingly influential in determining responses to client situations, case managers (and their managers) find themselves with limited capacity to exercise control over their practices. A growing gap between professionally influenced discourses--those presumably intended to guide practice--and organizational priorities creates a dissonance for case managers as the political-ethical dimensions of their practices are displaced by budget "realities." For front-line workers, such displacement cannot be sustained in their face-to-face encounters with clients, leading to a growing sense of frustration and powerlessness among these highly skilled practitioners.

Adolescents' physical activity is associated with previous and current physical activity practice by their parents.

PubMed

Christofaro, Diego Giulliano Destro; Andersen, Lars Bo; Andrade, Selma Maffei de; Barros, Mauro Virgílio Gomes de; Saraiva, Bruna Thamyres Ciccotti; Fernandes, Rômulo Araújo; Ritti-Dias, Raphael Mendes

The purpose of this study was to determine whether parents' current and previous physical activity practice is associated with adolescents' physical activity. The sample was composed of 1231 adolescents (14-17 years), and 1202 mothers and 871 fathers were interviewed. Weight and height of the adolescents were measured. Self-reported parents' weight and height were obtained. The current and previous physical activity levels (Baecke's questionnaire) of parents (during childhood and adolescence) and adolescents' physical activity levels were obtained using a questionnaire. The magnitude of the associations between parent and adolescent physical activity levels was determined by binary logistic regression (adjusted by sex, age, and socioeconomic level of adolescents and education level of parents). The current physical activity practice by parents was associated with adolescents' physical activity (p<0.001). The physical activities reported by parents in their childhood and adolescence were also associated with higher physical activity levels among adolescents. Adolescents whose parents were both physically active in the past and present were six times (OR=6.67 [CI=1.94-22.79]) more likely to be physically active compared to adolescents with no parents who were physically active in the past. The current and previous physical activities of parents were associated with higher levels of physical activity in adolescents, even after controlling for confounding factors. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Current Options for Determining Fracture Union

PubMed Central

2014-01-01

Determining whether a bone fracture is healed is one of the most important and fundamental clinical determinations made in orthopaedics. However, there are currently no standardized methods of assessing fracture union, which in turn has created significant disagreement among orthopaedic surgeons in both clinical and research settings. An extensive amount of research has been dedicated to finding novel and reliable ways of determining healing with some promising results. Recent advancements in imaging techniques and introduction of new radiographic scores have helped decrease the amount of disagreement on this topic among physicians. The knowledge gained from biomechanical studies of bone healing has helped us refine our tools and create more efficient and practical research instruments. Additionally, a deeper understanding of the molecular pathways involved in the bone healing process has led to emergence of serologic markers as possible candidates in assessment of fracture union. In addition to our current physician centered methods, patient-centered approaches assessing quality of life and function are gaining popularity in assessment of fracture union. Despite these advances, assessment of union remains an imperfect practice in the clinical setting. Therefore, clinicians need to draw on multiple modalities that directly and indirectly measure or correlate with bone healing when counseling patients. PMID:26556422

Dimensions of Questioning: A Qualitative Study of Current Classroom Practice in Malaysia

ERIC Educational Resources Information Center

Hussin, Habsah

2006-01-01

This study investigated questioning as practiced in Malaysian secondary school classrooms, to determine teachers' rationale for adopting certain techniques of questioning, and to use the findings to inform teacher education. Questioning is a central aspect of any classroom interaction as it serves so many functions but it is still an…

Observed Food Safety Practices in the Summer Food Service Program

ERIC Educational Resources Information Center

Patten, Emily Vaterlaus; Alcorn, Michelle; Watkins, Tracee; Cole, Kerri; Paez, Paola

2017-01-01

Purpose/Objectives: The purpose of this exploratory, observational study was three-fold: 1) Determine current food safety practices at Summer Food Service Program (SFSP) sites; 2) Identify types of food served at the sites and collect associated temperatures; and 3) Establish recommendations for food safety training in the SFSP.…

Effective School Board Governance Behaviors of Montana School Board Members: A Delphi Study

ERIC Educational Resources Information Center

Rocksund, Jill Ann

2017-01-01

School board governance matters. Past research has demonstrated that effective school boards are associated with higher student achievement. However, this research has been less clear about what those agreed upon effective practices are. The current study set out to identify effective school board governance practices and to determine the extent…

Does Psychiatry Residency Training Reflect the "Real World" of Psychiatry Practice? A Survey of Residency Graduates

ERIC Educational Resources Information Center

Petersen, Timothy; Fava, Maurizio; Alpert, Jonathan E.; Vorono, Sienna; Sanders, Kathy M.; Mischoulon, David

2007-01-01

Objective: The authors determine whether Massachusetts General Hospital's residency graduates believed their training reflected their current practice activities. Method: The authors surveyed 134 graduates from MGH and MGH-McLean residency classes from 1983 to 2003. Subjects ranked their satisfaction with different components of training on a…

Defining Continuous Improvement and Cost Minimization Possibilities through School Choice Experiments

ERIC Educational Resources Information Center

Merrifield, John

2009-01-01

Studies of existing best practices cannot determine whether the current "best" schooling practices could be even better, less costly, or more effective and/or improve at a faster rate, but we can discover a cost effective menu of schooling options and each item's minimum cost through market accountability experiments. This paper describes…

Evidence-Based Practices in Public School Programs for Young Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Herzog, Tania

2011-01-01

This study surveyed 77 special education teachers currently instructing elementary aged students diagnosed with Autism Spectrum Disorders to determine the extent of evidence-based practices utilized within public school programs. In addition, the survey examined the pre-service and on-going training these teachers receive to prepare them to…

76 FR 67130 - Bridger-Teton National Forest; Big Piney Ranger District; Wyoming; Environmental Impact Statement...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... Management Project AGENCY: Forest Service, USDA. ACTION: Notice of intent to prepare an environmental impact... current levels is appropriate, and to determine if current livestock management practices are sufficient for achieving and maintaining compliance with the 1990 Bridger-Teton Land and Resource Management Plan...

The Current State of Marketing Activity among Higher Education Institutions.

ERIC Educational Resources Information Center

Newman, Cynthia M.

2002-01-01

Investigated the current state of marketing, marketing research, and planning practices at four-year higher education institutions. Builds upon previous studies by Blackburn (1979) and Goldgehn (1982 and 1989). Determined whether the use and apparent understanding of marketing and its attendant activities by admissions and enrollment management…

A Document Analysis of Teacher Evaluation Systems Specific to Physical Education

ERIC Educational Resources Information Center

Norris, Jason M.; van der Mars, Hans; Kulinna, Pamela; Kwon, Jayoun; Amrein-Beardsley, Audrey

2017-01-01

Purpose: The purpose of this document analysis study was to examine current teacher evaluation systems, understand current practices, and determine whether the instrumentation is a valid measure of teaching quality as reflected in teacher behavior and effectiveness specific to physical education (PE). Method: An interpretive document analysis…

Evaluating best practices for Campylobacter and Salmonella reduction in poultry processing plants.

PubMed

Wideman, N; Bailey, M; Bilgili, S F; Thippareddi, H; Wang, L; Bratcher, C; Sanchez-Plata, M; Singh, M

2016-02-01

Poultry processing plants in the United States were surveyed on their current Campylobacter and Salmonella control practices. Following surveys, data were collected to develop a baseline for prevalence rates of Salmonella and Campylobacter; then changes in practices were implemented and evaluated for improvements in pathogen control. Surveys were sent to the plant Quality Assurance managers to determine production levels, antimicrobial interventions, and current pathogen testing practices. Initial sampling was performed at 6 plants with similar production volumes, at sites that included carcass samples before any pre-evisceration intervention, after exiting the inside-outside bird washer (IOBW), after exiting the pre-chiller, after exiting the primary chiller, and after exiting any post-chill intervention, as well as a water sample from each scalder, pre-chiller, primary chiller, and post-chill dip tank or finishing chiller. Enumerations and enrichments were performed for Campylobacter and Salmonella. Following the baseline sampling, changes in practices were suggested for each plant and a second sampling was conducted to determine their effectiveness. Results demonstrated that peracetic acid (PAA) was the most effective (P < 0.05) antimicrobial currently in use. The use of a post-chill antimicrobial immersion tank and/or use of a cetylpyridinium chloride (CPC) spray cabinet also displayed a further reduction in microbial levels (P < 0.05) when the primary chiller was not sufficient (P > 0.05). Microbial buildup in the immersion tanks demonstrates the need for effective cleaning, sanitation practices, and chiller maintenance to reduce contamination of poultry with Campylobacter and Salmonella. © 2015 Poultry Science Association Inc.

Nutritional practices and growth velocity in the first month of life in extremely low gestational age newborns

PubMed Central

Martin, Camilia R.; Brown, Yolanda F.; Ehrenkranz, Richard A.; O'Shea, T. Michael; Allred, Elizabeth N.; Belfort, Mandy B.; McCormick, Marie C.; Leviton, Alan

2010-01-01

OBJECTIVES The goals of this study were to describe nutritional practices in the first month of life for a large cohort of extremely low gestational age newborns and to determine the impact of these nutritional practices on growth velocity over the same period. METHODS The sample included 1187 infants born at 23 weeks to 27 weeks of gestation, at 14 institutions, between 2002 and 2004. Inclusion criteria included survival until day 28 and weight information for both day 7 and day 28. Growth velocity, expressed as grams per kilogram per day (g/kg/day), was calculated for the interval between days 7 and 28. Nutritional practices during the first week and on days 14, 21, and 28 were compared to current nutritional guidelines in the literature. Multivariable logistic regression models estimated the contribution of limited nutrition to limited growth velocity. RESULTS Protein and fat delivery approximated current nutritional recommendations while carbohydrate and total caloric delivery did not. Despite this, growth velocity of our study infants exceeded the current guideline of 15 g/kg/day. Nevertheless, we found extrauterine growth restriction (i.e., weight for gestational age below the 10th centile) in 75% of infants at 28 days, as compared to only 18% at birth. A growth velocity of 20-30 g/kg/day was associated with infants' maintaining or exceeding their birth weight Z-score, with rates in the upper range for the gestationally youngest infants. Early (day 7) nutritional practices were positively associated with growth velocity measured between days 7 and 28. CONCLUSION The early provision of nutrients is an important determinant of postnatal growth. Extrauterine growth restriction remains high in extremely premature infants even when they achieve a growth velocity rate within current guidelines. PMID:19651583

Assessment practices of professionals serving students who are deaf or hard of hearing: an initial investigation.

PubMed

Luckner, John L; Bowen, Sandy

2006-01-01

Assessment currently plays a critical role in American schools and society, in tasks ranging from ranking schools' effectiveness, to determining individual placement, to planning instruction. The purpose of the study was to gather data about the formal and informal assessment instruments and processes used by professionals in deaf education. Respondents indicated that statewide annual assessments are the most frequently used measures, followed by the Stanford Achievement Test series and the Woodcock-Johnson III Test of Achievement. Commonly used assessment instruments and procedures for each academic area are reported in rank order. Issues about current practices are raised, and suggestions for additional research related to assessment practices in deaf education are provided.

[Perception of health and safety risks among workers pathology laboratories].

PubMed

Alvarado-Cabrero, Isabel; Valencia-Cedillo, Raquel

2015-01-01

Health care workers are experiencing increasing numbers of occupational illnesses. Safety practices in anatomical pathology laboratories (APL) are crucial to prevent unnecessary exposures to both chemical and biological agents. The main goal of this study was to determine if pathologists perceptions and actual practice mirror regulatory guidelines. Current available recommendations for APL were reviewed and used to construct an online survey distributed to pathologists. The survey was completed by 121 participants. Eighty-seven (72 %) of respondents reported receiving inadequate safety training. Most pathologists (82 %) were not well-informed about biosafety practices. Sixty-three (52 %) participants felt that the risks of chemical and infectious disease exposures in the APL were low. Most respondents reported having a needle stick or cut (71 %). Eighty-six (71 %) of participants reported musculo skeletal problems. This study indicated that there is a need for improving training in anatomical pathology safety practices in Mexican laboratories as daily practices do not reflected current guidelines.

Standardized Predictive Testing: Practices, Policies, and Outcomes

ERIC Educational Resources Information Center

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

2014-01-01

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

The Effects of Out-of-School Suspension on High School Students: An Inside View

ERIC Educational Resources Information Center

Scelso, Alicia K.

2013-01-01

This study examined the effects of out-of-school suspension on high school students. Its purpose was to determine if exclusionary discipline practices led to negative consequences such as poor academic achievement and juvenile delinquency. The study also hoped to generate new insight into current disciplinary practices in order to yield a better…

Assessing Suturing Skills in a Self-Guided Learning Setting: Absolute Symmetry Error

ERIC Educational Resources Information Center

Brydges, Ryan; Carnahan, Heather; Dubrowski, Adam

2009-01-01

Directed self-guidance, whereby trainees independently practice a skill-set in a structured setting, may be an effective technique for novice training. Currently, however, most evaluation methods require an expert to be present during practice. The study aim was to determine if absolute symmetry error, a clinically important measure that can be…

Educational Preparation for the Role of the School Nurse: Perceptions of School Nurses in Washington State

ERIC Educational Resources Information Center

Newell, Mary E.

2013-01-01

The purpose of this quantitative research study was to identify the perceptions of currently practicing school nurses regarding their baccalaureate nursing education and determine if they felt adequately prepared to effectively practice in the role of a school nurse. A descriptive, quantitative on-line survey was conducted of Washington State…

Pedagogical Practices and Counselor Self-Efficacy: A Mixed Methods Investigations

ERIC Educational Resources Information Center

Brogan, Justin R.

2009-01-01

The current study investigated the Lecture Teaching Method and Socratic Teaching Method to determine if there was a relationship between pedagogical methods and Counselor Self-Efficacy (CSE). A course in Advanced Professional Development was utilized to determine if teaching methods could affect student perceptions of competence to practice…

A Comparative Study Concerning Administrative Aspects of Elementary Off-Campus Student Teaching Programs: Current Practices and Proposed Patterns.

ERIC Educational Resources Information Center

Armstrong, Robert J.

A study was made to determine the current status of selected administrative areas of student teaching programs in Massachusetts and cooperative student teaching programs throughout the nation, the desirability of establishing cooperative programs in Massachusetts, and the organization and impelementation of these programs. Specific administrative…

Determining Effective Teaching Behaviors through the Hiring Process

ERIC Educational Resources Information Center

Schumacher, Gary; Grigsby, Bettye; Vesey, Winona

2015-01-01

Purpose: One bad hiring decision can lead to low student achievement. Research supports that teachers are the most influential factor in student success. As a result, principals' current practice of hiring teachers based on intuition and likeability must change. Given the current high stakes era, principals need reassurance that the teachers they…

Has the Construct "Intelligence" Determined Our Perception of Cognitive Hierarchy?

ERIC Educational Resources Information Center

Fuller, Renee

The discovery that retarded children can learn to read with comprehension suggests a critique of current educational testing and teaching practices. IQ tests, consisting of segmental, out-of-context tasks, originally were based on turn-of-the-century educational techniques that emphasized rote and segmental learning. Currently, most IQ tests still…

A Review of Meta-Analyses in Education: Methodological Strengths and Weaknesses

ERIC Educational Resources Information Center

Ahn, Soyeon; Ames, Allison J.; Myers, Nicholas D.

2012-01-01

The current review addresses the validity of published meta-analyses in education that determines the credibility and generalizability of study findings using a total of 56 meta-analyses published in education in the 2000s. Our objectives were to evaluate the current meta-analytic practices in education, identify methodological strengths and…

An independent Cepheid distance scale: Current status

NASA Technical Reports Server (NTRS)

Barnes, T. G., III

1980-01-01

An independent distance scale for Cepheid variables is discussed. The apparent magnitude and the visual surface brightness, inferred from an appropriate color index, are used to determine the angular diameter variation of the Cepheid. When combined with the linear displacement curve obtained from the integrated radial velocity curve, the distance and linear radius are determined. The attractiveness of the method is its complete independence of all other stellar distance scales, even though a number of practical difficulties currently exist in implementing the technique.

Roadwaste : issues and options.

DOT National Transportation Integrated Search

1998-06-01

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

Values and principles evident in current health promotion practice.

PubMed

Gregg, Jane; O'Hara, Lily

2007-04-01

Modern health promotion practice needs to respond to complex health issues that have multiple interrelated determinants. This requires an understanding of the values and principles of health promotion. A literature review was undertaken to explore the values and principles evident in current health promotion theory and practice. A broad range of values and principles are espoused as being integral to modern health promotion theory and practice. Although there are some commonalities across these lists, there is no recognised, authoritative set of values and principles accepted as fundamental and applicable to modern health promotion. There is a continuum of values and principles evident in health promotion practice from those associated with holistic, ecological, salutogenic health promotion to those more in keeping with conventional health promotion. There is a need for a system of values and principles consistent with modern health promotion that enables practitioners to purposefully integrate these values and principles into their understanding of health, as well as their needs assessment, planning, implementation and evaluation practice.

A Standard of Knowledge for the Professional Practice of Toxicology.

PubMed

Hulla, Janis E; Kinter, Lewis B; Kelman, Bruce

2015-08-01

Employers, courts, and the general public judge the credibility of professionals based on credentials such as academic degrees, publications, memberships in professional organizations, board certifications, and professional registrations. However, the relevance and merit of these credentials can be difficult to determine objectively. Board certification can be a reliable indicator of proficiency if the certifying organization demonstrates, through regularly scheduled independent review, that its processes meet established standards and when a certificate holder is required to periodically demonstrate command of a body of knowledge that is essential to current professional practice. We report herein a current Standard of Knowledge in general toxicology compiled from the experience and opinions of 889 certified practicing professional toxicologists. An examination is the most commonly used instrument for testing a certification candidate's command of the body of knowledge. However, an examination-based certification is only creditable when the body of knowledge, to which a certification examination tests, is representative of the current knowledge, skills, and capabilities needed to effectively practice at the professional level. Thus, that body of knowledge must be the current "Standard of Knowledge" for the profession, compiled in a transparent fashion from current practitioners of the profession. This work was conducted toward ensuring the scientific integrity of the products produced by professional toxicologists.

Optical Information Processing for Aerospace Applications

NASA Technical Reports Server (NTRS)

1981-01-01

Current research in optical processing is reviewed. Its role in future aerospace systems is determined. The development of optical devices and components demonstrates that system concepts can be implemented in practical aerospace configurations.

30 CFR 810.2 - Objective.

Code of Federal Regulations, 2013 CFR

2013-07-01

... practicable with mining operations; (e) Minimizing, to the extent possible using the best technology currently... threatened species and their critical habitats as determined by the Endangered Species Act of 1973 (16 U.S.C...

30 CFR 810.2 - Objective.

Code of Federal Regulations, 2011 CFR

2011-07-01

... practicable with mining operations; (e) Minimizing, to the extent possible using the best technology currently... threatened species and their critical habitats as determined by the Endangered Species Act of 1973 (16 U.S.C...

30 CFR 810.2 - Objective.

Code of Federal Regulations, 2014 CFR

2014-07-01

... practicable with mining operations; (e) Minimizing, to the extent possible using the best technology currently... threatened species and their critical habitats as determined by the Endangered Species Act of 1973 (16 U.S.C...

30 CFR 810.2 - Objective.

Code of Federal Regulations, 2012 CFR

2012-07-01

... practicable with mining operations; (e) Minimizing, to the extent possible using the best technology currently... threatened species and their critical habitats as determined by the Endangered Species Act of 1973 (16 U.S.C...

A Survey of Rank, Salary, Promotion, and Tenure Policies in Fifteen Colleges and Universities. A Survey of Current Practices.

ERIC Educational Resources Information Center

Southeast Missouri State Univ., Cape Girardeau.

Questionnaires designed to find out how institutional policies for evaluating special degrees affected institutional practices in determining initial rank, salary level, tenure status, and eligibility for promotion of faculty members were sent to 27 institutions. The special degrees fell in 4 categories: (1) faculty members with a degree in law…

e-Portfolio as Reflection Tool during Teaching Practice: The Interplay between Contextual and Dispositional Variables

ERIC Educational Resources Information Center

Carl, Arend; Strydom, Sonja

2017-01-01

This paper focuses on an e-portfolio pilot initiative at the Faculty of Education at a South African university and aims to determine whether the theoretical underpinning and expectations of an e-portfolio aligns with the current practices and attributes of students' training during school practicum as teachers at a South African university. In…

Best practices for interacting with the public about wildland fire: Key findings from interviews

Treesearch

Daniel Berkman

2012-01-01

Interviews were conducted with public information and line officers about wildland fire communications with the public. The goal of these interviews was to determine the best practices and most useful content and format for an annotated bibliography about external wildland fire communications, i.e., does the current literature reviewed address the issues of greatest...

1983 Home Study Survey. A Report on Current Course Structure and Educational Practices in NHSC Member Institutions.

ERIC Educational Resources Information Center

National Home Study Council, Washington, DC.

A study examined the course structure and educational practices used by National Home Study Council (NHSC) member institutions. To gather data for the study, researchers mailed questionnaires to 60 members of the NHSC. Based on data from the 51 usable responses, the researchers determined that the average age of students enrolled in programs…

Organisational determinants of production and efficiency in general practice: a population-based study.

PubMed

Olsen, Kim Rose; Gyrd-Hansen, Dorte; Sørensen, Torben Højmark; Kristensen, Troels; Vedsted, Peter; Street, Andrew

2013-04-01

Shortage of general practitioners (GPs) and an increased political focus on primary care have enforced the interest in efficiency analysis in the Danish primary care sector. This paper assesses the association between organisational factors of general practices and production and efficiency. We assume that production and efficiency can be modelled using a behavioural production function. We apply the Battese and Coelli (Empir Econ 20:325-332, 1995) estimator to accomplish a decomposition of exogenous variables to determine the production frontier and variables determining the individual GPs distance to this frontier. Two different measures of practice outputs (number of office visits and total production) were applied and the results compared. The results indicate that nurses do not substitute GPs in the production. The production function exhibited constant returns to scale. The mean level of efficiency was between 0.79 and 0.84, and list size was the most important determinant of variation in efficiency levels. Nurses are currently undertaking other tasks than GPs, and larger practices do not lead to increased production per GP. However, a relative increase in list size increased the efficiency. This indicates that organisational changes aiming to increase capacity in general practice should be carefully designed and tested.

Industry Training: The Factors that Affect Demand. Discussion Paper.

ERIC Educational Resources Information Center

Smith, A.; Roberts, P.; Noble, C.; Hayton, G.; Thorne, E.

A study was conducted in Australia, to determine the factors that affect demand for job training. The study consisted of 30 detailed industry case studies, an industry analysis, and a literature review. Each case study examined current training practices, training decision making in the business, and the determinants of training for the…

Current Practices in Instruction in the Literary Braille Code University Personnel Preparation Programs

ERIC Educational Resources Information Center

Rosenblum, L. Penny; Lewis, Sandra; D'Andrea, Frances Mary

2010-01-01

University instructors were surveyed to determine the requirements for their literary braille courses. Twenty-one instructors provided information on the textbooks they used; how they determined errors; reading proficiency requirements; and other pertinent information, such as methods of assessing mastery of the production of braille using a…

CPT Special Report: Survey of Ph.D. Programs in Chemistry.

ERIC Educational Resources Information Center

Journal of Chemical Education, 1997

1997-01-01

Presents preliminary results from a survey taken by the American Chemical Society (ACS) Committee on Professional Training (CPT) to determine the current practices among 155 Ph.D. programs in chemistry. (DKM)

Longer Lasting Bridge Deck Overlays

DOT National Transportation Integrated Search

2018-04-01

The objective of this report is to determine the most effective method for bridge deck overlay construction and repair by assessing current practices; examining new products and technologies; and reviewing NCHRP (National Cooperative Highway Research...

Impacts of proposed RCRA regulations and other related federal environmental regulations on fossil fuel-fired facilities: Final report, Volume 3

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

Not Available

1987-03-01

Estimation of the costs associated with implementation of the Resource Conservation and Recovery Act (RCRA) regulations for non-hazardous and hazardous material disposal in the utility industry are provided. These costs are based on engineering studies at a number of coal-fired power plants in which the costs for hazardous and non-hazardous disposal are compared to the costs developed for the current practice design for each utility. The relationship of the three costs is displayed. The emphasis of this study is on the determination of incremental costs rather than the absolute costs for each case (current practice, non-hazardous, or hazardous). For themore » purpose of this project, the hazardous design cost was determined for both minimum and maximum compliance.« less

Characteristics of Queensland physicians and the influence of rural exposure on practice location.

PubMed

Runge, C E; MacKenzie, A; Loos, C; Waller, M; Gabbett, M; Mills, R; Eley, D

2016-08-01

The Queensland branch of the Royal Australasian College of Physicians (RACP) commissioned this study to update their workforce profile and examine rural practice. The present investigation aimed to describe characteristics of Queensland physicians and determine the influence of childhood and training locations on current rural practice. A cross-sectional online survey, conducted 4 July-4 November 2013, was administered to Fellows of The RACP, Queensland. Descriptive statistics report characteristics and logistic regression analyses identify associations and interactions. The outcome measure was current practice location using the Australian Standard Geographic Classification - Remoteness Area. Data were obtained for 633 physicians. Their average age was 49.5 years, a third was female and a quarter was in rural practice. Rural practice was associated with a rural childhood (odds ratio (OR) (95% confidence interval, CI) 1.89 (1.10, 3.27) P = 0.02) and any time spent as an intern (OR 4.07 (2.12, 7.82) P < 0.001) or registrar (OR 4.00 (2.21, 7.26) P < 0.001) in a rural location. Physicians with a rural childhood and rural training were most likely to be in rural practice. However, those who had a metropolitan childhood and a rural internship were approximately five times more likely to be working in rural practice than physicians with no rural exposure (OR 5.33 (1.61, 17.60) P < 0.01). The findings demonstrate the positive effect of rural vocational training on rural practice. A prospective study would determine if recent changes to the Basic Physician Training Pathway and the Basic Paediatric Training Network (more rural training than previous pathways) increases the rate of rural practice. © 2016 Royal Australasian College of Physicians.

Business and Practice Management Knowledge Deficiencies in Graduating Orthopedic Residents.

PubMed

Miller, D Joshua; Throckmorton, Thomas W; Azar, Frederick M; Beaty, James H; Canale, S Terry; Richardson, David R

2015-10-01

We conducted a study to determine the general level of knowledge that orthopedic residents have on business and practice management topics at graduation and to evaluate the level of knowledge that practicing orthopedic surgeons need in order to function effectively in a medical practice. Residency graduates from a single training program were asked to complete a survey that gathered demographic information and had surgeons rate their understanding of 9 general business and practice management skills and the importance of these skills in their current practice situation. The amount of necessary business knowledge they lacked at graduation was defined as a functional knowledge deficiency (FKD) and was calculated as the difference between the reported importance of a topic in current practice and the level of understanding of that topic at graduation (larger FKD indicates greater deficiency). Those in physician-managed practices reported significantly higher levels of understanding of economic analytical tools than those in nonphysician-managed practices. There were no other statistically significant differences among groups. Hospital-employed physicians had the lowest overall FKD (4.0), followed by those in academic practices (5.1) and private practices (5.9). Graduating orthopedic surgeons appear to be inadequately prepared to effectively manage business issues in their practices, as evidenced by the low overall knowledge levels and high FKDs.

A Standard of Knowledge for the Professional Practice of Toxicology

PubMed Central

Kinter, Lewis B.; Kelman, Bruce

2015-01-01

Background Employers, courts, and the general public judge the credibility of professionals based on credentials such as academic degrees, publications, memberships in professional organizations, board certifications, and professional registrations. However, the relevance and merit of these credentials can be difficult to determine objectively. Board certification can be a reliable indicator of proficiency if the certifying organization demonstrates, through regularly scheduled independent review, that its processes meet established standards and when a certificate holder is required to periodically demonstrate command of a body of knowledge that is essential to current professional practice. Objective We report herein a current Standard of Knowledge in general toxicology compiled from the experience and opinions of 889 certified practicing professional toxicologists. Discussion An examination is the most commonly used instrument for testing a certification candidate’s command of the body of knowledge. However, an examination-based certification is only creditable when the body of knowledge, to which a certification examination tests, is representative of the current knowledge, skills, and capabilities needed to effectively practice at the professional level. Thus, that body of knowledge must be the current “Standard of Knowledge” for the profession, compiled in a transparent fashion from current practitioners of the profession. Conclusion This work was conducted toward ensuring the scientific integrity of the products produced by professional toxicologists. Citation Hulla JE, Kinter LB, Kelman B. 2015. A Standard of Knowledge for the professional practice of toxicology. Environ Health Perspect 123:743–748; http://dx.doi.org/10.1289/ehp.1408643 PMID:25782181

Factors influencing Dutch practice nurses' intention to adopt a new smoking cessation intervention.

PubMed

Leitlein, Lisa; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2012-10-01

This article is a report of a study that aimed to identify factors influencing practice nurses' and nurse practitioners' intention to adopt a new smoking cessation intervention. Although effective smoking cessation interventions exist and practice nurses can offer a considerable resource in advertising patients to quit smoking, due to several reasons the majority of practice nurses do not implement these interventions. A cross-sectional study was undertaken among Dutch practice nurses and nurse practitioners working in general practices (n = 139) using electronic questionnaires. Data were collected from January until March in 2009. T-tests were used to compare adopters with non-adopters about their predisposing and motivational factors. Logistic regression analyses were conducted to assess the variation in intention explained by these factors. The majority of practice nurses did not intend to adopt the new intervention (n = 85; 61.2%). More practice nurses than nurse practitioners intended to adopt the intervention. Attitude and perceived social norms were found to be positively correlated with the intention to adopt the intervention whereas satisfaction with current smoking cessation activities was found to be negatively correlated. Important associations were found between profession, attitude, social norms and satisfaction, and the intention to adopt the new smoking cessation intervention. Practice nurses who do not intend to adopt need to be persuaded of the advantages of adopting. Perceived social norms need to be restructured and before presenting the intervention to a general practice current smoking cessation activities should be determined to increase the intervention's compatibility with these current practices. © 2011 Blackwell Publishing Ltd.

A comparison of current practice patterns of US dermatologists versus published guidelines for the biopsy, initial management, and follow up of patients with primary cutaneous melanoma.

PubMed

Farberg, Aaron S; Rigel, Darrell S

2016-12-01

Guidelines exist for the management of cutaneous malignant melanoma, but their adoption, prevalence, and impact have not yet been determined. To determine current melanoma clinical management practices of US dermatologists and the variance from guidelines that might exist. A cross-sectional e-mail survey study assessing preferred biopsy methods for lesions suspicious for melanoma, margins used for excision, and recommended follow-up intervals were sent to 6177 US dermatologists (540 responding). The representative nature of the responding subset was verified by comparing their demographics to that from the American Academy of Dermatology (AAD) membership. Management varied from published guidelines. Shave biopsy (35%) was the most commonly used method followed by narrow excisional biopsy (31%), saucerization/scoop shave (12%), punch (11%), and wide excision (3%). Excisional margins narrower than recommended were noted and follow-up intervals varied. There were significant management differences noted for dermatologists by practice setting and by years in practice. The impact of patient history, lesion anatomic site, and size of lesion were not assessed. Recall and nonresponder sampling bias may exist. Variations in dermatologists' approaches to melanoma management and variance from current guidelines suggest that a knowledge gap may exist representing an educational opportunity. However, emerging data may also justify deviations from existing guidelines, suggesting a reassessment of the guidelines may be indicated. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Survey of transit bus maintenance programs in Virginia.

DOT National Transportation Integrated Search

1981-01-01

Transit bus maintenance practices as used by thirteen small and medium-sized transit systems in Virginia were cataloged. Different approaches to maintenance were investigated and the current condition of transit bus maintenance was determined. Factor...

How To Make a Curriculum: The 1987 Guidelines for Curriculum Development in the Norwegian High School--A New Paradigma in Curriculum Development Practice?

ERIC Educational Resources Information Center

Gundem, Bjorg B.

This paper relates to a research project on the history and current practice of curriculum administration in Norway. An elaboration is provided on the changing high school system and the growing impact of curriculum scholarship on curriculum development. The discussion revolves around three objectives: (1) to determine if the newly formulated set…

Determining an Effective Intervention within a Brief Experimental Analysis for Reading: A Meta-Analytic Review

ERIC Educational Resources Information Center

Burns, Matthew K.; Wagner, Dana

2008-01-01

The current study applied meta-analytic procedures to brief experimental analysis research of reading fluency interventions to better inform practice and suggest areas for future research. Thirteen studies were examined to determine what magnitude of effect was needed to identify an intervention as the most effective within a brief experimental…

Social Determinants in Communication Events in a Small Bilingual Community in New Mexico.

ERIC Educational Resources Information Center

Oliver, Joseph D.

The purpose of this report is to present an outline of actual occurrences in communication and their social determinants in the small Spanish-English bilingual community of Los Ojos, New Mexico, with some emphasis on difference in occurrences as related to age. These generalizations are linked to past and current educational practices and social…

21 CFR 111.75 - What must you do to determine whether specifications are met?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false What must you do to determine whether specifications are met? 111.75 Section 111.75 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN...

Effects of Collaborative Consultative Services for Students Who Are Deaf and Hard of Hearing

ERIC Educational Resources Information Center

Kiske, Katie

2017-01-01

The purpose of this research was to determine the perception of consultative services as well as the self-efficacy of both teachers of the deaf and general education teachers that work with students who are D/HH. This study investigated current perceptions and attitudes as well as identified trends in current consultative practice between teachers…

Current State of Inclusion of Children with Special Needs in Child Care Programmes in One Canadian Province

ERIC Educational Resources Information Center

Wiart, Lesley; Kehler, Heather; Rempel, Gwen; Tough, Suzanne

2014-01-01

Background: Access to quality child care is an important support for families with children with disabilities. The objectives of this study were to determine: (1) the current state of inclusion of children with special needs in child care programmes, and (2) the presence of child care staff practices and programme characteristics that support…

Expert system verification and validation survey, delivery 4

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

Expert system verification and validation survey. Delivery 2: Survey results

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and industry applications. This is the first task of the series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

Expert system verification and validation survey. Delivery 5: Revised

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

Expert system verification and validation survey. Delivery 3: Recommendations

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to determine the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of ESs.

Comparison of urban and rural general surgeons: motivations for practice location, practice patterns, and education requirements.

PubMed

Heneghan, Steven J; Bordley, James; Dietz, Patrick A; Gold, Michael S; Jenkins, Paul L; Zuckerman, Randall J

2005-11-01

The purpose of this study is to determine the differences between rural and urban surgeons with regard to practice patterns, factors in choosing a practice location, and educational needs. A list of surgeons obtained from the American Medical Association was examined using the Office of Management and Budget definition of rural. Seventeen hundred rural surgeons were mailed surveys; 421 responded. One hundred fourteen urban surgeons were contacted by telephone. Questions were designed to measure job and community satisfaction, factors influencing their decision to practice in their current location, spectrum and volume of cases, and their perceived educational needs. Age distribution did not differ markedly between urban and rural surgeons. Motivation to practice in their current location varied considerably between urban and rural surgeons. Both groups equally rated quality of life as the leading factor influencing their current practice location. Urban surgeons rated other factors, such as income, practice growth, hospital facilities, and proximity to family, higher than rural surgeons. Practice patterns and educational needs also varied between the two groups. Rural surgeons performed more procedures per year with more variety in procedure type. Both groups felt that additional training in advanced laparoscopic techniques would be helpful, and rural surgeons felt that additional training in the surgical subspecialty areas was important. Although rural and urban surgeons do not differ in age or the importance of lifestyle in deciding career location, different factors do impact their choice of location. Practice pattern and educational needs varied markedly between rural and urban general surgeons.

Perioperative antibiotic usage by facial plastic surgeons: national survey results and comparison with evidence-based guidelines.

PubMed

Grunebaum, Lisa Danielle; Reiter, David

2006-01-01

To determine current practice for use of perioperative antibiotics among facial plastic surgeons, to determine the extent of use of literature support for preferences of facial plastic surgeons, and to compare patterns of use with nationally supported evidence-based guidelines. A link to a Web site containing a questionnaire on perioperative antibiotic use was e-mailed to more than 1000 facial plastic surgeons in the United States. Responses were archived in a dedicated database and analyzed to determine patterns of use and methods of documenting that use. Current literature was used to develop evidence-based recommendations for perioperative antibiotic use, emphasizing current nationally supported guidelines. Preferences varied significantly for medication used, dosage and regimen, time of first dose relative to incision time, setting in which medication was administered, and procedures for which perioperative antibiotic was deemed necessary. Surgical site infection in facial plastic surgery can be reduced by better conformance to currently available evidence-based guidelines. We offer specific recommendations that are supported by the current literature.

Design of piles for integral abutment bridges.

DOT National Transportation Integrated Search

1984-08-01

More and more, integral abutment bridges are being used in place : of the more traditional bridge designs with expansion releases. In : this study, states which use integral abutment bridges were surveyed : to determine their current practice in the ...

Topical vs. systemic treatments for acute otitis media.

PubMed

Thornton, Kathy; Parrish, Francie; Swords, Christine

2011-01-01

Acute otitis media (AOM) is a common condition in children that is often treated with systemic antibiotic therapy; however, research suggests that non-complicated AOM will resolve spontaneously using only eardrops. To determine best practice for the use of systematic antibiotics compared to topical treatment of AOM, a systematic review of evidence was conducted. Cochrane, Medline, CINAHL, and other databases were searched. Inclusion criteria were studies published from 1995-2010 that included children with AOM and were randomized controlled trials (RCTs). Five systematic reviews and five RCTs were included in the review. Current evidence recommends using topical and other alternative approaches for treating non-complicated AOM in children 2 years of age or older; however, many practitioners are not currently following these recommendations for various reasons. Additional research to address these reasons may help determine how to improve practitioner adherence to best practice evidence and guidelines to help reduce the unnecessary use of systemic antibiotics.

Particle sedimentation in curved tubes: A 3D simulation and optimization for treatment of vestibular vertigo

NASA Astrophysics Data System (ADS)

White, Brian; Squires, Todd M.; Hain, Timothy C.; Stone, Howard A.

2003-11-01

Benign paroxysmal positional vertigo (BPPV) is a mechanical disorder of the vestibular system where micron-size crystals abnormally drift into the semicircular canals of the inner ear that sense angular motion of the head. Sedimentation of these crystals causes sensation of motion after true head motion has stopped: vertigo results. The usual clinical treatment is through a series of head maneuvers designed to move the particles into a less sensitive region of the canal system. We present a three-dimensional model to simulate treatment of BPPV by determining the complete hydrodynamic motion of the particles through the course of a therapeutic maneuver while using a realistic representation of the actual geometry. Analyses of clinical maneuvers show the parameter range for which they are effective, and indicate inefficiencies in current practice. In addition, an optimization process determines the most effective head maneuver, which significantly differs from those currently in practice.

Is it working? A look at the changing nutrient practices in Oregon's Southern Willamette Valley Groundwater Management Area

NASA Astrophysics Data System (ADS)

Pearlstein, S.; Compton, J.; Eldridge, A.; Henning, A.; Selker, J. S.; Brooks, J. R.; Schmitz, D.

2016-12-01

Groundwater nitrate contamination affects thousands of households in the southern Willamette Valley and many more across the Pacific Northwest. The southern Willamette Valley Groundwater Management Area (SWV GWMA) was established in 2004 due to nitrate levels in the groundwater exceeding the human health standard of 10 mg nitrate-N L-1. Much of the nitrogen inputs to the GWMA comes from agricultural nitrogen use, and thus efforts to reduce N inputs to groundwater are focused upon improving N management. Previous work in the 1990s in the Willamette Valley by researchers at Oregon State University determined the importance of cover crops and irrigation practices and made recommendations to the local farm community for reducing nitrogen (N) leaching. We are currently re-sampling many of the same fields studied by OSU to examine the influence of current crops and nutrient management practices on nitrate leaching below the rooting zone. This study represents important crops currently grown in the GWMA and includes four grass fields, three vegetable row-crop fields, two peppermint and wheat fields, and one each of hazelnuts and blueberries. New nutrient management practices include slow release fertilizers and precision agriculture approaches in some of the fields. Results from the first two years of sampling show nitrate leaching is lower in some crops like row crops grown for seed and higher in others like perennial rye grass seed when compared to the 1990s data. We will use field-level N input-output balances in order to determine the N use efficiency and compare this across crops and over time. The goal of this project is to provide information and tools that will help farmers, managers and conservation groups quantify the water quality benefits of management practices they are conducting or funding.

How accurate are medical oncologists' impressions of management of metastatic colorectal cancer in Australia?

PubMed

Au, Lewis; Turner, Natalie; Wong, Hui-Li; Field, Kathryn; Lee, Belinda; Boadle, David; Cooray, Prasad; Karikios, Deme; Kosmider, Suzanne; Lipton, Lara; Nott, Louise; Parente, Phillip; Tie, Jeanne; Tran, Ben; Wong, Rachel; Yip, Desmond; Shapiro, Jeremy; Gibbs, Peter

2018-04-01

Current efforts to understand patient management in clinical practice are largely based on clinician surveys with uncertain reliability. The TRACC (Treatment of Recurrent and Advanced Colorectal Cancer) database is a multisite registry collecting comprehensive treatment and outcome data on consecutive metastatic colorectal cancer (mCRC) patients at multiple sites across Australia. This study aims to determine the accuracy of oncologists' impressions of real-word practice by comparing clinicians' estimates to data captured by TRACC. Nineteen medical oncologists from nine hospitals contributing data to TRACC completed a 34-question survey regarding their impression of the management and outcomes of mCRC at their own practice and other hospitals contributing to the database. Responses were then compared with TRACC data to determine how closely their impressions reflected actual practice. Data on 1300 patients with mCRC were available. Median clinician estimated frequency of KRAS testing within 6 months of diagnosis was 80% (range: 20-100%); the TRACC documented rate was 43%. Clinicians generally overestimated the rates of first-line treatment, particularly in patients over 75 years. Estimate for bevacizumab in first line was 60% (35-80%) versus 49% in TRACC. Estimated rate for liver resection varied substantially (5-35%), and the estimated median (27%) was inconsistent with the TRACC rate (12%). Oncologists generally felt their practice was similar to other hospitals. Oncologists' estimates of current clinical practice varied and were discordant with the TRACC database, often with a tendency to overestimate interventions. Clinician surveys alone do not reliably capture contemporary clinical practices in mCRC. © 2017 John Wiley & Sons Australia, Ltd.

Subject cataloging practices in North American medical school libraries.

PubMed Central

Fredericksen, R B; Michael, H N

1976-01-01

A survey of North American medical school libraries was made to determine current trends in subject cataloging practices. First, responses from 114 of these libraries are recorded and analyzed in the following areas: subject heading authority lists employed; use of the divided versus the dictionary catalog; and the form in which local subject authority files are kept. Then, focusing on 78 libraries that use MeSH in combination with a divided catalog, a further analysis of responses is made concerning issues relating to subject cataloging practices: updating the subject catalog to conform to annual MeSH changes; use of guide cards in the catalog; use of MeSH subheadings; filing conventions; and related issues. An attempt is made to analyze the extent to which these libraries vary from NLM practices. Suggestions are offered for formulating subject cataloging practices for an individual library. Finally, while it is concluded that MeSH and the Current Catalog are useful tools, a more detailed explication of the use of MeSH and NLM cataloging practices would be beneficial. PMID:989741

NASA Formal Methods Workshop, 1990

NASA Technical Reports Server (NTRS)

Butler, Ricky W. (Compiler)

1990-01-01

The workshop brought together researchers involved in the NASA formal methods research effort for detailed technical interchange and provided a mechanism for interaction with representatives from the FAA and the aerospace industry. The workshop also included speakers from industry to debrief the formal methods researchers on the current state of practice in flight critical system design, verification, and certification. The goals were: define and characterize the verification problem for ultra-reliable life critical flight control systems and the current state of practice in industry today; determine the proper role of formal methods in addressing these problems, and assess the state of the art and recent progress toward applying formal methods to this area.

An evaluation of an ICCD imager of dynamic range expansion technique and application of insitu procedures for life-time extension

NASA Technical Reports Server (NTRS)

Currie, D. G.

1982-01-01

Research toward practical implementation of the Intensified Charge Coupled Device (ICCD) as a photon-counting array detector for astronomy is reported. The first area of concentration was to determine the rate and extent of the lifetime limiting damage to the CCD caused by the impact of high energy electrons, and to find whether various methods of annealing the damage were productive. The second effort was to determine the performance of the ICCD in a photon-counting mode to produce extended dynamic range measurements. There are two main effects that appear as the practical results of the electron damage to the CCD. One is an increase in the leakage current, i.e., the normal thermal generation of charge carriers in the silicon that provides a background dark signal that adds to the light produced image. In an undamaged CCD, the leakage current is usually fairly uniform across the photosensitive area of the silicon chip, with the exception of various bright pixels which have an anomalous leakage current well above the overall level.

Chlorinated pesticides in stream sediments from organic, integrated and conventional farms.

PubMed

Shahpoury, Pourya; Hageman, Kimberly J; Matthaei, Christoph D; Magbanua, Francis S

2013-10-01

To determine if current sheep/beef farming practices affect pesticide residues in streams, current-use and legacy chlorinated pesticides were quantified in 100 sediment samples from 15 streams on the South Island of New Zealand. The study involved five blocks of three neighboring farms, with each block containing farms managed by organic, integrated and conventional farming practices. Significantly higher concentrations of dieldrin, ∑ endosulfans, ∑ current-use pesticides, and ∑ chlorinated pesticides were measured in sediments from conventional farms compared to organic and integrated farms. However, streams in the latter two farming categories were not pesticide-free and sometimes contained relatively high concentrations of legacy pesticides. Comparison of measured pesticide concentrations with sediment quality guidelines showed that, regardless of farming practice, mean pesticide concentrations were below the recommended toxicity thresholds. However, up to 23% of individual samples contained chlorpyrifos, endosulfan sulfate, ∑ DDT, dieldrin, or ∑ chlordane concentrations above these thresholds. Copyright © 2013 Elsevier Ltd. All rights reserved.

Family physicians' approach to psychotherapy and counseling. Perceptions and practices.

PubMed Central

Swanson, J. G.

1994-01-01

To determine how family physicians perceive the support they get for psychotherapy and counseling, we surveyed a random sample of Ontario College of Family Physicians members. Of 100 physicians who had family medicine residency training with psychotherapy experience, 43% indicated that such training was inadequate for their current needs. Because family physicians often provide psychotherapy and counseling, their training should reflect the needs found in practice. PMID:8080505

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. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Accuracy of alternate oven drying procedures

USDA-ARS?s Scientific Manuscript database

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

A practical method to rapidly dissolve metallic stents.

PubMed

Bradshaw, Scott H; Kennedy, Lloyd; Dexter, David F; Veinot, John P

2009-01-01

Metallic stents are commonly used in many clinical applications including peripheral vascular disease intervention, biliary obstruction, endovascular repair of aneurysms, and percutaneous coronary interventions. In the examination of vascular stent placement, it is important to determine if the stent is open or has become obstructed. This is increasingly important in the era of drug-eluting stent usage in coronary arteries. We describe a practical, rapid and cost-effective method to dissolve most metallic stents leaving the vascular and luminal tissues intact. This practical method may replace the laborious and expensive plastic embedding methods currently utilized.

Morphological Analysis in Context versus Isolation: Use of a Dynamic Assessment Task with School-Age Children

ERIC Educational Resources Information Center

Ram, Gayatri; Marinellie, Sally A.; Benigno, Joann; McCarthy, John

2013-01-01

Purpose: The current study investigated the ability of typically developing children in Grades 3 and 5 to use morphological analysis to determine the meanings of derived words with and without context clues. Also of interest was the relation between children's reading practices and their performance in determining the meanings of derived words.…

Prevalence of urinary tract infection in acutely unwell children in general practice: a prospective study with systematic urine sampling.

PubMed

O'Brien, Kathryn; Edwards, Adrian; Hood, Kerenza; Butler, Christopher C

2013-02-01

Urinary tract infection (UTI) in children may be associated with long-term complications that could be prevented by prompt treatment. To determine the prevalence of UTI in acutely ill children ≤ 5 years presenting in general practice and to explore patterns of presenting symptoms and urine sampling strategies. Prospective observational study with systematic urine sampling, in general practices in Wales, UK. In total, 1003 children were recruited from 13 general practices between March 2008 and July 2010. The prevalence of UTI was determined and multivariable analysis performed to determine the probability of UTI. Out of 597 (60.0%) children who provided urine samples within 2 days, the prevalence of UTI was 5.9% (95% confidence interval [CI] = 4.3% to 8.0%) overall, 7.3% in those < 3 years and 3.2% in 3-5 year olds. Neither a history of fever nor the absence of an alternative source of infection was associated with UTI (P = 0.64; P = 0.69, respectively). The probability of UTI in children aged ≥3 years without increased urinary frequency or dysuria was 2%. The probability of UTI was ≥5% in all other groups. Urine sampling based purely on GP suspicion would have missed 80% of UTIs, while a sampling strategy based on current guidelines would have missed 50%. Approximately 6% of acutely unwell children presenting to UK general practice met the criteria for a laboratory diagnosis of UTI. This higher than previously recognised prior probability of UTI warrants raised awareness of the condition and suggests clinicians should lower their threshold for urine sampling in young children. The absence of fever or presence of an alternative source of infection, as emphasised in current guidelines, may not rule out UTI in young children with adequate certainty.

Changing corporate practices to reduce cancer disparities.

PubMed

Freudenberg, Nicholas; Galea, Sandro; Fahs, Marianne

2008-02-01

While reducing racial/ethnic and socioeconomic disparities in cancer mortality has been identified as a national goal, current policies are unlikely to achieve it. In order to advance the development of policies for the primary prevention of cancer and cancer disparities, we propose that the practices of the tobacco, alcohol, and food industries be considered as modifiable social determinants of health. We review evidence that the practices of these industries in product design, marketing, retail distribution, and pricing contribute to cancer risk behavior, incidence, and disparities, then examine public health strategies designed to reduce health-damaging practices of these industries and encourage healthier alternatives. We conclude with recommendations for research, practice, and policy that could contribute to the development of less carcinogenic corporate practices.

A survey to assess the provision of conscious sedation by general dental practitioners in the Republic of Ireland.

PubMed

Fisher, Veronica; Stassen, Leo F A; Nunn, June

2011-01-01

To quantify and qualify how conscious sedation was used in general dental practice before the introduction of formal sedation teaching in the Republic of Ireland. 1. To determine the extent of use of oral, inhalational and intravenous sedation; 2. to determine the training and experience of general dental practitioners providing conscious sedation; 3. to determine the perceived barriers to the practice of conscious sedation; and, 4. to gauge the level of interest in a postgraduate course in conscious sedation. Postal questionnaire sent to one general practitioner in seven, selected randomly from the General Dental Council register, in 2007. Seventy six percent of respondents agreed that the provision of conscious sedation in general dental practice is important. However, the current provision of inhalation and intravenous sedation by respondents is low in comparison to provision in the UK. The main barrier to the use of conscious sedation in general dental practice appears to be lack of availability of training. The data from this study indicated the need for postgraduate training in conscious sedation in Ireland and a need for increased awareness of the Dental Council Code of Practice on sedation.

Should ongoing airway education be a mandatory component of continuing professional development for College of Intensive Care Medicine Fellows?

PubMed

Brewster, D J; Nickson, C P; Gatward, J J; Staples, M; Hawker, F

2018-03-01

This study aimed to determine whether airway education should be introduced to the continuing professional development (CPD) program for College of Intensive Care Medicine (CICM) Fellows. A random representative sample of 11 tertiary intensive care units (ICUs) was chosen from the list of 56 units accredited for 12 or 24 months of CICM training. All specialist intensive care Fellows (n=140) currently practising at the eleven ICUs were sent the questionnaire via email. Questionnaire data collection and post-collection data analysis was used to determine basic respondent demographics, frequency of certain airway procedures in the past 12 months, confidence with advanced airway practices in ICU, participation in airway education in the past three years, knowledge of can't intubate, can't oxygenate (CICO) algorithms, preference for certain airway equipment/techniques, and support for required airway education as a component of the CICM CPD program. All responses were tabled for comparison. Data was analysed to establish any significant effect of another specialty qualification and current co-practice in anaesthesia on volume of practice, confidence with multiple airway procedures, use of airway equipment, and support for airway education. In total, 112 responses (response rate 80%) to the questionnaire were received within four weeks; 107 were completed in full (compliance 96%). All results were tabled. There is currently widespread support amongst CICM Fellows for airway skills education as a CPD requirement for CICM Fellows. Volumes of practice and confidence levels with different airway procedures vary amongst Fellows and further support the need for education.

Financial management practices and attitudes of dental hygienists: a descriptive study.

PubMed

Russell, Katherine; Stramoski, Sandra

2011-01-01

The purpose of this study was to determine the financial management goals and practices of registered dental hygienists, their satisfaction with their current financial situations and their attitudes about savings, investments and retirement. A 40 question electronic survey was completed by 388 registered dental hygienists. The descriptive instrument assessed financial practices, attitudes, goals and beliefs, retirement mindset, savings habits, debt tendencies and demographic characteristics of respondents. Statistical analyses compared respondents' beliefs about their financial independence and security with their current financial practices. Analyses included: independent samples t-tests, chi-square analysis and ANOVA. Most dental hygienists believed themselves to be financially independent and reported satisfaction with their current financial situation. Significant relationships existed between respondents' satisfaction with their current financial situations and their financial attitudes and practices (saving regularly and having limited debt). Those who indicated they had personally saved for retirement were more likely to view these savings as their largest source of income during retirement, as opposed to Social Security benefits. A majority agreed that financial management education should be included in the dental hygiene curriculum, and that they would attend a continuing education course on the subject if offered. The results of this study suggest that hygienists have confidence in their ability to provide secure financial futures for themselves. Hygienists who practiced sound financial planning, such as adhering to monthly budgets, having wills, lowering debt and saving regularly, reported a higher level of financial security than those who did not. Most respondents expressed interest in receiving education about financial management through the dental hygiene curriculum and continuing education courses.

Economic analysis of athletic team coverage by an orthopedic practice.

PubMed

Lombardi, Nicholas; Freedman, Kevin; Tucker, Brad; Austin, Luke; Eck, Brandon; Pepe, Matt; Tjoumakaris, Fotios

2015-11-01

Coverage of high school football by orthopedic sports medicine specialists is considered standard of care in many localities. Determining the economic viability of this endeavor has never been investigated. The primary purpose of the present investigation was to perform an economic analysis of local high school sports coverage by an orthopedic sports medicine practice. From January 2010 to June 2012, a prospective injury report database was used to collect sports injuries from five high school athletic programs covered by a single, private orthopedic sports medicine practice. Patients referred for orthopedic care were then tracked to determine expected cost of care (potential revenue). Evaluation and management codes and current procedure terminology codes were obtained to determine the value of physician visits and surgical care rendered. Overhead costs were calculated based on historical rates within our practice and incorporated to determine estimated profit. 19,165 athletic trainer contacts with athletes playing all sports, including both those 'on-field' and in the training room, resulted in 473 (2.5%) physician referrals. The covering orthopedic practice handled 89 (27.9%) of the orthopedic referrals. Of orthopedic physician referrals, 26 (5.4%) required orthopedic surgical treatment. The covering team practice handled 17/26 (65%) surgical cases. The total revenue collected by the covering team practice was $26,226.14. The overhead cost of treatment was $9441.41. Overall estimated profit of orthopedic visits and treatment during this period for the covering practice was $16,784.73. The covering team practice handled 28% of the orthopedic referrals, 65% of the surgical cases and captured 59% of the potential profit. An increase in physician referrals could increase the benefit for orthopedic surgeons.

The Bicameral Teacher Center.

ERIC Educational Resources Information Center

Ervay, Stuart; And Others

1983-01-01

Although some laypresons, teacher educators, and administrators favor current teacher centers in both concept and practice, others hesitate to endorse any movement that gives teachers added opportunities for self-determination and administrative involvement. A bicameral teacher center, with separate chambers for administrators and classroom…

ALTERNATE METHODS OF MANURE HANDLING

EPA Science Inventory

The objectives of this research project were to (a) construct an inexpensive storage facility for solid dairy cow manure, (b) evaluate its performance and the extent of pollutants in runoff from storage facilities, and (c) determine current manure handling practices in Vermont an...

Current Status and Issues in Basic Pharmaceutical Education.

PubMed

Yasuhara, Tomohisa

2017-01-01

Basic research in pharmaceutical sciences has a long and successful history. Researchers in this field have long given prime importance to the knowledge they have gained through their pharmaceutical education. The transition of pharmacy education to a 6-year course term has not only extended its duration but also placed more emphasis on practical clinical education. The School Education Act (in article 87, second paragraph) determines that "the term of the course, whose main purpose is to cultivate practical ability in clinical pharmacy, shall be six years" (excerpt). The 6-year pharmacy education is an exception to the general 4-year university term determined by the School Education Act. Therefore, the purpose of the 6-year course in pharmacy is clearly proscribed. This is true of the basic course in pharmaceutical education as well; hence, the basic course must be oriented toward developing "practical ability in clinical" education, too. The 6-year pharmacy course, starting from practice (Do), has evolved with the development of a syllabus that includes a model core curriculum (Plan). Furthermore, improvement in the course can be seen by the promoted development of faculty (Act). Now, evidence-based education research will be introduced (Check). This is how the Plan-Do-Check-Act cycle in pharmaceutical education is expected to work. Currently, pedagogy research in pharmacy education has just begun, so it is difficult to evaluate at this time whether basic pharmaceutical education does in fact contribute to enhancing the "practical clinical ability" component of pharmaceutical education.

Establishing CASA as an evidence-based practice.

PubMed

Lawson, Jennifer; Berrick, Jill Duerr

2013-01-01

In this article the authors examine the evidentiary status of the Court Appointed Special Advocates (CASA) program through a review of current research findings and a critical analysis of the study methodologies used to produce those findings. Due to the equivocal research findings and widespread methodological weaknesses (most notably selection bias) in the literature base, it is determined that there is not currently enough evidence to establish CASA as an evidence-based practice. In spite of the challenges to the feasibility of such research, a future research agenda is suggested that calls for the execution of large randomized controlled trials in order to produce findings that will inform a deeper understanding of CASA effectiveness in improving child outcomes.

Genetic methods for detection of antibiotic resistance: focus on extended-spectrum β-lactamases.

PubMed

Chroma, Magdalena; Kolar, Milan

2010-12-01

In 1928, the first antibiotic, penicillin, was discovered. That was the beginning of a great era in the development and prescription of antibiotics. However, the introduction of these antimicrobial agents into clinical practice was accompanied by the problem of antibiotic resistance. Currently, bacterial resistance to antibiotics poses a major problem in both hospital and community settings throughout the world. This review provides examples of modern genetic methods and their practical application in the field of extended-spectrum β-lactamase detection. Since extended-spectrum β-lactamases are the main mechanism of Gram-negative bacterial resistance to oxyimino-cephalosporins, rapid and accurate detection is requested in common clinical practice. Currently, the detection of extended-spectrum β-lactamases is primarily based on the determination of bacterial phenotypes rather than genotypes. This is because therapeutic decisions are based on assessing the susceptibility rather than presence of resistance genes. One of the main disadvantages of genetic methods is high costs, including those of laboratory equipment. On the other hand, if these modern methods are introduced into diagnostics, they often help in rapid and accurate detection of certain microorganisms or their resistance and pathogenic determinants.

Bimodal Programming: A Survey of Current Clinical Practice.

PubMed

Siburt, Hannah W; Holmes, Alice E

2015-06-01

The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

Determining pile bearing capacity by some means other than the engineering news formula : final report.

DOT National Transportation Integrated Search

1989-12-01

A review of the practice used in monitoring pile driving activities within the Louisiana Department of Transportation and Development (LADOTD) and elsewhere is reported. The Engineering News Record formula is currently the most commonly reported meth...

Primary healthcare solo practices: homogeneous or heterogeneous?

PubMed

Pineault, Raynald; Borgès Da Silva, Roxane; Provost, Sylvie; Beaulieu, Marie-Dominique; Boivin, Antoine; Couture, Audrey; Prud'homme, Alexandre

2014-01-01

Introduction. Solo practices have generally been viewed as forming a homogeneous group. However, they may differ on many characteristics. The objective of this paper is to identify different forms of solo practice and to determine the extent to which they are associated with patient experience of care. Methods. Two surveys were carried out in two regions of Quebec in 2010: a telephone survey of 9180 respondents from the general population and a postal survey of 606 primary healthcare (PHC) practices. Data from the two surveys were linked through the respondent's usual source of care. A taxonomy of solo practices was constructed (n = 213), using cluster analysis techniques. Bivariate and multilevel analyses were used to determine the relationship of the taxonomy with patient experience of care. Results. Four models were derived from the taxonomy. Practices in the "resourceful networked" model contrast with those of the "resourceless isolated" model to the extent that the experience of care reported by their patients is more favorable. Conclusion. Solo practice is not a homogeneous group. The four models identified have different organizational features and their patients' experience of care also differs. Some models seem to offer a better organizational potential in the context of current reforms.

Primary Healthcare Solo Practices: Homogeneous or Heterogeneous?

PubMed Central

Beaulieu, Marie-Dominique; Boivin, Antoine; Prud'homme, Alexandre

2014-01-01

Introduction. Solo practices have generally been viewed as forming a homogeneous group. However, they may differ on many characteristics. The objective of this paper is to identify different forms of solo practice and to determine the extent to which they are associated with patient experience of care. Methods. Two surveys were carried out in two regions of Quebec in 2010: a telephone survey of 9180 respondents from the general population and a postal survey of 606 primary healthcare (PHC) practices. Data from the two surveys were linked through the respondent's usual source of care. A taxonomy of solo practices was constructed (n = 213), using cluster analysis techniques. Bivariate and multilevel analyses were used to determine the relationship of the taxonomy with patient experience of care. Results. Four models were derived from the taxonomy. Practices in the “resourceful networked” model contrast with those of the “resourceless isolated” model to the extent that the experience of care reported by their patients is more favorable. Conclusion. Solo practice is not a homogeneous group. The four models identified have different organizational features and their patients' experience of care also differs. Some models seem to offer a better organizational potential in the context of current reforms. PMID:24523964

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

PubMed

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

Economic impact of converting an interventional pain medicine physician office-based practice into a provider-based ambulatory pain practice.

PubMed

Grider, Jay S; Findley, Kelley A; Higdon, Courtney; Curtright, Jonathan; Clark, Don P

2014-01-01

One consequence of the shifting economic health care landscape is the growing trend of physician employment and practice acquisition by hospitals. These acquired practices are often converted into hospital- or provider-based clinics. This designation brings the increased services of the hospital, the accreditation of the hospital, and a new billing structure verses the private clinic (the combination of the facility and professional fee billing). One potential concern with moving to a provider-based designation is that this new structure might make the practice less competitive in a marketplace that may still be dominated by private physician office-based practices. The aim of the current study was to evaluate the impact of the provider-based/hospital fee structure on clinical volume. Determine the effect of transition to a hospital- or provider-based practice setting (with concomitant cost implications) on patient volume in the current practice milieu.   Community hospital-based academic interventional pain medicine practice. Economic analysis of effect of change in price structure on clinical volumes. The current study evaluates the effect of a change in designation with price implications on the demand for clinical services that accompany the transition to a hospital-based practice setting from a physician office setting in an academic community hospital. Clinical volumes of both procedures and clinic volumes increased in a mature practice setting following transition to a provider-based designation and the accompanying facility and professional fee structure. Following transition to a provider-based designation clinic visits were increased 24% while procedural volume demand did not change. Single practice entity and single geographic location in southeastern United States. The conversion to a hospital- or provider-based setting does not negatively impact clinical volume and referrals to community-based pain medicine practice. These results imply that factors other than price are a driver of patient choice.  

Modelling the dispersion of treated wastewater in a shallow coastal wind-driven environment, Geographe Bay, Western Australia: implications for environmental management.

PubMed

Dunn, Ryan J K; Zigic, Sasha; Shiell, Glenn R

2014-10-01

Numerical models are useful for predicting the transport and fate of contaminants in dynamic marine environments, and are increasingly a practical solution to environmental impact assessments. In this study, a three-dimensional hydrodynamic model and field data were used to validate a far-field dispersion model that, in turn, was used to determine the fate of treated wastewater (TWW) discharged to the ocean via a submarine ocean outfall under hypothetical TWW flows. The models were validated with respect to bottom and surface water current speed and direction, and in situ measurements of total nitrogen and faecal coliforms. Variations in surface and bottom currents were accurately predicted by the model as were nutrient and coliform concentrations. Results indicated that the ocean circulation was predominately wind driven, evidenced by relatively small oscillations in the current speeds along the time-scale of the tide, and that dilution mixing zones were orientated in a predominantly north-eastern direction from the outfall and parallel to the coastline. Outputs of the model were used to determine the 'footprint' of the TWW plume under a differing discharge scenario and, particularly, whether the resultant changes in TWW contaminants, total nitrogen and faecal coliforms would meet local environmental quality objectives (EQO) for ecosystem integrity, shellfish harvesting and primary recreation. Modelling provided a practical solution for predicting the dilution of contaminants under a hypothetical discharge scenario and a means for determining the aerial extent of exclusion zones, where the EQOs for shellfish harvesting and primary recreation may not always be met. Results of this study add to the understanding of regional discharge conditions and provide a practical case study for managing impacts to marine environments under a differing TWW discharge scenario, in comparison to an existing scenario.

Cutaneous T cell lymphoma: Current practices in blood assessment and the utility of T-cell receptor Vβ chain restriction

PubMed Central

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

2016-01-01

Background Accurate quantification of malignant cells in the peripheral blood of patients with cutaneous T cell lymphoma (CTCL) is important for early detection, prognosis, and monitoring disease burden. Objective Determine the spectrum of current clinical practices; critically evaluate elements of current ISCL B1 and B2 staging criteria; and assess the potential role of TCR-Vβ analysis by flow cytometry. Methods We assessed current clinical practices by survey, and performed a retrospective analysis of 161 patients evaluated at Yale (2011-2014) to compare the sensitivity, specificity, PPV, and NPV of parameters for ISCL B2 staging. Results There was heterogeneity in clinical practices among institutions. ISCL B1 criteria did not capture five Yale cohort patients with immunophenotypic abnormalities who later progressed. TCR-Vβ testing was more specific than PCR and aided diagnosis in detecting clonality, but was of limited benefit in quantification of tumor burden. Limitations Because of limited follow-up involving a single center, further investigation will be necessary to conclude whether our proposed diagnostic algorithm is of general clinical benefit. Conclusion We propose further study of “modified B1 criteria”: CD4/CD8 ratio ≥5, %CD4+/CD26- ≥ 20%, %CD4+/CD7- ≥ 20%, with evidence of clonality. TCR-Vβ testing should be considered in future diagnostic and staging algorithms. PMID:26874819

An evidence based approach to undergraduate physical assessment practicum course development.

PubMed

Anderson, Brenda; Nix, Elizabeth; Norman, Bilinda; McPike, H Dawn

2014-05-01

Physical assessment is an important component of professional nursing practice. New nurse graduates experience difficulty transitioning the traditional head to toe physical assessment into real world nursing practice. This study was conducted to provide current data concerning physical assessment competencies utilized consistently by registered nurses. This quantitative study used a 126 item survey mailed to 900 Registered Nurses. Participants used a Likert-type scale to report frequency of use for physical assessment competencies. Thirty seven competencies were determined to be essential components of the physical assessment, 18 were determined supplemental, and 71 were determined to be non-essential. Transition of the new graduate nurse into professional practice can be enhanced by focusing content in physical assessment practicum courses on the essential competencies of physical assessment. Faculty for the university has analyzed data from this study to support evidence based changes to the undergraduate nursing program physical assessment practicum course. Copyright © 2013 Elsevier Ltd. All rights reserved.

Current practices in vestibular schwannoma management: a survey of American and Canadian neurosurgeons.

PubMed

Fusco, Matthew R; Fisher, Winfield S; McGrew, Benjamin M; Walters, Beverly C

2014-12-01

Comprehensive therapy for vestibular schwannomas has changed dramatically over the past fifty years. Previously, neurosurgeons were most likely to treat these tumors via an independent surgical approach. Currently, many neurosurgeons treat vestibular schwannomas employing an interdisciplinary team approach with neuro-otologists and radiation oncologists. This survey aims to determine the current treatment paradigm for vestibular schwannomas among American and Canadian neurosurgeons, with particular attention to the utilization of a team approach to the surgical resection of these lesions. A seventeen part survey questionnaire was sent by electronic mail to residency trained members of the American Association of Neurological Surgeons currently practicing in Canada or the United States. Questions were divided into groups regarding physician background, overall practice history, recent practice history, opinions on treatment paradigms, and experience with an interdisciplinary team approach. Seven hundred and six responses were received. The vast majority of neurosurgeons surgically resect vestibular schwannomas as part of an interdisciplinary team (85.7%). Regional variations were observed in the use of an interdisciplinary team: 52.3% of responding neurosurgeons who surgically treat vestibular schwannomas without neuro-otologists currently practice in the South (no other region represented more than 15.4% of this group, p=0.02). Surgeons who have treated >50 vestibular schwannomas show a trend towards more frequent utilization of an interdisciplinary approach than less experienced surgeons, but this did not reach statistical significance. The majority of neurosurgeons in the United States and Canada surgically resect vestibular schwannomas via an interdisciplinary approach with the participation of a neuro-otologist. Neurosurgeons in the South appear more likely to surgically treat these tumors alone than neurosurgeons in other regions of the U.S. and Canada. Copyright © 2014 Elsevier B.V. All rights reserved.

Chapter 21: Estimating Net Savings - Common Practices. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W; Violette, Daniel M.; Rathbun, Pamela

This chapter focuses on the methods used to estimate net energy savings in evaluation, measurement, and verification (EM and V) studies for energy efficiency (EE) programs. The chapter provides a definition of net savings, which remains an unsettled topic both within the EE evaluation community and across the broader public policy evaluation community, particularly in the context of attribution of savings to a program. The chapter differs from the measure-specific Uniform Methods Project (UMP) chapters in both its approach and work product. Unlike other UMP resources that provide recommended protocols for determining gross energy savings, this chapter describes and comparesmore » the current industry practices for determining net energy savings but does not prescribe methods.« less

Air Vehicle Integration and Technology Research (AVIATR). Task Order 0003: Condition-Based Maintenance Plus Structural Integrity (CBM+SI) Demonstration (April 2011 to August 2011)

DTIC Science & Technology

2011-08-01

investigated. Implementation of this technology into the maintenance framework depends on several factors, including safety of the structural system, cost... Maintenance Parameters The F-15 Program has indicated that, in practice , maintenance actions are generally performed on flight hour multiples of 200...Risk Analysis or the Perform Cost Benefit Analysis sections of the flowchart. 4.6. Determine System Configurations The current maintenance practice

The relationship between chiropractor required and current level of business knowledge.

PubMed

Ciolfi, Michael Anthony; Kasen, Patsy Anne

2017-01-01

Chiropractors frequently practice within health care systems requiring the business acumen of an entrepreneur. However, some chiropractors do not know the relationship between the level of business knowledge required for practice success and their current level of business knowledge. The purpose of this quantitative study was to examine the relationship between chiropractors' perceived level of business knowledge required and their perceived level of current business knowledge. Two hundred and seventy-four participants completed an online survey (Health Care Training and Education Needs Survey) which included eight key business items. Participants rated the level of perceived business knowledge required (Part I) and their current perceived level of knowledge (Part II) for the same eight items. Data was collected from November 27, 2013 to December 18, 2013. Data were analyzed using Spearman's ranked correlation to determine the statistically significant relationships for the perceived level of knowledge required and the perceived current level of knowledge for each of the paired eight items from Parts I and II of the survey. Wilcoxon Signed Ranks Tests were performed to determine the statistical difference between the paired items. The results of Spearman's correlation testing indicated a statistically significant ( p < 0.01) positive correlation for the perceived level of knowledge required and perceived current level of knowledge for six variables: (a) organizational behavior, (b) strategic management, (c) marketing, (d) legal and ethical, (e) managerial decisions, and (f) operations. Wilcoxon Signed Ranks testing indicated a significant difference for three paired items: strategic management; marketing and; legal and ethical. The results suggest that relationships exist for the majority of business items (6 of 8) however a statistically difference was demonstrated in only three of the paired business items. The implications of this study for social change include the potential to improve chiropractors' business knowledge and skills, enable practice success, enhance health services delivery and positively influence the profession as a viable career.

Reducing Potentially Avoidable Complications in Patients with Chronic Diseases: The Prometheus Payment Approach

PubMed Central

de Brantes, Francois; Rastogi, Amita; Painter, Michael

2010-01-01

Objective (or Study Question) To determine whether a new payment model can reduce current incidence of potentially avoidable complications (PACs) in patients with a chronic illness. Data Sources/Study Setting A claims database of 3.5 million commercially insured members under age 65. Study Design We analyzed the database using the Prometheus Payment model's analytical software for six chronic conditions to quantify total costs, proportion spent on PACs, and their variability across the United States. We conducted a literature review to determine the feasibility of reducing PACs. We estimated the financial impact on a prototypical practice if that practice received payments based on the Prometheus Payment model. Principal Findings We find that (1) PACs consume an average of 28.6 percent of costs for the six chronic conditions studied and vary significantly; (2) reducing PACs to the second decile level would save U.S.$116.7 million in this population; (3) current literature suggests that practices in certain settings could decrease PACs; and (4) using the Prometheus model could create a large potential incentive for a prototypical practice to reduce PACs. Conclusions By extrapolating these findings we conclude that costs might be reduced through payment reform efforts. A full extrapolation of these results, while speculative, suggests that total costs associated to the six chronic conditions studied could decrease by 3.8 percent. PMID:20662949

Alcohol-related problems: emergency physicians' current practice and attitudes.

PubMed

O'Rourke, Maria; Richardson, Lynne D; Wilets, Ilene; D'Onofrio, Gail

2006-04-01

To determine whether emergency physicians' (EPs) attitudes affect their support and practice of brief intervention in the Emergency Department (ED), EPs completed an anonymous survey. EPs were asked about their attitudes toward patients with alcohol problems, current ED screening, use of brief intervention, and barriers to use of brief intervention. Chi-square analysis was used and a step-wise regression model was constructed. Respondents reported a high prevalence of patients with alcohol-related problems: 18% in a typical shift. Eighty-one percent said it is important to advise patients to change behavior; half said using a brief intervention is important. Attending physicians had significantly less alcohol education than residents, but were significantly more likely to support the use of brief intervention. Support was not associated with gender, race, census, hours of education, or personal experience. EPs who felt that brief intervention was an integral part of their job were more likely to use it in their daily practice.

Determination of Energy of a Clinical Electron Beam as Part of a Routine Quality Assurance and Audit System

NASA Astrophysics Data System (ADS)

Hernández-Bello, Jimmy; D'Souza, Derek; Rossenberg, Ivan

2002-08-01

A method to determine the electron beam energy and an electron audit based on the current IPEM electron Code of Practice has been devised. During the commissioning on the new Varian 2100CD linear accelerator in The Middlesex Hospital, two methods were devised for the determination of electron energy. The first method involves the use of a two-depth method, whereby the ratio of ionisation (presented as a percentage) measured by an ion chamber at two depths in solid water is used to compare against the baseline ionisation depth value for that energy. The second method involves the irradiation of an X-ray film in solid water to obtain a depth dose curve and, hence determine the half value depth and practical range of the electrons. The results showed that the two-depth method has a better accuracy, repeatability, reliability and consistency than the X-ray method. The results for the electron audit showed that electron absolute outputs are obtained from ionisation measurements in solid water, where the energy-range parameters such as practical range and the depth at which ionisation is 50% of that at the maximum for the depth-ionisation curve are determined.

Three-phase short circuit calculation method based on pre-computed surface for doubly fed induction generator

NASA Astrophysics Data System (ADS)

Ma, J.; Liu, Q.

2018-02-01

This paper presents an improved short circuit calculation method, based on pre-computed surface to determine the short circuit current of a distribution system with multiple doubly fed induction generators (DFIGs). The short circuit current, injected into power grid by DFIG, is determined by low voltage ride through (LVRT) control and protection under grid fault. However, the existing methods are difficult to calculate the short circuit current of DFIG in engineering practice due to its complexity. A short circuit calculation method, based on pre-computed surface, was proposed by developing the surface of short circuit current changing with the calculating impedance and the open circuit voltage. And the short circuit currents were derived by taking into account the rotor excitation and crowbar activation time. Finally, the pre-computed surfaces of short circuit current at different time were established, and the procedure of DFIG short circuit calculation considering its LVRT was designed. The correctness of proposed method was verified by simulation.

Where we are now and how we can improve: a qualitative study of practitioners' perspectives on providing ART adherence support in Romania.

PubMed

Dima, Alexandra Lelia; Linn, Annemiek J; Schweitzer, Ana-Maria

2016-01-01

Supporting medication adherence is a priority in HIV care worldwide as low adherence threatens the effectiveness of antiretroviral treatment (ART). While evidence on adherence causes and consequences has steadily accumulated, investigating current practice and relevant determinants of practitioners' behaviors has only recently been highlighted as essential for developing effective and sustainable interventions. In Romania, ART adherence is low despite universal access to HIV care, and improving support services is a priority. We report a qualitative exploration of practitioners' experiences and views on ART adherence support, guided by current behavioral theory. Semi-structured interviews were performed with 10 practitioners from six HIV centers, aiming for maximum variation sampling on professional experience, location, and organization type. Questions addressed practitioners' views and experiences on assessing patients' adherence behaviors and determinants, content and format of adherence support, and perceived influences on their capacity to deliver support. Verbatim transcripts were analyzed via template analysis. Results show that adherence support is provided in Romania by trained psychologists in multidisciplinary teams that operate flexibly and perform multiple HIV care activities. Assessment of adherence behaviors and determinants is primarily interview-based, and practitioners use mostly psychotherapeutic techniques and theories with a degree of intervention tailoring. Practitioners' descriptions covered a broad range of common determinants and behavior change techniques, but showed limited use of behavioral theory. Participants also described difficulties to cope with limited resources, and lack of support for managing practical and emotional challenges. Several opportunities for improvement were identified, such as standardizing patient profiling and intervention delivery, conceptualizing and recording active intervention content based on behavioral theory, and actively monitoring intervention effectiveness. This qualitative inquiry provided valuable information for improving adherence support in this clinical context. Understanding practitioners' perspectives based on behavioral theory-informed analyses can help intervention developers increase intervention fidelity by integrating current practice information in program design.

Underachieving Gifted Students: Two Case Studies

ERIC Educational Resources Information Center

Bennett-Rappell, Hannah; Northcote, Maria

2016-01-01

Almost half of all gifted students do not achieve according to their exceptional potential. Though significant research has investigated identifying characteristics of underachieving gifted students, current research is yet to fully employ the established theoretical knowledge to determine practical strategies for the reversal and remediation of…

The Application of Buddhist Principles to Lifelong Learning.

ERIC Educational Resources Information Center

Johnson, Ian

2002-01-01

Defining lifelong learning as conscious learning taking place throughout life, Buddhist meditation, contemplation, and mindfulnes are practices suitable to developing awareness of life experience. This broadens the concept of lifelong learning beyond the narrow vocationalism and economic determinism of much current discourse. (Contains 36…

Evaluation of Project Processes in Relation to Transportation System Management and Operations (TSM&O)

DOT National Transportation Integrated Search

2018-01-01

This study was conducted to explore the current state-of-the-practice of Transportation Systems Management and Operations (TSM&O) in the Florida Department of Transportation (FDOT) and determine what would be required to mainstream TSM&O throughout t...

Fiches pratiques: Le circuit de l'herbe; Journal a plusieurs mains; Comment aborder l'economie d'une facon economique; Des articles d'autrefois aux determinants d'aujourd'hui (Practical Ideas: The Path of Grass; Group Diary; Approaching Economics in an Economical Way; From Yesterday's Articles to Today's Determiners).

ERIC Educational Resources Information Center

Vever, Daniel; And Others

1991-01-01

Four activities for the French language classroom are described, including a comprehension game based on the cow's digestive system, a group journal exercise using current events, an economics vocabulary development activity, and a grammar exercise focusing on the use of determiners in news articles. (MSE)

Clinical Practices in Collegiate Concussion Management.

PubMed

Baugh, Christine M; Kroshus, Emily; Stamm, Julie M; Daneshvar, Daniel H; Pepin, Michael J; Meehan, William P

2016-06-01

In recent years, sports leagues and sports medicine experts have developed guidelines for concussion management. The extent to which current clinical practice is consistent with guideline recommendations is unclear. At the collegiate level, there have been few examinations of concussion management practices and the extent to which meaningful differences across divisions of competition exist. The purposes of this study were to (1) examine current practices in concussion diagnosis and management at National Collegiate Athletic Association (NCAA) member colleges, (2) explore the extent to which current practices reflect current recommendations for concussion diagnosis and management, and (3) determine whether there are differences in management patterns across divisions of competition. Descriptive epidemiology study. An electronic questionnaire was sent to sports medicine clinicians at all NCAA member colleges during September and October 2013. Clinicians were asked about baseline assessments, diagnosis and management practices, return-to-play protocols, the perceived prevalence of underdiagnosis, and basic demographic information. Approximately 30% (n = 866) of contacted clinicians, representing nearly 50% (n = 527) of NCAA member colleges, responded to the questionnaire. Preparticipation baseline examinations were administered at the majority of schools (95%), but most (87.5%) administered baseline assessments only to selected high-risk athletes. Computerized neurocognitive testing and balance assessments were most commonly used as preseason baseline and postinjury assessments. Multimodal examination in line with NCAA and other guidance was used only at a minority of institutions. Athletic trainers most commonly administered and interpreted the preseason baseline examination. Most clinicians reported that their institutions' practices were in line with NCAA guidelines during the first 24 hours of an athlete's concussion diagnosis, with exact percentages varying across measures. Differences across divisions of competition included shorter return-to-play time at Division I schools than Division III schools (9.13 vs 10.31 days, respectively) and more frequently referring concussed athletes to a physician within 24 hours of diagnosis at Division I schools. Concussion management at many colleges in the United States incorporates elements recommended by current guidelines; however, there is room to improve. Increasing the use of a multimodal baseline and postinjury examination will elevate the concussion care provided to college athletes and better align with best practice guidance. © 2016 The Author(s).

The effect of recent amblyopia research on current practice in the UK.

PubMed

Newsham, D

2010-10-01

Several studies have recently provided insights into how amblyopia may be most effectively managed. Despite the new evidence, a US study reported that a recent randomised controlled trial had made little influence on clinical practice. The aims of this research are to assess current practice of amblyopia management in the UK and to determine the comparability with the evidence-based recommendations. A questionnaire was constructed to assess current amblyopia management practice, particularly in relation to areas investigated by recent research and emailed to every head orthoptist within the UK. There was a great deal of variability in the amount of occlusion that was prescribed for moderate and severe amblyopia. Sixty per cent of clinicians indicated that the maximum they would prescribe was in excess of the 6 h recommended by research. Atropine was rarely recommended as a first-line treatment, with occlusion generally being considered to be more effective. Despite recommendations regarding education as a means of reducing non-compliance, only 39% of clinicians always gave written information, although various other methods of enhancing compliance were used. A period of refractive adaptation was allowed by most clinicians but often far less than recommended. The uptake of recent research evidence into clinical practice is sporadic and incomplete with one-third of respondents indicating that following the studies, they had made no changes whatsoever to their practice. This is similar to other areas of medicine; the reasons are likely to be varied, and is an area that would benefit from greater attention.

What should we mean by empirical validation in hypnotherapy: evidence-based practice in clinical hypnosis.

PubMed

Alladin, Assen; Sabatini, Linda; Amundson, Jon K

2007-04-01

This paper briefly surveys the trend of and controversy surrounding empirical validation in psychotherapy. Empirical validation of hypnotherapy has paralleled the practice of validation in psychotherapy and the professionalization of clinical psychology, in general. This evolution in determining what counts as evidence for bona fide clinical practice has gone from theory-driven clinical approaches in the 1960s and 1970s through critical attempts at categorization of empirically supported therapies in the 1990s on to the concept of evidence-based practice in 2006. Implications of this progression in professional psychology are discussed in the light of hypnosis's current quest for validation and empirical accreditation.

Occupational therapy practice in acute physical hospital settings: Evidence from a scoping review.

PubMed

Britton, Lauren; Rosenwax, Lorna; McNamara, Beverley

2015-12-01

Increased accountability and growing fiscal limitations in global health care continue to challenge how occupational therapy practices are undertaken. Little is known about how these changes affect current practice in acute hospital settings. This article reviews the relevant literature to further understanding of occupational therapy practice in acute physical hospital settings. A scoping review of five electronic databases was completed using the keywords Occupational therapy, acute hospital settings/acute physical hospital settings, acute care setting/acute care hospital setting, general medicine/general medical wards, occupational therapy service provision/teaching hospitals/tertiary care hospitals. Criteria were applied to determine suitability for inclusion and the articles were analysed to uncover key themes. In total 34 publications were included in the review. Analysis of the publications revealed four themes: (1) Comparisons between the practice of novice and experienced occupational therapists in acute care (2) Occupational therapists and the discharge planning process (3) Role of occupation in the acute care setting and (4) Personal skills needed and organisation factors affecting acute care practice. The current literature has highlighted the challenges occupational therapists face in practicing within an acute setting. Findings from this review enhance understanding of how occupational therapy department managers and educators can best support staff that practise in acute hospital settings. © 2015 Occupational Therapy Australia.

Applications of turbidity monitoring to forest management in California.

PubMed

Harris, Richard R; Sullivan, Kathleen; Cafferata, Peter H; Munn, John R; Faucher, Kevin M

2007-09-01

Many California streams have been adversely affected by sedimentation caused by historic and current land uses, including timber harvesting. The impacts of timber harvesting and logging transportation systems on erosion and sediment delivery can be directly measured, modeled, or inferred from water quality measurements. California regulatory agencies, researchers, and land owners have adopted turbidity monitoring to determine effects of forest management practices on suspended sediment loads and water quality at watershed, project, and site scales. Watershed-scale trends in sediment discharge and responses to current forest practices may be estimated from data collected at automated sampling stations that measure turbidity, stream flow, suspended sediment concentrations, and other water quality parameters. Future results from these studies will provide a basis for assessing the effectiveness of modern forest practice regulations in protecting water quality. At the project scale, manual sampling of water column turbidity during high stream flow events within and downstream from active timber harvest plans can identify emerging sediment sources. Remedial actions can then be taken by managers to prevent or mitigate water quality impacts. At the site scale, manual turbidity sampling during storms or high stream flow events at sites located upstream and downstream from new, upgraded, or decommissioned stream crossings has proven to be a valuable way to determine whether measures taken to prevent post-construction erosion and sediment production are effective. Turbidity monitoring at the project and site scales is therefore an important tool for adaptive management. Uncertainty regarding the effects of current forest practices must be resolved through watershed-scale experiments. In the short term, this uncertainty will stimulate increased use of project and site-scale monitoring.

Management system to a photovoltaic panel based on the measurement of short-circuit currents

NASA Astrophysics Data System (ADS)

Dordescu, M.

2016-12-01

This article is devoted to fundamental issues arising from operation in terms of increased energy efficiency for photovoltaic panel (PV). By measuring the current from functioning cage determine the current value prescribed amount corresponding to maximum power point results obtained by requiring proof of pregnancy with this method are the maximum energy possible, thus justifying the usefulness of this process very simple and inexpensive to implement in practice. The proposed adjustment method is much simpler and more economical than conventional methods that rely on measuring power cut.

Hemorrhage Control for Major Traumatic Vascular Injuries

DTIC Science & Technology

2017-10-01

subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO...aims: 1) Determine current practice patterns for the treatment of patients with NCTH among 4 clinical sites using a retrospective study design (Phase...competency, and training issues for catheter-based hemorrhage control (Phase 1b); 3) Conduct a prospective 4-site observational study to test the hypothesis

Cast Stone Formulation for Nuclear Waste Immobilization at Higher Sodium Concentrations

DOE PAGES

Fox, Kevin; Cozzi, Alex; Roberts, Kimberly; ...

2014-11-01

Low activity radioactive waste at U.S. Department of Energy sites can be immobilized for permanent disposal using cementitious waste forms. This study evaluated waste forms produced with simulated wastes at concentrations up to twice that of currently operating processes. The simulated materials were evaluated for their fresh properties, which determine processability, and cured properties, which determine waste form performance. The results show potential for greatly reducing the volume of material. Fresh properties were sufficient to allow for processing via current practices. Cured properties such as compressive strength meet disposal requirements. Leachability indices provide an indication of expected long-term performance.

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

PubMed

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

2014-06-01

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

Ohm's Law, Batteries, and the Clean Energy Landscape

NASA Astrophysics Data System (ADS)

Balsara, Nitash

The need for creating safe electrolytes for lithium batteries is significant given the continued safety problems associated with current lithium-ion batteries. Nonflammable polymer electrolytes offer a possible solution but the rate of lithium ion transport is too low for practical applications. In this talk, I will discuss some of the fundamental factors that limit ion transport in polymers. Polymer electrolytes obey Ohm's Law, i.e. in the limit of small applied potentials, the current generated at steady state is proportional to the applied potential. Factors that determine the current generated will be determined using the continuum theory of Newman. Independent measurements of ion diffusion by pulsed-field gradient NMR will also be presented. The talk will end with a discussion of the possibility of commercializing all-solid batteries with polymer electrolytes.

Evaluating Student Performance and Qualifications in Rehabilitation Counseling

ERIC Educational Resources Information Center

Fleming, Allison R.; Kline, Katherine M.; Phillips, Brian N.

2017-01-01

Purpose: To determine methods of student learning assessment and clinical training in rehabilitation counseling programs. With many shifts occurring in postsecondary education and in rehabilitation counseling, it is critical to understand these current practices. Method: The authors used an Internet-based survey design to solicit program…

Handwriting Instruction: An Analysis of Perspectives from Three Elementary Teachers

ERIC Educational Resources Information Center

Sharp, Laurie; Brown, Tiffany

2015-01-01

Handwriting is an essential skill for learners, but advancements with technology have greatly altered perceptions towards handwriting and handwriting instruction. This study sought to determine the current state of handwriting through an exploratory analysis of the teaching experiences of three practicing elementary teachers with varying…

Collaborative Learning in Higher Education: Evoking Positive Interdependence

ERIC Educational Resources Information Center

Scager, Karin; Boonstra, Johannes; Peeters, Ton; Vulperhorst, Jonne; Wiegant, Fred

2016-01-01

Collaborative learning is a widely used instructional method, but the learning potential of this instructional method is often underused in practice. Therefore, the importance of various factors underlying effective collaborative learning should be determined. In the current study, five different life sciences undergraduate courses with successful…

Evaluation and analysis of current compaction methods for FDOT pipe trench backfills in areas of high water tables

DOT National Transportation Integrated Search

1999-01-01

This research project was undertaken to examine the practicality and adequacy of the FDOT specifications regarding compaction methods for pipe trench backfills under high water table. Given the difficulty to determine density and to attain desired de...

Changing Teacher Preparation in Art Education

ERIC Educational Resources Information Center

Henry, Carole; Lazzari, Mary

2007-01-01

Within art education, Day (1997) and others (for example; Beudert, 2006; Galbraith, 2001; Galbraith & Grauer, 2004; Hutchens, 1997; Sabol, 2004; Thurber, 2004; Zimmerman, 1997, 2004) have called for increased research into teacher preparation in order to understand current practice, to recognize what is working well, and to determine directions…

Current status for gastrointestinal nematode diagnosis in small ruminants: where are we and where are we going?

PubMed

Preston, Sarah Jane Margaret; Sandeman, Mark; Gonzalez, Jorge; Piedrafita, David

2014-01-01

Gastrointestinal nematode (GIN) parasites pose a significant economic burden particularly in small ruminant production systems. Anthelmintic resistance is a serious concern to the effective control of GIN parasites and has fuelled the focus to design and promote sustainable control of practices of parasite control. Many facets of sustainable GIN parasite control programs rely on the ability to diagnose infection both qualitatively and quantitatively. Diagnostics are required to determine anthelmintic efficacies, for targeted treatment programs and selection of animals for parasite resistant breeding. This review describes much of the research investigated to date to improve the current diagnostic for the above practices which is based on counting the number of parasite eggs in faeces.

Cost analysis of laparoscopic gastric bypass practice using current Medicare reimbursement and practice costs.

PubMed

Madan, Atul K; Powelson, Jill E; Tichansky, David S

2008-01-01

We performed a formal cost analysis of a hypothetical bariatric practice consisting of a surgeon, dietitian, clinical coordinator/office manager, receptionist, and certified medical assistant to determine whether a bariatric practice would have a difficult time surviving financially with the current Medicare reimbursement. The number of possible cases was calculated for the 2005 calendar year. Most of the costs and assumptions were taken from an actual bariatric practice. The malpractice insurance premium (but not physician salary and benefits) was calculated into the practice cost. With a total of 231 days available for clinical work in 2005, 300 scheduled laparoscopic gastric bypasses could have been performed to allow for appropriate clinic time for new patient visits, postoperative visits, and annual visits. The total reimbursement from Medicare would have been $516,158, with most of the reimbursement coming from procedure fees ($407,063). The total practice cost would have been $444,592. Most of the costs were clinic staff salary and benefits ($207,065) and the malpractice premium ($55,150). The net difference of $71,566 was left to pay the salary and benefits of the bariatric surgeon. The low reimbursement of Medicare for laparoscopic gastric bypass threatens the financial viability of a bariatric surgery practice. With the increasing cost of malpractice and the threatened decrease in Medicare physician reimbursement, Medicare recipients could see a decrease in the number of bariatric surgeons offering them service.

Promoting CPAP adherence in clinical practice: A survey of Swedish and Norwegian CPAP practitioners' beliefs and practices.

PubMed

Broström, Anders; Pakpour, Amir H; Nilsen, Per; Gardner, Benjamin; Ulander, Martin

2018-03-01

The benefits of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea are well established, but adherence tends to be low. Research exploring CPAP practitioners' beliefs around determinants of CPAP adherence, and the actions they use in clinical practice to promote CPAP adherence is lacking. This study aimed to: (i) develop and validate a questionnaire to assess beliefs and current practices among CPAP practitioners; (ii) explore practitioners' beliefs regarding the main determinants of patient adherence, and the actions practitioners most commonly use to promote CPAP adherence; and (iii) explore the associations between perceived determinants and adherence-promotion actions. One-hundred and forty-two CPAP practitioners in Sweden and Norway, representing 93% of all Swedish and 62% of all Norwegian CPAP centres, were surveyed via a questionnaire exploring potential determinants (18 items) and adherence-promotion actions (20 items). Confirmatory factor analysis and second-order structural equational modelling were used to identify patterns of beliefs, and potential associations with adherence-promotion actions. Patients' knowledge, motivation and attitudes were perceived by practitioners to be the main determinants of CPAP adherence, and educating patients about effects, management and treatment adjustments were the most common practices. Knowledge was shown to predict educational and informational actions (e.g. education about obstructive sleep apnea and CPAP). Educational and informational actions were associated with medical actions (e.g. treatment adjustment), but knowledge, attitude and support had no association with medical actions. These findings indicate that a wide variety of determinants and actions are considered important, though the only relationship observed between beliefs and actions was found for knowledge and educational and informational actions. © 2018 European Sleep Research Society.

Polling and public policy.

PubMed

Hausman, Daniel M

2004-09-01

This commentary distinguishes five reasons why one might want to conduct a survey concerning people's beliefs about death and the permissibility of harvesting organs: (1) simply to learn what people know and want; (2) to determine if current law and practice conform to the wishes of the population; (3) to determine the level of popular support for or opposition to policy changes; (4) to ascertain the causes and effects of popular beliefs and attitudes; and (5) to provide guidance in determining which law and practices are ethical. The commentary expresses qualms about how well surveys in general can perform with respect to the fifth objective, and it provides specific reasons to doubt whether this survey is informative from the perspective of a moral philosopher concerned with the nature of death and the contours of a permissible system of organ procurement.

Compstat 2.0: An Innovative Police Strategic Management Plan That Facilitates Performance in the All Crimes and All Hazards Environment

DTIC Science & Technology

2011-03-01

1 B. RESEARCH QUESTION (S) .........................................................................3 C. RESEARCH OBJECTIVES...3 D. SIGNIFICANCE OF RESEARCH ... RESEARCH QUESTION (S) The research herein is designed to examine Compstat, as it is practiced currently, and to determine what, if any

Is a Frog a Fish with Lungs? A Case Study of the Fungicide Trifloxystrobin

EPA Science Inventory

Current risk assessment practice is to use fish as a surrogate for larval stage amphibian species in determining chemical sensitivity when data for amphibians is not available. While evidence exists that fish are a sufficiently sensitive surrogate for amphibians for a wide range...

Fostering Hooks and Shifts: Tutorial Tactics for Guided Mathematical Discovery

ERIC Educational Resources Information Center

Abrahamson, Dor; Gutierrez, Jose; Charoenying, Timothy; Negrete, Andrea; Bumbacher, Engin

2012-01-01

How do instructors guide students to discover mathematical content? Are current explanatory models of pedagogical practice suitable to capture pragmatic essentials of discovery-based instruction? We examined videographed data from the implementation of a natural user interface design for proportions, so as to determine one constructivist tutor's…

28 CFR 36.208 - Direct threat.

Code of Federal Regulations, 2010 CFR

2010-07-01

... risk to the health or safety of others that cannot be eliminated by a modification of policies, practices, or procedures, or by the provision of auxiliary aids or services. (c) In determining whether an... individualized assessment, based on reasonable judgment that relies on current medical knowledge or on the best...

Optical Information Processing for Aerospace Applications 2

NASA Technical Reports Server (NTRS)

Stermer, R. L. (Compiler)

1984-01-01

Current research in optical processing, and determination of its role in future aerospace systems was reviewed. It is shown that optical processing offers significant potential for aircraft and spacecraft control, pattern recognition, and robotics. It is demonstrated that the development of optical devices and components can be implemented in practical aerospace configurations.

Top Ten Trends in Enrollment Management. Synopsis: Higher Education Research Highlights.

ERIC Educational Resources Information Center

Wolff, Tracy L.; Bryant, Peter S.

This national survey of college and university enrollment management practices examines how current technology is being used to make enrollment management more efficient and cost-effective. The report finds that more enrollment managers use advanced tracking, research, and analysis systems to determine the most effective outreach methods; they…

Neurologists' Views of Current Medications: Spasticity and Athetosis

ERIC Educational Resources Information Center

Obringer, S. John; Coffey, Kenneth

2008-01-01

Medications to treat individuals with cerebral palsy have increased significantly over the last few decades. The purpose of this article was to randomly survey practicing neurologists on a national level to determine prescribing patterns for both spasticity and athetosis. The results indicated that the most frequently prescribed medication for…

A Critical Analysis of the Child and Adolescent Wellness Scale (CAWS)

ERIC Educational Resources Information Center

Weller-Clarke, Alandra

2006-01-01

Current practice for assessing children and adolescents rely on objectively scored deficit-based models and/or informal assessments to determine how maladaptive behaviors affect performance. Social-emotional assessment instruments are used in schools and typically provide information related to behavioral and emotional deficits, but provide little…

Postgraduate Research Supervision: A Critical Review of Current Practice

ERIC Educational Resources Information Center

McCallin, Antoinette; Nayar, Shoba

2012-01-01

Changes in the funding and delivery of research programmes at the university level have, in recent years, resulted in significant changes to research supervision. This paper critically reviews key influences effecting postgraduate supervision. Analysis draws on literature spanning 2000-2010 to determine the appropriateness of traditional models of…

Evaluating the Effectiveness of Student Assistance Programs in Pennsylvania.

ERIC Educational Resources Information Center

Fertman, Carl I.; Fichter, Cele; Schlesinger, Jo; Tarasevich, Susan; Wald, Holly; Zhang, Xiaoyan

2001-01-01

This evaluation of the Pennsylvania Student Assistance Program (SAP) was conducted to determine overall efficacy of SAPs and, more specifically, how SAP is currently implemented. Findings indicate that SAP is being implemented as designed. Recommended is the development of benchmarks and indicators focusing on best SAP practices and effectiveness.…

The Response of Higher Education to Women's Inequality.

ERIC Educational Resources Information Center

Rae, Judith

The status of academic women is compared with that of men to determine whether disciminating practices and resulting inequality for women continue to exist. Current scientific periodicals, monographs, and books were searched, and the most recent statistics are presented. Results are discussed in terms of admissions, enrollment and degrees earned,…

78 FR 41934 - Agency Information Collection Activities; Proposed Collection; Comment Request; Human Cells...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0731... Determination for Donors; and Current Good Tissue Practice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing an opportunity for public comment...

75 FR 11545 - Agency Information Collection Activities; Proposed Collection; Comment Request; Human Cells...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0101... Determination for Donors; and Current Good Tissue Practice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing an opportunity for public comment...

Emergy baseline for the Earth: A historical review of the science and a new calculation

EPA Science Inventory

Quantifying the emergy baseline of the Earth is a practical necessity for emergy evaluations, because it serves as a unified basis for determining transformities of the available energy storages and flows of the geobiosphere. The current debate over the value and significance of ...

Surviving Troubled Times: Five Best Practices for Training Professionals

ERIC Educational Resources Information Center

Villachica, Steven W.; Stepich, Donald A.

2010-01-01

With the current economic downturn and signs of an emerging recovery, executives are trying to determine how to best use their organizations' funds and resources. This may mean downsizing human resource departments and eliminating positions for training personnel. The authors offer five strategies drawn from the professional literature to survive…

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

PubMed

Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

2012-12-01

Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

Pharmacy technician self-efficacies: Insight to aid future education, staff development, and workforce planning.

PubMed

Desselle, Shane P; Hoh, Ryan; Holmes, Erin R; Gill, Amanpreet; Zamora, Lemuel

2017-07-15

The roles of pharmacy technicians are increasingly prominent given pharmacy's transition to patient-centered activities and evolving scopes of practice in many U.S. states and throughout the world. The aims of this study were to assess U.S. pharmacy technicians' self-efficacies for and attitudes toward performing current and emerging roles in hospital and in community pharmacy and to identify factors related to pharmacy technician self-efficacies in these roles. A total of 5000 pharmacy technicians from 8 U.S. states were sent an electronic survey eliciting data on current involvement, self-efficacies, and attitudes for practicing in an expansive list of practice activities. The 8 states from which the sample was drawn were selected from a stratified randomized procedure using U.S. Census Bureau geographically defined regions. Pre-notification and response reminders were employed. Data were analyzed descriptively and with univariate, inferential tests, as appropriate, to determine associations with commitment, practice environment, experience level, and other variables. Of the 612 participants who responded, 494 were currently working as a technician and not enrolled in a PharmD program of study. Participants reported various activities in which they were highly engaged. Overall, attitudes toward performing most of the activities and self-efficacies were quite favorable, even for those activities in which technicians were currently less involved. There were some notable differences between technicians practicing in community versus hospital settings. Years of experience, profession commitment, and advanced employee ranking were associated with higher levels of self-efficacy, overall. This initial examination of pharmacy technician self-efficacies identified areas that along with other factors could help employers with further expanding technician practice activities and vocational institutions with considerations for education and development of these key members of the workforce. The results would suggest technicians to be ready for continued evolution in their practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Prevalence of urinary tract infection in acutely unwell children in general practice: a prospective study with systematic urine sampling

PubMed Central

O’Brien, Kathryn; Edwards, Adrian; Hood, Kerenza; Butler, Christopher C

2013-01-01

Background Urinary tract infection (UTI) in children may be associated with long-term complications that could be prevented by prompt treatment. Aim To determine the prevalence of UTI in acutely ill children ≤ 5 years presenting in general practice and to explore patterns of presenting symptoms and urine sampling strategies. Design and setting Prospective observational study with systematic urine sampling, in general practices in Wales, UK. Method In total, 1003 children were recruited from 13 general practices between March 2008 and July 2010. The prevalence of UTI was determined and multivariable analysis performed to determine the probability of UTI. Result Out of 597 (60.0%) children who provided urine samples within 2 days, the prevalence of UTI was 5.9% (95% confidence interval [CI] = 4.3% to 8.0%) overall, 7.3% in those < 3 years and 3.2% in 3–5 year olds. Neither a history of fever nor the absence of an alternative source of infection was associated with UTI (P = 0.64; P = 0.69, respectively). The probability of UTI in children aged ≥3 years without increased urinary frequency or dysuria was 2%. The probability of UTI was ≥5% in all other groups. Urine sampling based purely on GP suspicion would have missed 80% of UTIs, while a sampling strategy based on current guidelines would have missed 50%. Conclusion Approximately 6% of acutely unwell children presenting to UK general practice met the criteria for a laboratory diagnosis of UTI. This higher than previously recognised prior probability of UTI warrants raised awareness of the condition and suggests clinicians should lower their threshold for urine sampling in young children. The absence of fever or presence of an alternative source of infection, as emphasised in current guidelines, may not rule out UTI in young children with adequate certainty. PMID:23561695

Benefits arising from SEA application -- a comparative review of North West England, Noord-Holland, and Brandenburg-Berlin

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

Fischer, T.B.

1999-03-01

This article seeks to determine the extent to which current assessment practice of transport infrastructure-related policies, plans, and programs (PPPs) results in certain benefits of strategic environmental assessment (SEA) in three European Union regions, namely, the region of North West England (UK), the provincie (administrative region) Noord-Holland (The Netherlands), and the engerer Verflechtungsraum (planning region) Brandenburg-Berlin (Germany). The number of assessments of transport infrastructure-related PPPs that potentially may be called SEA in the three regions is estimated. Benefits that should result from the application of SEA can be determined based on a review of existing academic literature. An analytical frameworkmore » is prepared, introducing evaluation criteria that are based on principles of SEA frameworks and procedures. The framework is used to analyze transport infrastructure-related PPPs at all administrative levels of decision-making in the three study regions. It is concluded that current assessment practice indeed results in certain related experience in the European Union than is frequently anticipated in the academic literature. It is observed that case studies that were reviewed on a number of previous occasions and those that are included in this analysis do not necessarily appear to be good practice cases.« less

Three common faults in current practice that influence the validity of data obtained from electronic air pollution instrumentation.

PubMed

Dowd, G; Thomas, R S; Monkman, J L

1975-01-01

Instrumental development is now entering a more logical era, where the former artistic character of electronics is being replaced by cold technology. Because of this, one should be expect more reliability; however, there still exist many weak links in practical application. Digital readout systems and computer processing induce a false sense of security. In reality, it is the sample-measurement relationship that determines an instrument's credibility and not the number of digits on its meter. In describing three faulty practices that greatly influence an instrument's performance, it is hoped that measurement may be more closely related to the sample!

Methods for determining manning's coefficients for Illinois streams

USGS Publications Warehouse

Soong, D.T.; Halfar, T.M.; Jupin, M.A.; Wobig, L.A.; ,

2004-01-01

Determination of Manning's coefficient, n, for natural streams remains a challenge in practices. One source for determining the n-values that has received practitioners' attention is presenting the n-values determined from field data (measured discharge and water-surface slope) in combination of photographs and site descriptions (ancillary information). Further improvements in the visual approach can be made in presenting site characteristics and describing site ancillary information. In this manner, users can use the presented information for sites of interest with similar features. This approach in a current project on the subject for Illinois streams is discussed.

The Social Determinants of Tuberculosis: From Evidence to Action

PubMed Central

Boccia, Delia; Evans, Carlton A.; Adato, Michelle; Petticrew, Mark; Porter, John D. H.

2011-01-01

Growing consensus indicates that progress in tuberculosis control in the low- and middle-income world will require not only investment in strengthening tuberculosis control programs, diagnostics, and treatment but also action on the social determinants of tuberculosis. However, practical ideas for action are scarcer than is notional support for this idea. We developed a framework based on the recent World Health Organization Commission on Social Determinants of Health and on current understanding of the social determinants of tuberculosis. Interventions from outside the health sector—specifically, in social protection and urban planning—have the potential to strengthen tuberculosis control. PMID:21330583

Determinants in the development of advanced nursing practice: a case study of primary-care settings in Hong Kong.

PubMed

Twinn, Sheila; Thompson, David R; Lopez, Violeta; Lee, Diana T F; Shiu, Ann T Y

2005-01-01

Different factors have been shown to influence the development of models of advanced nursing practice (ANP) in primary-care settings. Although ANP is being developed in hospitals in Hong Kong, China, it remains undeveloped in primary care and little is known about the factors determining the development of such a model. The aims of the present study were to investigate the contribution of different models of nursing practice to the care provided in primary-care settings in Hong Kong, and to examine the determinants influencing the development of a model of ANP in such settings. A multiple case study design was selected using both qualitative and quantitative methods of data collection. Sampling methods reflected the population groups and stage of the case study. Sampling included a total population of 41 nurses from whom a secondary volunteer sample was drawn for face-to-face interviews. In each case study, a convenience sample of 70 patients were recruited, from whom 10 were selected purposively for a semi-structured telephone interview. An opportunistic sample of healthcare professionals was also selected. The within-case and cross-case analysis demonstrated four major determinants influencing the development of ANP: (1) current models of nursing practice; (2) the use of skills mix; (3) the perceived contribution of ANP to patient care; and (4) patients' expectations of care. The level of autonomy of individual nurses was considered particularly important. These determinants were used to develop a model of ANP for a primary-care setting. In conclusion, although the findings highlight the complexity determining the development and implementation of ANP in primary care, the proposed model suggests that definitions of advanced practice are appropriate to a range of practice models and cultural settings. However, the findings highlight the importance of assessing the effectiveness of such models in terms of cost and long-term patient outcomes.

Children's medicines in Tanzania: a national survey of administration practices and preferences.

PubMed

Adams, Lisa V; Craig, Sienna R; Mmbaga, Elia John; Naburi, Helga; Lahey, Timothy; Nutt, Cameron T; Kisenge, Rodrick; Noel, Gary J; Spielberg, Stephen P

2013-01-01

The dearth of age-appropriate formulations of many medicines for children poses a major challenge to pediatric therapeutic practice, adherence, and health care delivery worldwide. We provide information on current administration practices of pediatric medicines and describe key stakeholder preferences for new formulation characteristics. We surveyed children aged 6-12 years, parents/caregivers over age 18 with children under age 12, and healthcare workers in 10 regions of Tanzania to determine current pediatric medicine prescription and administration practices as well as preferences for new formulations. Analyses were stratified by setting, pediatric age group, parent/caregiver education, and healthcare worker cadre. Complete data were available for 206 children, 202 parents/caregivers, and 202 healthcare workers. Swallowing oral solid dosage forms whole or crushing/dissolving them and mixing with water were the two most frequently reported methods of administration. Children frequently reported disliking medication taste, and many had vomited doses. Healthcare workers reported medicine availability most significantly influences prescribing practices. Most parents/caregivers and children prefer sweet-tasting medicine. Parents/caregivers and healthcare workers prefer oral liquid dosage forms for young children, and had similar thresholds for the maximum number of oral solid dosage forms children at different ages can take. There are many impediments to acceptable and accurate administration of medicines to children. Current practices are associated with poor tolerability and the potential for under- or over-dosing. Children, parents/caregivers, and healthcare workers in Tanzania have clear preferences for tastes and formulations, which should inform the development, manufacturing, and marketing of pediatric medications for resource-limited settings.

Practical guidance on the use of faecal calprotectin.

PubMed

Brookes, Matthew J; Whitehead, Simon; Gaya, Daniel R; Hawthorne, Antony Barney

2018-04-01

Differentiation between inflammatory bowel disease (IBD) and functional gut disorders, and the determination of mucosal disease activity in established cases of IBD remain the cornerstones of disease diagnosis and management. Non-invasive, accurate biomarkers of gut inflammation are needed due to the variability of symptoms, the inaccuracies of currently available blood markers and the cost and invasive nature of endoscopy. Numerous biomarkers have been used and/or considered with some in current use. This article reviews the current evidence base around the indications for using biomarkers and their limitations, with a particular focus on faecal calprotectin.

Evaluation of community pharmacy-based services for type-2 diabetes in an Indonesian setting: pharmacist survey.

PubMed

Wibowo, Yosi; Parsons, Richard; Sunderland, Bruce; Hughes, Jeffery

2015-10-01

Diabetes is an emerging chronic disease in developing countries. Currently the management of diabetes in developing countries is mainly hospital or clinic based. With burgeoning numbers of patients with diabetes, other models need to be evaluated for service delivery in developing countries. Community pharmacists are an important option for provision of diabetes care. Currently, data regarding practices of community pharmacists in diabetes care have been limited to developed countries. To evaluate current community pharmacy-based services and perceived roles of pharmacists in type 2 diabetes care, and characteristics (pharmacist and pharmacy) associated with current practice. Community pharmacies in a developing country setting (Surabaya, Indonesia). A questionnaire was administered to pharmacists managing a random sample of 400 community pharmacies in Surabaya, Indonesia. Current practice and pharmacists' perceived roles were rated using Likert scales, whilst an open-ended question was used to identify priority roles. Logistic regression models determined characteristics associated with current practice. A response rate of 60% was achieved. Dispensing (100%) and education on how to use medications (72.6%) were common current pharmacy practices. More than 50% of pharmacists were supportive towards providing additional services beyond dispensing. The highest priorities for services beyond dispensing were education on medications [i.e. directions for use (58.6%) and common/important adverse effects (25.7%)], education on exercise (36.5%), education on diet (47.7%), and monitoring medication compliance (27.9%). Facilitators identified were: being perceived as part of a pharmacist's role (for all priority services), pharmacies with more than 50 diabetes customers per month (for diet education), and pharmacists' involvement in diabetes training (for compliance monitoring). The key barrier identified was lower pharmacist availability (for diet education as well as compliance monitoring). Most community pharmacies in Surabaya, Indonesia have only provided a basic service of dispensing for type 2 diabetes patients. Many pharmacists believed that they should extend their roles particularly regarding patient education and monitoring. The development of pharmacist professional roles would assist in managing the burgeoning burden of diabetes. The identified facilitators/barriers provide baseline data to support the development of community pharmacy-based diabetes services.

Determining accessibility to dermatologists and teledermatology locations in Kentucky: demonstration of an innovative geographic information systems approach.

PubMed

Shannon, Gary William; Buker, Carol Marie

2010-01-01

Teledermatology provides a partial solution to the problem of accessibility to dermatology services in underserved areas, yet methodologies to determine the locations and geographic dimensions of these areas and the locational efficiency of remote teledermatology sites have been found wanting. This article illustrates an innovative Geographic Information Systems approach using dermatologists' addresses, U.S. Census population data, and the Topologically Integrated Geographic Encoding and Referencing System. Travel-time-based service areas were calculated and mapped for each dermatologist in the state of Kentucky and for possible locations of several remote teledermatology sites. Populations within the current and possible remote service areas were determined. These populations and associated maps permit assessment of the locational efficiency of the current distribution of dermatologists, location of underserved areas, and the potential contribution of proposed hypothetical teledermatology sites. This approach is a valuable and practical tool for evaluating access to current distributions of dermatologists as well as planning for and implementing teledermatology.

Transformational leadership training programme for charge nurses.

PubMed

Duygulu, Sergul; Kublay, Gulumser

2011-03-01

This paper is a report of an evaluation of the effects of a transformational leadership training programme on Unit Charge Nurses' leadership practices. Current healthcare regulations in the European Union and accreditation efforts of hospitals for their services mandate transformation in healthcare services in Turkey. Therefore, the transformational leadership role of nurse managers is vital in determining and achieving long-term goals in this process. The sample consisted of 30 Unit Charge Nurses with a baccalaureate degree and 151 observers at two university hospitals in Turkey. Data were collected using the Leadership Practices Inventory-Self and Observer (applied four times during a 14-month study process from December 2005 to January 2007). The transformational leadership training programme had theoretical (14 hours) and individual study (14 hours) in five sections. Means, standard deviations and percentages, repeated measure tests and two-way factor analysis were used for analysis. According the Leadership Practices Inventory-Self and Observer ratings, leadership practices increased statistically significantly with the implementation of the programme. There were no significant differences between groups in age, length of time in current job and current position. The Unit Charge Nurses Leadership Practices Inventory self-ratings were significantly higher than those of the observers. There is a need to develop similar programmes to improve the leadership skills of Unit Charge Nurses, and to make it mandatory for nurses assigned to positions of Unit Charge Nurse to attend this kind of leadership programme. © 2010 Blackwell Publishing Ltd.

Work and retirement preferences of practicing radiologists as a predictor of workforce needs.

PubMed

Moriarity, Andrew K; Brown, Manuel L; Schultz, Lonni R

2014-08-01

The radiology job market has been described as highly variable, and recent practice hiring surveys predict that the number of available jobs will remain flat. Radiologists may be working more hours and retiring later than desired, activities that influence overall job availability. A national survey was performed to determine the desired work rate and retirement preferences of practicing radiologists, and the responses are used to estimate current and potential future work output and future workforce needs. Practicing radiologists were surveyed regarding current and preferred work level and desired and expected retirement age. A model incorporating these preferences and stratified by age was developed using survey responses and American Medical Association full-time equivalent (FTE) estimates. Available FTE radiologists are estimated under four scenarios from 2016 to 2031 in 5-year intervals. The model predicts a total of 26,362 FTE radiologists available in 2011, which corresponds to previous estimates. Participants reported working more hours and expecting to retire later than desired, with younger radiologists and women reporting the greatest desired decrease in FTE hours worked. Under each scenario, there is an initial FTE availability in 2016 ranging from 21,156 to 24,537, which increases to between 27,753 and 31,435 FTE by 2031 depending on work rate and retirement patterns. Practicing radiologists report that they currently work more hours than desired and expect to retire later than they would prefer. If radiologists changed current personal work rate and expected retirement age to meet these preferences, there would be an immediate shortage of FTE radiologists continuing until at least 2020 assuming no other workforce needs changes. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Early Career Experience of Pediatric Orthopaedic Fellows: What to Expect and Need for Their Services.

PubMed

Glotzbecker, Michael P; Shore, Benjamin J; Fletcher, Nicholas D; Larson, A Noelle; Hydorn, Christopher R; Sawyer, Jeffery R

2016-06-01

A dramatic increase in the number of pediatric orthopaedic fellows being trained has led to concerns that there may be an oversupply of pediatric orthopaedists. The purpose of this study was to determine whether this perception is accurate and whether the practice expectations of recent pediatric fellowship graduates are being met by surveying recent pediatric fellowship graduates about their early practice experiences. A 36-question survey approved by the Pediatric Orthopaedic Society of North America (POSNA) leadership was electronically distributed to 120 recent graduates of pediatric orthopaedic fellowships; 81 responses were ultimately obtained (67.5% response rate). Almost all (91%) of the respondents were very or extremely satisfied with their fellowship experience. Half of the respondents had at least 1 job offer before they entered their fellowships. After completion of fellowships, 35% received 1 job offer and 62.5% received ≥2 job offers; only 2.5% did not receive a job offer. Most reported a practice consisting almost entirely of pediatric orthopaedics, and 93.5% thought this was in line with their expectations; 87% indicated satisfaction with their current volume of pediatric orthopaedics, and 85% with the complexity of their pediatric orthopaedic cases. Despite the high employment percentages and satisfaction with practice profiles, nearly a third (28%) of respondents replied that too many pediatric orthopaedists are being trained. Positive messages from this survey include the satisfaction of graduates with their fellowship training, the high percentage of graduates who readily found employment, and the satisfaction of graduates with their current practice environments; this indicates that the pediatric orthopaedic job environment is not completely saturated and there are continued opportunities for graduating pediatric fellows despite the increased number of fellows being trained. Although not determined by this study, it may be that the stable demand for pediatric orthopaedic services is being driven by the expansion of the scope of practice as well as subspecialization within the practice of pediatric orthopaedics.

Protocol for the New Medicine Service Study: a randomized controlled trial and economic evaluation with qualitative appraisal comparing the effectiveness and cost effectiveness of the New Medicine Service in community pharmacies in England

PubMed Central

2013-01-01

Background Medication non-adherence is considered an important cause of morbidity and mortality in primary care. This study aims to determine the effectiveness, cost effectiveness and acceptability of a complex intervention delivered by community pharmacists, the New Medicine Service (NMS), compared with current practice in reducing non-adherence to, and problems with, newly prescribed medicines for chronic conditions. Methods/design Research subject group: patients aged 14 years and above presenting in a community pharmacy for a newly prescribed medicine for asthma/chronic obstructive pulmonary disease (COPD); hypertension; type 2 diabetes or anticoagulant/antiplatelet agents in two geographical regions in England. Design: parallel group patient-level pragmatic randomized controlled trial. Interventions: patients randomized to either: (i) current practice; or (ii) NMS intervention comprising pharmacist-delivered support for a newly prescribed medicine. Primary outcomes: proportion of adherent patients at six, ten and 26 weeks from the date of presenting their prescriptions at the pharmacy; cost effectiveness of the intervention versus current practice at 10 weeks and 26 weeks; in-depth qualitative understanding of the operationalization of NMS in pharmacies. Secondary outcomes: impact of NMS on: patients’ understanding of their medicines, pharmacovigilance, interprofessional and patient-professional relationships and experiences of service users and stakeholders. Economic analysis: Trial-based economic analysis (cost per extra adherent patient) and long-term modeling of costs and health effects (cost per quality-adjusted-life-year) will be conducted from the perspective of National Health Service (NHS) England, comparing NMS with current practice. Qualitative analysis: a qualitative study of NMS implementation in different community settings, how organizational influences affect NMS delivery, patterns of NMS consultations and experiences of professionals and patients participating in NMS, and patients receiving current practice. Sample size: 250 patients in each treatment arm would provide at least 80% power (two-tailed alpha of 0.05) to demonstrate a reduction in patient-reported non-adherence from 20% to 10% in the NMS arm compared with current practice, assuming a 20% drop-out rate. Discussion At the time of submission of this article, 58 community pharmacies have been recruited and the interventions are being delivered. Analysis has not yet been undertaken. Trial registration Current controlled trials: ISRCTN23560818 Clinical Trials US (clinicaltrials.gov): NCT01635361 PMID:24289059

Protocol for the New Medicine Service Study: a randomized controlled trial and economic evaluation with qualitative appraisal comparing the effectiveness and cost effectiveness of the New Medicine Service in community pharmacies in England.

PubMed

Boyd, Matthew; Waring, Justin; Barber, Nick; Mehta, Rajnikant; Chuter, Antony; Avery, Anthony J; Salema, Nde-Eshimuni; Davies, James; Latif, Asam; Tanajewski, Lukasz; Elliott, Rachel A

2013-12-01

Medication non-adherence is considered an important cause of morbidity and mortality in primary care. This study aims to determine the effectiveness, cost effectiveness and acceptability of a complex intervention delivered by community pharmacists, the New Medicine Service (NMS), compared with current practice in reducing non-adherence to, and problems with, newly prescribed medicines for chronic conditions. Research subject group: patients aged 14 years and above presenting in a community pharmacy for a newly prescribed medicine for asthma/chronic obstructive pulmonary disease (COPD); hypertension; type 2 diabetes or anticoagulant/antiplatelet agents in two geographical regions in England. parallel group patient-level pragmatic randomized controlled trial. patients randomized to either: (i) current practice; or (ii) NMS intervention comprising pharmacist-delivered support for a newly prescribed medicine. proportion of adherent patients at six, ten and 26 weeks from the date of presenting their prescriptions at the pharmacy; cost effectiveness of the intervention versus current practice at 10 weeks and 26 weeks; in-depth qualitative understanding of the operationalization of NMS in pharmacies. impact of NMS on: patients' understanding of their medicines, pharmacovigilance, interprofessional and patient-professional relationships and experiences of service users and stakeholders.Economic analysis: Trial-based economic analysis (cost per extra adherent patient) and long-term modeling of costs and health effects (cost per quality-adjusted-life-year) will be conducted from the perspective of National Health Service (NHS) England, comparing NMS with current practice.Qualitative analysis: a qualitative study of NMS implementation in different community settings, how organizational influences affect NMS delivery, patterns of NMS consultations and experiences of professionals and patients participating in NMS, and patients receiving current practice. 250 patients in each treatment arm would provide at least 80% power (two-tailed alpha of 0.05) to demonstrate a reduction in patient-reported non-adherence from 20% to 10% in the NMS arm compared with current practice, assuming a 20% drop-out rate. At the time of submission of this article, 58 community pharmacies have been recruited and the interventions are being delivered. Analysis has not yet been undertaken. Current controlled trials: ISRCTN23560818. Clinical Trials US (clinicaltrials.gov): NCT01635361.

Isolated Sub-Dehumidification Strategies in Large Supermarkets and Grocery Stores

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

Fricke, Brian A; Sharma, Vishaldeep

2011-10-01

The objective of this project was to determine the potential energy savings associated with reducing the relative humidity in the vicinity of refrigerated display cases in supermarkets, as compared to the widely accepted current practice of maintaining a relatively higher and uniform humidity level throughout the entire supermarket. Existing and new strategies for maintaining lower relative humidity levels near the vicinity of refrigerated display cases were analyzed to determine their effectiveness and limits of application.

Body composition and functional assessment of nutritional status in adults: a narrative review of imaging, impedance, strength and functional techniques.

PubMed

Smith, S; Madden, A M

2016-12-01

The accurate and valid assessment of body composition is essential for the diagnostic evaluation of nutritional status, identifying relevant outcome measures, and determining the effectiveness of current and future nutritional interventions. Developments in technology and our understanding of the influences of body composition on risk and outcome will provide practitioners with new opportunities to enhance current practice and to lead future improvements in practice. This is the second of a two-part narrative review that aims to critically evaluate body composition methodology in diverse adult populations, with a primary focus on its use in the assessment and monitoring of under-nutrition. Part one focused on anthropometric variables [Madden and Smith (2016) J Hum Nutr Diet 29: 7-25] and part two focuses on the use of imaging techniques, bioelectrical impedance analysis, markers of muscle strength and functional status, with particular reference to developments relevant to practice. © 2016 The British Dietetic Association Ltd.

Standard Test Methods for Textile Composites

NASA Technical Reports Server (NTRS)

Masters, John E.; Portanova, Marc A.

1996-01-01

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

Achieving competitive advantage through strategic human resource management.

PubMed

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

1990-01-01

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

A qualitative investigation of specialist orthodontists in New Zealand. Part 1. Orthodontists and orthodontic practice.

PubMed

Soma, Kieran J; Thomson, W Murray; Morgaine, Kate C; Harding, Winifred J

2012-05-01

Current knowledge of orthodontic practice is largely anecdotal and the lack of systematic knowledge can create barriers to better identifying the factors that make a successful orthodontist. The aim of this study was to investigate the routine practising lives of New Zealand orthodontists in order to generate an understanding of the reality of orthodontic specialist practice and its effects on their professional and personal lives. Semi-structured interviews were conducted involving 19 practising orthodontists (four females, 15 males; mean age 50 years) throughout New Zealand.Transcribed interviews were analysed for themes using an applied grounded theory approach. A core category of 'practising orthodontists' was derived, and related themes were grouped under the sub-categories of: (a) NZ orthodontic specialist practice; (b) NZ specialist orthodontists; and (c) work-life balance. The present paper reports on the first two subcategories. Themes elucidated under the specialist practice sub-category included modernisation, changing social norms, practice arrangement, branch practice, staffing, competition, legislation, advertising, the future and the provision of orthodontics by non-specialists. Themes in the orthodontic specialist sub-category were prior experience, postgraduate training, recent graduates, reasons for specialising, generational differences, females in orthodontics, NZ and overseas practice, the ageing profession and the prospect of an orthodontist shortage. This investigation has shed light on orthodontists and the practice of orthodontics in New Zealand and determined aspects rarely discussed in the current or previous literature. It will be valuable to observe how orthodontists and orthodontic practice continue to evolve in response to changes in NZ society.

From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice.

PubMed

Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee

2014-04-01

Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician's ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs.

From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice

PubMed Central

Fazalullasha, Fatima; Taras, Jillian; Morinis, Julia; Levin, Leo; Karmali, Karima; Neilson, Barbara; Muskat, Barbara; Bloch, Gary; Chan, Kevin; McDonald, Maureen; Makin, Sue; Ford-Jones, E Lee

2014-01-01

Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician’s ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs. PMID:24855416

Application of a faith-based integration tool to assess mental and physical health interventions.

PubMed

Saunders, Donna M; Leak, Jean; Carver, Monique E; Smith, Selina A

2017-01-01

To build on current research involving faith-based interventions (FBIs) for addressing mental and physical health, this study a) reviewed the extent to which relevant publications integrate faith concepts with health and b) initiated analysis of the degree of FBI integration with intervention outcomes. Derived from a systematic search of articles published between 2007 and 2017, 36 studies were assessed with a Faith-Based Integration Assessment Tool (FIAT) to quantify faith-health integration. Basic statistical procedures were employed to determine the association of faith-based integration with intervention outcomes. The assessed studies possessed (on average) moderate, inconsistent integration because of poor use of faith measures, and moderate, inconsistent use of faith practices. Analysis procedures for determining the effect of FBI integration on intervention outcomes were inadequate for formulating practical conclusions. Regardless of integration, interventions were associated with beneficial outcomes. To determine the link between FBI integration and intervention outcomes, additional analyses are needed.

Determining Need for School-Based Physical Therapy Under IDEA: Commonalities Across Practice Guidelines.

PubMed

Vialu, Carlo; Doyle, Maura

2017-10-01

The Individuals with Disabilities Education Act (IDEA) includes physical therapy (PT) as a related service that may be provided to help students with disabilities benefit from their education. However, the IDEA does not provide specific guidance for the provision of school-based PT, resulting in variations in practice across the United States. The authors examined 22 state and local education agency guidelines available online to find commonalities related to the determination of a student's need for PT. Seven commonalities found: educational benefit, team decision, need for PT expertise, establishment of Individualized Education Program (IEP) goal before determining need for PT, distinction between medical and educational PT, the student's disability adversely affects education, and the student's potential for improvement. These commonalities are discussed in relation to current PT and special education literature. This article suggests applying these commonalities as procedural requirements and questions for discussion during an IEP team meeting.

Determining Competencies for Frontline Sales Managers in For-Profit Organizations

ERIC Educational Resources Information Center

Busch, Tina Killough

2012-01-01

Practice in the sales profession and current competency research indicate salesperson competence is key to organizational competitive advantage. With models of selling evolving to respond to the marketplace, there are changes in the competency requirements and roles people must play for future success, resulting in the emergence of new kinds of…

Legal Frameworks for Higher Education Governance in Sub-Saharan Africa

ERIC Educational Resources Information Center

Saint, William

2009-01-01

This is a preliminary survey of the laws and statutes that determine governance arrangements for higher education systems as well as individual institutions in 24 countries of Sub-Saharan Africa. Following an overview of recent higher education governance trends within Africa, it describes the current range of practice and most common approaches…

Women in Vocational Education. Project Baseline Supplemental Report.

ERIC Educational Resources Information Center

Steele, Marilyn

Reviewing the current status of women in vocational education, the study determines whether there is a cause-effect relationship between school practices and limited job options for women in the world of work. According to a review and analysis of available data, schools at all levels are operating separate vocational education programs for women.…

Staffing for Success: Linking Teacher Evaluation and School Personnel Management in Practice

ERIC Educational Resources Information Center

Master, Benjamin

2014-01-01

Teacher evaluation is at the center of current education policy reform. Most evaluation systems rely at least in part on principals' assessments of teachers, and their discretionary judgments carry substantial weight. However, we know relatively little about what they value when determining evaluations and high stakes personnel decisions.…

Relevance of Programs for Emotionally Disturbed Youth in Other Lands

ERIC Educational Resources Information Center

David, Henry P.

1970-01-01

A survey of current trends was conducted in more than 40 countries. Focus was on the organization of services and their relevance for evolving practices in the United States. Apparent was a willingness to experiment with administrative and therapeutic roles. Ideological differences are important determinants of the organization, range, and quality…

Rickets and osteopenia are more common in infants <600g birth weight than those 600-1000g

USDA-ARS?s Scientific Manuscript database

Osteopenia and rickets are common among extremely low birth weight infants (ELBW, <1000g birth weight) despite current nutritional practices. To determine the incidence of osteopenia and rickets in ELBW infants. We evaluated all ELBW infants admitted to Texas Children's Hospital NICU in 2006 and 200...

Status, distribution, and movements of martens in northeastern Minnesota.

Treesearch

L. David Mech; Lynn L. Rogers

1977-01-01

The decline of martens in Minnesota is reviewed and a recent increase documented. Adjacent and partially overlapping home ranges of 4.3 to 19.9 km2 were determined by telemetry for a female and three males. Habitat use is described. If current trapping and timber management practices persist, martens should continue to increase.

Assessing Mentoring Culture: Faculty and Staff Perceptions, Gaps, and Strengths

ERIC Educational Resources Information Center

Sheridan, Lynn; Murdoch, Natasha Hubbard; Harder, Emily

2015-01-01

The purpose of this non-experimental, cross-sectional, descriptive research was to survey faculty and staff perceptions of mentorship in a postsecondary institution in order to determine gaps and strengths in the current mentorship environment. The anecdotal activities we present reflect our educational practice environment through the work of our…

The Impact of Field Experiences in Yellowstone National Park on Practice in Secondary Classrooms

ERIC Educational Resources Information Center

McGrew, Christopher N.

2012-01-01

The current study focused on how six participants of a 2009 professional development activity at Yellowstone National Park described their experience and classroom instructional impact. The author focused on words and phrases illustrating perspective gathering, reflection and public performance to determine the impact of both the experience at…

"Plays Nice with Others": Social-Emotional Learning and Academic Success

ERIC Educational Resources Information Center

Denham, Susanne A.; Brown, Chavaughn

2010-01-01

Research Findings: Social-emotional learning (SEL) is increasingly becoming an area of focus for determining children's school readiness and predicting their academic success. Practice or Policy: The current article outlines a model of SEL, identifies specific SEL skills, and discusses how such skills contribute and relate to academic success.…

Evaluation of Online Education about Diabetes Management in the School Setting

ERIC Educational Resources Information Center

Bachman, Jean A.; Hsueh, Kuei-Hsiang

2008-01-01

There are a variety of initiatives to provide education to improve the quality of care for children with diabetes in the school setting. This study piloted and evaluated an online continuing education program for school nurses about diabetes management for children in schools using current practice principles. The evaluation determined if…

Geostatistical Evaluation of Natural Tree Regeneration of a Disturbed Forest

Treesearch

José Germán Flores Garnica; David Arturo Moreno Gonzalez; Juan de Dios Benavides Solorio

2006-01-01

The implementation of silvicultural strategies in a forest management has to guaranty forest sustainability, which is supported by an adequate regeneration. Therefore, quality and intensity of silvicultural practices is based on an accurate knowledge of the current spatial distribution of regeneration. At the same time, this regeneration is determined by the spatial...

Inquiry-Based Science Education: A Scenario on Zambia's High School Science Curriculum

ERIC Educational Resources Information Center

Chabalengula, Vivien M.; Mumba, Frackson

2012-01-01

This paper is aimed at elucidating the current state of inquiry-based science education (IBSE) in Zambia's high school science curriculum. Therefore, we investigated Zambian teachers' conceptions of inquiry; determined inquiry levels in the national high school science curriculum materials, which include syllabi, textbooks and practical exams; and…

FACILITIES FOR EDUCATION IN VA HOSPITALS. FINAL REPORT.

ERIC Educational Resources Information Center

GREEN, ALAN C.; AND OTHERS

THIS STUDY WAS AUTHORIZED BY THE VA DEPARTMENT OF MEDICINE AND SURGERY FOR THE PURPOSE OF IDENTIFYING AND DETERMINING THE FACILITIES NEEDED TO PROPERLY HOUSE AND SUPPORT EDUCATION ACTIVITIES IN EXISTING AND FUTURE VA HOSPITALS AND TO PRODUCE ARCHITECTURAL GUIDANCE IN THE DESIGN OF THE FACILITIES. CURRENT PRACTICES AND SIGNIFICANT TRENDS IN MEDICAL…

Fertilization and irrigation of Eucalyptus in southern California

Treesearch

Paul W. Moore

1983-01-01

An experiment to determine the interaction of three levels of irrigation, three levels of fertility and three densities of planting was started at the University of California Moreno Ranch in 1982. Differential irrigation and fertility treatments will begin in June of 1983. Some current practices of irrigation and fertilization by southern California growers are...

Staff Developers' Perceptions on Building a Culture of Teaching and Learning

ERIC Educational Resources Information Center

Roy, I. J.

2007-01-01

The rapid education transformation in South African education over the past decade (1994-current), forced Institutions of Higher Learning to critically examine their own practices. The transformation of the post apartheid South African education system is largely driven and determined by a social and economic agenda. At institutions of higher…

Developmental and Autism Screening: A Survey across Six States

ERIC Educational Resources Information Center

Arunyanart, Wirongrong; Fenick, Ada; Ukritchon, Supak; Imjaijitt, Worarachanee; Northrup, Veronika; Weitzman, Carol

2012-01-01

The American Academy of Pediatrics (AAP) recommends screening children for developmental delay and autism. Studies of current screening practice to date have been limited in scope and primarily focused on small, local samples. This study is designed to determine compliance with AAP screening recommendations: (1) developmental screening at 9, 18,…

Communication of Energy Efficiency Information to Remodelers: Lessons From Current Practice

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

Liaukus, C.

2012-10-01

The effective communication of energy efficiency and building science information to remodeling contractors is achieved through varying formats, timelines, and modes depending on who is delivering the information, who is intended to receive it, and what technical, intellectual,and time resources the recipients have at their disposal. Determining what type of communication is effective does not lend itself to a clearly quantifiable test but rather a qualitative one. That qualitative judgment can be supported by the research of current practices deemed effective for one or more of the following reasons: it has led to the successful completion of a certifying testmore » or other evaluation, it has been widely used for the remodeling industry, it has been considered effective by a sampling of remodeling contractors, and/or it has proven effective in the field for the BARA team. These criteria were used to create a select list of communications to be further analyzed to determine why they are effective and how less successful formats or strategies can be revised for greater effectiveness.« less

Identifying changes in the role of the infection preventionist through the 2014 practice analysis study conducted by the Certification Board of Infection Control and Epidemiology, Inc.

PubMed

Henman, Lita Jo; Corrigan, Robert; Carrico, Ruth; Suh, Kathryn N

2015-07-01

The Certification Board of Infection Control and Epidemiology, Inc (CBIC) is a voluntary autonomous multidisciplinary board that provides direction and administers the certification process for professionals who are responsible for the infection prevention and control program in a health care facility. The CBIC performs a practice analysis approximately every 4-5 years. The practice analysis is an integral part of the certification examination development process and serves as the backbone of the test content outline. In 2013, the CBIC determined that a practice analysis was required and contracted with Prometric to facilitate the process. The practice analysis was carried out in 2014 by a diverse group of subject matter experts from the United States and Canada. The practice analysis results showed a significant change in the number of tasks and associated knowledge required for the competent practice of infection prevention. As authorized by the CBIC, the test committee is currently reclassifying the bank of examination questions as required and is writing and reviewing questions based on the updated test specifications and content outline. The new content outline will be reflected in examinations that are taken beginning in July 2015. This iterative process of assessing and updating the certification examination ensures not only a valid competency tool but a true reflection of current practices. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Virtual science instructional strategies: A set of actual practices as perceived by secondary science educators

NASA Astrophysics Data System (ADS)

Gillette, Tammy J.

2009-12-01

The purpose of this proposed research study was to identify actual teaching practices/instructional strategies for online science courses. The identification of these teaching practices/instructional strategies could be used to compile a set of teaching practices/instructional strategies for virtual high school and online academy science instructors. This study could assist online science instructors by determining which teaching practices/instructional strategies were preferred for the online teaching environment. The literature reviewed the role of online and face-to-face instructional strategies, then discussed and elaborated on the science instructional strategies used by teachers, specifically at the secondary level. The current literature did not reflect an integration of these areas of study. Therefore, the connectedness of these two types of instructional strategies and the creation of a set of preferred instructional practices for online science instruction was deemed necessary. For the purpose of this study, the researcher designed a survey for face-to-face and online teachers to identify preferred teaching practices, instructional strategies, and types of technology used when teaching high school science students. The survey also requested demographic data information from the faculty members, including years of experience, subject(s) taught, and whether the teacher taught in a traditional classroom or online, to determine if any of those elements affect differences in faculty perceptions with regard to the questions under investigation. The findings from the current study added to the literature by demonstrating the differences and the similarities that exist between online and face-to-face instruction. Both forms of instruction tend to rely on student-centered approaches to teaching. There were many skills that were similar in that both types of instructors tend to focus on implementing the scientific method. The primary difference is the use of technology tools that were used by online instructors. Online instructors tend to rely on more technological tools such as virtual labs. A list of preferred instructional practices was generated from the qualitative responses to the open-ended questions. Research concerned with this line of inquiry should continue in order to enhance both theory and practice in regard to online instruction.

Current practice and usual care of major cervical disorders in Korea

PubMed Central

Choi, A Ryeon; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-riong; Oh, Min-seok; Lee, Eun-Jung; Kim, Sungchul; Kim, Mia; Ha, In-Hyuk

2017-01-01

Abstract Neck pain is a highly common condition and is the 4th major cause of years lived with disability. Previous literature has focused on the effect of specific treatments, and observations of actual practice are lacking to date. This study examined Korean health insurance review and assessment service (HIRA) claims data to the aim of assessing prevalence and comparing current medical practice and costs of cervical disorders in Korea. Current practice trends were determined through assessment of prevalence, total expenses, per-patient expense, average days in care, average days of visits, sociodemographic characteristics, distribution of medical costs, and frequency of treatment types of high frequency cervical disorders (cervical sprain/strain, cervical intervertebral disc displacement [IDD], and cervicalgia). Although the number of cervical IDD patients was few, total expenses, per-patient expense, average days in care, and average days of visits were highest. The proportion of women was higher than men in all 3 groups with highest prevalence in the ≥50s middle-aged population for IDD compared to sprain/strain. Primary care settings were commonly used for ambulatory care, of which approximately 70% chose orthopedic specialist treatment. In analysis of medical expenditure distribution, costs of visit (consultation) (22%–34%) and physical therapy (14%–16%) were in the top 3 for all 3 disorders. Although heat and electrical therapies were the most frequently used physical therapies, traction use was high in the cervical IDD group. In nonnarcotics, aceclofenac and diclofenac were the most commonly used NSAIDs, and pethidine was their counterpart in narcotics. This study investigated practice trends and cost distribution of treatment regimens for major cervical disorders, providing current usage patterns to healthcare policy decision makers, and the detailed treatment reports are expected to be of use to clinicians and researchers in understanding current usual care. PMID:29145327

Current practice and usual care of major cervical disorders in Korea: A cross-sectional study of Korean health insurance review and assessment service national patient sample data.

PubMed

Choi, A Ryeon; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Oh, Min-Seok; Lee, Eun-Jung; Kim, Sungchul; Kim, Mia; Ha, In-Hyuk

2017-11-01

Neck pain is a highly common condition and is the 4th major cause of years lived with disability. Previous literature has focused on the effect of specific treatments, and observations of actual practice are lacking to date. This study examined Korean health insurance review and assessment service (HIRA) claims data to the aim of assessing prevalence and comparing current medical practice and costs of cervical disorders in Korea.Current practice trends were determined through assessment of prevalence, total expenses, per-patient expense, average days in care, average days of visits, sociodemographic characteristics, distribution of medical costs, and frequency of treatment types of high frequency cervical disorders (cervical sprain/strain, cervical intervertebral disc displacement [IDD], and cervicalgia).Although the number of cervical IDD patients was few, total expenses, per-patient expense, average days in care, and average days of visits were highest. The proportion of women was higher than men in all 3 groups with highest prevalence in the ≥50s middle-aged population for IDD compared to sprain/strain. Primary care settings were commonly used for ambulatory care, of which approximately 70% chose orthopedic specialist treatment. In analysis of medical expenditure distribution, costs of visit (consultation) (22%-34%) and physical therapy (14%-16%) were in the top 3 for all 3 disorders. Although heat and electrical therapies were the most frequently used physical therapies, traction use was high in the cervical IDD group. In nonnarcotics, aceclofenac and diclofenac were the most commonly used NSAIDs, and pethidine was their counterpart in narcotics.This study investigated practice trends and cost distribution of treatment regimens for major cervical disorders, providing current usage patterns to healthcare policy decision makers, and the detailed treatment reports are expected to be of use to clinicians and researchers in understanding current usual care.

Determining clinical practice of expert physiotherapy for patients undergoing lumbar spinal fusion: a cross-sectional survey study.

PubMed

Janssen, Esther R C; Scheijen, Elle E M; van Meeteren, Nico L U; de Bie, Rob A; Lenssen, Anton F; Willems, Paul C; Hoogeboom, Thomas J

2016-05-01

To determine the content of current Dutch expert hospital physiotherapy practice for patients undergoing lumbar spinal fusion (LSF), to gain insight into expert-based clinical practice. At each hospital where LSF is performed, one expert physiotherapist received an e-mailed questionnaire, about pre- and postoperative physiotherapy and discharge after LSF. The level of uniformity in goals and interventions was graded on a scale from no uniformity (50-60 %) to very strong uniformity (91-100 %). LSF was performed at 34 of the 67 contacted hospitals. From those 34 hospitals, 28 (82 %) expert physiotherapists completed the survey. Twenty-one percent of the respondents saw patients preoperatively, generally to provide information. Stated postoperative goals and administered interventions focused mainly on performing transfers safely and keeping the patient informed. Outcome measures were scarcely used. There was no uniformity regarding advice on the activities of daily living. Dutch perioperative expert physiotherapy for patients undergoing LSF is variable and lacks structural outcome assessment. Studies evaluating the effectiveness of best-practice physiotherapy are warranted.

Integrating Social Determinants of Health into Primary Care Clinical and Informational Workflow during Care Transitions

PubMed Central

Hewner, Sharon; Casucci, Sabrina; Sullivan, Suzanne; Mistretta, Francine; Xue, Yuqing; Johnson, Barbara; Pratt, Rebekah; Lin, Li; Fox, Chester

2017-01-01

Context: Care continuity during transitions between the hospital and home requires reliable communication between providers and settings and an understanding of social determinants that influence recovery. Case Description: The coordinating transitions intervention uses real time alerts, delivered directly to the primary care practice for complex chronically ill patients discharged from an acute care setting, to facilitate nurse care coordinator led telephone outreach. The intervention incorporates claims-based risk stratification to prioritize patients for follow-up and an assessment of social determinants of health using the Patient-centered Assessment Method (PCAM). Results from transitional care are stored and transmitted to qualified healthcare providers across the continuum. Findings: Reliance on tools that incorporated interoperability standards facilitated exchange of health information between the hospital and primary care. The PCAM was incorporated into both the clinical and informational workflow through the collaboration of clinical, industry, and academic partners. Health outcomes improved at the study practice over their baseline and in comparison with control practices and the regional Medicaid population. Major Themes: Current research supports the potential impact of systems approaches to care coordination in improving utilization value after discharge. The project demonstrated that flexibility in developing the informational and clinical workflow was critical in developing a solution that improved continuity during transitions. There is additional work needed in developing managerial continuity across settings such as shared comprehensive care plans. Conclusions: New clinical and informational workflows which incorporate social determinant of health data into standard practice transformed clinical practice and improved outcomes for patients.

The current theoretical assumptions of the Bobath concept as determined by the members of BBTA.

PubMed

Raine, Sue

2007-01-01

The Bobath concept is a problem-solving approach to the assessment and treatment of individuals following a lesion of the central nervous system that offers therapists a framework for their clinical practice. The aim of this study was to facilitate a group of experts in determining the current theoretical assumptions underpinning the Bobath concept.A four-round Delphi study was used. The expert sample included all 15 members of the British Bobath Tutors Association. Initial statements were identified from the literature with respondents generating additional statements. Level of agreement was determined by using a five-point Likert scale. Level of consensus was set at 80%. Eighty-five statements were rated from the literature along with 115 generated by the group. Ninety-three statements were identified as representing the theoretical underpinning of the Bobath concept. The Bobath experts agreed that therapists need to be aware of the principles of motor learning such as active participation, opportunities for practice and meaningful goals. They emphasized that therapy is an interactive process between individual, therapist, and the environment and aims to promote efficiency of movement to the individual's maximum potential rather than normal movement. Treatment was identified by the experts as having "change of functional outcome" at its center.

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

PubMed

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

2016-05-01

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

An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

PubMed

McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

2018-05-01

This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and interprofessional collaboration.

The accuracy of the Jamaican national physician register: a study of the status of physicians registered and their countries of training

PubMed Central

Knight-Madden, Jennifer; Gray, Robert

2008-01-01

Background The number of physicians per 10,000 population is a basic health indicator used to determine access to health care. Studies from the United States of America and Europe indicate that their physician registration databases may be flawed. Clinical research activities have suggested that the current records of physicians registered to practice in Jamaica may not be accurate. Our objective was to determine whether the Medical Council of Jamaica (MCJ) accurately records and reports the identities, number and specialty designation of physicians in Jamaica. An additional aim was to determine the countries in which these physicians were trained. Methods Data regarding physicians practicing in Jamaica in 2005 were obtained from multiple sources including the MCJ and the telephone directory. Intense efforts at tracing were undertaken in a sub-sample of physicians, internists and paediatricians to further improve the accuracy of the data. Data were analysed using SPSS, version 11.5. Results The MCJ listed 2667 registered physicians of which 118 (4.4%) were no longer practicing in Jamaica. Of the subset of 150 physicians who were more actively traced, an additional 11 were found to be no longer in practice. Thus at least 129 (4.8%) of the physicians on the MCJ list were not actively practising in Jamaica. Twenty-nine qualified physicians who were in practice, but not currently on the Jamaican register, were identified from other data sources. This yielded an estimate of 2567 physicians or 9.68 physicians per 10,000 persons. Seven hundred and twenty six specialists were identified, 118 from the MCJ list only, 452 from other sources, in particular medical associations, and 156 from both the MCJ list and other sources. Sixty-six percent of registered doctors completed medical school at the University of the West Indies (UWI). Conclusion These data suggest that the MCJ list includes some physicians no longer practicing in Jamaica while underestimating the number of specialists. Difficulty in accurately estimating the number of practicing physicians has been reported in studies done in other countries but the under-reporting of the number of specialists is uncommon. Additional consideration should be given to strategies to ensure compliance with the annual registration that is mandated by law and to changing the law to include registration of specialist qualifications. PMID:19077244

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 and...

Skin care practices in newborn nurseries and mother-baby units in Maryland.

PubMed

Khalifian, S; Golden, W C; Cohen, B A

2017-06-01

Skin provides several important homeostatic functions to the developing neonate. However, no consensus guidelines exist in the United States for skin care in the healthy term newborn. We performed a study of skin and umbilical cord care (including bathing practices, vernix removal and antiseptic cord application) in newborn nurseries and mother-baby units throughout the state of Maryland to determine practices in a variety of clinical settings and assess if uniformity in skin care exists. These data were then assessed in the context of a review of the current literature. We received responses from over 90% of nurseries across the state. In our cohort, practices varied widely between institutions and specific populations, and often were not evidence-based or were contrary to best practices discussed in the scientific literature. The frequent departures from evidence that occur regarding the aforementioned practices are likely due to a lack of consensus on these issues as well as limited data on such practices, further highlighting the need for data-driven guidelines on newborn skin care.

Understanding medical practice team roles.

PubMed

Hills, Laura

2015-01-01

Do you believe that the roles your employees play on your medical practice team are identical to their job titles or job descriptions? Do you believe that team roles are determined by personality type? This article suggests that a more effective way to build and manage your medical practice team is to define team roles through employee behaviors. It provides 10 rules of behavioral team roles that can help practice managers to select and build high-performing teams, build more productive team relationships, improve the employee recruitment process, build greater team trust and understanding; and increase their own effectiveness. This article describes in detail Belbin's highly regarded and widely used team role theory and summarizes four additional behavioral team role theories and systems. It offers lessons learned when applying team role theory to practice. Finally, this article offers an easy-to-implement method for assessing current team roles. It provides a simple four-question checklist that will help practice managers balance an imbalanced medical practice team.

Management of Helicobacter Pylori in the United States: Results from a national survey of gastroenterology physicians.

PubMed

Murakami, Traci T; Scranton, Rebecca A; Brown, Heidi E; Harris, Robin B; Chen, Zhao; Musuku, Sunitha; Oren, Eyal

2017-07-01

We sought to determine current knowledge and practices among gastroenterology physicians and assess adherence to current guidelines for H. pylori management. Online surveys were distributed in 2014 to practicing gastroenterology physicians for information related to the diagnosis and treatment of H. pylori infection. A total of 582 completed surveys were reviewed. The H. pylori screening test used "almost always" was gastric biopsy obtained during endoscopy (histology) (59%) followed by stool antigen test (20%). Standard triple therapy for 14days was commonly prescribed by 53% of respondents. The stool antigen test was most frequently chosen to confirm H. pylori eradication (51%), although only 58% of physicians checked for eradication in patients who underwent treatment. Adherence to current American College of Gastroenterology guidelines is low. Although more physicians treat patients with a positive H. pylori test, only half ensure eradication after treatment. Improving knowledge of the resistance patterns of H. pylori may be critical to ensure successful eradication. Copyright © 2017 Elsevier Inc. All rights reserved.

The assessment of language and the emergence from disorders of consciousness.

PubMed

Pundole, Amy; Crawford, Sarah

2017-04-06

In order to demonstrate emergence from a disorder of consciousness (DoC) an individual is currently required to demonstrate functional object use of two objects, or functional communication defined as accurately answering six yes/no questions on two consecutive occasions (Giacino et al., 2002 ). In practice, experienced speech and language therapists (SLTs) working with this group often focus on facilitating object use or employ other language tasks, since achieving a 100% accurate yes/no response can be difficult for patients following an extensive brain injury due to language and/or cognitive impairments. There is an increasing awareness of this issue in the literature and in practice and there is discussion about reviewing the current definition of emergence. This paper outlines the traditional definition of emergence and recent updates, discusses some of the problems and implications associated with current assessment, highlights the importance of getting it right, explores potential other ways to determine emergence, and suggests further areas for research.

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

I. W. Ginsberg

Multiresolutional decompositions known as spectral fingerprints are often used to extract spectral features from multispectral/hyperspectral data. In this study, the authors investigate the use of wavelet-based algorithms for generating spectral fingerprints. The wavelet-based algorithms are compared to the currently used method, traditional convolution with first-derivative Gaussian filters. The comparison analyses consists of two parts: (a) the computational expense of the new method is compared with the computational costs of the current method and (b) the outputs of the wavelet-based methods are compared with those of the current method to determine any practical differences in the resulting spectral fingerprints. The resultsmore » show that the wavelet-based algorithms can greatly reduce the computational expense of generating spectral fingerprints, while practically no differences exist in the resulting fingerprints. The analysis is conducted on a database of hyperspectral signatures, namely, Hyperspectral Digital Image Collection Experiment (HYDICE) signatures. The reduction in computational expense is by a factor of about 30, and the average Euclidean distance between resulting fingerprints is on the order of 0.02.« less

Personalized health care: from theory to practice.

PubMed

Snyderman, Ralph

2012-08-01

The practice of medicine stands at the threshold of a transformation from its current focus on the treatment of disease events to an emphasis on enhancing health, preventing disease and personalizing care to meet each individual's specific health needs. Personalized health care is a new and strategic approach that is driven by personalized health planning empowered by personalized medicine tools, which are facilitated by advances in science and technology. These tools improve the capability to predict health risks, to determine and quantify the dynamics of disease development, and to target therapeutic approaches to the needs of the individual. Personalized health care can be implemented today using currently available technologies and know-how and thereby provide a market for the rational introduction of new personalized medicine tools. The need for early adoption of personalized health care stems from the necessity to reduce the egregious and wasteful burden of preventable chronic diseases, which is not effectively addressed by our current approach to care. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Quantitative Determination of Caffeine in Beverages Using a Combined SPME-GC/MS Method

NASA Astrophysics Data System (ADS)

Pawliszyn, Janusz; Yang, Min J.; Orton, Maureen L.

1997-09-01

Solid-phase microextraction (SPME) combined with gas chromatography/mass spectrometry (GC/MS) has been applied to the analysis of various caffeinated beverages. Unlike the current methods, this technique is solvent free and requires no pH adjustments. The simplicity of the SPME-GC/MS method lends itself to a good undergraduate laboratory practice. This publication describes the analytical conditions and presents the data for determination of caffeine in coffee, tea, and coke. Quantitation by isotopic dilution is also illustrated.

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 Act...

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 regulations...

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, inclusive...

Feeding of prohibited substances (swill) to pigs in Australia.

PubMed

Schembri, N; Hernández-Jover, M; Toribio, J-A; Holyoake, P K

2010-08-01

To assess current swill feeding legislation, swill feeding investigation practices by authorities and feeding practices of pig producers who trade via saleyards in eastern Australia in order to determine levels of understanding and conformance related to current swill feeding legislation. A three-tiered approach was undertaken to gather information on the feeding of prohibited substances (swill) to pigs in Australia. Firstly, a review of swill feeding legislation was undertaken to highlight the commonalities and inconsistencies between the various state and territory legislations in defining swill. Secondly, agricultural authorities were contacted in each state to gather information on swill feeding investigations undertaken in 2006. Finally, face-to-face interviews were conducted with 106 pig producers who traded pigs at one of six saleyards in eastern Australia to ascertain their knowledge of swill feeding and to determine the feeding practices of this sector of the industry. Areas of concern identified included (1) inconsistencies in the feedstuffs classed as 'swill' among states, (2) the number of producers who had been prosecuted for swill feeding in 2006 (n = 4 of 148 inspections), (3) the low knowledge base of producers who sell pigs at saleyards regarding swill feeding, and (4) the types of feedstuffs provided to pigs marketed at saleyards. Our findings highlight the need for a consistent definition for 'swill' across Australian states and for improved awareness of swill feeding among producers, particularly those who market pigs at saleyards.

Accidental needle sticks, the Occupational Safety and Health Administration, and the fallacy of public policy.

PubMed

Wolf, Bruce L; Marks, Albert; Fahrenholz, John M

2006-07-01

Current Occupational Safety and Health Administration (OSHA) guidelines mandate the use of safety needles when allergy injections are given. Safety needles for intradermal testing remain optional. Whether safety needles reduce the number of accidental needle sticks (ANSs) in the outpatient setting has yet to be proven. To determine the rate of ANSs with new (safety) needles vs old needles used in allergy immunotherapy and intradermal testing. Allergy practices from 22 states were surveyed by e-mail. Seventy practices (28%) responded to the survey. Twice as many ANSs occurred in practices giving immunotherapy when using new needles vs old needles (P < .01). The rate of ANSs was roughly the same for intradermal testing with new needles vs old needles. These findings further question whether OSHA's guidelines for safety needle use in outpatient practice need revision and if allergy practices might be excluded from the requirement to use safety needles.

Secure software practices among Malaysian software practitioners: An exploratory study

NASA Astrophysics Data System (ADS)

Mohamed, Shafinah Farvin Packeer; Baharom, Fauziah; Deraman, Aziz; Yahya, Jamaiah; Mohd, Haslina

2016-08-01

Secure software practices is increasingly gaining much importance among software practitioners and researchers due to the rise of computer crimes in the software industry. It has become as one of the determinant factors for producing high quality software. Even though its importance has been revealed, its current practice in the software industry is still scarce, particularly in Malaysia. Thus, an exploratory study is conducted among software practitioners in Malaysia to study their experiences and practices in the real-world projects. This paper discusses the findings from the study, which involved 93 software practitioners. Structured questionnaire is utilized for data collection purpose whilst statistical methods such as frequency, mean, and cross tabulation are used for data analysis. Outcomes from this study reveal that software practitioners are becoming increasingly aware on the importance of secure software practices, however, they lack of appropriate implementation, which could affect the quality of produced software.

An Optimization System with Parallel Processing for Reducing Common-Mode Current on Electronic Control Unit

NASA Astrophysics Data System (ADS)

Okazaki, Yuji; Uno, Takanori; Asai, Hideki

In this paper, we propose an optimization system with parallel processing for reducing electromagnetic interference (EMI) on electronic control unit (ECU). We adopt simulated annealing (SA), genetic algorithm (GA) and taboo search (TS) to seek optimal solutions, and a Spice-like circuit simulator to analyze common-mode current. Therefore, the proposed system can determine the adequate combinations of the parasitic inductance and capacitance values on printed circuit board (PCB) efficiently and practically, to reduce EMI caused by the common-mode current. Finally, we apply the proposed system to an example circuit to verify the validity and efficiency of the system.

Assessment of the Density of Suppression to Identify Risk of Intractable Diplopia in the United Kingdom.

PubMed

Newsham, David; O'Connor, Anna R

2016-06-01

Occlusion used to treat amblyopia towards the end of the developmental component of the critical period gives a risk of inducing intractable diplopia. In the United Kingdom, the density of suppression is assessed via the Sbisa/Bagolini filter bar, but there is very little research evidence to guide clinical practice or interpretation of the tests used. The aims of this study were to determine current practice and estimate the incidence of intractable diplopia following amblyopia treatment. Current practice and incidence of intractable diplopia following amblyopia were determined via a questionnaire distributed to head orthoptists in every eye department in the United Kingdom. The questionnaire explored testing and test conditions, interpretation of the test results, and cases of intractable diplopia over the last 5 years. There was considerable variation in clinical practice of the measurement of the density of suppression and interpretation of the results to guide the treatment of amblyopia. The minimum age of patients taking the test ranged from 2 to 8 years and the minimum filter considered still safe to continue treatment ranged from 4 to 17. It is estimated there were 24 cases of intractable diplopia over the last 5 years. The issue of intractable diplopia and amblyopia treatment is likely to become increasingly important as there appears to be greater plasticity and scope to treat amblyopia in teenagers and adults than was previously thought. Lack of knowledge of how to evaluate the risk may lead to more cases of intractable diplopia or alternatively treatment being withheld unnecessarily.

Current practices of commercial cryobanks in screening prospective donors for genetic disease and reproductive risk.

PubMed

Conrad, E A; Fine, B; Hecht, B R; Pergament, E

1996-01-01

To determine how the screening practices of commercial semen banks vary from published guidelines, which factors influence cryobanks to exclude prospective semen donors for genetic reasons, and the current role of clinical geneticists/genetic counselors in evaluating prospective semen donors. The genetic screening of prospective donors by commercial semen banks was evaluated using written questionnaires completed by bank directors. Responses were analyzed to determine exclusion criteria, adherence to published guidelines, and contribution of genetic professionals. Semen banks were selected on the basis of membership in the American Association of Tissue Banks and commercial use of semen for artificial insemination by donor. Semen bank practices as reported by commercial semen bank directors. Of 37 eligible banks, 16 responded. All screen prospective donors by medical/family history and physical examination, 94% have upper age limits; 63% examine for minor physical defects; 56% routinely karyotype; 81% screen men of ethnic groups at risk for Tay Sachs disease, sickle cell disease and thalassemia; 19% screen all donors; 25% screen all donors for cystic fibrosis and 50% only screen if family history positive. Donor rejection was based on three criteria: mode of inheritance of familial disorder, severity of disease, and availability of carrier/confirmatory testing of donor genotype. Ten of 16 banks have no genetic professional on staff. Commercial semen banks primarily rely on family history as the major exclusion criterion in genetic screening of donors. Considerable differences exist among semen bank practices in accordance with guidelines published by national agencies. Genetic professionals have a minimal effect overall on evaluation of semen donors.

Red reflex screening in New Zealand: a large survey of practices and attitudes in the Auckland region.

PubMed

Raoof, Naz; Dai, Shuan

2016-07-15

Red reflex testing forms an essential part of newborn (within the first week of life) and infant (6 weeks of age) screening in New Zealand, as outlined in the Well Child/Tamariki Ora handbook. This survey of practitioners undertaking red reflex screening aimed to determine current practices and attitudes of screeners, as well as any barriers to screening. A short, multiple-choice, on-line questionnaire was sent to approximately 1,500 health care professionals undertaking red reflex screening, over a 4-week period. Four hundred and eighty-three survey responses were received from 267 GPs (55.4%), 153 midwives (31.7%), and 50 paediatricians (10.4%). Thirty-six respondents (7.8%) performed red reflex screening only when they had time to do so, 13 (2.8%) only undertook this when there were concerns raised by the parents. Most respondents (97.3%) used an ophthalmoscope to perform screening. Seventynine respondents (16.6%) felt they were "not sure/underconfident" at performing this test. Only 83 of 479 respondents (17.3%) had received any formal training. The development of an online resource or practical 'refresher' sessions would be well received and likely to improve current practices.

Shared decision-making – transferring research into practice: the Analytic Hierarchy Process (AHP)

PubMed Central

Dolan, James G.

2008-01-01

Objective To illustrate how the Analytic Hierarchy Process (AHP) can be used to promote shared decision-making and enhance clinician-patient communication. Methods Tutorial review. Results The AHP promotes shared decision making by creating a framework that is used to define the decision, summarize the information available, prioritize information needs, elicit preferences and values, and foster meaningful communication among decision stakeholders. Conclusions The AHP and related multi-criteria methods have the potential for improving the quality of clinical decisions and overcoming current barriers to implementing shared decision making in busy clinical settings. Further research is needed to determine the best way to implement these tools and to determine their effectiveness. Practice Implications Many clinical decisions involve preference-based trade-offs between competing risks and benefits. The AHP is a well-developed method that provides a practical approach for improving patient-provider communication, clinical decision-making, and the quality of patient care in these situations. PMID:18760559

Polymer on Top: Current Limits and Future Perspectives of Quantitatively Evaluating Surface Grafting.

PubMed

Michalek, Lukas; Barner, Leonie; Barner-Kowollik, Christopher

2018-03-07

Well-defined polymer strands covalently tethered onto solid substrates determine the properties of the resulting functional interface. Herein, the current approaches to determine quantitative grafting densities are assessed. Based on a brief introduction into the key theories describing polymer brush regimes, a user's guide is provided to estimating maximum chain coverage and-importantly-examine the most frequently employed approaches for determining grafting densities, i.e., dry thickness measurements, gravimetric assessment, and swelling experiments. An estimation of the reliability of these determination methods is provided via carefully evaluating their assumptions and assessing the stability of the underpinning equations. A practical access guide for comparatively and quantitatively evaluating the reliability of a given approach is thus provided, enabling the field to critically judge experimentally determined grafting densities and to avoid the reporting of grafting densities that fall outside the physically realistic parameter space. The assessment is concluded with a perspective on the development of advanced approaches for determination of grafting density, in particular, on single-chain methodologies. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Gastroenterology training in Australia: how much is enough?

PubMed

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

2013-04-01

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

Health impact assessment review: a framework for determining the current state-of science and areas for improvement

EPA Science Inventory

A systematic review is being conducted of health impact assessments (HIAs) from the U.S. The purpose of this review is to obtain a clear picture of how HIAs are being implemented nationally and to identify potential areas for improving the HIA community of practice. The review is...

Pupils' Thinking and Course Requirements in Science Teaching (EKNA). Newsletter School Research.

ERIC Educational Resources Information Center

Andersson, Bjorn; And Others

The ENKA Project is concerned with two major problem areas: the conceptions of physical and chemical phenomena, central to an upper level course, held by compulsory school pupils (grades 7-9) and the implications from descriptions of pupils' conceptions and ways of reasoning for current teaching practice. To determine conceptions held, pupils were…

Measuring the mechanical behavior of paperboard in a changing humidity environment

Treesearch

Dennis E. Gunderson; John M. Considine

1986-01-01

“Both the strength and stability of compressively loaded paperboard are known to be adversely affected by cyclic changes in relative humidity. Current research at the Forest Products Laboratory (FPL) seeks to observe and explain this phenomenon and to develop a simple, practical test to determine allowable "working loads" in cyclicmoisture environments. A new...

Music Student Teaching Seminars: An Examination of Current Practices Across the United States

ERIC Educational Resources Information Center

Baumgartner, Christopher M.; Councill, Kimberly H.

2017-01-01

The purpose of this study was to examine the structure and content of music student teaching seminars at 4-year, degree-granting institutions accredited by the National Association of Schools of Music across the United States. A secondary purpose was to determine how these seminars (a) addressed perceived needs of student teachers and beginning…

Current Practices and Future Directions in Reporting Disability in School-Based Physical Education Research

ERIC Educational Resources Information Center

Haegele, Justin Anthony; Hodge, Samuel

2017-01-01

The primary purpose of this study was to determine what trends exist in the identification and description of participants with disabilities used in school-based physical education research. A total of 60 research articles published in the "Journal of Teaching in Physical Education" from 2010-2014 which included school-aged individuals…

Feed Efficiency: An Assessment of Current Knowledge from a Voluntary Subsample of the Swine Industry

ERIC Educational Resources Information Center

Flohr, Josh R.; Tokach, Mike D.; DeRouchey, Joel M.; Goodband, Robert D.; Dritz, Steve S.; Nelssen, Jim L.; Patience, John F.

2014-01-01

A voluntary sample of pork producers and advisers to the swine industry were surveyed about feed efficiency. The questionnaire was designed to accomplish three objectives: (a) determine the level of knowledge related to feed efficiency topics, (b) identify production practices used that influence feed efficiency, and (c) identify information gaps…

Vineyard management practices and the quality of grapes and grape products in the Pacific Northwest - USDA-ARS CRIS (Current Research Information System) project

USDA-ARS?s Scientific Manuscript database

One of our three program goals for this USDA-ARS-CRIS project is to determine the effects of vineyard and vine microclimate (sunlight, temperature, humidity, etc) upon fruit development, vine productivity, and fruit quality, particularly phenolic compounds. Plant phenolics are important due to their...

The Negro in the Furniture Industry. The Racial Policies of American Industry Series.

ERIC Educational Resources Information Center

Fulmer, William E.

This is the twenty-eighth of a series of studies conducted to determine variances in industrial employment practices of Negroes and to develop appropriate hiring policies. This particular study sought to examine current racial employment policies in the furniture industry within the context of the industry's structure and history. Interviews with…

Design and fabrication of a four-man capacity urine wick evaporator system

NASA Technical Reports Server (NTRS)

1979-01-01

The integrated system was tested to determine the performance characteristics and limitations of the dual catalyst concept. The primary objective of the dual catalyst concept is to remove ammonia and other noxious substances in the gas phase and thereby eliminate the need for and current practice of chemically or electrochemically pretreating urine prior to distillation.

Retooling for the future.

PubMed

Andrews, D

1999-04-01

Several trends will accelerate changes in the industry initiated by Medicare's change in payment methodology, including explosive growth fueled by changing demographics, patient preferences, and technological advances; altered customer buying incentives created by managed care organization-provider partnerships; and accelerated consolidation. Home care agencies should "take inventory" of current practices and systems to determine capability gaps for competing in the new environment.

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 for...

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 set...

Breast-feeding practices in Mexico: results from the Second National Nutrition Survey 1999.

PubMed

González-Cossío, Teresa; Moreno-Macías, Hortensia; Rivera, Juan A; Villalpando, Salvador; Shamah-Levy, Teresa; Monterrubio, Eric A; Hernández-Garduño, Adolfo

2003-01-01

To assess breast-feeding (BF) practices and determinants of exclusive BF (EBF) < 4 and < 6 months (mo) among women and infants < 23 mo in the NNS-1999. BF practices from the day and night before the interview were ascertained, and median duration estimated. Determinants of EBF < 4 and < 6 mo were analysed by logistic regression models for complex surveys. Prevalence of EBF < 4 mo was 25.7%, and of < 6 mo 20.3%. The overall rate of continued BF (second year) was 30.9%, median duration of BF 9 mo, and the national proportion of children ever breast-fed 92.3%. The probability (p) of EBF < 4 mo was determined by infant age and sex, by maternal socio-economic level (SEL) and ethnicity, and by the interaction between infant sex and SEL. The pEBF < 6 mo was determined by infant age and length, by maternal ethnicity, and employment. EBF rates and duration are low in Mexico and have improved only slightly in the last 20 y. Infant and maternal characteristics determine the pEBF. If improvements in infant health are a national priority, aggressive interventions to promote and protect BF are urgently needed in Mexico, as well as formal evaluation of current initiatives. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

Determinism and Underdetermination in Genetics: Implications for Students' Engagement in Argumentation and Epistemic Practices

NASA Astrophysics Data System (ADS)

Jiménez-Aleixandre, María Pilar

2014-02-01

In the last two decades science studies and science education research have shifted from an interest in products (of science or of learning), to an interest in processes and practices. The focus of this paper is on students' engagement in epistemic practices (Kelly in Teaching scientific inquiry: Recommendations for research and implementation. Sense Publishers, Rotterdam, pp 99-117, 2008), or on their practical epistemologies (Wickman in Sci Educ 88(3):325-344, 2004). In order to support these practices in genetics classrooms we need to take into account domain-specific features of the epistemology of genetics, in particular issues about determinism and underdetermination. I suggest that certain difficulties may be related to the specific nature of causality in genetics, and in particular to the correspondence between a given set of factors and a range of potential effects, rather than a single one. The paper seeks to bring together recent developments in the epistemology of biology and of genetics, on the one hand, with science education approaches about epistemic practices, on the other. The implications of these perspectives for current challenges in learning genetics are examined, focusing on students' engagement in epistemic practices, as argumentation, understood as using evidence to evaluate knowledge claims. Engaging in argumentation in genetics classrooms is intertwined with practices such as using genetics models to build explanations, or framing genetics issues in their social context. These challenges are illustrated with studies making part of our research program in the USC.

Child obesity prevention in primary health care: investigating practice nurse roles, attitudes and current practices.

PubMed

Robinson, Alison; Denney-Wilson, Elizabeth; Laws, Rachel; Harris, Mark

2013-04-01

Overweight and obesity affects approximately 20% of Australian pre-schoolers. The general practice nurse (PN) workforce has increased in recent years; however, little is known of PN capacity and potential to provide routine advice for the prevention of child obesity. This mixed methods pilot study aims to explore the current practices, attitudes, confidence and training needs of Australian PNs surrounding child obesity prevention in the general practice setting. PNs from three Divisions of General Practice in New South Wales were invited to complete a questionnaire investigating PN roles, attitudes and practices in preventive care with a focus on child obesity. A total of 59 questionnaires were returned (response rate 22%). Semi-structured qualitative interviews were also conducted with a subsample of PNs (n = 10). Questionnaire respondent demographics were similar to that of national PN data. PNs described preventive work as enjoyable despite some perceived barriers including lack of confidence. Number of years working in general practice did not appear to strongly influence nurses' perceived barriers. Seventy per cent of PNs were interested in being more involved in conducting child health checks in practice, and 85% expressed an interest in taking part in child obesity prevention training. Findings from this pilot study suggest that PNs are interested in prevention of child obesity despite barriers to practice and low confidence levels. More research is needed to determine the effect of training on PN confidence and behaviours in providing routine healthy life-style messages for the prevention of child obesity. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Contaminated waste incinerator modification study. Final report

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

Wolf, F.

1995-08-01

An explosive waste incinerator (EWI) can be installed in the existing Badger AAP Contaminated Waste Processor (CWP). An engineering evaluation of installing a rotary kiln furnace to dispose of waste energetic material has shown the installation to be possible. An extensive literature search was completed to develop the known proven methods of energetic waste disposal. Current incineration practice including thermal treatment alternatives was investigated. Existing and new equipment was reviewed for adequacy. Current CWP operations and hazardous waste to be disposed of were determined. Comparisons were made with other AAP`s EWI.

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 reducing the impact of recurring errors in the handling of samples and the reporting of results. Our findings will inform our continuing work with patients and staff to develop, implement and evaluate improvements to existing systems of managing the testing and result communication process. PMID:26243888

Temperature metrology

NASA Astrophysics Data System (ADS)

Fischer, J.; Fellmuth, B.

2005-05-01

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

Industry challenge to best practice risk communication.

PubMed

McEntire, J; Boateng, A

2012-04-01

Effective food safety and food defense risk communication helps to inform consumers without causing panic and alarm. The Risk Communication Team of the Natl. Center for Food Protection and Defense has developed a list of 11 best practices recommended for effective risk communication. These practices, designed for a food defense crisis, are currently applied to food safety issues, since fortunately a food defense crisis has yet to occur. IFT examined the utility of these best practices and the limitations on their use during food safety and food defense crises by academics, trade associations, and the government. It was hypothesized that legal and business considerations as well as the nature of the event would determine the implementation of the best practices. Through the use of focus group meetings, it was discovered that there was a low level of awareness of the best practices. However, stakeholders practiced some aspects of the recommended practices. Participants felt some of the practices were related and could be consolidated. They also agreed that a food defense event will increase the urgency of the communication and include players not typically involved in food safety issues. The challenges reported by the stakeholders varied, but legal liability, as well as the impact their communications could have on an industry, were often cited. From the government perspective, their need to act within their authorities drove some of their actions with respect to communication. Determining the differences in communication limitations during food safety against food defense events can provide key information to further developing and refining risk communications and specific messages targeted for a food defense incident. Effective food safety and food defense risk communication helps to inform consumers without causing panic and alarm. Determining the differences in communication limitations during food safety against food defense events can provide key information to further developing and refining risk communications and specific messages targeted for a food defense incident. © 2012 Institute of Food Technologists®

Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study

PubMed Central

Whitford, David L; Hickey, Anne; Horgan, Frances; O'Sullivan, Bernadette; McGee, Hannah; O'Neill, Desmond

2009-01-01

Background Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care. Methods Postal survey of random sample of general practitioners undertaken (N = 204; 46% response). Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation. Results Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care. Conclusion General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care. PMID:19402908

Coupling time constants of striated and copper-plated coated conductors and the potential of striation to reduce shielding-current-induced fields in pancake coils

NASA Astrophysics Data System (ADS)

Amemiya, Naoyuki; Tominaga, Naoki; Toyomoto, Ryuki; Nishimoto, Takuma; Sogabe, Yusuke; Yamano, Satoshi; Sakamoto, Hisaki

2018-07-01

The shielding-current-induced field is a serious concern for the applications of coated conductors to magnets. The striation of the coated conductor is one of the countermeasures, but it is effective only after the decay of the coupling current, which is characterised with the coupling time constant. In a non-twisted striated coated conductor, the coupling time constant is determined primarily by its length and the transverse resistance between superconductor filaments, because the coupling current could flow along its entire length. We measured and numerically calculated the frequency dependences of magnetisation losses in striated and copper-plated coated conductors with various lengths and their stacks at 77 K and determined their coupling time constants. Stacked conductors simulate the turns of a conductor wound into a pancake coil. Coupling time constants are proportional to the square of the conductor length. Stacking striated coated conductors increases the coupling time constants because the coupling currents in stacked conductors are coupled to one another magnetically to increase the mutual inductances for the coupling current paths. We carried out the numerical electromagnetic field analysis of conductors wound into pancake coils and determined their coupling time constants. They can be explained by the length dependence and mutual coupling effect observed in stacked straight conductors. Even in pancake coils with practical numbers of turns, i.e. conductor lengths, the striation is effective to reduce the shielding-current-induced fields for some dc applications.

Defining applied behavior analysis: An historical analogy

PubMed Central

Deitz, Samuel M.

1982-01-01

This article examines two criteria for a definition of applied behavior analysis. The criteria are derived from a 19th century attempt to establish medicine as a scientific field. The first criterion, experimental determinism, specifies the methodological boundaries of an experimental science. The second criterion, philosophic doubt, clarifies the tentative nature of facts and theories derived from those facts. Practices which will advance the science of behavior are commented upon within each criteria. To conclude, the problems of a 19th century form of empiricism in medicine are related to current practices in applied behavior analysis. PMID:22478557

Education and information for practicing school nurses: which technology-supported resources meet their needs?

PubMed

Anderson, Lori S; Enge, Karmin J

2012-10-01

School nurses care for children with a variety of health-related conditions and they need information about managing these conditions, which is accessible, current, and useful. The goal of this literature review was to gather and synthesize information on technology-supported resources and to determine which met the educational needs of school nurses. Successful online educational programs were interactive and self-directed. The most common barriers were lack of time to find educational information, lack of knowledge about computers, technology, the Internet and specific programs, and lack of administrative support from school officials to use technology to access information and evidence for practice. Recommendations for successful use of technology to meet practicing school nurse's educational needs are offered.

Utilization of information technology in eastern North Carolina physician practices: determining the existence of a digital divide.

PubMed

Rosenthal, David A; Layman, Elizabeth J

2008-02-13

The United States Department of Health and Human Services (DHHS) has emphasized the importance of utilizing health information technologies, thus making the availability of electronic resources critical for physicians across the country. However, few empirical assessments exist regarding the current status of computerization and utilization of electronic resources in physician offices and physicians' perceptions of the advantages and disadvantages of computerization. Through a survey of physicians' utilization and perceptions of health information technology, this study found that a "digital divide" existed for eastern North Carolina physicians in smaller physician practices. The physicians in smaller practices were less likely to utilize or be interested in utilizing electronic health records, word processing applications, and the Internet.

Who controls the uses of organs after death? Law in the books, law in practice and the view of the people.

PubMed

Naffine, Ngaire; Richards, Bernadette; de Lacey, Sheryl; Braunack-Mayer, Annette; Rogers, Wendy

2012-12-01

The conventional wisdom is that we are free to dispose of our organs at death and that they will be employed according to our wishes. However, this reflects neither the formal law nor medical practice. This article explores the theory underlying the principle of self-determination after death. It presents an overview of Australian law and the way that the law is interpreted in clinical practice. It then presents the results of a community survey on organ disposition, and identifies a gap between community expectations and the current operation of Australian law. It concludes with some specific recommendations for development of the law to align it more closely with contemporary community views.

Knowledge, Attitudes, and Practices of Pediatric Dentists Regarding Speech Evaluation of Patients: Implications for Dental Education.

PubMed

Van Eyndhoven, Lisa; Chussid, Steven; Yoon, Richard K

2015-11-01

The aim of this cross-sectional study was to determine pediatric dentists' attitudes about speech evaluation in the dental setting and assess their knowledge of speech development and pathology. In October 2013, members of the American Academy of Pediatric Dentistry were invited to participate in an electronic questionnaire. Categories of questions were demographics, attitudes and confidence in speech pathology, and theoretical and practical knowledge of speech development and speech pathology. Theoretical knowledge was assessed using questions about phonetics and speech milestones. Practical knowledge was determined with three 30-second interview-style video clips. A total of 539 responses were received for a response rate of 10.4%. The majority of respondents reported feeling that speech evaluation should be part of the pediatric dental visit (72.8%) and felt confident in their ability to detect speech issues (73.2%). However, they did poorly on the theoretical knowledge questions (41.9%) as well as the practical knowledge questions (8.5%). There was a statistically significant difference in theoretical score between gender and type of occupation (p<0.05). This difference was not observed when examining practical knowledge. This study suggests that although pediatric dentists are in an ideal position to aid in the detection of speech issues, they currently have insufficient training and knowledge to do so.

Determinants of cord care practices among mothers in Benin City, Edo State, Nigeria.

PubMed

Abhulimhen-Iyoha, B I; Ibadin, M O

2012-01-01

Mothers care for their infants' umbilical cord stump in various ways. Different cord care practices have been documented; some are beneficial while others are harmful. Who and what influence the cord care practiced by mothers have, however, not been fully explored particularly in the study locale. The objective of this study was to determine the factors that influence cord care practices among mothers in Benin City. The study subjects included 497 mothers who brought their babies to Well Baby/Immunization Clinic at the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, between July and August 2009. A structured questionnaire served as an instrument to extract information on their biodata and possible determinants of cord care practices. Significantly older women (P=0.023), educated mothers (P=0.029), and those who had male babies (P=0.013) practiced beneficial cord stump care practices. Beneficial cord care practice increased with increasing maternal educational status. The best predictors of beneficial cord care practices are maternal level of education (P=0.029) and infant's sex (P=0.013). The use of harmful cord care practices was more common among mothers who delivered outside the Teaching hospitals. Most (71.2%) of the mothers were aware of hygienic/beneficial cord care. The choices of cord care methods eventually practiced by mothers were influenced mainly by the disposition of nurses (51.3%), participants' mothers (32.0%), and their mothers-in-law (5.8%). There was no significant relationship between cord care practice on one hand and maternal parity, tribe, and socioeconomic classes on the other. The need for female education is again emphasized. The current findings strongly justify the need for public enlightenment programs, using the mass media and health talks in health facilities, targeting not only women of reproductive age but also secondary audience like their mothers, mothers-in-law, nurses, and attendants at health facilities. Proper hygiene including proper hand washing techniques while caring for newborns along with vaccination of infants and their mothers will help prevent infections including tetanus while prompt health-seeking behavior is advised to improve outcome should such infections occur.

Managing fever in children: a national survey of parents' knowledge and practices in France.

PubMed

Bertille, Nathalie; Fournier-Charrière, Elisabeth; Pons, Gérard; Chalumeau, Martin

2013-01-01

Identifying targets to improve parental practices for managing fever in children is the first step to reducing the overloaded healthcare system related to this common symptom. We aimed to study parents' knowledge and practices and their determinants in managing fever symptoms in children in France as compared with current recommendations. We conducted an observational national study between 2007 and 2008 of French general practitioners, primary care pediatricians and pharmacists. These healthcare professionals (HPs) were asked to include 5 consecutive patients from 1 month to 12 years old with fever for up to 48 hr who were accompanied by a family member. Parents completed a questionnaire about their knowledge of fever in children and their attitudes about the current fever episode. We used a multilevel logistic regression model to assess the joint effects of patient- and HP-level variables. In all, 1,534 HPs (participation rate 13%) included 6,596 children. Parental concordance with current recommendations for temperature measurement methods, the threshold for defining fever, and physical (oral hydration, undressing, room temperature) and drug treatment was 89%, 61%, 15%, and 23%, respectively. Multivariate multi-level analyses revealed a significant HP effect. In general, high concordance with recommendations was associated with high educational level of parents and the HP consulted being a pediatrician. In France, parents' knowledge and practices related to managing fever symptoms in children frequently differ from recommendations. Targeted health education interventions are needed to effectively manage fever symptoms in children.

Managing Fever in Children: A National Survey of Parents' Knowledge and Practices in France

PubMed Central

Bertille, Nathalie; Fournier-Charrière, Elisabeth; Pons, Gérard; Chalumeau, Martin

2013-01-01

Introduction Identifying targets to improve parental practices for managing fever in children is the first step to reducing the overloaded healthcare system related to this common symptom. We aimed to study parents' knowledge and practices and their determinants in managing fever symptoms in children in France as compared with current recommendations. Methods We conducted an observational national study between 2007 and 2008 of French general practitioners, primary care pediatricians and pharmacists. These healthcare professionals (HPs) were asked to include 5 consecutive patients from 1 month to 12 years old with fever for up to 48 hr who were accompanied by a family member. Parents completed a questionnaire about their knowledge of fever in children and their attitudes about the current fever episode. We used a multilevel logistic regression model to assess the joint effects of patient- and HP-level variables. Results In all, 1,534 HPs (participation rate 13%) included 6,596 children. Parental concordance with current recommendations for temperature measurement methods, the threshold for defining fever, and physical (oral hydration, undressing, room temperature) and drug treatment was 89%, 61%, 15%, and 23%, respectively. Multivariate multi-level analyses revealed a significant HP effect. In general, high concordance with recommendations was associated with high educational level of parents and the HP consulted being a pediatrician. Conclusions In France, parents' knowledge and practices related to managing fever symptoms in children frequently differ from recommendations. Targeted health education interventions are needed to effectively manage fever symptoms in children. PMID:24391772

Australasian Society for Parenteral and Enteral Nutrition guidelines for supplementation of trace elements during parenteral nutrition.

PubMed

Osland, Emma J; Ali, Azmat; Isenring, Elizabeth; Ball, Patrick; Davis, Melvyn; Gillanders, Lyn

2014-01-01

This work represents the first part of a progressive review of AuSPEN's 1999 Guidelines for Provision of Micronutrient Supplementation in Adult Patients receiving Parenteral Nutrition, in recognition of the developments in the literature on this topic since that time. A systematic literature review was undertaken and recommendations were made based on the available evidence and with consideration to specific elements of the Australian and New Zealand practice environment. The strength of evidence underpinning each recommendation was assessed. External reviewers provided feedback on the guidelines using the AGREE II tool. Reduced doses of manganese, copper, chromium and molybdenum, and an increased dose of selenium are recommended when compared with the 1999 guidelines. Currently the composition of available multi-trace element formulations is recognised as an obstacle to aligning these guidelines with practice. A paucity of available literature and limitations with currently available methods of monitoring trace element status are acknowledged. The currently unknown clinical impact of changes to trace element contamination of parenteral solutions with contemporary practices highlights need for research and clinical vigilance in this area of nutrition support practice. Trace elements are essential and should be provided daily to patients receiving parenteral nutrition. Monitoring is generally only required in longer term parenteral nutrition, however should be determined on an individual basis. Industry is encouraged to modify existing multi-trace element solutions available in Australia and New Zealand to reflect changes in the literature outlined in these guidelines. Areas requiring research are highlighted.

Revalidation and electronic cataract surgery audit: a Scottish survey on current practice and opinion.

PubMed

Megaw, R; Rane-Malcolm, T; Brannan, S; Smith, R; Sanders, R

2011-11-01

To determine current knowledge and opinion on revalidation, and methods of cataract surgery audit in Scotland and to outline the current and future possibilities for electronic cataract surgery audit. In 2010 we conducted a prospective, cross-sectional, Scottish-wide survey on revalidation knowledge and opinion, and cataract audit practice among all senior NHS ophthalmologists. Results were anonymised and recorded manually for analysis. In all, 61% of the ophthalmologists surveyed took part. Only 33% felt ready to take part in revalidation, whereas 76% felt they did not have adequate information about the process. Also, 71% did not feel revalidation would improve patient care, but 85% agreed that cataract surgery audit is essential for ophthalmic practice. In addition, 91% audit their cataract outcomes; 52% do so continuously. Further, 63% audit their subspecialist surgical results. Only 25% audit their cataract surgery practice electronically, and only 12% collect clinical data using a hospital PAS system. Funding and system incompatibility were the main reasons cited for the lack of electronic audit setup. Currently, eight separate hospital IT patient administration systems are used across 14 health boards in Scotland. Revalidation is set to commence in 2012. The Royal College of Ophthalmologists will use cataract outcome audit as a tool to ensure surgical competency for the process. Retrospective manual auditing of cataract outcome is time consuming, and can be avoided with an electronic system. Scottish ophthalmologists view revalidation with scepticism and appear to have inadequate knowledge of the process. However, they strongly agree with the concept of cataract surgery audit. The existing and future electronic applications that may support surgical audit are commercial electronic records, web-based applications, centrally funded software applications, and robust NHS connections between community and hospital.

Exploring the cost-utility of stratified primary care management for low back pain compared with current best practice within risk-defined subgroups.

PubMed

Whitehurst, David G T; Bryan, Stirling; Lewis, Martyn; Hill, Jonathan; Hay, Elaine M

2012-11-01

Stratified management for low back pain according to patients' prognosis and matched care pathways has been shown to be an effective treatment approach in primary care. The aim of this within-trial study was to determine the economic implications of providing such an intervention, compared with non-stratified current best practice, within specific risk-defined subgroups (low-risk, medium-risk and high-risk). Within a cost-utility framework, the base-case analysis estimated the incremental healthcare cost per additional quality-adjusted life year (QALY), using the EQ-5D to generate QALYs, for each risk-defined subgroup. Uncertainty was explored with cost-utility planes and acceptability curves. Sensitivity analyses were performed to consider alternative costing methodologies, including the assessment of societal loss relating to work absence and the incorporation of generic (ie, non-back pain) healthcare utilisation. The stratified management approach was a cost-effective treatment strategy compared with current best practice within each risk-defined subgroup, exhibiting dominance (greater benefit and lower costs) for medium-risk patients and acceptable incremental cost to utility ratios for low-risk and high-risk patients. The likelihood that stratified care provides a cost-effective use of resources exceeds 90% at willingness-to-pay thresholds of £4000 (≈ 4500; $6500) per additional QALY for the medium-risk and high-risk groups. Patients receiving stratified care also reported fewer back pain-related days off work in all three subgroups. Compared with current best practice, stratified primary care management for low back pain provides a highly cost-effective use of resources across all risk-defined subgroups.

National Practice Patterns of Obtaining Informed Consent for Stroke Thrombolysis.

PubMed

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

2018-03-01

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

7 CFR 14.6 - Criteria for determining the pri- mary purpose of payments with respect to potential exclusion...

Code of Federal Regulations, 2010 CFR

2010-01-01

... conservation includes actions that, for a given level of water supply, reduce the demand for or use of water by... reuse of water, thereby making existing supplies available for other current or future uses; or (iv) Improving land management practices for the purpose of reducing water use, loss, waste, increasing the...

Pre-Activity and Post-Activity Stretching Perceptions and Practices in NCAA Division I Volleyball Programs

ERIC Educational Resources Information Center

Judge, Lawrence W.; Bodey, Kimberly J.; Bellar, David; Bottone, Adam; Wanless, Elizabeth

2010-01-01

The purpose of this study was to determine if NCAA Division I women's volleyball programs were in compliance with suggested current pre- and post-activity stretching protocols. Questionnaires were sent to NCAA division I women's volleyball programs in the United States. Fifty six coaches (23 males & 33 females) participated in the study. Some…

National Study of Word Processing Installations in Selected Business Organizations. A Report on the National Word Processing Research Study of Delta Pi Epsilon.

ERIC Educational Resources Information Center

Scriven, Jolene D.; And Others

A study was conducted (1) to determine current practices in word processing installations in selected organizations throughout the United States, and (2) to ascertain anticipated future developments in word processing as well as to provide recommendations for educational institutions that prepare workers for business offices. Seven interview…

Method and apparatus for controlling LCL converters using asymmetric voltage cancellation techniques

DOEpatents

Wu, Hunter; Sealy, Kylee Devro; Sharp, Bryan Thomas; Gilchrist, Aaron

2016-01-26

A method and apparatus for LCL resonant converter control utilizing Asymmetric Voltage Cancellation is described. The methods to determine the optimal trajectory of the control variables are discussed. Practical implementations of sensing load parameters are included. Simple PI, PID and fuzzy logic controllers are included with AVC for achieving good transient response characteristics with output current regulation.

Simple, Efficient, and Rapid Methods to Determine the Potential for Vapor Intrusion into the Home: Temporal Trends, Vapor Intrusion Forecasting, Sampling Strategies, and Contaminant Migration Routes

EPA Science Inventory

Current practice for evaluating the vapor intrusion pathway involves a multiple line of evidence approach based on direct measurements of volatile organic compound (VOC) concentrations in groundwater, external soil gas, subslab soil gas, and/or indoor air. No single line of evide...

Challenging the Presumption of Diminished Capacity to Parent: Does Divorce Really Change Parenting Practices?

ERIC Educational Resources Information Center

Strohschein, Lisa

2007-01-01

The purpose of this paper is to determine whether divorced parents exhibit a diminished capacity to parent in the period following divorce. Using 2 waves of data from a national survey of Canadian children, the current study prospectively follows 5,004 children living in 2-biological parent households at initial interview and compares changes in…

21st Century Standards and Curriculum: Current Research and Practice

ERIC Educational Resources Information Center

Alismail, Halah Ahmed; McGuire, Patrick

2015-01-01

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

Home blood pressure monitoring and self-titration of antihypertensive medications: Proposed patient selection criteria.

PubMed

Hill, James R

2016-05-01

Recent studies have demonstrated that home blood pressure monitoring (HBPM), coupled with self-titration of medications is a viable intervention to control hypertension. There are currently no established criteria to evaluate patients for inclusion in such a program. The purpose of this discussion is to propose criteria for determining if a patient is appropriate to participate in a program of HBPM and self-titration. Inclusion criteria for two self-titration trials were examined, and additional factors in clinical practice were identified and discussed. Additional selection criteria were proposed to support the decision to enroll a patient in an antihypertensive self-titration program. Inclusion criteria from self-titration trials provide a reasonable starting point for choosing appropriate patients in clinical practice, but additional research is necessary. Adaptation of these criteria and consideration of the identified factors can be used to develop decision support instruments. Such instruments should be evaluated for effectiveness and reliability prior to use in clinical practice. HBPM combined with self-titration is an effective patient-centered approach for hypertension management. Decision support instruments to determine appropriate patients are necessary for safe and effective use in clinical practice. ©2015 American Association of Nurse Practitioners.

Organizational determinants of evaluation practice in Australian prevention agencies.

PubMed

Schwarzman, J; Bauman, A; Gabbe, B; Rissel, C; Shilton, T; Smith, B J

2018-06-01

Program evaluation is essential to inform decision making, contribute to the evidence base for strategies, and facilitate learning in health promotion and disease prevention organizations. Theoretical frameworks of organizational learning, and studies of evaluation capacity building describe the organization as central to evaluation capacity. Australian prevention organizations recognize limitations to current evaluation effectiveness and are seeking guidance to build evaluation capacity. This qualitative study identifies organizational facilitators and barriers to evaluation practice, and explores their interactions in Australian prevention organizations. We conducted semi-structured interviews with 40 experienced practitioners from government and non-government organizations. Using thematic analysis, we identified seven key themes that influence evaluation practice: leadership, organizational culture, organizational systems and structures, partnerships, resources, workforce development and training and recruitment and skills mix. We found organizational determinants of evaluation to have multi-level interactions. Leadership and organizational culture influenced organizational systems, resource allocation and support of staff. Partnerships were important to overcome resource deficits, and systems were critical to embed evaluation within the organization. Organizational factors also influenced the opportunities for staff to develop skills and confidence. We argue that investment to improve these factors would allow organizations to address evaluation capacity at multiple levels, and ultimately facilitate effective evaluation practice.

Pharmacogenetics of asthma: toward precision medicine.

PubMed

Kersten, Elin T G; Koppelman, Gerard H

2017-01-01

Although currently available drugs to treat asthma are effective in most patients, a proportion of patients do not respond or experience side-effects; which is partly genetically determined. Pharmacogenetics is the study of how genetic variations influence drug response. In this review, we summarize prior results and recent studies in pharmacogenetics to determine if we can use genetic profiles for personalized treatment of asthma. The field of pharmacogenetics has moved from candidate gene studies in single populations toward genome-wide association studies and meta-analysis of multiple studies. New technologies have been used to enrich results, and an expanding number of genetic loci have been associated with therapeutic responses to asthma drugs. Prospective, genotype-stratified treatment studies have been conducted for β2-agonists, showing attenuated response in children carrying the Arg16 variant in the β2-adrenoreceptor gene. Although there has been much progress, many findings have not been replicated and currently known genetic loci only account for a fraction of variability in drug response. More research is necessary to translate into clinical practice. A polygenic predictive approach integrated in complex networks with other 'omics' technologies could aid to achieve this goal. Finally, to change clinical practice, studies that compare precision medicine with traditional medicine are needed.

The impact of cotton growing practices on soil microbiology and its relation to plant and soil health

NASA Astrophysics Data System (ADS)

Pereg, Lily

2013-04-01

Crop production and agricultural practices heavily impact the soil microbial communities, which differ among varying types of soils and environmental conditions. Soil-borne microbial communities in cotton production systems, as in every other cropping system, consist of microbial populations that may either be pathogenic, beneficial or neutral with respect to the cotton crop. Crop production practices have major roles in determining the composition of microbial communities and function of microbial populations in soils. The structure and function of any given microbial community is determined by various factors, including those that are influenced by farming and those not controlled by farming activities. Examples of the latter are environmental conditions such as soil type, temperature, daylight length and UV radiation, air humidity, atmospheric pressure and some abiotic features of the soil. On the other hand, crop production practices may determine other abiotic soil properties, such as water content, density, oxygen levels, mineral and elemental nutrient levels and the load of other crop-related soil amendments. Moreover, crop production highly influences the biotic properties of the soil and has a major role in determining the fate of soil-borne microbial communities associated with the crop plant. Various microbial strains react differently to the presence of certain plants and plant exudates. Therefore, the type of plant and crop rotations are important factors determining microbial communities. In addition, practice management, e.g. soil cultivation versus crop stubble retention, have a major effect on the soil conditions and, thus, on microbial community structure and function. All of the above-mentioned factors can lead to preferential selection of certain microbial population over others. It may affect not only the composition of microbial communities (diversity and abundance of microbial members) but also the function of the community (the ability of different microbes to perform certain activities). Therefore, agricultural practices may determine the ability of beneficial microbes to realise their plant growth promoting potential or the pathogenic expression of others. This presentation will review the current knowledge about the impact of cotton growing practices on microbial communities and soil health in different environments as well as endeavour to identify gaps worthwhile exploring in future research for promoting plant growth in healthy soils.

A sample of Canadian orthopedic surgeons expressed willingness to participate in osteoporosis management for fragility fracture patients

PubMed Central

Bogoch, Earl R.; Snowden, Elizabeth

2008-01-01

Objective The orthopedic community is in a unique position to initiate and provide osteoporosis care in fragility fracture patients to prevent future hip fractures in a high-risk population. The attitudes and intentions of Canadian orthopedic surgeons in the domain of osteoporosis care are unknown. Our objective was to identify current attitudes and osteoporosis management practices and to determine their overall willingness to participate in osteoporosis care for fragility fracture patients. Methods A real-time interactive polling session was conducted at the 58th Annual Meeting of the Canadian Orthopaedic Association. Results Of the orthopedic surgeons who responded, 90.4% agreed that the current emphasis on osteoporosis in orthopedic practice is appropriate; 85.2% of surgeons indicated that they currently refer or personally investigate for osteoporosis, or both, in fragility fracture patients. Conclusion Most of the Canadian orthopedic surgeons sampled consider themselves to be currently engaged or ready to engage in osteoporosis care for fragility fracture patients. Focus should now shift from education and persuasion to program support through provision of resources and system modification that will enable Canadian orthopedic surgeons to effectively manage osteoporosis in their fracture patients. PMID:18248700

Application of a faith-based integration tool to assess mental and physical health interventions

PubMed Central

Saunders, Donna M.; Leak, Jean; Carver, Monique E.; Smith, Selina A.

2017-01-01

Background To build on current research involving faith-based interventions (FBIs) for addressing mental and physical health, this study a) reviewed the extent to which relevant publications integrate faith concepts with health and b) initiated analysis of the degree of FBI integration with intervention outcomes. Methods Derived from a systematic search of articles published between 2007 and 2017, 36 studies were assessed with a Faith-Based Integration Assessment Tool (FIAT) to quantify faith-health integration. Basic statistical procedures were employed to determine the association of faith-based integration with intervention outcomes. Results The assessed studies possessed (on average) moderate, inconsistent integration because of poor use of faith measures, and moderate, inconsistent use of faith practices. Analysis procedures for determining the effect of FBI integration on intervention outcomes were inadequate for formulating practical conclusions. Conclusions Regardless of integration, interventions were associated with beneficial outcomes. To determine the link between FBI integration and intervention outcomes, additional analyses are needed. PMID:29354795

Typography and layout of technical reports - Survey of current practices

NASA Technical Reports Server (NTRS)

Pinelli, T. E.; Cordle, V. M.; Mccullough, R.

1985-01-01

As part of a review of the NASA Langley Research Center scientific and technical information program, 50 technical reports from industry, research institutions, and government agencies were systematically examined and analyzed to determine current usage and practice in regard to (1) typography, including composition method, type style, type size, and margin treatment; (2) graphic design, including layout and imposition of material on the page; and (3) physical media, including paper, ink, and binding methods. The results indicate that approximately 50 percent of the reports were typeset, 70 percent used Roman (serif) type, 80 percent used 10- or 11-point type for text, 60 percent used a ragged right-hand margin, slightly more than half used paragraph indentation, 75 percent used a single-column layout, 65 percent had one or more figures or tables placed perpendicular to (not aligned with) the text, and perfect binding was the most frequently used binding method.

Current practice in airway management: A descriptive evaluation.

PubMed

Kjonegaard, Rebecca; Fields, Willa; King, Major L

2010-03-01

Ventilator-associated pneumonia, a common complication of mechanical ventilation, could be reduced if health care workers implemented evidence-based practices that decrease the risk for this complication. To determine current practice and differences in practices between registered nurses and respiratory therapists in managing patients receiving mechanical ventilation. A descriptive comparative design was used. A convenience sample of 41 registered nurses and 25 respiratory therapists who manage critical care patients treated with mechanical ventilation at Sharp Grossmont Hospital, La Mesa, California, completed a survey on suctioning techniques and airway management practices. Descriptive and inferential statistics were used to analyze the data. Significant differences existed between nurses and respiratory therapists for hyperoxygenation before suctioning (P =.03). In the 2 groups, nurses used the ventilator for hyper-oxygenation more often, and respiratory therapists used a bag-valve device more often (P =.03). Respiratory therapists instilled saline (P <.001) and rinsed the closed system with saline after suctioning (P =.003) more often than nurses did. Nurses suctioned oral secretions (P <.001) and the nose of orally intubated patients (P =.01), brushed patients' teeth with a toothbrush (P<.001), and used oral swabs to clean the mouth (P <.001) more frequently than respiratory therapists did. Nurses and respiratory therapists differed significantly in the management of patients receiving mechanical ventilation. To reduce the risk of ventilator-associated pneumonia, both nurses and respiratory therapists must be consistent in using best practices when managing patients treated with mechanical ventilation.

Blood transfusion practice in the UK and Ireland: a survey of palliative care physicians.

PubMed

Neoh, Karen; Stanworth, Simon; Bennett, Michael I

2018-03-23

Red cell (blood) transfusions are used in palliative care to manage patients with symptomatic anaemia or when patients have lost blood. We aimed to understand current blood transfusion practice among palliative medicine doctors and compare this with National Institute for Health and Care Excellence (NICE) guidance. NICE guidance advocates more restrictive transfusion practice but is based on clinical trials in non-palliative care contexts; the extent to which these findings should be applied to palliative care remains unclear. Four clinical vignettes of common clinical palliative care scenarios were developed. Members of the Association for Palliative Medicine were invited to complete the survey. Results were compared with acceptable responses based on current NICE recommendations and analysed to determine the influence of respondents' gender, experience or work setting. 27% of 1070 members responded. Overall, ideal or acceptable responses were selected by less than half of doctors to all four vignettes. Doctors were more liberal in prescribing blood transfusions than NICE guidance would advocate. Senior doctors were less likely to choose an acceptable response than junior colleagues. Palliative care practice is varied and not consistent with a restrictive blood transfusion policy. More recently trained doctors follow less liberal practices than senior colleagues. More direct evidence of benefits and harms of blood transfusion is needed in palliative care to inform practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The "wins" of change: evaluating the impact of predicted changes on case management practice.

PubMed

Stanton, Marietta P; Barnett Lammon, Carol Ann

2008-01-01

A variety of strategies were employed to identify current and future trends that would impact the practice of case management. Historical review, consultation with case management experts, literature review, and environmental scanning by practicing case managers were strategies employed to determine the impact of current and future trends on case management. The trends identified in this article have implications for case managers in a variety of settings. Case managers participating in the environmental scanning process to evaluate the impact of the identified trends on their organization included representation from acute care, home care, behavioral health, workers' compensation, and private insurance settings. The top 7 trends identified by experts in the field of case management included pay for performance, recovery audit contractors, Medicare demonstration projects, transitions of care, informatics in healthcare and case management, metrics for case management, and the impact of an aging population in case management. Practicing case managers were asked to react to these trends in terms of likelihood of occurrence in their organization and impact of these trends on their case management practice. Case management will ultimately have a higher degree of accountability for its practice if metrics to evaluate and reimbursement for case management become a reality. A multitude of performance measures exist that will be monitored and be tied to reimbursement. To ensure that agencies are accomplishing these performance measures, case management will potentially have a growing importance. Case managers perceive that these trends have a predominantly positive impact on case management.

Workplace discrimination: experiences of practicing physicians.

PubMed

Coombs, Alice A Tolbert; King, Roderick K

2005-04-01

In response to a growing concern regarding physician discrimination in the workplace, this study was developed to: (1) describe the types of discrimination that exist for the practicing physician and (2) determine which groups of physicians are more likely to experience the various forms of discrimination. Surveys were mailed to 1930 practicing physicians in Massachusetts. Participants were asked if they had encountered discrimination, how significant the discrimination was against a specific group, the frequency of personal discrimination, and the type of discrimination. Factor analysis identified four types of discrimination: career advancement, punitive behaviors, practice barriers and hiring barriers. A total of 445 responses were received (a 24% response rate). Sixty-three percent of responding physicians had experienced some form of discrimination. Respondents were women (46%), racial/ethnic minorities (42%) and international medical graduates (IMGs) (40%). In addition, 26% of those classified as white were also IMGs. Over 60% of respondents believed discrimination against IMGs was very or somewhat significant. Almost 27% of males acknowledged that gender bias against females was very or somewhat significant. IMGs were more likely to indicate that discrimination against IMGs was significant in their current organization. Of U.S. medical graduates (USMGs) 44% reported that discrimination against IMGs in their current organization was significant. Nonwhites were more likely to report that discrimination based on race/ethnicity was significant. Nearly 29% of white respondents also believed that such discrimination was very or somewhat significant. Physicians practicing in academic, research, and private practice sectors experience discrimination based on gender, ethnic/racial, and IMG status.

Critical leadership and management skills for pathology practice.

PubMed

Brimhall, Bradley B; Wright, Louis D; McGregor, Kelli L; Hernandez, James S

2007-10-01

Managed care has changed the nature of medical practice. The practice of pathology has also changed and is likely to undergo further modification. Additional skills in leadership and management are needed to perform optimally in the current medical marketplace. To determine whether pathologists view business and informatics skills as being important and valuable in their practices. A survey was sent electronically (via e-mail) to 2566 pathologists and pathology administrators. Two hundred sixteen survey recipients (8.4%) responded to the survey. The response rate to individual questions ranged from 86% to 99% (186 to 214 of 216 total respondents). Most who took the survey ranked communication (203/209; 97%), leadership skills (165/209; 79%), and systems thinking skills (155/209; 74%) as either "very important" or "essential." Fewer respondents were willing to offer salary premiums for marketing (108/196; 55%), business or finance (92/196; 47%), or staff leadership (95/196; 48%) skills unless the candidate had a track record of measurable achievement using these skills. Those practicing in academia as well as those making hiring decisions by themselves were more likely to value leadership and management skills. Fewer than 1% of respondents in any category considered current pathology residency training in leadership and management to be adequate. Prospective employers value leadership and management skills. Pathology residency programs must include meaningful training in pathology practice management and informatics to satisfy the demand for these skills in the modern pathology marketplace.

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

...] Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission... entitled ``PET Drugs--Current Good Manufacturing Practice (CGMP); Small Entity Compliance Guide.'' FDA has... consistent with FDA's good guidance practices regulation (21 CFR 10.115). The guidance represents the Agency...

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..., methods, practices, and controls used in the processing, bottling, holding, and shipping of bottled...

Legal and definitional issues affecting the identification and education of adults with specific learning disabilities in adult education programs.

PubMed

Taymans, Juliana M

2012-01-01

Although the exact prevalence is not determined, a noticeable subset of individuals who enroll in adult education and training programs have either diagnosed or undiagnosed specific learning disabilities (SLD). Understanding SLD is important basic information for adult educators to inform program policies as well as determine effective instructional practices. This article discusses the development of definitions of SLD and current agreement on the nature of SLD relevant to working with adults. It concludes with implications for adult education programs.

Quantity and quality assessment of randomized controlled trials on orthodontic practice in PubMed.

PubMed

Shimada, Tatsuo; Takayama, Hisako; Nakamura, Yoshiki

2010-07-01

To find current high-quality evidence for orthodontic practice within a reasonable time, we tested the performance of a PubMed search. PubMed was searched using publication type randomized controlled trial and medical subject heading term "orthodontics" for articles published between 2003 and 2007. The PubMed search results were compared with those from a hand search of four orthodontic journals to determine the sensitivity of PubMed search. We evaluated the precision of the PubMed search result and assessed the quality of individual randomized controlled trials using the Jadad scale. Sensitivity and precision were 97.46% and 58.12%, respectively. In PubMed, of the 277 articles retrieved, 161 (58.12%) were randomized controlled trials on orthodontic practice, and 115 of the 161 articles (71.42%) were published in four orthodontic journals: American Journal of Orthodontics and Dentofacial Orthopedics, The Angle Orthodontist, the European Journal of Orthodontics, and the Journal of Orthodontics. Assessment by the Jadad scale revealed 60 high-quality randomized controlled trials on orthodontic practice, of which 45 (75%) were published in these four journals. PubMed is a highly desirable search engine for evidence-based orthodontic practice. To stay current and get high-quality evidence, it is reasonable to look through four orthodontic journals: American Journal of Orthodontics and Dentofacial Orthopedics, The Angle Orthodontist, the European Journal of Orthodontics, and the Journal of Orthodontics.

Paediatric dental chair sedation: An audit of current practice in Gauteng, South Africa.

PubMed

Bham, F; Perrie, H; Scribante, J; Lee, C-A

2015-06-01

Procedural sedation and analgesia (PSA) is often required to perform dental procedures in children. Serious adverse outcomes, while rare, are usually preventable. To determine the proportion of dental practitioners making use of paediatric dental chair PSA in Gauteng Province, South Africa, describe their PSA practice, and determine compliance with recommended safety standards. A prospective, contextual, descriptive study design was used, with 222 randomly selected dental practitioners contacted to determine whether they offered paediatric dental chair PSA. Practitioners offering PSA were then asked to complete a web-based questionnaire assessing their practice. Of the 213 dental practitioners contacted, 94 (44.1%; 95% confidence interval 37 - 51) provided PSA to children. Most patients were 1 - 5 years old, although there were practices that offered PSA to infants. While most procedures were performed under minimal to moderate sedation, deep sedation and general anaesthesia were also administered in dental rooms. Midazolam was the most frequently used sedative agent, often in conjunction with inhaled nitrous oxide; 28.1% of PSA providers administered a combination of three or more agents. Presedation patient assessment was documented in 83.0% of cases, and informed consent for sedation was obtained in 75.6%. The survey raised several areas of concern regarding patient safety: 41.3% of dental practices did not use any monitoring equipment during sedation; the operator was responsible for the sedation and monitoring of the patient in 41.3%; 43.2% did not keep any recommended emergency drugs; and 19.6% did not have any emergency or resuscitation equipment available. Most respondents (81.8%) indicated an interest in sedation training. Paediatric dental chair PSA was offered by 44.1% of dental practitioners interviewed in Gauteng. Modalities of PSA provided varied between practices, with a number of safety concerns being raised.

[Current treatment of hepatic trauma].

PubMed

Silvio-Estaba, Leonardo; Madrazo-González, Zoilo; Ramos-Rubio, Emilio

2008-05-01

The therapeutic and diagnostic approach of liver trauma injuries (by extension, of abdominal trauma) has evolved remarkably in the last decades. The current non-surgical treatment in the vast majority of liver injuries is supported by the accumulated experience and optimal results in the current series. It is considered that the non-surgical treatment of liver injuries has a current rate of success of 83-100%, with an associated morbidity of 5-42%. The haemodynamic stability of the patient will determine the applicability of the non-surgical treatment. Arteriography with angioembolisation constitutes a key technical tool in the context of liver trauma. Patients with haemodynamic instability will need an urgent operation and can benefit from abdominal packing techniques, damage control and post-operative arteriography. The present review attempts to contribute to the current, global and practical management in the care of liver trauma.

Maximizing ion current rectification in a bipolar conical nanopore fluidic diode using optimum junction location.

PubMed

Singh, Kunwar Pal

2016-10-12

The ion current rectification has been obtained as a function of the location of a heterojunction in a bipolar conical nanopore fluidic diode for different parameters to determine the junction location for maximum ion current rectification using numerical simulations. Forward current peaks for a specific location of the junction and reverse current decreases with the junction location due to a change in ion enrichment/depletion in the pore. The optimum location of the heterojunction shifts towards the tip with base/tip diameter and surface charge density, and towards the base with the electrolyte concentration. The optimum location of the heterojunction has been approximated by an equation as a function of pore length, base/tip diameter, surface charge density and electrolyte concentration. The study is useful to design a rectifier with maximum ion current rectification for practical purposes.

Is implementation of the 2013 Australian treatment guidelines for posttraumatic stress disorder cost-effective compared to current practice? A cost-utility analysis using QALYs and DALYs.

PubMed

Mihalopoulos, Cathrine; Magnus, Anne; Lal, Anita; Dell, Lisa; Forbes, David; Phelps, Andrea

2015-04-01

To assess, from a health sector perspective, the incremental cost-effectiveness of three treatment recommendations in the most recent Australian Clinical Practice Guidelines for posttraumatic stress disorder (PTSD). The interventions assessed are trauma-focused cognitive behavioural therapy (TF-CBT) and selective serotonin reuptake inhibitors (SSRIs) for the treatment of PTSD in adults and TF-CBT in children, compared to current practice in Australia. Economic modelling, using existing databases and published information, was used to assess cost-effectiveness. A cost-utility framework using both quality-adjusted life-years (QALYs) gained and disability-adjusted life-years (DALYs) averted was used. Costs were tracked for the duration of the respective interventions and applied to the estimated 12 months prevalent cases of PTSD in the Australian population of 2012. Simulation modelling was used to provide 95% uncertainty around the incremental cost-effectiveness ratios. Consideration was also given to factors not considered in the quantitative analysis but could determine the likely uptake of the proposed intervention guidelines. TF-CBT is highly cost-effective compared to current practice at $19,000/QALY, $16,000/DALY in adults and $8900/QALY, $8000/DALY in children. In adults, 100% of uncertainty iterations fell beneath the $50,000/QALY or DALY value-for-money threshold. Using SSRIs in people already on medications is cost-effective at $200/QALY, but has considerable uncertainty around the costs and benefits. While there is a 13% chance of health loss there is a 27% chance of the intervention dominating current practice by both saving dollars and improving health in adults. The three Guideline recommended interventions evaluated in this study are likely to have a positive impact on the economic efficiency of the treatment of PTSD if adopted in full. While there are gaps in the evidence base, policy-makers can have considerable confidence that the recommendations assessed in the current study are likely to improve the efficiency of the mental health care sector. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Current practice of antibiotic prophylaxis for surgical fixation of closed long bone fractures: a survey of 297 members of the Orthopaedic Trauma Association.

PubMed

Gans, Itai; Jain, Amit; Sirisreetreerux, Norachart; Haut, Elliott R; Hasenboehler, Erik A

2017-01-01

The risk of postoperative surgical site infection after long bone fracture fixation can be decreased with appropriate antibiotic use. However, there is no agreement on the superiority of a single- or multiple-dose perioperative regimen of antibiotic prophylaxis. The purpose of this study is to determine the following: 1) What are the current practice patterns of orthopaedic trauma surgeons in using perioperative antibiotics for closed long bone fractures? 2) What is the current knowledge of published antibiotic prophylaxis guidelines among orthopaedic trauma surgeons? 3) Are orthopaedic surgeons willing to change their current practices? A questionnaire was distributed via email between September and December 2015 to 955 Orthopaedic Trauma Association members, of whom 297 (31%) responded. Most surgeons (96%) use cefazolin as first-line infection prophylaxis. Fifty-nine percent used a multiple-dose antibiotic regimen, 39% used a single-dose regimen, and 2% varied this decision according to patient factors. Thirty-six percent said they were unfamiliar with Centers for Disease Control and Prevention (CDC) antibiotic prophylaxis guidelines; only 30% were able to select the correct CDC recommendation from a multiple-choice list. However, 44% of surgeons said they followed CDC recommendations. Fifty-six percent answered that a single-dose antibiotic prophylaxis regimen was not inferior to a multiple-dose regimen. If a level-I study comparing a single preoperative dose versus multiple perioperative antibiotic dosing regimen for treatment of closed long bone fractures were published, most respondents (64%) said they would fully follow these guidelines, and 22% said they would partially change their practice to follow these guidelines. There is heterogeneity in the use of single- versus multiple-dose antibiotic prophylaxis for surgical repair of closed long bone fractures. Many surgeons were unsure of current evidence-based recommendations regarding perioperative antibiotic use. Most respondents indicated they would be receptive to high-level evidence regarding the single- versus multiple-dose perioperative prophylactic antibiotics for the treatment of closed long bone fractures.

Partnership, inclusion and innovation in occupational therapy: Essential or optional ingredients to flourish in a changing environment?

PubMed

Gilbert Hunt, Susan

2017-12-01

Historically occupational therapy has evidenced a tenacity to adjust and adapt to societal changes. Currently in Australia we are in the midst of significant change in health, disability and aged care service delivery alongside increasing numbers of new graduates seeking employment. Both of these changes create challenges and opportunities for the profession. How the profession adjusts to new service delivery models and supports new graduates in this changing work environment will influence our future. Using examples from practice the paper explores ways in which partnership, inclusion and innovation can be effective in a changing environment. Doing effective partnership takes time, energy and a shared commitment of all involved and often requires negotiations and compromise. Inclusion can be tricky and requires vigilance and ongoing reflection on actions to determine if the outcomes are what was intended. Innovation can play two roles; it can be used to conserve current practice in new ways or it can offer agency to disrupt and redefine practice. The way in which the profession chooses to enact partnerships and inclusion will play a vital role in shaping the future. Similarly the space and support made for conservative or disruptive innovation will determine how we choose to define ourselves going forward. Moreover, these choices and actions will govern how effective we are in navigating the changing environment and supporting new graduates transitioning into the profession. © 2017 Occupational Therapy Australia.

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

PubMed

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

2016-01-01

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

75 FR 52627 - Disenrollment Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... program that has been discontinued. It also amends the regulation to reflect current VA practice and to... conform with current VA practice, which does not disenroll veterans based on their failure to file VA Form 10-10EZ. Current practice is reflected in current paragraph (d)(3)(iv). Removing paragraph (d)(5)(iii...

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... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10, 113.40..., methods, practices, and controls used by the commercial processor in the manufacture, processing, or...

Review article: Paediatric status epilepticus in the pre-hospital setting: An update.

PubMed

Furyk, Jeremy; Watt, Kerriane; Emeto, Theophilus I; Dalziel, Stuart; Bodnar, Daniel; Riney, Kate; Babl, Franz E

2017-08-01

Paediatric status epilepticus (SE) is a medical emergency and a common critical condition confronting pre-hospital providers. Management in the pre-hospital environment is challenging but considered extremely important as a potentially modifiable factor on outcome. Recent data from multicentre clinical trials, quality observational studies and consensus documents have influenced management in this area, and is important to both pre-hospital providers and emergency physicians. The objective of this review was to: (i) present an overview of the available evidence relevant to pre-hospital care of paediatric SE; and (ii) assess the current pre-hospital practice guidelines in Australia and New Zealand. The review outlines current definitions and guidelines of SE management, regional variability in pre-hospital protocols within Australasia and aspects of pre-hospital care that could potentially be improved. Contemporary data is required to determine current practice in our setting. It is important that paediatric neurologists, emergency physicians and pre-hospital care providers are all engaged in future endeavours to improve clinical care and knowledge translation efforts for this patient group. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Waste-handling practices at red meat abattoirs in South Africa.

PubMed

Roberts, Hester; de Jager, Linda; Blight, Geoffrey

2009-02-01

Abattoir waste disposal must be carefully managed because the wastes can be a source of food-borne diseases (Nemerow & Dasgupta Industrial and Hazardous Waste Treatment, p. 284, Van Nostrand Reinhold, New York, 1991; Bradshaw et al. The Treatment and Handling of Wastes, p. 183, The Royal Society, Chapman & Hall, London, 1992). Disposal of food that has been condemned because it is known to be diseased is of particular concern, and this paper looks at current disposal methods for such waste in the light of new scientific developments and waste-management strategies. Questionnaires were presented to management and workers at low- and high-throughput red meat abattoirs in the Free State Province, South Africa to determine current waste-handling procedures for condemned products. The waste-handling practices, almost without exception, did not fully comply with the requirements of the South African Red Meat Regulations of 2004, framed under the Meat Safety Act (Act 40 of 2000). The survey highlighted the need to improve current waste-handling strategies to prevent condemned products from re-entering the food chain and contributing to environmental pollution.

Criticisms of chlorination: social determinants of drinking water beliefs and practices among the Tz'utujil Maya.

PubMed

Nagata, Jason M; Valeggia, Claudia R; Smith, Nathaniel W; Barg, Frances K; Guidera, Mamie; Bream, Kent D W

2011-01-01

To explore social determinants of drinking water beliefs and practices among the Tz'utujil Maya of Santiago Atitlán, Guatemala, through analysis of demographics, socioeconomic status, memory of historical events, sensory experience, and water attitudes. Parallel mixed (qualitative and quantitative) methods, including participant observation, in-depth interviews based on a purposive sample, and 201 semi-structured interviews based on a regional quota sample, were used to collect data from March 2007 to August 2008. Data analysis included the use of grounded theory methodology and Pearson's chi-square test for independence. Qualitative results based on grounded theory highlighted how memory of the Guatemalan Civil War and Hurricane Stan, attitudes about Lake Atitlán water, and the taste and smell of chlorine influenced Tz'utujil Maya drinking water beliefs. Quantitative survey results revealed that differences in ethnicity, literacy, years of schooling, distrust of the water supply during the Civil War and Hurricane Stan, and current beliefs about Lake Atitlán and tap water quality were associated with significantly different water self-treatment practices. In accordance with social determinants of health paradigms, demographic, socioeconomic, social, cultural, political, and historical factors continue to be significant determinants of water-related health. Public health water interventions must address inequalities related to these underlying factors in order to achieve maximum effectiveness.

Developing an advanced practice nurse-led liver clinic.

PubMed

McAfee, Jean L

2012-01-01

End-stage liver disease (ESLD) is a leading cause of digestive disease deaths in the United States and continues to increase exponentially every year. Best practice does not currently recognize or utilize a clinic practice model for ESLD management. Advanced practice registered nurses (APRNs) can impact ESLD disease management by implementing an outpatient clinic care model to focus on treatment compliance, patient education, improvement of patient outcomes, and reduction in hospital admission rates for ESLD patients. A review of 15 research articles was completed to determine the impact APRNs can make on chronic care of ESLD patients. Results from the review support APRN analysis, assessment, diagnosis, treatment, intervention, and evaluation of ESLD patients. The literature reviewed also demonstrates that ESLD patients have improved symptom management when maintained in an outpatient setting, allowing for decreased hospital and insurance expenditures. Following evaluation of the evidence, it was concluded that an APRN-led ESLD clinic merits further study.

Survey of Usual Practice: Dysphagia Therapy in Head & Neck Cancer Patients

PubMed Central

Krisciunas, Gintas P.; Sokoloff, William; Stepas, Katherine; Langmore, Susan E.

2012-01-01

There is no standardized dysphagia therapy for head and neck cancer patients and scant evidence to support any particular protocol, leaving institutions and individual speech language pathologists (SLPs) to determine their own protocols based on “typical” practices or anecdotal evidence. To gain an understanding of current usual practices, a national internet-based survey was developed and disseminated to SLPs who treat HNC patients. From a random sample of 4,000 ASHA SID 13 members, 1,931 fit the inclusion criteria, and 759 complete responses were recorded for a 39.3% response rate. Results were analyzed by institution type as well as by individual clinical experience. While some interesting trends emerged from the data, a lack of uniformity and consensus regarding best practices was apparent. This is undoubtedly due to a paucity of research adequately addressing the efficacy of any one therapy for dysphagia in the HNC population. PMID:22456699

Quantifying the uncertainties in life cycle greenhouse gas emissions for UK wheat ethanol

NASA Astrophysics Data System (ADS)

Yan, Xiaoyu; Boies, Adam M.

2013-03-01

Biofuels are increasingly promoted worldwide as a means for reducing greenhouse gas (GHG) emissions from transport. However, current regulatory frameworks and most academic life cycle analyses adopt a deterministic approach in determining the GHG intensities of biofuels and thus ignore the inherent risk associated with biofuel production. This study aims to develop a transparent stochastic method for evaluating UK biofuels that determines both the magnitude and uncertainty of GHG intensity on the basis of current industry practices. Using wheat ethanol as a case study, we show that the GHG intensity could span a range of 40-110 gCO2e MJ-1 when land use change (LUC) emissions and various sources of uncertainty are taken into account, as compared with a regulatory default value of 44 gCO2e MJ-1. This suggests that the current deterministic regulatory framework underestimates wheat ethanol GHG intensity and thus may not be effective in evaluating transport fuels. Uncertainties in determining the GHG intensity of UK wheat ethanol include limitations of available data at a localized scale, and significant scientific uncertainty of parameters such as soil N2O and LUC emissions. Biofuel polices should be robust enough to incorporate the currently irreducible uncertainties and flexible enough to be readily revised when better science is available.

Who does workforce planning well? Workforce review team rapid review summary.

PubMed

Curson, J A; Dell, M E; Wilson, R A; Bosworth, D L; Baldauf, B

2010-01-01

This paper sets out to disseminate new knowledge about workforce planning, a crucial health sector issue. The Health Select Committee criticised NHS England's failure to develop and apply effective workforce planning. The Workforce Review Team (WRT) commissioned the Institute for Employment Research, Warwick University, to undertake a "rapid review" of global literature to identify good practice. A workforce planning overview, its theoretical principles, good practice exemplars are provided before discussing their application to healthcare. The literature review, undertaken September-November 2007, determined the current workforce planning evidence within and outside health service provision and any consensus on successful workforce planning. Much of the literature was descriptive and there was a lack of comparative or evaluative research-based evidence to inform U.K. healthcare workforce planning. Workforce planning practices were similar in other countries. There was no evidence to challenge current WRT approaches to NHS England workforce planning. There are a number of indications about how this might be extended and improved, given additional resources. The evidence-base for workforce planning would be strengthened by robust and authoritative studies. Systematic workforce planning is a key healthcare quality management element. This review highlights useful information that can be turned into knowledge by informed application to the NHS. Best practice in other sectors and other countries appears to warrant exploration.

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

PubMed

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

2018-04-01

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

The continuing medical education activities and attitudes of Australian doctors working in different clinical specialties and practice locations.

PubMed

Stewart, Grant D; Khadra, Mohamed H

2009-02-01

Currently, it is not clear which continuing medical education (CME) methods are being used by senior doctors and what their attitudes towards them are. The aims of this study were to investigate which modes of CME delivery senior Australian doctors utilise, to assess doctors' attitudes towards CME and to determine any differences in modes used and attitudes between clinical specialties and practice locations. A 52-statement questionnaire enquiring about doctors' current CME activities and their attitudes towards CME was distributed to 1336 senior Australian doctors. 494 doctors responded to the questionnaire. Traditional forms of CME (eg, meetings, conferences, journals and lectures) were most commonly used. Doctors thought CME involving face-to-face interaction was superior to electronic forms of CME. All doctors, especially those in hospital practice, had a positive attitude towards CME but found lack of time a barrier to learning. Rural doctors found CME sessions more difficult to attend than did their metropolitan colleagues. Traditional forms of CME were more popular than modern CME approaches, such as e-learning. Australian doctors had a positive attitude towards undertaking CME despite struggling to find time to perform CME. The differences in attitudes towards CME demonstrated between specialties and different practice location will aid future CME planning.

Attitudes and practices on HIV preventions among students of higher education institutions in Ethiopia: the case of Addis Ababa University.

PubMed

Regassa, Nigatu; Kedir, Seman

2011-06-01

The main objective of this cross-sectional study is to assess higher education students' attitudes, their practice on preventive measures against HIV/AIDS; and examined factors affecting attitude and practice of the students related to HIV/AIDS prevention. The 606 study participants were drawn from Addis Ababa University, which is the oldest and biggest public university in Ethiopia, through multistage sampling. Data were collected using survey quantitative (questionnaire) and qualitative (FGDs), and subsequently, analysis of the data was made through the use of descriptive statistics (Frequency and logistic regression model). The findings of the study revealed that 207 (34.2%) of respondents were sexually active during the survey. Of these, 144 (23.8%) of them had sexual intercourse with their partner or someone in the last 6 months. The mean and median age at first sex debut was computed as 17.8 and 18.0 years respectively. About 489 (80.7%) did not perceive being at risk of contracting HIV/AIDS. But 65.5% of the respondent had favorable attitude on HIV prevention. 359 (59.2%) of the respondents had experienced at least one of the three HIV prevention practice. Of which, more than half (52.4%) adopted abstinence as top preventive measure. The result also showed that out of the total respondents 47.2% had been tested for HIV/AIDS and more than 80% have willingness to take VCT service for HIV/AIDS. As to the multivariate analysis result; sex, previous residence, religious participation, pornographic viewing, currently alcohol intake, chewing khat and cigarette smoking were found to be determinant of AAU students' attitude on HIV prevention. Similarly, age, having pocket money, pornographic film show and currently khat chewing were determinants of practices on HIV prevention. Finally, based on the findings, the study has forwarded some workable recommendations.

Data on energy conservation activity in multifamily housing

NASA Astrophysics Data System (ADS)

1981-07-01

A policy review to determine how the multifamily building sector is responding to market signals and to evaluate what role the federal government should play in encouraging conservation in this subsector is presented. Available data is used to assess the current status of weatherization in multifamily housing and the current trends in adding weatherization measures on using them in new construction are identified and catalogued. Data on energy practices in multifamily housing and other energy related characteristics are also identified. The purpose, the sources covered, and the findings and recommendations are described. The data are summarized.

Assessment of state-of-the-art of in-service inspection methods for graphite epoxy composite structures on commercial transport aircraft

NASA Technical Reports Server (NTRS)

Phelps, M. L.

1979-01-01

A survey was conducted to determine current in-service inspection practices for all types of aircraft structure and particularly for advanced composite structures. The survey consisted of written questionnaires to commercial airlines, visits to airlines, aircraft manufacturers, and government agencies, and a literature search. Details of the survey including visits, questions asked, a bibliography of reviewed literature and details of the results are reported. From the results, a current in-service inspection baseline and a preliminary inspection program for advanced composite structures is documented as appendices to the report.

Predictive vs. Empiric Assessment of Schistosomiasis: Implications for Treatment Projections in Ghana

PubMed Central

Kabore, Achille; Biritwum, Nana-Kwadwo; Downs, Philip W.; Soares Magalhaes, Ricardo J.; Zhang, Yaobi; Ottesen, Eric A.

2013-01-01

Background Mapping the distribution of schistosomiasis is essential to determine where control programs should operate, but because it is impractical to assess infection prevalence in every potentially endemic community, model-based geostatistics (MBG) is increasingly being used to predict prevalence and determine intervention strategies. Methodology/Principal Findings To assess the accuracy of MBG predictions for Schistosoma haematobium infection in Ghana, school surveys were evaluated at 79 sites to yield empiric prevalence values that could be compared with values derived from recently published MBG predictions. Based on these findings schools were categorized according to WHO guidelines so that practical implications of any differences could be determined. Using the mean predicted values alone, 21 of the 25 empirically determined ‘high-risk’ schools requiring yearly praziquantel would have been undertreated and almost 20% of the remaining schools would have been treated despite empirically-determined absence of infection – translating into 28% of the children in the 79 schools being undertreated and 12% receiving treatment in the absence of any demonstrated need. Conclusions/Significance Using the current predictive map for Ghana as a spatial decision support tool by aggregating prevalence estimates to the district level was clearly not adequate for guiding the national program, but the alternative of assessing each school in potentially endemic areas of Ghana or elsewhere is not at all feasible; modelling must be a tool complementary to empiric assessments. Thus for practical usefulness, predictive risk mapping should not be thought of as a one-time exercise but must, as in the current study, be an iterative process that incorporates empiric testing and model refining to create updated versions that meet the needs of disease control operational managers. PMID:23505584

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

... CDC-2011-0008] Assessing the Current Research, Policy, and Practice Environment in Public Health... information helpful to assess the current research, policy, and practice environment in public health genomics. HHS/CDC is currently leading a process to assess the most important steps for public health genomics...

From theory to practice: what drives the core business of public health?

PubMed

Smith, Tina Anderson; Minyard, Karen J; Parker, Christopher A; Van Valkenburg, Rachel Ferencik; Shoemaker, John A

2007-01-01

In 1994, the Public Health Functions Steering Committee proffered a description of the Essential Public Health Services (Essential Services). Questions remain, however, about the relationship between the roles defined therein and current public health practice at state and local levels. This case study describes the core business of public health in Georgia relative to the theoretical ideal and elucidates the primary drivers of the core business, thus providing data to inform future efforts to strengthen practice in the state. The principal finding was that public health in Georgia is not aligned with the Essential Services. Further analysis revealed that the primary drivers or determinants of public health practice are finance-related rather than based in need or strategy, precluding an integrated and intentional focus on health improvement. This case study provides a systems context for public health financing discussions, suggests leverage points for public health system change, and furthers the examination of applications for systems thinking relative to public health finance, practice, and policy.

Teaching for Scientific Literacy? An Examination of Instructional Practices in Secondary Schools in Barbados

NASA Astrophysics Data System (ADS)

Archer-Bradshaw, Ramona E.

2017-02-01

This study examined the extent to which the instructional practices of science teachers in Barbados are congruent with best practices for teaching for scientific literacy. Additionally, through observation of practice, it sought to determine the teachers' demonstrated role in the classroom, their demonstration of learning through discourse, learning goals and the nature of classroom activities. Five hundred nineteen students from 12 of the 23 secondary schools on the island and 15 teachers across 8 schools participated in the study. Data were collected by means of a questionnaire, an observational schedule and field notes. It was found that while problem-solving and questioning were mainly used in the classroom, the use of experiments was among the least popular teaching strategies. Additionally, results showed that teachers' display of the knowledge of the characteristics of scientific literacy was unsatisfactory. Generally, the findings indicate a gap between teaching for scientific literacy as expressed in the literature and current instructional practices in secondary science classrooms in Barbados.

Review of current sonic boom studies.

NASA Technical Reports Server (NTRS)

Kane, E. J.

1973-01-01

Several aspects of the sonic boom phenomena are currently under investigation at The Boeing Co. This work, supported by the NASA and the FAA, includes an in-depth analysis of sonic boom measurements recorded at the BREN tower, a summary and evaluation of sonic boom investigations done in the last decade and a half, and configuration studies to determine practical lower bound sonic boom limits. The BREN tower test program yielded unique and valuable data because it was the first time that vertical profile measurements were made through caustics produced by maneuvers and atmospheric refraction. The objective of the second effort is to compile in a single reference an annotated abstract, including significant results, for each published sonic boom study and to provide a comprehensive review of the current state of the art to aid future researchers. The configuration work is devoted toward determining the feasibility of supersonic transport type airplanes with a primary design goal of acceptable sonic boom characteristics. Each of these investigations is briefly reviewed and significant results are discussed.

Development of an Accelerated Test Method for the Determination of Susceptibility to Atmospheric Corrosion

NASA Technical Reports Server (NTRS)

Ambrose, John R.

1991-01-01

The theoretical rationale is presented for use of a repetitive cyclic current reversal voltammetric technique for characterization of localized corrosion processes, including atmospheric corrosion. Applicability of this proposed experimental protocol is applied to characterization of susceptibility to crevice and pitting corrosion, atmospheric corrosion and stress corrosion cracking. Criteria upon which relative susceptibility is based were determined and tested using two iron based alloys commonly in use at NASA-Kennedy; A36 (a low carbon steel) and 4130 (a low alloy steel). Practicality of the procedure was demonstrated by measuring changes in anodic polarization behavior during high frequency current reversal cycles of 25 cycles per second with 1 mA/sq cm current density amplitude in solutions containing Cl anions. The results demonstrated that, due to excessive polarization which affects conductivity of barrier corrosion product layers, A36 was less resistant to atmospheric corrosion than its 4130 counterpart; behavior which was also demonstrated during exposure tests.

Comparing hardcopy and softcopy results in the study of the impact of workflow on perceived reproduction quality of fine art images

NASA Astrophysics Data System (ADS)

Farnand, Susan; Jiang, Jun; Frey, Franziska

2011-01-01

A project, supported by the Andrew W. Mellon Foundation, is currently underway to evaluate current practices in fine art image reproduction, determine the image quality generally achievable, and establish a suggested framework for art image interchange. To determine the image quality currently being achieved, experimentation has been conducted in which a set of objective targets and pieces of artwork in various media were imaged by participating museums and other cultural heritage institutions. Prints and images for display made from the delivered image files at the Rochester Institute of Technology were used as stimuli in psychometric testing in which observers were asked to evaluate the prints as reproductions of the original artwork and as stand alone images. The results indicated that there were limited differences between assessments made using displayed images relative to printed reproductions. Further, the differences between rankings made with and without the original artwork present were much smaller than expected.

Health social work in Canada: Five trends worth noting.

PubMed

Bryson, Stephanie A; Bosma, Harvey

2018-05-30

Highlighting a strong human rights and social justice orientation underlying health social work in Canada, this paper describes recent contributions of Canadian health social work practitioners and scholars to five areas identified by Auslander (2001) in a delphi study of health social work in its first century. Five current 'trends' are discussed which correspond with Auslander's themes of professional legitimacy and scope, social causation, dissemination of knowledge, interventions, and cultural appropriateness. These trends are: 1) defining the scope of health social work practice; 2) addressing the social determinants of health; 3) promoting evidence-based practice in health social work; 4) delivering client and family-centered care; and 5) implementing cultural safety and trauma-informed practice. Suggestions are made to further strengthen the position of health social work in Canada.

The Use of EPOSTL to Determine the Self-Efficacy of Prospective EFL Teachers: Raising Awareness in English Language Teacher Education

ERIC Educational Resources Information Center

Bergil, Ayfer Su; Sariçoban, Arif

2017-01-01

The current practices in the field of foreign language teacher education have a heavy inclination to make use of traditional means especially throughout the assessment process of student teachers at foreign language departments. Observing the world in terms of teacher education makes it urgent to include more reflective and objective tools in…

Effects of livestock grazing on morphology, hydrology and nutrient retention in four riparian/stream ecosystems, New Mexico, USA

Treesearch

James R. Thibault; Douglas L. Moyer; Clifford N. Dahm; H. Maurice Valett; Michael C. Marshall

1999-01-01

Land-use practices such as livestock grazing influence the structure and function of riparian/stream ecosystems. In New Mexico, four streams were selected to determine the impact of moderate livestock grazing on morphology, solute transport, and nutrient retention. Each stream contained a reach currently exposed to grazing and an exclosed, ungrazed reach. Channel width...

Current Practices for Providing School Field Trip Meals: Perspectives of School Nutrition Managers and Teachers

ERIC Educational Resources Information Center

Sneed, Jeannie; Vaterlaus Patten, Emily

2015-01-01

Purpose/Objectives: The Healthy, Hunger Free Kids Act of 2010 extended the requirements for a school food safety program to wherever food is stored, prepared, or served, including meals for field trips. The purpose of this study was to determine what foods are used for field trip meals, how those foods are transported and stored, and what standard…

An Examination of Potential Racial and Gender Bias in the Principal Version of the Interactive Computer Interview System

ERIC Educational Resources Information Center

DiPonio, Joseph M.

2010-01-01

The primary object of this study was to determine whether racial and/or gender bias were evidenced in the use of the ICIS-Principal. Specifically, will the use of the ICIS-Principal result in biased scores at a statistically significant level when rating current practicing administrators of varying gender and race. The study involved simulated…

Comparison of Annie Sullivan's Teaching Strategies for Literacy and Communication to the Current Outcome Performance Indicators in Deaf-Blindness: An Exploratory Mixed-Methods Study

ERIC Educational Resources Information Center

Pevsner, Diane

2010-01-01

This study explored teaching strategies for communication and literacy development in deaf-blind students by determining if there was a significant relationship between the instructional strategies practiced by Annie Sullivan in the early 1900s and the contemporary instructional strategies recommended by The National Consortium on Deaf-Blindness…

A Snapshot of School-Based Mental Health and Substance Abuse in Canada: Where We Are and Where It Leads Us

ERIC Educational Resources Information Center

Manion, Ian; Short, Kathy H.; Ferguson, Bruce

2013-01-01

The Mental Health Commission of Canada supported a comprehensive research project to determine the current state of mental health and substance use programs and practices in Canadian schools. The School-Based Mental Health and Substance Abuse Consortium is made up of a group of 40 leading Canadian researchers, policy makers, and practitioners. The…

Merchantable height of trees in Oregon—a comparison of current logging practice and volume table specifications.

Treesearch

Don Minore; Donald R. Gedney

1960-01-01

A large proportion of present-day timber cruising is done by measuring or estimating three tree dimensions: diameter at breast height, form class, and merchantable height. Tree volumes are then determined from tables which equate volume to the varying combinations of height, d.b.h., and form class. Assumptions concerning merchantable height were made in constructing...

Sine Qua Non: Indispensable Resources for Ed Tech Professionals. Part 1: Educational Technology

ERIC Educational Resources Information Center

Conley, Kate

2004-01-01

Because the field of educational technology is so broad and dynamic, it is extremely difficult to find time to keep up with the best practices, current research, and innovative ideas. In an effort to help readers keep up their knowledge of the field and to determine some of the most interesting and useful resources to date, a large body of…

Summary Report of National Study of Word Processing Installations in Selected Business Organizations. A Summary of a Report on the National Word Processing Research Study of Delta Pi Epsilon.

ERIC Educational Resources Information Center

Scriven, Jolene D.; And Others

A study sought to determine current practices in word processing installations located in selected organizations throughout the United States. A related problem was to ascertain anticipated future developments in word processing to provide information for educational institutions preparing workers for the business office. Six interview instruments…

Effect of the Transcendental Meditation Program on Graduation, College Acceptance and Dropout Rates for Students Attending an Urban Public High School

ERIC Educational Resources Information Center

Colbert, Robert D.

2013-01-01

High school graduation rates nationally have declined in recent years, despite public and private efforts. The purpose of the current study was to determine whether practice of the Quiet Time/Transcendental Meditation® program at a medium-size urban school results in higher school graduation rates compared to students who do not receive training…

The Effect of Political Science Education on Political Trust and Interest: Results from a 5-Year Panel Study

ERIC Educational Resources Information Center

Claes, Ellen; Hooghe, Marc

2017-01-01

Citizenship education has evolved substantially in recent decades, with a rapid proliferation of education forms and approaches. The currently available evaluation studies, however, do not allow us to determine what kind of approach can be considered as a best practice for schools and education systems. In this article, we rely on the results of a…

A Study of Vehicle Structural Layouts in Post-WWII Aircraft

NASA Technical Reports Server (NTRS)

Sensmeier, Mark D.; Samareh, Jamshid A.

2004-01-01

In this paper, results of a study of structural layouts of post-WWII aircraft are presented. This study was undertaken to provide the background information necessary to determine typical layouts, design practices, and industry trends in aircraft structural design. Design decisions are often predicated not on performance-related criteria, but rather on such factors as manufacturability, maintenance access, and of course cost. For this reason, a thorough understanding of current best practices in the industry is required as an input for the design optimization process. To determine these best practices and industry trends, a large number of aircraft structural cutaway illustrations were analyzed for five different aircraft categories (commercial transport jets, business jets, combat jet aircraft, single engine propeller aircraft, and twin-engine propeller aircraft). Several aspects of wing design and fuselage design characteristics are presented here for the commercial transport and combat aircraft categories. A great deal of commonality was observed for transport structure designs over a range of eras and manufacturers. A much higher degree of variability in structural designs was observed for the combat aircraft, though some discernable trends were observed as well.

Expert system verification and validation study. Phase 2: Requirements identification. Delivery 1: Updated survey report

NASA Technical Reports Server (NTRS)

1990-01-01

The purpose is to report the state-of-the-practice in Verification and Validation (V and V) of Expert Systems (ESs) on current NASA and Industry applications. This is the first task of a series which has the ultimate purpose of ensuring that adequate ES V and V tools and techniques are available for Space Station Knowledge Based Systems development. The strategy for determining the state-of-the-practice is to check how well each of the known ES V and V issues are being addressed and to what extent they have impacted the development of Expert Systems.

Experience of Application of Liquid Lubricating Materials during Wide Strip Hot Rolling

NASA Astrophysics Data System (ADS)

Platov, S. I.; Dema, R. R.; Kharchenko, M. V.; Amirov, R. N.

2017-12-01

The paper presents the results of the scientific and practical research of roller systems operation at feed of liquid lubricating materials through the example of the wide strip hot rolling Mill-2000 at PAO MMK. The experiments proved that application of lubricating materials leads to decrease of energy-power parameters of the process by 12 to 15 %, and reduction of work roll wear by 10 to 12%. The practical results of the study are developed recommendations on determination of consumption-volumetric parameters of the supplied lubricating material depending on rheological and geometrical parameters of the rolled strip and current wear of work rolls.

To Meet or Not To Meet Physical vs. Virtual Configuration Control Board

NASA Technical Reports Server (NTRS)

Rice, Shelley

2017-01-01

This presentation will define the CCB, discuss its functions and members. We will look into traditional processes of managing change control via the CCB meeting and advanced practices utilizing enhanced product tools and technologies. Well step through a summary of the feedback from the community of CM professionals at NASA Goddard Space Flight Center of best practices as well as pros and cons for facilitating both a physical CCB and managing stakeholder approvals in a virtual environment. Attendees will come away with current industry strategies to determine if process for managing change control and approvals can be streamlined within their local work environments.

Condoms, Culture, and Conviction: The Effect of Acculturation and Religiosity on Latina Condom Use during First Sex with New Partners.

PubMed

Smith, Scott James

2017-04-03

Latinas in the United States are less likely than their non-Hispanic peers to use condoms. Previous research has identified acculturation and religiosity as two key determinants of Latina condom use, but results are inconsistent, impairing the translation of findings to practice. The current study examines these constructs together and addresses methodological concerns noted in the literature. Structural equation modeling performed on a nationally representative sample of Latinas indicated that intrinsic religiosity increased condom use whereas acculturation decreased condom use. Extrinsic religiosity indirectly increased condom use via intrinsic religiosity. Implications for practice and policy are discussed.

Analytical and experimental study of high phase order induction motors

NASA Technical Reports Server (NTRS)

Klingshirn, Eugene A.

1989-01-01

Induction motors having more than three phases were investigated to determine their suitability for electric vehicle applications. The objective was to have a motor with a current rating lower than that of a three-phase motor. The name chosen for these is high phase order (HPO) motors. Motors having six phases and nine phases were given the most attention. It was found that HPO motors are quite suitable for electric vehicles, and for many other applications as well. They have characteristics which are as good as or better than three-phase motors for practically all applications where polyphase induction motors are appropriate. Some of the analysis methods are presented, and several of the equivalent circuits which facilitate the determination of harmonic currents and losses, or currents with unbalanced sources, are included. The sometimes large stator currents due to harmonics in the source voltages are pointed out. Filters which can limit these currents were developed. An analysis and description of these filters is included. Experimental results which confirm and illustrate much of the theory are also included. These include locked rotor test results and full-load performance with an open phase. Also shown are oscillograms which display the reduction in harmonic currents when a filter is used with the experimental motor supplied by a non-sinusoidal source.

Non-Economic Determinants of Energy Use in Rural Areas of South Africa

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

Annecke, W.

1999-03-29

This project will begin to determine the forces and dimensions in rural energy-use patterns and begin to address policy and implementation needs for the future. This entails: Forecasting the social and economic benefits that electrification is assumed to deliver regarding education and women's lives; Assessing negative perceptions of users, which have been established through the slow uptake of electricity; Making recommendations as to how these perceptions could be addressed in policy development and in the continuing electrification program; Making recommendations to policy makers on how to support and make optimal use of current energy-use practices where these are socio-economically sound;more » Identifying misinformation and wasteful practices; and Other recommendations, which will significantly improve the success of the rural electrification program in a socio-economically sound manner, as identified in the course of the work.« less

Feeding practices of low-income mothers: how do they compare to current recommendations?

PubMed

Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A

2015-03-07

Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Eighty low-income mothers and their preschool children were videotaped at dinner in their homes. Mothers were chosen from a larger study to create a 2 X 2 X 2 design: maternal ethnicity (African American vs. Latina) by child gender by child weight status (healthy weight vs. overweight/obese). Observers coded videotapes for a range of maternal feeding strategies and other behaviors. Many mothers spent considerable time encouraging eating--often in spite of the child's insistence that he or she was finished. Mothers talked little about food characteristics, rarely referred to feelings of hunger and fullness, and made more attempts to enforce table manners than to teach eating skills. Latina mothers showed higher levels of teaching eating skills and encouraging their children to eat; African American mothers showed higher levels of enforcing table manners and getting children to clear their plates. Mothers of boys used more unelaborated commands and less questions/suggestions than mothers of girls. Finally, compared to mothers of overweight/obese children, mothers of healthy weight children showed higher levels of encouraging eating and lower levels of discouraging eating. Most of the mothers in this study did not engage in feeding practices that are consistent with current recommendations. They did this, despite the fact that they knew they were being observed. These results should be used to inform future research about the motivations behind mothers' feeding practices and the development of interventions by helping identify areas in greatest need of change.

Sediment Flux and Storage in a Rural Southeastern Piedmont River System

NASA Astrophysics Data System (ADS)

Jackson, C. R.; Martin, J. K.

2001-12-01

A sediment budget was developed for a representative rural southeastern Piedmont watershed to provide information on the relative importance of sediment sources. Sediment issues in the southeastern Piedmont are complicated by the so-called legacy sediment produced by poor farming practices during the cotton-farming era, approximately 1810-1930. The Murder Creek basin near Monticello, GA was chosen because: it featured forestry and agriculture as the principal land uses; a USGS gage provided a flow record; and the creek deposited in a reservoir built in 1948. Suspended load export was calculated using a sediment rating curve and the USGS flow time series. Bed load export was determined by estimating the volume of sediment deposited in the reservoir since construction. Unpaved road erosion was estimated using the WEPP model, and other surface erosion was estimated using USLE and delivery ratios. Historical floodplain storage was determined by coring floodplain deposits, measuring the depth to the pre-historic/historic sediment interface, and multiplying by the area of the floodplain. Recent accretion rates were estimated using dendrogeomorphology. Results showed that the practices of the cotton farming era deposited an average of 1.6 meters of sediment on the floodplains. This depth was relatively uniform across the watershed. The cotton-farming sediment in storage exceeds the current annual export by a factor of about 5000. Approximately half of the current export comes from current inputs, and half comes from remobilized floodplain sediments.

The value of improved (ERS) information based on domestic distribution effects of U.S. agriculture crops

NASA Technical Reports Server (NTRS)

Bradford, D. F.; Kelejian, H. H.; Brusch, R.; Gross, J.; Fishman, H.; Feenberg, D.

1974-01-01

The value of improving information for forecasting future crop harvests was investigated. Emphasis was placed upon establishing practical evaluation procedures firmly based in economic theory. The analysis was applied to the case of U.S. domestic wheat consumption. Estimates for a cost of storage function and a demand function for wheat were calculated. A model of market determinations of wheat inventories was developed for inventory adjustment. The carry-over horizon is computed by the solution of a nonlinear programming problem, and related variables such as spot and future price at each stage are determined. The model is adaptable to other markets. Results are shown to depend critically on the accuracy of current and proposed measurement techniques. The quantitative results are presented parametrically, in terms of various possible values of current and future accuracies.

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

PubMed

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

2015-11-01

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. 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. 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. 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 reducing the impact of recurring errors in the handling of samples and the reporting of results. Our findings will inform our continuing work with patients and staff to develop, implement and evaluate improvements to existing systems of managing the testing and result communication process. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pregnancy screening strategies for diagnostic nuclear medicine: survey results from Australia and New Zealand.

PubMed

James, Daphne J; Cardew, Paul; Warren-Forward, Helen M

2013-09-01

The ionizing radiation used in diagnostic nuclear medicine procedures has the potential to cause biologic harm to a fetus. Although the risks are relatively small, it is recommended that all female patients of childbearing age be questioned regarding their pregnancy status before administration of the radiopharmaceutical. This can be a sensitive situation especially for certain types of patients, such as teenagers. Currently, there are no guidelines that detail how to question the patient. Previous studies have revealed the lack of a consistent approach in this area. The aim of this study was to investigate current practice for pregnancy screening before diagnostic nuclear medicine procedures in Australia and New Zealand and to determine whether a standardized practice guideline is required. An online survey was administered via SurveyMonkey from October to December 2011. Members of the Australian and New Zealand Society of Nuclear Medicine were invited to participate. The survey consisted of 30 questions divided into 4 sections: demographics, policy and regulations, current practice, and open-ended clinical scenarios. Three hundred thirty-five responses were recorded from participants in all states and territories of Australia and New Zealand; 90% were nuclear medicine technologists. Participants reported a low awareness of radiation policy and regulations but demonstrated good knowledge of the relative risk to the fetus from commonly performed procedures. The most common minimum and maximum age to question patients was 12 y (32%) and 55 y (42%), respectively, although the range was from 10 to 60 y. Verbal questioning (44%) was the most commonly used approach. Pregnancy testing was used by 72%, usually if the patient indicated she was unsure of her pregnancy status. Responses to clinical scenarios were varied, and these will be discussed in a subsequent paper. The survey revealed a lack of awareness of government regulations and departmental policy regarding radiation protection. The study demonstrated wide variety in pregnancy screening strategies used to determine the pregnancy status of patients before diagnostic nuclear medicine procedures, indicating that a standardized practice guideline is required for Australia and New Zealand.

Scale Determinants of Fiscal Investment in Geological Exploration: Evidence from China

PubMed Central

Lu, Linna; Lei, Yalin

2013-01-01

With the continued growth in demand for mineral resources and China's efforts in increasing investment in geological prospecting, fiscal investment in geological exploration becomes a research hotspot. This paper examines the yearly relationship among fiscal investment in geological exploration of the current term, that of the last term and prices of mining rights over the period 1999–2009. Hines and Catephores' investment acceleration model is applied to describe the scale determinants of fiscal investment in geological exploration which are value-added of mining rights, value of mining rights and fiscal investment in the last term. The results indicate that when value-added of mining rights, value of mining rights or fiscal investment in the last term moves at 1 unit, fiscal investment in the current term will move 0.381, 1.094 or 0.907 units respectively. In order to determine the scale of fiscal investment in geological exploration for the current year, the Chinese government should take fiscal investment in geological exploration for the last year and the capital stock of the previous investments into account. In practice, combination of government fiscal investment in geological exploration with its performance evaluation can create a virtuous circle of capital management mechanism. PMID:24204652

Scale determinants of fiscal investment in geological exploration: evidence from China.

PubMed

Lu, Linna; Lei, Yalin

2013-01-01

With the continued growth in demand for mineral resources and China's efforts in increasing investment in geological prospecting, fiscal investment in geological exploration becomes a research hotspot. This paper examines the yearly relationship among fiscal investment in geological exploration of the current term, that of the last term and prices of mining rights over the period 1999-2009. Hines and Catephores' investment acceleration model is applied to describe the scale determinants of fiscal investment in geological exploration which are value-added of mining rights, value of mining rights and fiscal investment in the last term. The results indicate that when value-added of mining rights, value of mining rights or fiscal investment in the last term moves at 1 unit, fiscal investment in the current term will move 0.381, 1.094 or 0.907 units respectively. In order to determine the scale of fiscal investment in geological exploration for the current year, the Chinese government should take fiscal investment in geological exploration for the last year and the capital stock of the previous investments into account. In practice, combination of government fiscal investment in geological exploration with its performance evaluation can create a virtuous circle of capital management mechanism.

Village midwives and their changing roles in Brunei Darussalam: A qualitative study.

PubMed

Abdul-Mumin, Khadizah Haji

2016-10-01

There are lay midwives worldwide, interchangeably and universally called traditional birth attendants or traditional midwives by organisations such as the World Health Organization and the International Confederation of Midwives. This study aimed to explore the history of lay midwives (village midwives) in Brunei, describe the evolution from their previous to current roles and determine if they are still needed by women today. This qualitative, descriptive study included in-depth, semi-structured interviews with eight women who had received care from village midwives. Data analysis was based on the principles underpinning thematic analysis and used a constant comparative method. Village midwives have been popular in Brunei since the 1900s, with their major role being to assist women with childbirth. However, since the 1960s, their roles and practices have changed to focus on pre-conception, antenatal, postnatal and women's general healthcare. Traditional practices were influenced by religion, culture and the social context of and within Brunei. The major changes in village midwives' roles and practices resulted from the enforcement of the Brunei Midwives' Act in 1956. Village midwives' traditional practices became juxtaposed with modern complementary alternative medicine practices, and they began charging a fee for their services. Brunei village midwives are trusted by women, and their practices may still be widely accepted in Brunei. Further research is necessary to confirm their existence, determine the detailed scope and appropriateness of their practices and verify the feasibility of them working together with healthcare professionals. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

PubMed Central

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain.

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

2014-01-15

Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

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

PubMed

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

2015-12-09

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

Workplace discrimination: experiences of practicing physicians.

PubMed Central

Coombs, Alice A. Tolbert; King, Roderick K.

2005-01-01

BACKGROUND: In response to a growing concern regarding physician discrimination in the workplace, this study was developed to: (1) describe the types of discrimination that exist for the practicing physician and (2) determine which groups of physicians are more likely to experience the various forms of discrimination. METHODS: Surveys were mailed to 1930 practicing physicians in Massachusetts. Participants were asked if they had encountered discrimination, how significant the discrimination was against a specific group, the frequency of personal discrimination, and the type of discrimination. Factor analysis identified four types of discrimination: career advancement, punitive behaviors, practice barriers and hiring barriers. RESULTS: A total of 445 responses were received (a 24% response rate). Sixty-three percent of responding physicians had experienced some form of discrimination. Respondents were women (46%), racial/ethnic minorities (42%) and international medical graduates (IMGs) (40%). In addition, 26% of those classified as white were also IMGs. Over 60% of respondents believed discrimination against IMGs was very or somewhat significant. Almost 27% of males acknowledged that gender bias against females was very or somewhat significant. IMGs were more likely to indicate that discrimination against IMGs was significant in their current organization. Of U.S. medical graduates (USMGs) 44% reported that discrimination against IMGs in their current organization was significant. Nonwhites were more likely to report that discrimination based on race/ethnicity was significant. Nearly 29% of white respondents also believed that such discrimination was very or somewhat significant. CONCLUSIONS: Physicians practicing in academic, research, and private practice sectors experience discrimination based on gender, ethnic/racial, and IMG status. Images Figure 3 Figure 4 Figure 5 PMID:15868767

Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis.

PubMed

Pan, Yuanqing; Yang, Kehu; Wang, Yuliang; Zhang, Laiping; Liang, Haiqing

2017-04-01

To determine if yoga as a complementary and alternative therapy was associated with enhanced health and treatment-related side effects in patients with breast cancer. This systematic review examines whether yoga practice provides any measurable benefit, both physically and psychologically, for women with breast cancer. PubMed, EMBASE and the Cochrane Library for randomized controlled trials (RCTs) throughout June 2013. We evaluated the quality of the included studies by the Cochrane Handbook 5.2 standards and analyzed the data using the Stata software, version 10.0. Meta-regression and subgroup analysis were also performed to identify additional predictors of outcome and to assess heterogeneity. Sixteen RCTs with a total of 930 participants were included. Comparing yoga groups to control groups, there was a statistically significant difference in overall health-related quality of life, depression, anxiety and gastrointestinal symptoms. Meta-regression analyses revealed that the duration of yoga practice and type of control group partly explained the heterogeneity. Subgroup analyses revealed that yoga had a positive effect on anxiety only when it had been practiced for longer than 3 months. Only the wait-list control group showed an effect of yoga on physical well-being. The current evidence demonstrates that yoga practice could be effective in enhancing health and managing some treatment-related side effects for patients recovering from breast cancer. In future clinical studies, clinicians should consider the patient's wishes along with the current best evidence of the effects of yoga practice in their clinical decision-making. © 2015 Wiley Publishing Asia Pty Ltd.

Trauma-informed juvenile justice systems: A systematic review of definitions and core components.

PubMed

Branson, Christopher Edward; Baetz, Carly Lyn; Horwitz, Sarah McCue; Hoagwood, Kimberly Eaton

2017-11-01

The U.S. Department of Justice has called for the creation of trauma-informed juvenile justice systems in order to combat the negative impact of trauma on youth offenders and frontline staff. Definitions of trauma-informed care have been proposed for various service systems, yet there is not currently a widely accepted definition for juvenile justice. The current systematic review examined published definitions of a trauma-informed juvenile justice system in an effort to identify the most commonly named core elements and specific interventions or policies. A systematic literature search was conducted in 10 databases to identify publications that defined trauma-informed care or recommended specific practices or policies for the juvenile justice system. We reviewed 950 unique records, of which 10 met criteria for inclusion. The 10 publications included 71 different recommended interventions or policies that reflected 10 core domains of trauma-informed practice. We found 8 specific practice or policy recommendations with relative consensus, including staff training on trauma and trauma-specific treatment, while most recommendations were included in 2 or less definitions. The extant literature offers relative consensus around the core domains of a trauma-informed juvenile justice system, but much less agreement on the specific practices and policies. A logical next step is a review of the empirical research to determine which practices or policies produce positive impacts on outcomes for youth, staff, and the broader agency environment, which will help refine the core definitional elements that comprise a unified theory of trauma-informed practice for juvenile justice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Rationale and methods of the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA).

PubMed

Rodríguez-Artalejo, Fernando; Guallar, Eliseo; Borghi, Claudio; Dallongeville, Jean; De Backer, Guy; Halcox, Julian P; Hernández-Vecino, Ramón; Jiménez, Francisco Javier; Massó-González, Elvira L; Perk, Joep; Steg, Philippe Gabriel; Banegas, José R

2010-06-30

The EURIKA study aims to assess the status of primary prevention of cardiovascular disease (CVD) across Europe. Specifically, it will determine the degree of control of cardiovascular risk factors in current clinical practice in relation to the European guidelines on cardiovascular prevention. It will also assess physicians' knowledge and attitudes about CVD prevention as well as the barriers impeding effective risk factor management in clinical practice. Cross-sectional study conducted simultaneously in 12 countries across Europe. The study has two components: firstly at the physician level, assessing eight hundred and nine primary care and specialist physicians with a daily practice in CVD prevention. A physician specific questionnaire captures information regarding physician demographics, practice settings, cardiovascular prevention beliefs and management. Secondly at the patient level, including 7641 patients aged 50 years or older, free of clinical CVD and with at least one classical risk factor, enrolled by the participating physicians. A patient-specific questionnaire captures information from clinical records and patient interview regarding sociodemographic data, CVD risk factors, and current medications. Finally, each patient provides a fasting blood sample, which is sent to a central laboratory for measuring serum lipids, apolipoproteins, hemoglobin-A1c, and inflammatory biomarkers. Primary prevention of CVD is an extremely important clinical issue, with preventable circulatory diseases remaining the leading cause of major disease burden. The EURIKA study will provide key information to assess effectiveness of and attitudes toward primary prevention of CVD in Europe. A transnational study creates opportunities for benchmarking good clinical practice across countries and improving outcomes. (ClinicalTrials.gov number, NCT00882336).

Evaluation of economic efficiencies in clinical retina practice: activity-based cost analysis and modeling to determine impacts of changes in patient management

PubMed Central

Murray, Timothy G; Tornambe, Paul; Dugel, Pravin; Tong, Kuo Bianchini

2011-01-01

Background The purpose of this study is to report the use of activity-based cost analysis to identify areas of practice efficiencies and inefficiencies within a large academic retinal center and a small single-specialty group. This analysis establishes a framework for evaluating rapidly shifting clinical practices (anti-vascular endothelial growth factor therapy, microincisional vitrectomy surgery) and incorporating changing reimbursements for care delivery (intravitreal injections, optical coherence tomography [OCT]) to determine the impact on practice profitability. Pro forma modeling targeted the impact of declining reimbursement for OCT imaging and intravitreal injection using a strategy that incorporates activity-based cost analysis into a direct evaluation schema for clinical operations management. Methods Activity-based costing analyses were performed at two different types of retinal practices in the US, ie, a small single-specialty group practice and an academic hospital-based practice (Bascom Palmer Eye Institute). Retrospective claims data were utilized to identify all procedures performed and billed, submitted charges, allowed charges, and net collections from each of these two practices for the calendar years 2005–2006 and 2007–2008. A pro forma analysis utilizing current reimbursement profiles was performed to determine the impact of altered reimbursement on practice profitability. All analyses were performed by a third party consulting firm. Results The small single-specialty group practice outperformed the academic hospital-based practice on almost all markers of efficiency. In the academic hospital-based practice, only four service lines were profitable, ie, nonlaser surgery, laser surgery, non-OCT diagnostics, and injections. Profit margin varied from 62% for nonlaser surgery to 1% for intravitreal injections. Largest negative profit contributions were associated with office visits and OCT imaging. Conclusion Activity-based cost analysis is a powerful tool to evaluate retinal practice efficiencies. These two distinct practices were able to provide significant increases in clinical care (office visits, ophthalmic imaging, and patient procedures) through maintaining efficiencies of care. Pro forma analysis of 2011 data noted that OCT payments to facilities and physicians continue to decrease dramatically and that this payment decrease further reduced the profitability for the two largest aspects of these retinal practices, ie, intravitreal injections and OCT retinal imaging. Ultimately, all retinal practices are at risk for significant shifts in financial health related to rapidly evolving changes in patterns of care and reimbursement associated with providing outstanding clinical care. PMID:21792278

Impact of a State Law on Physician Practice in Sports-Related Concussions.

PubMed

Flaherty, Michael R; Raybould, Toby; Jamal-Allial, Aziza; Kaafarani, Haytham M A; Lee, Jarone; Gervasini, Alice; Ginsburg, Richard; Mandell, Mark; Donelan, Karen; Masiakos, Peter T

2016-11-01

To determine physician-reported adherence to and support of the 2010 Massachusetts youth concussion law, as well as barriers to care and clinical practice in the context of legislation. Primary care physicians (n = 272) in a large pediatric network were eligible for a cross-sectional survey in 2014. Survey questions addressed key policy and practice provisions: concussion knowledge, state regulations and training, practice patterns, referrals, patient characteristics, and barriers to care. Analyses explored relationships between practice and policy, adjusting for physician demographic and practice characteristics. The survey response rate was 64% among all responders (173 of 272). A total of 146 respondents who had evaluated, treated, or referred patients with a suspected sports-related concussion in the previous year were eligible for analysis. The vast majority (90%) of providers agreed that the current Massachusetts laws regarding sports concussions are necessary and support the major provisions. Three-quarters (74%) had taken a required clinician training course on concussions. Those who took training courses were significantly more likely to develop individualized treatment plans (OR, 3.6; 95% CI, 1.1-11.0). Physician training did not improve screening of youth with concussion for depression or substance use. Most physicians (77%) advised patients to refrain from computer, telephone, or television for various time periods. Physicians reported limited communication with schools. Primary care physicians report being comfortable with the diagnosis and management of concussions, and support statewide regulations; however, adherence to mandated training and specific legal requirements varied. Broader and more frequent training may be necessary to align current best evidence with clinical care and state-mandated practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Evidence-based dentistry: a clinician's perspective.

PubMed

Bauer, Janet; Spackman, Sue; Chiappelli, Francesco; Prolo, Paolo; Stevenson, Richard

2006-07-01

Evidence-based dentistry is a discipline that provides best, explicit-based evidence to dentists and their patients in shared decision-making. Currently, dentists are being trained and directed to adopt the role of translational researchers in developing evidence-based dental practices. Practically, evidence-based dentistry is not usable in its current mode for the provision of labor-intensive services that characterize current dental practice. The purpose of this article is to introduce a model of evidence-based dental practice. This model conceptualizes a team approach in explaining problems and solutions to change current dental practice. These changes constitute an evidence-based dental practice that involves the electronic chart, centralized database, knowledge management software, and personnel in optimizing effective oral health care to dental patients.

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

PubMed

Cooper, Megan; McCutcheon, Helen; Warland, Jane

2017-10-01

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

Management of occiput posterior position in the second stage of labor: a survey of midwifery practice in Australia.

PubMed

Phipps, Hala; de Vries, Brad; Jagadish, Ujvala; Hyett, Jon

2014-03-01

The management of the occiput posterior (OP) position has been controversial for many years. Manual rotation can be performed by midwives and could reduce cesarean sections and instrumental births. We aimed to determine current midwifery views, knowledge, and practice of manual rotation. A de-identified, self-reported questionnaire was e-mailed to all Australian College of Midwives full members (n = 3,997). Of 3,182 surveyed, 57 percent (1,817) responded, of whom 51 percent (920) were currently practicing midwifery. Seventy-seven percent of midwives thought that manual rotation at full dilatation was a valid intervention. Sixty-four percent stated the procedure was acceptable before instrumental delivery, but 30 percent were unsure. Most practicing midwives (93%) had heard of manual rotation, but only 18 percent had performed one in the last year. Midwives would support the routine performance of manual rotation for OP position if it reduced operative births from 68 to 50 percent and would support manual rotation for occiput transverse (OT) position if it reduced operative births from 39 to 25 percent. This study indicates that manual rotation is considered acceptable by most midwives in Australia, yet is only performed by a minority. Midwives would be willing to perform prophylactic manual rotation if it was known to facilitate normal vaginal births suggesting a scope to introduce this procedure into widespread clinical practice. © 2014, Copyright the Authors Journal compilation © 2014, Wiley Periodicals, Inc.

Determinants for grading Malaysian rice

NASA Astrophysics Data System (ADS)

ChePa, Noraziah; Yusoff, Nooraini; Ahmad, Norhayati

2016-08-01

Due to un-uniformity of rice grading practices in Malaysia, zones which actively producing rice in Malaysia are using their own way of grading rice. Rice grading is important in determining rice quality and its subsequent price in the market. It is an important process applied in the rice production industry with the purpose of ensuring that the rice produced for the market meets the quality requirements of consumer. Two important aspects that need to be considered in determining rice grades are grading technique and determinants to be used for grading (usually referred as rice attributes). This article proposes the list of determinants to be used in grading Malaysian rice. Determinants were explored through combination of extensive literature review and series of interview with the domain experts and practitioners. The proposed determinants are believed to be beneficial to BERNAS in improving the current Malaysian rice grading process.

Improving organ procurement practices in Michigan

PubMed Central

Lynch, RJ; Mathur, AK; Hundley, JC; Kubus, J; Pietroski, RE; Mattice, BJ; Punch, JD; Englesbe, MJ

2015-01-01

Travel to procure deceased donor organs is associated with risk to transplant personnel. In many instances, multiple teams are present for a given operation. We studied our statewide experience to determine how much excess travel this redundancy entails, and generated alternate models for organ recovery. We reviewed our organ procurement organization’s experience with deceased donor operations between 2002 and 2008. Travel was expressed as cumulative person-miles between procurement team origin and donor hospital. A model of minimal travel was created, using thoracic and abdominal teams from the closest in-state center. A second model involved transporting donors to a dedicated procurement facility. Travel distance was recalculated using these models, and mode and cost of travel extrapolated from current practices. In 654 thoracic and 1469 abdominal donors studied, mean travel for thoracic teams was 1066 person-miles, and for abdominal teams was 550 person-miles. The mean distance traveled by thoracic and abdominal organs was 223 miles and 142 miles, respectively. Both hypothetical models showed reductions in team travel and reliance on air transport, with favorable costs and organ transport times compared to historical data. In summary, we found significant inefficiency in current practice, which may be alleviated using new paradigms for donor procurement. PMID:19656129

Test-retest reliability and construct validity of the ENERGY-parent questionnaire on parenting practices, energy balance-related behaviours and their potential behavioural determinants: the ENERGY-project.

PubMed

Singh, Amika S; Chinapaw, Mai J M; Uijtdewilligen, Léonie; Vik, Froydis N; van Lippevelde, Wendy; Fernández-Alvira, Juan M; Stomfai, Sarolta; Manios, Yannis; van der Sluijs, Maria; Terwee, Caroline; Brug, Johannes

2012-08-13

Insight in parental energy balance-related behaviours, their determinants and parenting practices are important to inform childhood obesity prevention. Therefore, reliable and valid tools to measure these variables in large-scale population research are needed. The objective of the current study was to examine the test-retest reliability and construct validity of the parent questionnaire used in the ENERGY-project, assessing parental energy balance-related behaviours, their determinants, and parenting practices among parents of 10-12 year old children. We collected data among parents (n = 316 in the test-retest reliability study; n = 109 in the construct validity study) of 10-12 year-old children in six European countries, i.e. Belgium, Greece, Hungary, the Netherlands, Norway, and Spain. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC) and percentage agreement comparing scores from two measurements, administered one week apart. To assess construct validity, the agreement between questionnaire responses and a subsequent interview was assessed using ICC and percentage agreement.All but one item showed good to excellent test-retest reliability as indicated by ICCs > .60 or percentage agreement ≥ 75%. Construct validity appeared to be good to excellent for 92 out of 121 items, as indicated by ICCs > .60 or percentage agreement ≥ 75%. From the other 29 items, construct validity was moderate for 24 and poor for 5 items. The reliability and construct validity of the items of the ENERGY-parent questionnaire on multiple energy balance-related behaviours, their potential determinants, and parenting practices appears to be good. Based on the results of the validity study, we strongly recommend adapting parts of the ENERGY-parent questionnaire if used in future research.

Searches for Randomized Controlled Trials of Drugs in MEDLINE and EMBASE Using Only Generic Drug Names Compared with Searches Applied in Current Practice in Systematic Reviews

ERIC Educational Resources Information Center

Waffenschmidt, Siw; Guddat, Charlotte

2015-01-01

Background: It is unclear which terms should be included in bibliographic searches for randomized controlled trials (RCTs) of drugs, and identifying relevant drug terms can be extremely laborious. The aim of our analysis was to determine whether a bibliographic search using only the generic drug name produces sufficient results for the generation…

In-Service Training in South African Libraries. A Brief Review Based on a Thesis for the M.Bibl. Degree of the University of Pretoria.

ERIC Educational Resources Information Center

Vink, C. M.

A study was undertaken to ascertain the position of inservice training for librarians in South Africa and to determine what adjustments were necessary for inservice training practice in South African libraries. An examination of the literature on inservice training revealed current trends, and the literature in the field of library science was…

Library Management: Quantifying Goals. Papers Presented at the Fourth Annual Library Science Institute (Indiana State University, Terre Haute, Indiana, April 27-29, 1972). Changing Concept Series No. 2.

ERIC Educational Resources Information Center

Kim, Choong H., Ed.; And Others

Recognizing that the rational determination of priority goals for library services is only possible on the basis of objectively defined quantities, these papers discuss the problems of such quantification. The lead paper reviews current thought on the subject, noting the lack of practical techniques for the disciplined measurement of library…

Nonclinical dose formulation analysis method validation and sample analysis.

PubMed

Whitmire, Monica Lee; Bryan, Peter; Henry, Teresa R; Holbrook, John; Lehmann, Paul; Mollitor, Thomas; Ohorodnik, Susan; Reed, David; Wietgrefe, Holly D

2010-12-01

Nonclinical dose formulation analysis methods are used to confirm test article concentration and homogeneity in formulations and determine formulation stability in support of regulated nonclinical studies. There is currently no regulatory guidance for nonclinical dose formulation analysis method validation or sample analysis. Regulatory guidance for the validation of analytical procedures has been developed for drug product/formulation testing; however, verification of the formulation concentrations falls under the framework of GLP regulations (not GMP). The only current related regulatory guidance is the bioanalytical guidance for method validation. The fundamental parameters for bioanalysis and formulation analysis validations that overlap include: recovery, accuracy, precision, specificity, selectivity, carryover, sensitivity, and stability. Divergence in bioanalytical and drug product validations typically center around the acceptance criteria used. As the dose formulation samples are not true "unknowns", the concept of quality control samples that cover the entire range of the standard curve serving as the indication for the confidence in the data generated from the "unknown" study samples may not always be necessary. Also, the standard bioanalytical acceptance criteria may not be directly applicable, especially when the determined concentration does not match the target concentration. This paper attempts to reconcile the different practices being performed in the community and to provide recommendations of best practices and proposed acceptance criteria for nonclinical dose formulation method validation and sample analysis.

Impact of medical student origins on the likelihood of ultimately practicing in areas of low vs high socio-economic status.

PubMed

Puddey, Ian B; Playford, Denese E; Mercer, Annette

2017-01-05

Medical schools are in general over-represented by students from high socio-economic status backgrounds. The University of Western Australia Medical School has been progressively widening the participation of students from a broader spectrum of the community both through expanded selection criteria and quota-based approaches for students of rural, indigenous and other socio-educationally disadvantaged backgrounds. We proposed that medical students entering medical school from such backgrounds would ultimately be more likely to practice in areas of increased socio-economic disadvantage. The current practice address of 2829 medical students who commenced practice from 1980 to 2011 was ascertained from the Australian Health Practitioner Regulation Agency (AHPRA) Database. Logistic regression was utilised to determine the predictors of the likelihood of the current practice address being in the lower 8 socio-economic deciles versus the top 2 socio-economic deciles. Those who were categorised in the lower 8 socio-economic deciles at entry to medical school had increased odds of a current practice address in the lower 8 socio-economic deciles 5 or more years after graduation (OR 2.05, 95% CI 1.72, 2.45, P < 0.001). Other positive univariate predictors included age at medical degree completion (for those 25 years or older vs those 24 years or younger OR 1.53, 95% CI 1.27, 1.84, P < 0.001), being female (OR 1.26, 95% CI 1.07, 1.48, P = 0.005) and having a general practice versus specialist qualification (OR 4.16, 95% CI 3.33, 5.19, P < 0.001). Negative predictors included having attended an independent school vs a government school (OR 0.77, 95% CI 0.64, 0.92, P < 0.001) or being originally from overseas vs being born in Oceania (OR 0.80, 95% CI 0.67, 0.96, P = 0.017). After adjustment for potential confounders in multivariate logistic regression, those in the lower 8 socio-economic deciles at entry to medical school still had increased odds of having a current practice address in the lower 8 socio-economic deciles (OR 1.63, 95% CI 1.34, 1.99, P < 0.001). Widening participation in medical school to students from more diverse socio-educational backgrounds is likely to increase the distribution of the medical workforce to ultimate service across areas representative of a broader socio-economic spectrum.

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 practice regulations. 210.2 Section 210.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING...

21 CFR 184.1452 - Manganese gluconate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... used in food with no limitation other than current good manufacturing practice. The affirmation of this... following current good manufacturing practice conditions of use: (1) The ingredient is used as a nutrient... levels not to exceed current good manufacturing practice: baked goods as defined in § 170.3(n)(1) of this...

Best practice guidelines for stroke in Cameroon: An innovative and participatory knowledge translation project.

PubMed

Cockburn, Lynn; Fanfon, Timothy N; Bramall, Alexa; Ngole, Eta M; Kuwoh, Pius; Anjonga, Emmanuel; Difang, Brenda M E; Kiani, Shirin; Muso, Petra S; Trivedi, Navjyot; Sama, Julius; Teboh, Sylvian

2014-01-01

Although the adherence to stroke guidelines in high-income countries has been shown to be associated with improved patient outcomes, the research, development and implementation of rehabilitation related guidelines in African countries is lacking. The purpose of this article is to describe how a group of front-line practitioners collaborated with academics and students to develop best practice guidelines (BPG) for the management and rehabilitation of stroke in adult patients in Cameroon. A working group was established and adapted internationally recognised processes for the development of best practice guidelines. The group determined the scope of the guidelines, documented current practices, and critically appraised evidence to develop guidelines relevant to the Cameroon context. The primary result of this project is best practice guidelines which provided an overview of the provision of stroke rehabilitation services in the region, and made 83 practice recommendations to improve these services. We also report on the successes and challenges encountered during the process, and the working group's recommendations aimed at encouraging others to consider similar projects. This project demonstrated that there is interest and capacity for improving stroke rehabilitation practices and for stroke guideline development in Africa.

Identification of Pediatric Oral Health Core Competencies through Interprofessional Education and Practice.

PubMed

Hallas, D; Fernandez, J B; Herman, N G; Moursi, A

2015-01-01

Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD) and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP) program at New York University College of Nursing (NYUCN) have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice.

Identification of Pediatric Oral Health Core Competencies through Interprofessional Education and Practice

PubMed Central

Hallas, D.; Fernandez, J. B.; Herman, N. G.; Moursi, A.

2015-01-01

Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD) and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP) program at New York University College of Nursing (NYUCN) have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice. PMID:25653873

Reflections on the framing of 'health equity' in the National Primary Health Care Strategic Framework: a cause for celebration or concern?

PubMed

Smith, James A

2014-04-01

There has been a growing national and global focus on the need to address social determinants of health to better achieve equitable health outcomes. In Australia, this focus is now being embedded into state, territory and Commonwealth government health policies. In this paper I use the National Primary Health Care Strategic Framework as a case study to examine the way in which 'health equity' and other related terms have been framed within a current national health policy context. Using a critically reflective approach, I argue that primary health care and health promotion professionals need to capitalise on the inclusion of terms such as 'action on social determinants of health', 'health equity' and 'reducing inequity' through emerging national health policies, such as the National Primary Health Care Strategic Framework. Yet, there is also a need to proceed with caution. The way in which these terms are framed appears to deviate from the principles, values and ideologies on which they are historically based. The implications for contemporary health promotion practice in Australia are discussed. Primary health care and health promotion professionals working in both policy and practice contexts are encouraged to engage in critical reflective practice when interpreting and considering the implementation requirements of national health policies that incorporate a health equity focus. So what? To build health equity in Australia, primary health care and health promotion professionals will be required to engage in the skilful reframing of current primary health care policy discourses relating to health equity during health promotion planning, implementation and evaluation processes.

Surgical Education and Health Care Reform: Defining the Role and Value of Trainees in an Evolving Medical Landscape.

PubMed

Fayanju, Oluwadamilola M; Aggarwal, Reena; Baucom, Rebeccah B; Ferrone, Cristina R; Massaro, David; Terhune, Kyla P

2017-03-01

Health care reform and surgical education are often separated functionally. However, especially in surgery, where resident trainees often spend twice as much time in residency and fellowship than in undergraduate medical education, one must consider their contributions to health care. In this short commentary, we briefly review the status of health care in the United States as well as some of the recent and current changes in graduate medical education that pertain to surgical trainees. This is a perspective piece that draws on the interests and varied background of the multiinstitutional and international group of authors. The authors propose 3 main areas of focus for research and practice- (1) accurately quantifying the care provided currently by trainees, (2) determining impact to trainees and hospital systems of training parameters, focusing on long-term outcomes rather than short-term outcomes, and (3) determining practice models of education that work best for both health care delivery and trainees. The authors propose that surgical education must align itself with rather than separate itself from overall health care reform measures and even individual hospital financial pressures. This should not be seen as additional burden of service, but rather practical education in training as to the pressures trainees will face as future employees. Rethinking the contributions and training of residents and fellows may also synergistically work to impress to hospital administrators that providing better, more focused and applicable education to residents and fellows may have long-term, strategic, positive impacts on institutions.

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

PubMed Central

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

2016-01-01

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

Diffusion of innovation theory for clinical change.

PubMed

Sanson-Fisher, Robert W

2004-03-15

Maximising the adoption of evidence-based practice has been argued to be a major factor in determining healthcare outcomes. However, there are gaps between evidence-based recommendations and current care. Bridging the evidence gap will not be achieved simply by informing clinicians about the evidence. One theoretical approach to understanding how change may be achieved is Rogers' diffusion model. He argues that certain characteristics of the innovation itself may facilitate its adoption. Other factors influencing acceptance include promotion by influential role models, the degree of complexity of the change, compatibility with existing values and needs, and the ability to test and modify the new procedure before adopting it. The diffusion model may provide valuable insights into why some practices change and others do not, as well as guiding those who try to effect adoption of best-evidence practice.

Gender and teamwork: an analysis of professors' perspectives and practices

NASA Astrophysics Data System (ADS)

Beddoes, Kacey; Panther, Grace

2018-05-01

Teamwork is increasingly seen as an important component of engineering education programmes. Yet, prior research has shown that there are numerous ways in which teamwork is gendered, and can lead to negative experiences for women students. This article presents the first interview findings on professors' perspectives on gender and teamwork. Semi-structured interviews were conducted with 39 engineering professors to determine what and how they thought about gender in engineering and engineering education. For this article, the parts of the interviews about teamwork are analysed. We conclude that professors need tools to help them facilitate gender-inclusive teamwork, and those tools must address the beliefs that they already hold about teamwork. The findings raise questions about the adoption of evidence-based instructional practices and suggest current teamwork practices may exacerbate gender inequalities in engineering.

Selecting for a sustainable workforce to meet the future healthcare needs of rural communities in Australia.

PubMed

Hay, M; Mercer, A M; Lichtwark, I; Tran, S; Hodgson, W C; Aretz, H T; Armstrong, E G; Gorman, D

2017-05-01

An undersupply of generalists doctors in rural communities globally led to widening participation (WP) initiatives to increase the proportion of rural origin medical students. In 2002 the Australian Government mandated that 25% of commencing Australian medical students be of rural origin. Meeting this target has largely been achieved through reduced standards of entry for rural relative to urban applicants. This initiative is based on the assumption that rural origin students will succeed during training, and return to practice in rural locations. One aim of this study was to determine the relationships between student geographical origin (rural or urban), selection scores, and future practice intentions of medical students at course entry and course exit. Two multicentre databases containing selection and future practice preferences (location and specialisation) were combined (5862), representing 54% of undergraduate medical students commencing from 2006 to 2013 across nine Australian medical schools. A second aim was to determine course performance of rural origin students selected on lower scores than their urban peers. Selection and course performance data for rural (461) and urban (1431) origin students commencing 2006-2014 from one medical school was used. For Aim 1, a third (33.7%) of rural origin students indicated a preference for future rural practice at course exit, and even fewer (6.7%) urban origin students made this preference. Results from logistic regression analyses showed significant independent predictors were rural origin (OR 4.0), lower Australian Tertiary Admissions Rank (ATAR) (OR 2.1), or lower Undergraduate Medical and Health Sciences Admissions Test Section 3 (non-verbal reasoning) (OR 1.3). Less than a fifth (17.6%) of rural origin students indicated a preference for future generalist practice at course exit. Significant predictors were female gender (OR 1.7) or lower ATAR (OR 1.2), but not rural origin. Fewer (10.5%) urban origin students indicated a preference for generalist practice at course exit. For Aim 2, results of Mann-Whitney U tests confirmed that slightly reducing selection scores does not result in increased failure, or meaningfully impaired performance during training relative to urban origin students. Our multicentre analysis supports success of the rural origin WP pathway to increase rural student participation in medical training. However, our findings confirm that current selection initiatives are insufficient to address the continuing problem of doctor maldistribution in Australia. We argue for further reform to current medical student selection, which remains largely determined by academic meritocracy. Our findings have relevance to the selection of students into health professions globally.

Interpretation of Landscape Scale SWAT Model Outputs in the Western Lake Erie Basin: Potential Implications for Conservation Decision-Making

NASA Astrophysics Data System (ADS)

Johnson, M. V. V.; Behrman, K. D.; Atwood, J. D.; White, M. J.; Norfleet, M. L.

2017-12-01

There is substantial interest in understanding how conservation practices and agricultural management impact water quality, particularly phosphorus dynamics, in the Western Lake Erie Basin (WLEB). In 2016, the US and Canada accepted total phosphorus (TP) load targets recommended by the Great Lakes Water Quality Agreement Annex 4 Objectives and Targets Task Team; these were 6,000 MTA delivered to Lake Erie and 3,660 MTA delivered to WLEB. Outstanding challenges include development of metrics to determine achievement of these goals, establishment of sufficient monitoring capacity to assess progress, and identification of appropriate conservation practices to achieve the most cost-effective results. Process-based modeling can help inform decisions to address these challenges more quickly than can system observation. As part of the NRCS-led Conservation Effects Assessment Project (CEAP), the Soil Water Assessment Tool (SWAT) was used to predict impacts of conservation practice adoption reported by farmers on TP loss and load delivery dynamics in WLEB. SWAT results suggest that once the conservation practices in place in 2003-06 and 2012 are fully functional, TP loads delivered to WLEB will average 3,175 MTA and 3,084 MTA, respectively. In other words, SWAT predicts that currently adopted practices are sufficient to meet Annex 4 TP load targets. Yet, WLEB gauging stations show Annex 4 goals are unmet. There are several reasons the model predictions and current monitoring efforts are not in agreement: 1. SWAT assumes full functionality of simulated conservation practices; 2. SWAT does not simulate changing management over time, nor impacts of past management on legacy loads; 3. SWAT assumes WLEB hydrological system equilibrium under simulated management. The SWAT model runs used to construct the scenarios that informed the Annex 4 targets were similarly constrained by model assumptions. It takes time for a system to achieve equilibrium when management changes and it takes time for monitoring efforts to measure meaningful changes over time. Careful interpretation of model outputs is imperative for appropriate application of current scientific knowledge to inform decision making, especially when models are used to set spatial and temporal goals around conservation practice adoption and water quality.

Electric field characteristics of electroconvulsive therapy with individualized current amplitude: a preclinical study.

PubMed

Lee, Won Hee; Lisanby, Sarah H; Laine, Andrew F; Peterchev, Angel V

2013-01-01

This study examines the characteristics of the electric field induced in the brain by electroconvulsive therapy (ECT) with individualized current amplitude. The electric field induced by bilateral (BL), bifrontal (BF), right unilateral (RUL), and frontomedial (FM) ECT electrode configurations was computed in anatomically realistic finite element models of four nonhuman primates (NHPs). We generated maps of the electric field strength relative to an empirical neural activation threshold, and determined the stimulation strength and focality at fixed current amplitude and at individualized current amplitudes corresponding to seizure threshold (ST) measured in the anesthetized NHPs. The results show less variation in brain volume stimulated above threshold with individualized current amplitudes (16-36%) compared to fixed current amplitude (30-62%). Further, the stimulated brain volume at amplitude-titrated ST is substantially lower than that for ECT with conventional fixed current amplitudes. Thus individualizing the ECT stimulus current could compensate for individual anatomical variability and result in more focal and uniform electric field exposure across different subjects compared to the standard clinical practice of using high, fixed current for all patients.

Assessment of training capacity in New Zealand general practices: a stocktake in the lower North Island and South Island.

PubMed

Murton, Samantha A; Pullon, Susan Rh

2017-09-22

General practices are providing clinically-based training for rapidly increasing numbers of medical (and other health professional) trainees. This study investigated capacity and intention of general practices to additionally teach junior doctors (now required to undertake community-based attachments by the New Zealand Medical Council) alongside current trainees in their service. A web-based/telephone survey of all general practices was developed and administered November 2015-April 2016. In the Otago study region (lower North Island, South Island), 463 currently operating practices were identified. (A companion Auckland-based study concurrently investigated the upper North Island.) Of the 280/463 (60%) responding practices, 93% (261/280) were currently taking health professional trainees, with 86% (241/280) taking at least one type of medical trainee. Practices indicate that 14% fewer of them will take undergraduate medical students than previously (199 practices down to 162), but more would take junior doctors (42 up to 79) and GP registrars (129 practices up to 142). Most practices in these regions already contribute to teaching. Practices indicated limitations in accommodating continued increases in numbers of trainees in the current poorly coordinated system. Improved support and training for practices is needed to enable practices to take more trainees of multiple types per practice, both concurrently and sequentially.

The 50 million missing women.

PubMed

Allahbadia, Gautam N

2002-09-01

The epidemic of gender selection is ravaging countries like India & China. Approximately fifty million women are "missing" in the Indian population. Generally three principle causes are given: female infanticide, better food and health care for boys and maternal death at childbirth. Prenatal sex determination and the abortion of female fetuses threatens to skew the sex ratio to new highs. Estimates of the number of female fetuses being destroyed every year in India vary from two million to five million. This review from India attempts to summarize all the currently available methods of sex selection and also highlights the current medical practice regards the subject in south-east Asia.

Ultrahigh-Density Nanowire Arrays Grown in Self-Assembled Diblock Copolymer Templates

NASA Astrophysics Data System (ADS)

Thurn-Albrecht, T.; Schotter, J.; Kästle, G. A.; Emley, N.; Shibauchi, T.; Krusin-Elbaum, L.; Guarini, K.; Black, C. T.; Tuominen, M. T.; Russell, T. P.

2000-12-01

We show a simple, robust, chemical route to the fabrication of ultrahigh-density arrays of nanopores with high aspect ratios using the equilibrium self-assembled morphology of asymmetric diblock copolymers. The dimensions and lateral density of the array are determined by segmental interactions and the copolymer molecular weight. Through direct current electrodeposition, we fabricated vertical arrays of nanowires with densities in excess of 1.9 × 1011 wires per square centimeter. We found markedly enhanced coercivities with ferromagnetic cobalt nanowires that point toward a route to ultrahigh-density storage media. The copolymer approach described is practical, parallel, compatible with current lithographic processes, and amenable to multilayered device fabrication.

Figures in clinical trial reports: current practice & scope for improvement.

PubMed

Pocock, Stuart J; Travison, Thomas G; Wruck, Lisa M

2007-11-19

Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses) and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

Hospital administrative characteristics and volunteer resource management practices.

PubMed

Intindola, Melissa; Rogers, Sean; Flinchbaugh, Carol; Della Pietra, Doug

2016-05-16

Purpose - The purpose of this paper is to explore the links between various characteristics of hospital administration and the utilization of classes of volunteer resource management (VRM) practices. Design/methodology/approach - This paper uses original data collected via surveys of volunteer directors in 122 hospitals in five Northeastern and Southern US states. Findings - Structural equation modeling results suggest that number of paid volunteer management staff, scope of responsibility of the primary volunteer administrator, and hospital size are positively associated with increased usage of certain VRM practices. Research limitations/implications - First, the authors begin the exploration of VRM antecedents, and encourage others to continue this line of inquiry; and second, the authors assess dimensionality of practices, allowing future researchers to consider whether specific dimensions have a differential impact on key individual and organizational outcomes. Practical implications - Based on the findings of a relationship between administrative characteristics and the on-the-ground execution of VRM practice, a baseline audit comparing current practices to those VRM practices presented here might be useful in determining what next steps may be taken to focus investments in VRM that can ultimately drive practice utilization. Originality/value - The exploration of the dimensionality of volunteer management adds a novel perspective to both the academic study, and practice, of volunteer management. To the authors' knowledge, this is the first empirical categorization of VRM practices.

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

PubMed

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

2018-06-21

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

Pain assessment and management in end of life care: a survey of assessment and treatment practices of hospice music therapy and nursing professionals.

PubMed

Groen, Kara Mills

2007-01-01

The primary focus of this paper is to describe current trends in pain assessment in end of life care with a secondary focus on music therapy techniques commonly used to address pain for hospice patients. These trends were determined through a survey of 72 board certified music therapists and 92 hospice and palliative nurses. Survey results indicate that most music therapists in the hospice setting incorporate formal pain assessment into their practice; both nursing professionals and music therapists surveyed utilize multiple assessment tools to assess patient pain. Although there are currently a variety of pain assessment tools used, this study indicates that nursing professionals most frequently use the Numerical Rating Scale (NRS) and FACES scales, and identified them as appropriate for use by nonnursing members of the interdisciplinary hospice team. This paper also describes music therapy techniques most often utilized by music therapists with hospice patients to address acute and chronic pain symptoms.

Current practices in library/informatics instruction in academic libraries serving medical schools in the Western United States: a three-phase action research study.

PubMed

Eldredge, Jonathan D; Heskett, Karen M; Henner, Terry; Tan, Josephine P

2013-09-04

To conduct a systematic assessment of library and informatics training at accredited Western U.S. medical schools. To provide a structured description of core practices, detect trends through comparisons across institutions, and to identify innovative training approaches at the medical schools. Action research study pursued through three phases. The first phase used inductive analysis on reported library and informatics skills training via publicly-facing websites at accredited medical schools and the academic health sciences libraries serving those medical schools. Phase Two consisted of a survey of the librarians who provide this training to undergraduate medical education students at the Western U.S. medical schools. The survey revealed gaps in forming a complete picture of current practices, thereby generating additional questions that were answered through the Phase Three in-depth interviews. Publicly-facing websites reviewed in Phase One offered uneven information about library and informatics training at Western U.S. medical schools. The Phase Two survey resulted in a 77% response rate. The survey produced a clearer picture of current practices of library and informatics training. The survey also determined the readiness of medical students to pass certain aspects of the United States Medical Licensure Exam. Most librarians interacted with medical school curricular leaders through either curricula committees or through individual contacts. Librarians averaged three (3) interventions for training within the four-year curricula with greatest emphasis upon the first and third years. Library/informatics training was integrated fully into the respective curricula in almost all cases. Most training involved active learning approaches, specifically within Problem-Based Learning or Evidence-Based Medicine contexts. The Phase Three interviews revealed that librarians are engaged with the medical schools' curricular leaders, they are respected for their knowledge and teaching skills, and that they need to continually adapt to changes in curricula. This study offers a long overdue, systematic view of current practices of library/informatics training at Western U.S. medical schools. Medical educators, particularly curricular leaders, will find opportunities in this study's results for more productive collaborations with the librarians responsible for library and informatics training at their medical schools.

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

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false What is current good manufacturing practice for PET drugs? 212.2 Section 212.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION...

21 CFR 184.1101 - Diacetyl tartaric acid esters of mono- and diglycerides.

Code of Federal Regulations, 2010 CFR

2010-04-01

... used in food with no limitation other than current good manufacturing practice. The affirmation of this... following current good manufacturing practice conditions of use: (1) The ingredient is used in food as an... levels not to exceed current good manufacturing practice: baked goods and baking mixes as defined in...

21 CFR 184.1101 - Diacetyl tartaric acid esters of mono- and diglycerides.

Code of Federal Regulations, 2011 CFR

2011-04-01

... used in food with no limitation other than current good manufacturing practice. The affirmation of this... following current good manufacturing practice conditions of use: (1) The ingredient is used in food as an... levels not to exceed current good manufacturing practice: baked goods and baking mixes as defined in...

The Race To X-ray Microbeam and Nanobeam Science

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

Ice, Gene E; Budai, John D; Pang, Judy

2011-01-01

X-ray microbeams are an emerging characterization tool with transformational implications for broad areas of science ranging from materials structure and dynamics, geophysics and environmental science to biophysics and protein crystallography. In this review, we discuss the race toward sub-10 nm- x-ray beams with the ability to penetrate tens to hundreds of microns into most materials and with the ability to determine local (crystal) structure. Examples of science enabled by current micro/nanobeam technologies are presented and we provide a perspective on future directions. Applications highlighted are chosen to illustrate the important features of various submicron beam strategies and to highlight themore » directions of current and future research. While it is clear that x-ray microprobes will impact science broadly, the practical limit for hard x-ray beam size, the limit to trace element sensitivity, and the ultimate limitations associated with near-atomic structure determinations are the subject of ongoing research.« less

Prescribing benzodiazepines for noninstitutionalized elderly.

PubMed Central

Thomson, M.; Smith, W. A.

1995-01-01

OBJECTIVE: To describe benzodiazepine prescribing for elderly people living in the community in British Columbia, and to compare such prescribing with an indicator of current guidelines. DESIGN: Descriptive analysis of pharmacy billing data. SETTING: Province of British Columbia. PARTICIPANTS: All elderly persons (age 65 and older) dispensed benzodiazepines by community pharmacies in British Columbia during 1990. MAIN OUTCOME MEASURE: Potentially inappropriate prescriptions were defined by a maximum 2-month limit of 20 diazepam equivalents daily, as determined by the BC Drug Usage Review Program in consultation with experts in the field. Physicians' rates of potentially inappropriate prescribing were determined per 100 benzodiazepine prescriptions written. RESULTS: Almost 24% of elderly people in British Columbia were prescribed benzodiazepines at least once during 1990. Of these, 17.1% were given potentially inappropriate prescriptions. Physicians who prescribed benzodiazepines most frequently had the highest rates of potentially inappropriate prescriptions. CONCLUSION: Prescribing practice does not correspond with our indicator of current guidelines. PMID:7756916

Cost-effectiveness analysis of HLA-B*58: 01 genetic testing before initiation of allopurinol therapy to prevent allopurinol-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in a Malaysian population.

PubMed

Chong, Huey Yi; Lim, Yi Heng; Prawjaeng, Juthamas; Tassaneeyakul, Wichittra; Mohamed, Zahurin; Chaiyakunapruk, Nathorn

2018-02-01

Studies found a strong association between allopurinol-induced Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and the HLA-B*58:01 allele. HLA-B*58:01 screening-guided therapy may mitigate the risk of allopurinol-induced SJS/TEN. This study aimed to evaluate the cost-effectiveness of HLA-B*58:01 screening before allopurinol therapy initiation compared with the current practice of no screening for Malaysian patients with chronic gout in whom a hypouricemic agent is indicated. This cost-effectiveness analysis adopted a societal perspective with a lifetime horizon. A decision tree model coupled with Markov models were developed to estimate the costs and outcomes, represented by quality-adjusted life years (QALYs) gained, of three treatment strategies: (a) current practice (allopurinol initiation without HLA-B*58:01 screening); (b) HLA-B*58:01 screening before allopurinol initiation; and (c) alternative treatment (probenecid) without HLA-B*58:01 screening. The model was populated with data from literature review, meta-analysis, and published government documents. Cost values were adjusted for the year 2016, with costs and health outcomes discounted at 3% per annum. A series of sensitivity analysis including probabilistic sensitivity analysis were carried out to determine the robustness of the findings. Both HLA-B*58:01 screening and probenecid prescribing were dominated by current practice. Compared with current practice, HLA-B*58:01 screening resulted in 0.252 QALYs loss per patient at an additional cost of USD 322, whereas probenecid prescribing resulted in 1.928 QALYs loss per patient at an additional cost of USD 2203. One SJS/TEN case would be avoided for every 556 patients screened. At the cost-effectiveness threshold of USD 8695 per QALY, the probability of current practice being the best choice is 99.9%, in contrast with 0.1 and 0% in HLA-B*58:01 screening and probenecid prescribing, respectively. This is because of the low incidence of allopurinol-induced SJS/TEN in Malaysia and the lower efficacy of probenecid compared with allopurinol in gout control. This analysis showed that HLA-B*58:01 genetic testing before allopurinol initiation is unlikely to be a cost-effective intervention in Malaysia.

Assessment of the NASA Flight Assurance Review Program

NASA Technical Reports Server (NTRS)

Holmes, J.; Pruitt, G.

1983-01-01

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

Awareness and practices regarding bio-medical waste management among health care workers in a tertiary care hospital in Delhi.

PubMed

Bhagawati, G; Nandwani, S; Singhal, S

2015-01-01

Health care institutions are generating large amount of Bio-Medical Waste (BMW), which needs to be properly segregated and treated. With this concern, a questionnaire based cross-sectional study was done to determine the current status of awareness and practices regarding BMW Management (BMWM) and areas of deficit amongst the HCWs in a tertiary care teaching hospital in New Delhi, India. The correct responses were graded as satisfactory (more than 80%), intermediate (50-80%) and unsatisfactory (less than 50%). Some major areas of deficit found were about knowledge regarding number of BMW categories (17%), mercury waste disposal (37.56%) and definition of BMW (47%).

Design High-Efficiency III-V Nanowire/Si Two-Junction Solar Cell.

PubMed

Wang, Y; Zhang, Y; Zhang, D; He, S; Li, X

2015-12-01

In this paper, we report the electrical simulation results of a proposed GaInP nanowire (NW)/Si two-junction solar cell. The NW physical dimensions are determined for optimized solar energy absorption and current matching between each subcell. Two key factors (minority carrier lifetime, surface recombination velocity) affecting power conversion efficiency (PCE) of the solar cell are highlighted, and a practical guideline to design high-efficiency two-junction solar cell is thus provided. Considering the practical surface and bulk defects in GaInP semiconductor, a promising PCE of 27.5 % can be obtained. The results depict the usefulness of integrating NWs to construct high-efficiency multi-junction III-V solar cells.

[Progress in precision medicine: a scientific perspective].

PubMed

Wang, B; Li, L M

2017-01-10

Precision medicine is a new strategy for disease prevention and treatment by taking into account differences in genetics, environment and lifestyles among individuals and making precise diseases classification and diagnosis, which can provide patients with personalized, targeted prevention and treatment. Large-scale population cohort studies are fundamental for precision medicine research, and could produce best evidence for precision medicine practices. Current criticisms on precision medicine mainly focus on the very small proportion of benefited patients, the neglect of social determinants for health, and the possible waste of limited medical resources. In spite of this, precision medicine is still a most hopeful research area, and would become a health care practice model in the future.

Practices and opinions on nitrous oxide/oxygen sedation from dentists licensed to perform relative analgesia in Brazil

PubMed Central

2012-01-01

Background Relative analgesia (RA), defined as the use of inhalation sedation with nitrous oxide and oxygen, is one of the most common pharmacological behavior management techniques used to provide sedation and analgesia for dental patients. This study aimed to assess RA licensed Brazilian dentists’ practices and opinions about nitrous oxide/oxygen sedation in the dental setting. Methods A cross sectional national survey was conducted with 281 dentists who were certified to perform RA, using an electronically mailed self-administered questionnaire containing closed questions about their practices and opinions regarding RA. Practice and opinion were individually analyzed by descriptive statistics. Non-parametric tests assessed the relationships between RA practice and independent variables. To test the interplay between practices and opinions, a k-means clusters analysis was used to divide the group for statistical comparisons. Results The response rate was 45.2%. Women made up 64.6% of the respondents, the mean age was 39.1 years (SD = 9.8), and the mean time since graduation in dentistry was 16 years (SD = 9.7). Seventy-seven percent of respondents reported the use of RA in clinical practice, most of them ‘sometimes’ (53.5%), and focusing more on adult patients. Patients with certain physical or mental deficiencies were indications associated with RA practice. ‘Equipment acquisition’ (p < 0.001) and ‘living in Southeast and South regions’ (p < 0.02) were also associated with RA practice. The scores for dentists’ opinions ranged from 15 to 41 points (mean 29.2, SD = 5.6), based on nine items scored from 1 to 5. Two clusters representing more favorable (n = 65) and less favorable (n = 55) opinions were established. Dentists who were women (p = 0.04), practiced RA in dental settings (p < 0.01) or practiced it frequently (p < 0.001), had more favorable opinions about RA. Conclusion Most of the RA licensed Brazilian dentists interviewed currently use RA. Current practice of RA and frequency of use determined the degree of favorable opinion about this inhalation sedation among this group of respondents. PMID:22808942

New techniques for wound debridement.

PubMed

Madhok, Brijesh M; Vowden, Kathryn; Vowden, Peter

2013-06-01

Debridement is a crucial component of wound management. Traditionally, several types of wound debridement techniques have been used in clinical practice such as autolytic, enzymatic, biodebridement, mechanical, conservative sharp and surgical. Various factors determine the method of choice for debridement for a particular wound such as suitability to the patient, the type of wound, its anatomical location and the extent of debridement required. Recently developed products are beginning to challenge traditional techniques that are currently used in wound bed preparation. The purpose of this review was to critically evaluate the current evidence behind the use of these newer techniques in clinical practice. There is some evidence to suggest that low frequency ultrasound therapy may improve healing rates in patients with venous ulcers and diabetic foot ulcers. Hydrosurgery debridement is quick and precise, but the current evidence is limited and further studies are underway. Debridement using a monofilament polyester fibre pad and plasma-mediated bipolar radiofrequency ablation are both very new techniques. The initial evidence is limited, and further studies are warranted to confirm their role in management of chronic wounds. © 2013 The Authors. International Wound Journal © 2013 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Current practice of usual clinic blood pressure measurement in people with and without diabetes: a survey and prospective ‘mystery shopper’ study in UK primary care

PubMed Central

2018-01-01

Objectives Hypertension trials and epidemiological studies use multiple clinic blood pressure (BP) measurements at each visit. Repeat measurement is also recommended in international guidance; however, little is known about how BP is measured routinely. This is important for individual patient management and because routinely recorded readings form part of research databases. We aimed to determine the current practice of BP measurement during routine general practice appointments. Design (1) An online cross-sectional survey and (2) a prospective ‘mystery shopper’ study where patients agreed to report how BP was measured during their next appointment. Setting Primary care. Participants Patient charity/involvement group members completing an online survey between July 2015 and January 2016. 334 participants completed the prospective study (51.5% male, mean age=59.3 years) of which 279 (83.5%) had diabetes. Primary outcome Proportion of patients having BP measured according to guidelines. Results 217 participants with (183) and without diabetes (34) had their BP measured at their last appointment. BP was measured in line with UK guidance in 63.7% and 60.0% of participants with and without diabetes, respectively. Initial pressures were significantly higher in those who had their BP measured more than once compared with only once (p=0.016/0.089 systolic and p<0.001/p=0.022 diastolic, in patients with/without diabetes, respectively). Conclusions Current practice of routine BP measurement in UK primary care is often concordant with guidelines for repeat measurement. Further studies are required to confirm findings in broader populations, to confirm when a third repeat reading is obtained routinely and to assess adherence to other aspects of BP measurement guidance. PMID:29654037

Genetic analysis of sudden cardiac death victims: a survey of current forensic autopsy practices.

PubMed

Michaud, Katarzyna; Mangin, Patrice; Elger, Bernice S

2011-05-01

Autopsy-negative sudden cardiac deaths (SCD) seen in forensic practice are most often thought to be the result of sudden arrhythmic death syndrome. Postmortem genetic analysis is recommended in such cases, but is currently performed in only a few academic centers. In order to determine actual current practice, an on-line questionnaire was sent by e-mail to members of various forensic medical associations. The questions addressed routine procedures employed in cases of sudden cardiac death (autopsy ordering, macroscopic and microscopic cardiac examination, conduction tissue examination, immunohistochemistry and electron microscopy, biochemical markers, sampling and storage of material for genetic analyses, toxicological analyses, and molecular autopsy). Some questions concerned the legal and ethical aspects of genetic analyses in postmortem examinations, as well as any existing multidisciplinary collaborations in SCD cases. There were 97 respondents, mostly from European countries. Genetic testing in cases of sudden cardiac death is rarely practiced in routine forensic investigation. Approximately 60% of respondents reported not having the means to perform genetic postmortem testing and 40% do not collect adequate material to perform these investigations at a later date, despite working at university hospitals. The survey demonstrated that many of the problems involved in the adequate investigation of SCD cases are often financial in origin, due to the fact that activities in forensic medicine are often paid by and dependent on the judicial authorities. Problems also exist concerning the contact with family members and/or the family doctor, as well as the often-nonexistent collaboration with others clinicians with special expertise beneficial in the investigation of SCD cases, such as cardiologists and geneticists. This study highlights the importance in establishing guidelines for molecular autopsies in forensic medicine.

Exercise during pregnancy: knowledge and beliefs of medical practitioners in South Africa: a survey study.

PubMed

Watson, Estelle D; Oddie, Brydie; Constantinou, Demitri

2015-10-07

There is compelling evidence for the benefits of regular exercise during pregnancy, and medical practitioners (MPs) can play an important role in changing antenatal health behaviours. The purpose of this study was to assess the knowledge, attitudes and beliefs of South African MPs towards exercise during pregnancy. A convenience sample of ninety-six MPs working in the private health care sector, including General Practitioners (n = 58), Obstetricians/Gynaecologists (n = 33) and other Specialists (n = 5), participated in this cross sectional, descriptive survey study. A 33-item questionnaire was distributed manually at medical practices and via email to an on-line survey tool. Descriptive statistics and frequency tables were calculated for all questions. Chi-squared and Fisher's exact statistical tests were used to determine the differences in response by age, speciality and years of practice (p < 0.05). The majority of practitioners (98%) believe that exercise during pregnancy is beneficial, and were knowledgeable on most of the expected benefits. Seventy-eight percent believed that providing exercise advice is an important part of prenatal care, however only 19% provided informational pamphlets and few (24%) referred to exercise specialists. A large majority (83%) were unaware of the recommended exercise guidelines. Although age and years of practice played no role in this awareness, practitioners who focussed on obstetrics and gynaecology were more likely to be aware of the current guidelines, than those in general practice (p < 0.001). Although the MPs were largely positive towards exercise during pregnancy, their advice did not always align with the current guidelines. Therefore, better dissemination of available research is warranted, to bridge the gap between clinical knowledge and current recommendations for physical activity promotion.

Assessment of children's capacity to consent for research: a descriptive qualitative study of researchers' practices.

PubMed

Gibson, Barbara E; Stasiulis, Elaine; Gutfreund, Shawna; McDonald, Maria; Dade, Lauren

2011-08-01

In Canadian jurisdictions without specific legislation pertaining to research consent, the onus is placed on researchers to determine whether a child is capable of independently consenting to participate in a research study. Little, however, is known about how child health researchers are approaching consent and capacity assessment in practice. The aim of this study was to explore and describe researchers' current practices. The study used a qualitative descriptive design consisting of 14 face-to-face interviews with child health researchers and research assistants in Southern Ontario. Transcribed interviews were analysed for common themes. Procedures for assessing capacity varied considerably from the use of age cutoffs to in-depth engagement with each child. Three key issues emerged from the accounts: (1) requirements that consent be provided by a single person thwarted researchers' abilities to support family decision-making; (2) little practical distinction was made between assessing if a child was capable, versus determining if study information had been adequately explained by the researcher; and (3) participants' perceived that review boards' requirements may conflict with what they considered ethical consent practices. The results suggest that researchers' consent and capacity knowledge and skills vary considerably. Perceived discrepancies between ethical practice and ethics boards' requirements suggest the need for dialogue, education and possibly ethics board reforms. Furthermore we propose, where appropriate, a 'family decision-making' model that allows parents and their children to consent together, thereby shifting the focus from separate assent and consent procedures to approaches that appropriately engage the child and family.

Prenuptial dental extractions in Acadian women: first report of a cultural tradition.

PubMed

Gordon, Sara C; Kaste, Linda M; Barasch, Andrei; Safford, Monika M; Foong, W Choong; ElGeneidy, Adry

2011-12-01

Prenuptial tooth extractions, extractions of all teeth in at least one dental arch before marriage, are not identified in the dental literature. Driven by a professional encounter, the purpose of this study was to confirm the existence of this practice among Acadian women. An 8-item survey instrument with space for comments was mailed to 182 dentists from traditionally Acadian regions of Canada. The survey was provided in English and French. Ninety dentists responded (50.3%); 8 of them (9%) had been asked to perform prenuptial extractions, and an additional 9 volunteered awareness of this practice. Awareness and requests were associated with dental practice in a county with a ≥20% French-speaking population. Prenuptial extractions in this population have been confirmed by the current cohort of dentists. The potential public health, clinical, and systemic health research implications for women who are edentulous for most of their adult life merit further study. Additionally, it is important to determine if interventions are needed to curtail cultural expectations of such practices.

Primary Care Practices' Abilities And Challenges In Using Electronic Health Record Data For Quality Improvement.

PubMed

Cohen, Deborah J; Dorr, David A; Knierim, Kyle; DuBard, C Annette; Hemler, Jennifer R; Hall, Jennifer D; Marino, Miguel; Solberg, Leif I; McConnell, K John; Nichols, Len M; Nease, Donald E; Edwards, Samuel T; Wu, Winfred Y; Pham-Singer, Hang; Kho, Abel N; Phillips, Robert L; Rasmussen, Luke V; Duffy, F Daniel; Balasubramanian, Bijal A

2018-04-01

Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. To determine whether EHRs produce reports adequate to the task, we examined survey responses from 1,492 practices across twelve states, supplemented with qualitative data. Meaningful-use participation, which requires the use of a federally certified EHR, was associated with the ability to generate reports-but the reports did not necessarily support quality improvement initiatives. Practices reported numerous challenges in generating adequate reports, such as difficulty manipulating and aligning measurement time frames with quality improvement needs, lack of functionality for generating reports on electronic clinical quality measures at different levels, discordance between clinical guidelines and measures available in reports, questionable data quality, and vendors that were unreceptive to changing EHR configuration beyond federal requirements. The current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures.

National Board Certification and Developmentally Appropriate Practices: Perceptions of Impact.

PubMed

McKenzie, Ellen Nancy

2013-04-01

The study investigated a relationship between National Board certification and perceived use of developmentally appropriate practices (DAP). A self-developed survey, the Early-childhood Teacher Inventory of Practices, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified (NBCT) early childhood teachers. Descriptives were reported for age, years of teaching experience, grade level currently teaching, ethnicity, degree type, certification type, and degree level. Inferential statistics were used to understand the differences between perceived use of DAP. NBCTs scored significantly higher than non-NBCTs in three of the four target areas and on the total of the scale. Pearson product-moment corelations were used to determine a relationship between years of experience or level of education and NBCTs' perceived use of DAP. Years of experience were significantly related, but level of education was not. The findings indicate that NBCT teachers perceive they incorporate more developmentally appropriate practices into their teaching than do non-NBCT teachers.

National Board Certification and Developmentally Appropriate Practices: Perceptions of Impact

PubMed Central

McKenzie, Ellen Nancy

2013-01-01

The study investigated a relationship between National Board certification and perceived use of developmentally appropriate practices (DAP). A self-developed survey, the Early-childhood Teacher Inventory of Practices, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified (NBCT) early childhood teachers. Descriptives were reported for age, years of teaching experience, grade level currently teaching, ethnicity, degree type, certification type, and degree level. Inferential statistics were used to understand the differences between perceived use of DAP. NBCTs scored significantly higher than non-NBCTs in three of the four target areas and on the total of the scale. Pearson product-moment corelations were used to determine a relationship between years of experience or level of education and NBCTs’ perceived use of DAP. Years of experience were significantly related, but level of education was not. The findings indicate that NBCT teachers perceive they incorporate more developmentally appropriate practices into their teaching than do non-NBCT teachers. PMID:23626399

On-Farm Mitigation of Transmission of Tuberculosis from White-Tailed Deer to Cattle: Literature Review and Recommendations

PubMed Central

Walter, W. David; Anderson, Charles W.; Smith, Rick; Vanderklok, Mike; Averill, James J.; VerCauteren, Kurt C.

2012-01-01

The Animal Industry Division of the Michigan Department of Agriculture and Rural Development (MDARD) has been challenged with assisting farmers with modifying farm practices to reduce potential for exposure to Mycobacterium bovis from wildlife to cattle. The MDARD recommendations for on-farm risk mitigation practices were developed from experiences in the US, UK and Ireland and a review of the scientific literature. The objectives of our study were to review the present state of knowledge on M. bovis excretion, transmission, and survival in the environment and the interactions of wildlife and cattle with the intention of determining if the current recommendations by MDARD on farm practices are adequate and to identify additional changes to farm practices that may help to mitigate the risk of transmission. This review will provide agencies with a comprehensive summary of the scientific literature on mitigation of disease transmission between wildlife and cattle and to identify lacunae in published research. PMID:22991687

Perspectives on academic misconduct: implications for education and practice.

PubMed

Klainberg, Marilyn B; McCrink, Andrea; Eckardt, Patricia; Schecter, Rose; Bongiorno, Anne; Sedhom, Laila

2014-01-01

From Harvard to high school, concern related to academic misconduct, specifically cheating and its impact on societal issues, has become a great concern for educational communities. While a significant number of studies on ethical behaviors in practice in other professions such as business have been published, little research exists on registered nurses in practice. Even fewer studies have, for registered nurses, addressed if there is an association between perceived academic misconduct as students and perceived unethical behaviors in the workplace. The purpose of this study was to determine the relationship between perceptions of registered professional nurses' (RNs) current workplace behaviors and the RNs' retrospective perceptions of their academic misconduct as students. A convenience sample of 1 66 RNs enrolled in master's degree programs at four university schools of nursing completed questionnaires regarding their beliefs and behaviors. The outcome of this study was significant. Results revealed a strong relationship between unethical behaviors of the RN in practice and their prior academic misconduct when they were students.

Building a Practical Framework for Enterprise-Wide Security Management

DTIC Science & Technology

2004-04-28

management. They have found that current efforts to manage security vulnerabilities and security risks only take an enterprise so far, with results...analyzed reports to determine the cause of the increase. Slide 5 © 2004 by Carnegie Mellon University Version 1.0 Secure IT 2004 - page 5 Attack...Nearly 1 in 5 of those surveyed reported that none of their IT staff have any formal security training. [A survey of 896 Computing Technology

Radiology practice in Latin America: a literature review.

PubMed

Teague, Jordan

2013-01-01

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

Current Strategies for Managing Providers Infected with Bloodborne Pathogens

PubMed Central

Turkel, Sarah; Henderson, David K.

2016-01-01

Background In 1991 CDC issued guidelines to reduce risks for provider-to-patient transmission of bloodborne pathogens. These guidelines, unchanged since 1991, recommend management strategies for hepatitis B ‘e’ antigen-positive providers and for providers infected with human immunodeficiency virus (HIV); they do not address hepatitis-C-virus (HCV)-infected providers. Objective We summarize current state practices and surveyed state health departments to determine: 1) if state policies have been modified since 1991; 2), if state laws require prospective notification of patients and/or expert review panels to manage infected providers; 3) the frequency with which infected-providers issues come to the attention of state health departments; and 4) how state health departments intervene. Methods We reviewed all 50 states’ laws and guidelines to determine current practices and conducted a structured telephone survey of all state health departments. Results Whereas only 19 states require infected providers to notify patients of the providers’ bloodborne pathogen infection, these 19 states require notification under highly varied circumstances. Only ten of 50 state health department officials identified these issues as requiring significant departmental effort. No state law or guideline incorporates information about providers’ viral burdens as part of the risk assessment. Only 3/50 States have modified policies or laws since initial passage; and only 1/50 discusses the management of HCV-infected providers.. Conclusions These results identify a need for incorporating contemporary scientific information into guidelines and also suggest that infected-provider issues are not occurring commonly, are not being detected, or that they are being managed at levels below the state health department. PMID:21515972

An Assessment of Need for Instructional Professional Development for Middle School Science Teachers Using Interactive Lessons

NASA Astrophysics Data System (ADS)

Burton, Amanda

Numerous studies on the impact of interactive lessons on student learning have been conducted, but there has been a lack of professional development (PD) programs at a middle school focusing on ways to incorporate interactive lessons into the science classroom setting. The purpose of this case study was to examine the instructional practices of science teachers to determine whether the need for an interactive lessons approach to teaching students exists. This qualitative case study focused on teachers' perceptions and pedagogy to determine whether the need to use interactive lessons to meet the needs of all students is present. The research question focused on identifying current practices and determining whether a need for interactive lessons is present. Qualitative data were gathered from science teachers at the school through interviews, lesson plans, and observations, all of which were subsequently coded using an interpretative analysis. The results indicated the need for a professional development (PD) program centered on interactive science lessons. Upon completion of the qualitative study, a detailed PD program has been proposed to increase the instructional practices of science teachers to incorporate interactive lessons within the science classroom. Implications for positive social change include improved teaching strategies and lessons that are more student-centered resulting in better understanding and comprehension, as well as performance on state-mandated tests.

Communicating their individual results to participants in an environmental exposure study: Insights from clinical ethics

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

Deck, W.; Kosatsky, T.

1999-02-01

A study measuring the uptake of chemical contaminants among sport fishers who consume fish caught in the St. Lawrence river is currently being conducted in Montreal, Canada. In this study, blood, hair, and urine collected from local sport fishers is being tested for heavy metals and persistent organochlorine chemicals. The objective of this study was to formulate a framework for determining what information to communicate to individual subjects of a study measuring biomarkers of exposure, consistent with the principles of ethical clinical and research practice. Methods consisted of review of the scope of environmental exposure studies, including the use ofmore » biomarker measurement in clinical medicine and environmental research and the relevant principles of clinical ethics and research practice. An exposure biomarker study is designed to elucidate constitutional, behavioral, and environmental determinants of tissue concentrations of exogenous substances. Ethical clinical and research practice, aiming to maximize autonomy and beneficence and to minimize harm, requires that study findings concerning the determinants of exposure be communicated to study participants. In addition, investigators should reference clinical action levels beyond which individual biomarker results are routinely communicated to participants. When biomarkers have no known relation to risk, or when levels fall below action levels, it may be preferable not co communicate individual results, if this arrangement has been formalized at the time of informed consent.« less

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...) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good manufacturing practice. The criteria in §§ 114.10, 114.80, 114.83, 114.89, and 114.100, as well as the criteria in part...

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

Code of Federal Regulations, 2013 CFR

2013-04-01

... 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 used...

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

Code of Federal Regulations, 2014 CFR

2014-04-01

... 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 used...

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

Code of Federal Regulations, 2012 CFR

2012-04-01

... 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 used...

Factors Relating to Education Professionals' Classroom Practices for the Inclusion of Students with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Segall, Matthew J.; Campbell, Jonathan M.

2012-01-01

It is essential to understand the current practices used to foster inclusive education for students with autism spectrum disorders (ASDs) as well as factors related to the implementation of classroom interventions. In the current study authors assess the experience, knowledge, attitudes and current practices of education professionals regarding…

Surgical practices in total knee arthroplasty in Turkey.

PubMed

Erduran, Mehmet; Akseki, Devrim; Araç, Sükrü

2012-01-01

The aim of this study was to determine the current practices in the total knee arthroplasty (TKA) and the differences of practice among the orthopedic surgeons in Turkey. Data in this cross-sectional and descriptive study was collected through a questionnaire from 76 orthopaedic surgeons performing TKA. The questionnaire form contained 57 questions under four main headings, covering the professional properties of the surgeon, pre-surgery approach, surgical technique applied for TKA and the surgical details peculiar to the technique with solutions applied for complication scenarios, and finally the postoperative approach. It was determined that 39.7% of the TKA applications were performed in operating theatres without laminar airflow or HEPA filters. Nearly 1/5 of the surgeons used more than one antibiotic for prophylaxis, and more than 85% continued prophylaxis use over 3 days. Low-molecular-weight heparin was the most commonly used method for thromboprophylaxis. 94.67% of the surgeons used only the cemented technique in primary TKA. 44% indicated that they performed simultaneous bilateral arthroplasty, 89% did not use any scoring system and 72.37% preferred fixed-bearing and posterior-cruciate-retaining type prosthesis. Results showed no standardization in TKA surgery among surgeons in Turkey, and important educational deficiencies were noted.

Soft-type trap-induced degradation of MoS2 field effect transistors.

PubMed

Cho, Young-Hoon; Ryu, Min-Yeul; Lee, Kook Jin; Park, So Jeong; Choi, Jun Hee; Lee, Byung-Chul; Kim, Wungyeon; Kim, Gyu-Tae

2018-06-01

The practical applicability of electronic devices is largely determined by the reliability of field effect transistors (FETs), necessitating constant searches for new and better-performing semiconductors. We investigated the stress-induced degradation of MoS 2 multilayer FETs, revealing a steady decrease of drain current by 56% from the initial value after 30 min. The drain current recovers to the initial state when the transistor is completely turned off, indicating the roles of soft-traps in the apparent degradation. The noise current power spectrum follows the model of carrier number fluctuation-correlated mobility fluctuation (CNF-CMF) regardless of stress time. However, the reduction of the drain current was well fitted to the increase of the trap density based on the CNF-CMF model, attributing the presence of the soft-type traps of dielectric oxides to the degradation of the MoS 2 FETs.

Soft-type trap-induced degradation of MoS2 field effect transistors

NASA Astrophysics Data System (ADS)

Cho, Young-Hoon; Ryu, Min-Yeul; Lee, Kook Jin; Park, So Jeong; Choi, Jun Hee; Lee, Byung-Chul; Kim, Wungyeon; Kim, Gyu-Tae

2018-06-01

The practical applicability of electronic devices is largely determined by the reliability of field effect transistors (FETs), necessitating constant searches for new and better-performing semiconductors. We investigated the stress-induced degradation of MoS2 multilayer FETs, revealing a steady decrease of drain current by 56% from the initial value after 30 min. The drain current recovers to the initial state when the transistor is completely turned off, indicating the roles of soft-traps in the apparent degradation. The noise current power spectrum follows the model of carrier number fluctuation–correlated mobility fluctuation (CNF–CMF) regardless of stress time. However, the reduction of the drain current was well fitted to the increase of the trap density based on the CNF–CMF model, attributing the presence of the soft-type traps of dielectric oxides to the degradation of the MoS2 FETs.

Modulation bandwidth of spin torque oscillators under current modulation

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

Quinsat, M.; CEA, INAC-SPINTEC, F-38054 Grenoble; CNRS, SPINTEC, F-38054 Grenoble

2014-10-13

For practical applications of spin torque nano-oscillators (STNO), one of the most critical characteristics is the speed at which an STNO responds to variations of external control parameters, such as current or/and field. Theory predicts that this speed is limited by the amplitude relaxation rate Γ{sub p} that determines the timescale over which the amplitude fluctuations are damped out. In this study, this limit is verified experimentally by analyzing the amplitude and frequency noise spectra of the output voltage signal when modulating an STNO by a microwave current. In particular, it is shown that due to the non-isochronous nature ofmore » the STNO the amplitude relaxation rate Γ{sub p} determines not only the bandwidth of an amplitude modulation, but also the bandwidth of a frequency modulation. The presented experimental technique will be important for the optimisation of the STNO characteristics for applications in telecommunications or/and data storage and is applicable even in the case when the STNO output signal is only several times higher than noise.« less

Primary care and behavioral health practice size: the challenge for health care reform.

PubMed

Bauer, Mark S; Leader, Deane; Un, Hyong; Lai, Zongshan; Kilbourne, Amy M

2012-10-01

We investigated the size profile of US primary care and behavioral health physician practices since size may impact the ability to institute care management processes (CMPs) that can enhance care quality. We utilized 2009 claims data from a nationwide commercial insurer to estimate practice size by linking providers by tax identification number. We determined the proportion of primary care physicians, psychiatrists, and behavioral health providers practicing in venues of >20 providers per practice (the lower bound for current CMP practice surveys). Among primary care physicians (n=350,350), only 2.1% of practices consisted of >20 providers. Among behavioral health practitioners (n=146,992) and psychiatrists (n=44,449), 1.3% and 1.0% of practices, respectively, had >20 providers. Sensitivity analysis excluding single-physician practices as "secondary" confirmed findings, with primary care and psychiatrist practices of >20 providers comprising, respectively, only 19.4% and 8.8% of practices (difference: P<0.0001). In secondary analyses, bipolar disorder was used as a tracer condition to estimate practice census for a high-complexity, high-cost behavioral health condition; only 1.3-18 patients per practice had claims for this condition. The tax identification number method for estimating practice size has strengths and limitations that complement those of survey methods. The proportion of practices below the lower bound of prior CMP studies is substantial, and care models and policies will need to address the needs of such practices and their patients. Achieving a critical mass of patients for disorder-specific CMPs will require coordination across multiple small practices.

[The ReWiKs project : Current results of research into participation opportunities for adults with disabilities in the area of sexual self-determination].

PubMed

Ortland, Barbara; Jennessen, Sven; Römisch, Kathrin; Kusber-Merkens, Dorothea; Reichert, Leonie; Arlabosse, Anneke

2016-09-01

Several studies point to various barriers in achieving sexual self-determination for people with disabilities as well as a high degree of thematic uncertainty among staff in residential homes. In addition, women with disabilities and people in institutions are especially at risk in a particular way, to be victims of sexual violence. The ReWiKs project develops, based on evaluated guidelines for sexual self-determination, materials in order to reflect the institutional handling of the subject. Training modules and recommendations are also developed. In addition, extracts of materials are created in simple language. All materials are evaluated before their publication in an intensive theory-practice dialogue.

Proposal for a new protein therapeutic immunogenicity titer assay cutpoint.

PubMed

Wakshull, Eric; Hendricks, Robert; Amaya, Caroline; Coleman, Daniel

2011-12-01

Generally, immunogenicity assessment strategies follow this assay triage schema: screen→confirm→titer. Each requires the determination of a threshold value (cutpoint) for decision making. No guidance documents exist for the determination of a specific titration assay cutpoint. The default practice is to use the screening assay cutpoint, frequently leading to controls or samples not reaching this cutpoint. We propose a method for determination of a titration cutpoint based upon the variance of the negative-control sample. Positive-control samples that did not cross a screening cutpoint did cross the titer cutpoint, albeit generating slightly lower titer values. Our approach is consistent with the statistical methods currently recommended for the screening and confirmatory assay cutpoints and is operationally simple and efficient.

AORN ergonomic tool 1: Lateral transfer of a patient from a stretcher to an OR bed.

PubMed

Waters, Thomas; Baptiste, Andrea; Short, Manon; Plante-Mallon, Lori; Nelson, Audrey

2011-03-01

Moving patients can result in injuries to patients and staff members. Lateral patient transfers from a stretcher to an OR bed pose a high risk for musculoskeletal disorders, including lower back, shoulder, and neck injuries for perioperative personnel. AORN Ergonomic Tool 1: Lateral Transfer of a Patient from a Stretcher to an OR Bed helps perioperative staff members determine best practices for safe lateral patient transfers. Safe moving of the patient is determined by the starting and ending position required and the patient's weight. Current ergonomic safety concepts and scientific evidence regarding weight limits help to determine how many caregivers are needed to safely move patients and whether mechanical assistance is needed during lateral transfers. Published by Elsevier Inc.

Current practice of microsurgery by members of the American Society for Surgery of the Hand.

PubMed

Payatakes, Alexander H; Zagoreos, Nikolaos P; Fedorcik, Gregory G; Ruch, David S; Levin, L Scott

2007-04-01

First, to determine the percentage of members of the American Society for Surgery of the Hand (ASSH) that use microsurgical techniques as part of their surgery practice, and second, to identify factors limiting their use of these techniques. A 34-item, anonymous, Web-based survey was sent to all active ASSH members. Twelve items concerned demographics and 22 items addressed prior microsurgical training, current use of these techniques, factors currently limiting their use of these techniques, and potential methods to address these limiting factors. Responses were received from 561 of 1,238 of the ASSH members contacted (45% response rate). Most had residency training in orthopedics (N=460, 82%) or plastic surgery (N=79, 14%), followed by a hand fellowship in an orthopedic (N=363, 62%) or combined program (N=170, 30%). More than 54% (N=304) practiced privately, 33% (N=184) practiced in tertiary institutions, and the remainder practiced at regional centers. Of those responding, 505 (90%) stated that hand surgery constituted more than 50% of their practice, whereas for 527 (94%) respondents microsurgery comprised less than 25%. Most members (N=398, 71%) accepted emergency patients, of which 223 (56%) at a referral center. Three hundred sixteen respondents (56%) performed replantations, of whom 196 (62%) performed fewer than 5 per year. Four hundred fifteen respondents (74%) observed a decrease in replantation attempts over the past decade. This was attributed to refinement of indications (N=17, 83%), fewer patients with amputations (N=116, 28%), and declining reimbursement (N=344, 4%). Reasons for not personally performing replantations included busy elective schedules (N=125, 51%), inadequate confidence in performing replantations (N=96, 39%), and disappointment in results (N=56, 23%). Thirty percent (N=74) stated they would reconsider performing replantations if reimbursement was greater. Practice rates of examined microsurgical procedures ranged from 22% to 57%, although most had received microsurgical training. Despite rating their fellowship as excellent (N=393, 70%) or good (N=135, 24%), only 315 (56%) considered their present microsurgical skills to be above average. Many respondents believed that they would benefit from continuous training through continuing education courses. Educational, economic, and practical factors discourage the clinical application of microsurgical technique by hand surgeons. This unfavorable environment should be addressed by policy-making organizations and continuous surgical training. Other/Survey.

Offsetting the impacts of mining to achieve no net loss of native vegetation.

PubMed

Sonter, L J; Barrett, D J; Soares-Filho, B S

2014-08-01

Offsets are a novel conservation tool, yet using them to achieve no net loss of biodiversity is challenging. This is especially true when using conservation offsets (i.e., protected areas) because achieving no net loss requires avoiding equivalent loss. Our objective was to determine if offsetting the impacts of mining achieves no net loss of native vegetation in Brazil's largest iron mining region. We used a land-use change model to simulate deforestation by mining to 2020; developed a model to allocate conservation offsets to the landscape under 3 scenarios (baseline, no new offsets; current practice, like-for-like [by vegetation type] conservation offsetting near the impact site; and threat scenario, like-for-like conservation offsetting of highly threatened vegetation); and simulated nonmining deforestation to 2020 for each scenario to quantify avoided deforestation achieved with offsets. Mines cleared 3570 ha of native vegetation by 2020. Under a 1:4 offset ratio, mining companies would be required to conserve >14,200 ha of native vegetation, doubling the current extent of protected areas in the region. Allocating offsets under current practice avoided deforestation equivalent to 3% of that caused by mining, whereas allocating under the threat scenario avoided 9%. Current practice failed to achieve no net loss because offsets did not conserve threatened vegetation. Explicit allocation of offsets to threatened vegetation also failed because the most threatened vegetation was widely dispersed across the landscape, making conservation logistically difficult. To achieve no net loss with conservation offsets requires information on regional deforestation trajectories and the distribution of threatened vegetation. However, in some regions achieving no net loss through conservation may be impossible. In these cases, other offsetting activities, such as revegetation, will be required. © 2014 Society for Conservation Biology.

Longitudinal rural clerkships: increased likelihood of more remote rural medical practice following graduation.

PubMed

Playford, Denese E; Nicholson, Asha; Riley, Geoffrey J; Puddey, Ian B

2015-03-21

Extended rural clerkships clearly increase the likelihood of rural practice post-graduation. What has not been determined is whether such rural interventions increase the likelihood of graduates practicing in more remote, versus inner regional, locations. The Australian Health Practitioner Regulation Agency database was used to identify the current workplace of every graduate of the Medical School of Western Australia, 1980 to 2011. There were 324 graduates working in a primary practice location defined by the Australian Standard Geographical Classification as inner regional to very remote. They were divided into 3 groups - 200 graduates who entered medical school before commencement of the Rural Clinical School of Western Australia (RCSWA), 63 who entered after the RCSWA had started, but not participated in RCSWA, and 61 who participated in the RCSWA. The RCSWA offers a longitudinal rural clinical clerkship throughout level 5 of the MBBS course. The two groups not participating in the RCSWA had 45.5% and 52.4% of subjects in outer regional/very remote locations, respectively. In comparison, 78.7% of those who had participated in the RCSWA were currently practicing in outer regional/very remote locations. When the 3 groups were compared, the significant predictors of working in a more remote practice compared to working in an inner regional area were being female (OR 1.75 95% CI 1.13, 2.72, P = 0.013) and participating in the RCSWA (OR 4.42, 95% CI 2.26, 8.67, P < 0.001). In multivariate logistic regression that corrected for gender and remoteness of rural address before entry to medical school, participation in the RCSWA still predicted a more than 4-fold increase in the odds of practicing in a more remote area (OR 4.11, 95% CI 2.04, 8.30, P < 0.001). Extended rural clinical clerkship during an undergraduate MBBS course is related to a much greater likelihood of practicing in more remote, under-serviced rural locations.

Therapeutic use of dolls for people living with dementia: A critical review of the literature.

PubMed

Mitchell, Gary; McCormack, Brendan; McCance, Tanya

2016-09-01

There are a number of therapies currently available to assist healthcare professionals and carers with non-pharmacological treatment for people living with dementia. One such therapy that has been growing in clinical practice is doll therapy. Providing dolls to some people living with dementia has the potential to enhance personal well-being through increased levels of communication and engagement with others. Despite its potential for benefits, the practice is currently under-developed in healthcare literature, probably due to varied ethical interpretations of its practice. To undertake a critical review of the published literature on doll therapy, using the Critical Appraisal Skills Programme Checklist (CASP) tool, in order to determine the potential benefits and challenges of this therapy for people living with dementia. A comprehensive literature search, incorporating the CINAHL, Medline, Embase, PubMed, Joanna Briggs, Cochrane Library and PsycINFO data bases, was conducted. Despite many commentaries and anecdotal accounts of the practice, this review identified only 11 empirical studies that were eligible. The majority of studies found that the use of dolls could be therapeutic for some people living with dementia by reporting increased levels of engagement, communication and reduction in episodes of distress. Some studies identified limitations to the therapy including; confusion over the ownership of the doll and healthcare professional uncertainty about issues pertaining to autonomy. According to this review, doll therapy has the potential to increase the well-being of some people living with dementia. This review illuminates that some healthcare professionals feel uncomfortable about its use in clinical practice. The operationalisation of doll therapy in clinical practice has been shown to be inconsistent with different approaches to the practice being advocated. This highlights the need for further empirical research to identify best practice and education to increase awareness in both healthcare professional and carer populations. © The Author(s) 2014.

Trends In Geoscience Professional Ethics Indicated By National Association of State Boards of Geology (ASBOG®) Surveys of The Practicing Profession

NASA Astrophysics Data System (ADS)

Williams, J. W.; Warner, J. L.

2016-12-01

ASBOG® was founded in 1988 to facilitate cooperation and coordination among states with licensing of practicing professional geologists-currently 29 states and Puerto Rico. ASBOG® creates national exams which are used by all of the states granting licensure. Periodic surveys of the practicing profession every 5 years are used to determine the skills and knowledge needed for professional practice and are used to generate the exam blueprints. Currently questions on professional ethics are included on the national licensing exams. Thirteen professional ethics issues in the geosciences were included on the Task Analysis Surveys (TAS) in 2005, 2010 and 2015. Professional geologists rate the seriousness of and the frequency of contact with these ethics issues. Topics include such items as gift-giving, whistleblowing, plagiarism, etc. The respondents are grouped into one of three categories: practicing licensed geologists in the United States, practicing licensed geologists in Canada, and geologists employed in the academic sector. Regardless of the employment sector, the responses to the professional ethics questions were statistically very similar (r values - Seriousness - USA vs. Academic +0.81, USA vs. Canada +0.94, Academic vs. Canada +0.86: Frequency - USA vs. Academic +0.71, USA vs. Canada +0.85, Academic vs. Canada +0.72). Some differences were detected. For example, plagiarism is regarded by practitioners in the academic sector as more important than this issue among licensed practicing geologists in the United States and Canada. The professional ethics issues asked on the 2010 and 2015 surveys are identical to facilitate detection of any temporal changes in response patterns. Statistically, the responses from practicing geologists in the USA in the 2010 and 2015 surveys are nearly identical, indicating that the profession has maintained virtually the same attitudes with regard to professional ethics (Seriousness r = +0.99, Frequency r = +0.99).

Practice improvement, part II: trends in employment versus private practice.

PubMed

Coleman, Mary Thoesen; Roett, Michelle A

2013-11-01

A growing percentage of physicians are selecting employment over solo practice, and fewer family physicians have hospital admission privileges. Results from surveys of recent medical school graduates indicate a high value placed on free time. Factors to consider when choosing a practice opportunity include desire for independence, decision-making authority, work-life balance, administrative responsibilities, financial risk, and access to resources. Compensation models are evolving from the simple fee-for-service model to include metrics that reward panel size, patient access, coordination of care, chronic disease management, achievement of patient-centered medical home status, and supervision of midlevel clinicians. When a practice is sold, tangible personal property and assets in excess of liabilities, patient accounts receivable, office building, and goodwill (ie, expected earnings) determine its value. The sale of a practice includes a broad legal review, addressing billing and coding deficiencies, noncompliant contractual arrangements, and potential litigations as well as ensuring that all employment agreements, leases, service agreements, and contracts are current, have been executed appropriately, and meet regulatory requirements. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

The who, what, and how of evaluation within online nursing education: state of the science.

PubMed

Russell, Bedelia H

2015-01-01

The resource capacity in nursing programs has a direct impact on student admissions and number of graduates who enter the nursing workforce. Online delivery of nursing education is identified as a solution to expand nursing program capacity. As nursing programs continue to address capacity with online course delivery, it is essential that nurse educators maintain consistent evaluation practices to ensure successful and positive outcomes, compared with traditional models. Evaluation is a central component to determine program quality and mastery of learning outcomes. This article examines the state of the science around the current evaluation of educational practices, instructional strategies, and outcomes within the context of online nursing education. Thirty-six articles met the inclusion criteria. Despite substantive contributions to the state of the science, the findings reflect evaluation practices that are diffuse and superficial and serve as the basis for future recommendations and research opportunities. Copyright 2015, SLACK Incorporated.

Management in the Ministry of Health: what are the vital signs?

PubMed

Benjamin, S; Ahmed, A A; al-Darazi, F

1997-01-01

Effective and efficient management of health services is becoming more and more important in all countries and in all organizations whether profit or non-profit. Management practices and attitudes which may have been accepted in previous years are no longer appropriate. A study was conducted in the Ministry of Health, State of Bahrain to determine the current status of management skills and attitudes. Participants were asked to identify the best and the worst practices of managers. Eight key areas of concern were identified: participative vs. non-participative style, communication, motivation, delegation, human relations skills, style of supervision, goal-oriented behavior, and use of supervisory power. In each of these management-related skill areas, examples of best and worst practices are provided in order to aid the manager/leader in self-assessing his/her abilities as a first step toward improving management.

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

PubMed

Reiner, Bruce I

2017-10-01

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

Gap analysis: a method to assess core competency development in the curriculum.

PubMed

Fater, Kerry H

2013-01-01

To determine the extent to which safety and quality improvement core competency development occurs in an undergraduate nursing program. Rapid change and increased complexity of health care environments demands that health care professionals are adequately prepared to provide high quality, safe care. A gap analysis compared the present state of competency development to a desirable (ideal) state. The core competencies, Nurse of the Future Nursing Core Competencies, reflect the ideal state and represent minimal expectations for entry into practice from pre-licensure programs. Findings from the gap analysis suggest significant strengths in numerous competency domains, deficiencies in two competency domains, and areas of redundancy in the curriculum. Gap analysis provides valuable data to direct curriculum revision. Opportunities for competency development were identified, and strategies were created jointly with the practice partner, thereby enhancing relevant knowledge, attitudes, and skills nurses need for clinical practice currently and in the future.

Safeguards Knowledge Management & Retention at U.S. National Laboratories.

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

Haddal, Risa; Jones, Rebecca; Bersell, Bridget

In 2017, four U.S. National Laboratories collaborated on behalf of DOE/NNSA to explore the safeguards knowledge retention problem, identify possible approaches, and develop a strategy to address it. The one-year effort consisted of four primary tasks. First, the project sought to identify critical safeguards information at risk of loss. Second, a survey and workshop were conducted to assess nine U.S. National Laboratories' efforts to determine current safeguards knowledge retention practices and challenges, and identify best practices. Third, specific tools were developed to identify and predict critical safeguards knowledge gaps and how best to recruit in order to fill those gaps.more » Finally, based on findings from the first three tasks and research on other organizational approaches to address similar issues, a strategy was developed on potential knowledge retention methods, customized HR policies, and best practices that could be implemented across the National Laboratory Complex.« less

Child neurology practice guidelines: past, present, and future.

PubMed

Hurwitz, Benjamin A; Hurwitz, Kathleen Bretzius; Ashwal, Stephen

2015-03-01

Practice guidelines have been developed in child neurology during the last fifteen years to address important clinical questions and provide evidence-based recommendations for patient care. This review describes the guideline development process and how it has evolved to meet the needs of child neurologists. Several current child neurology guidelines are reviewed and the advantages and disadvantages of guidelines, as well as the legal consequences of using them to determine a standard of care are discussed. The future of guidelines and of their influence on integrated support systems also is considered. Child neurology practice guidelines are a helpful resource for clinicians, families and institutions as they provide evidence-based recommendations concerning the diagnosis and management of common neurological conditions affecting children. Incorporating consensus processes has allowed expansion of clinically relevant recommendations that has increased the utility of guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

A question of dissemination: Assessing the practices and implications of research in tropical landscapes.

PubMed

Toomey, Anne H; Alvaro, María Eugenia Copa; Aiello-Lammens, Matthew; Loayza Cossio, Oscar; Barlow, Jos

2018-04-24

Current debates in the conservation sciences argue for better integration between research and practice, often citing the importance of the diffusion, dissemination and implementation of scientific knowledge for environmental management and policy. This paper focuses on a relatively well-researched protected area (Madidi National Park) in Bolivia in order to present different interpretations and understandings of the implications and availability of research findings. We draw on findings from quantitative and qualitative methods to determine the extent to which research carried out in the region was disseminated and/or implemented for management actions, and to understand subsequent implications for how local actors perceive the value of research and its role in management and conservation. We discuss the critical consequences of these findings for the future of conservation science and practice in biologically and culturally diverse landscapes, with an explicit call to action for academic institutions to support researchers in developing appropriate dissemination strategies.

Epidural analgesia in children. A survey of current opinions and practices amongst UK paediatric anaesthetists.

PubMed

Williams, D G; Howard, R F

2003-11-01

Despite the widespread use of epidural analgesia in children its place in paediatric pain management has not been clearly established. In order to investigate the current practice of paediatric epidural analgesia in the UK paediatric anaesthetists and paediatric pain management teams were surveyed. Questionnaires were sent to the members of the Association of Paediatric Anaesthetists (APA) working within the UK and to lead clinicians and clinical nurse specialists for acute pain in the 26 designated major paediatric centres. The response rate was 72%. There was little consensus regarding drugs and drug combinations used for epidural analgesia. A total of 36% of paediatric centres did not audit their epidural practice, and of those that did the reported incidences of side-effects showed wide variation. Important differences in practice were also identified in the areas of patient selection, informed consent, the use of epidural test doses, drug delivery systems, monitoring and the management of side-effects. Twelve per cent of specialist paediatric hospitals did not have an acute pain team and elsewhere the provision was often limited to staff with few or no specialist skills. There is wide variation in the practice of paediatric epidural analgesia in the UK. Inconsistencies are likely to be related to the poor evidence base available to guide clinical decision making and the lack of a specialized paediatric acute pain service in some centres. More research is required to determine the optimal management of epidural analgesia, and suitable clinical support for paediatric pain control should be more widely available.

Patterns of cultural consensus and intracultural diversity in Ghanaian complementary feeding practices.

PubMed

Kalra, Nikhila; Pelto, Gretel; Tawiah, Charlotte; Zobrist, Stephanie; Milani, Peiman; Manu, Grace; Laar, Amos; Parker, Megan

2018-01-01

Designing effective interventions to improve infant and young child (IYC) feeding requires knowledge about determinants of current practices, including cultural factors. Current approaches to obtaining and using research on culture tend to assume cultural homogeneity within a population. The purpose of this study was to examine the extent of cultural consensus (homogeneity) in communities where interventions to improve IYC feeding practices are needed to address undernutrition during the period of complementary feeding. A second, related objective was to identify the nature of intracultural variation, if such variation was evident. Selected protocols from the Focused Ethnographic Study for Infant and Young Child Feeding Manual were administered to samples of key informants and caregivers in a peri-urban and a rural area in Brong-Ahafo, Ghana. Cultural domain analysis techniques (free listing, caregiver assessment of culturally significant dimensions, and food ratings on these dimensions), as well as open-ended questions with exploratory probing, were used to obtain data on beliefs and related practices. Results reveal generally high cultural consensus on the 5 dimensions that were assessed (healthiness, appeal, child acceptance, convenience, and modernity) for caregiver decisions and on their ratings of individual foods. However, thematic analysis of caregiver narratives indicates that the meanings and content of the constructs connoted by the dimensions differed widely among individual mothers. These findings suggest that research on cultural factors that affect IYC practices, particularly cultural beliefs, should consider the nature and extent of cultural consensus and intracultural diversity, rather than assuming cultural homogeneity. © 2017 John Wiley & Sons Ltd.

Discharge planning for heart failure patients in a tertiary hospital in Shanghai: a best practice implementation project.

PubMed

Chen, Yu; Zhu, Li; Xu, Fei; Chen, Jun

2016-02-01

Heart failure is a major public health concern which contributes significantly to rising healthcare costs. Comprehensive discharge planning can improve health outcomes and reduce readmission rates which, in turn, can lead to cost savings. The aim of this project was to promote best practice in the discharge planning of heart failure patients admitted in the coronary care unit of Zhongshan Hospital. A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Five audit criteria that represent best practice recommendations for heart failure discharge planning were used. A baseline audit was conducted followed by the implementation of multiple strategies, and the project was finalized with a follow-up audit to determine change in practice. Improvements in practice were observed for all five criteria. The most significant improvements were in the following: completion of a discharge checklist (from 0% to 100% compliance), comprehensive (i.e. inclusion of six topics for self-care) discharge education for patients (from 7% to 100% compliance), and conducting a telephone follow-up (from 0% to 76% compliance). The compliance rates for the two remaining criteria, completion of a structured education for patients and scheduling an outpatient clinic visit, both increased from 93% to 100%.Strategies that were implemented to achieve change in practice included development of a local discharge planning checklist, provision of training for nurses, and development of resources. The project demonstrated positive changes in the discharge planning practices of nurses in the coronary care unit of Zhongshan Hospital. A formalized discharge planning is currently in place and plans for sustaining practice change are underway. A continuous cycle of audit and re-audit will need to be carried out in the future to determine the impact of this evidence implementation activity on heart failure patient outcomes.

Analysis and numerical modelling of eddy current damper for vibration problems

NASA Astrophysics Data System (ADS)

Irazu, L.; Elejabarrieta, M. J.

2018-07-01

This work discusses a contactless eddy current damper, which is used to attenuate structural vibration. Eddy currents can remove energy from dynamic systems without any contact and, thus, without adding mass or modifying the rigidity of the structure. An experimental modal analysis of a cantilever beam in the absence of and under a partial magnetic field is conducted in the bandwidth of 01 kHz. The results show that the eddy current phenomenon can attenuate the vibration of the entire structure without modifying the natural frequencies or the mode shapes of the structure itself. In this study, a new inverse method to numerically determine the dynamic properties of the contactless eddy current damper is proposed. The proposed inverse method and the eddy current model based on a lineal viscous force are validated by a practical application. The numerically obtained transfer function correlates with the experimental one, thus showing good agreement in the entire bandwidth of 01 kHz. The proposed method provides an easy and quick tool to model and predict the dynamic behaviour of the contactless eddy current damper, thereby avoiding the use of complex analytical models.

Neurosurgery workforce in Canada, 1996 to 2011. Canadian Neurosurgical Society.

PubMed Central

Hugenholtz, H

1996-01-01

OBJECTIVE. To determine the number of neurosurgeons in clinical practice in Canada on Jan. 1, 1996, and their practice profile and to determine requirements for 2001 and 2011. DESIGN. Telephone survey and national mail survey. SETTING. Canada. PARTICIPANTS. All 174 neurosurgeons in Canada engaged in active clinical practice on Jan. 1, 1996, and all residents enrolled in neurosurgery training programs in Canada during the 1995-96 academic year. OUTCOME MEASURES. Demographic characteristics, full-time equivalents, workload, attrition, reasons for exit, vacancies, supply and shortfall. RESULTS. All 174 neurosurgeons responded to the survey. There is a chronic shortage of 25 neurosurgeons in Canada. Sixty-two established neurosurgeons will have stopped practice by 2001 and 181 by 2011. They will need to be replaced, for a total requirement of 87 and 206 neurosurgeons by 2001 and 2011 respectively. Canadian neurosurgery training programs can currently generate only up to 69 and 177 graduates by 2001 and 2011 respectively. During the period 1985-95, 50% of neurosurgery graduates emigrated from Canada within 2 years of obtaining certification, creating potential deficits of up to 52 and 117 neurosurgeons by 2001 and 2011 respectively. CONCLUSIONS. Strategies need to be developed quickly to address not only the chronic shortfall but also the attrition of established neurosurgeons. Strategies to increase and retain the number of Canadian neurosurgery graduates are also needed. PMID:8673984

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

PubMed

Porter, Blake; Iriye, Brian; Ghamsary, Mark

2018-01-01

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

Organizational Use of a Framework for Innovation Adoption

DTIC Science & Technology

2011-09-01

in current processes , the eight practices identified by Denning and Dunham’s The Innovator’s Way, Essential Practices For Successful Innovation (2010...framework for identifying gaps in current processes , the eight practices identified by Denning and Dunham’s The Innovator’s Way, Essential Practices For...60 2. Methods to Use within the Eight Practice Framework ..................63 a. Marine Corps Planning Process (MCPP) for Executing

Prevalence of Parental Smoking and Predictors of Cessation: A Study in the South Carolina Pediatric Practice Research Network

PubMed Central

Roberts, James R.; Basco, William T.; Hulsey, Thomas C.; Ebeling, Myla D.; O’Brien, Elizabeth; Alberg, Anthony J.

2015-01-01

Background Secondhand smoke exposure harms children. The objectives of the study were to determine the prevalence of secondhand smoke exposure in children ≤2 years and determine the predictors of smoking and smoking cessation in parents. Methods We surveyed parents of children ≤2 years of age, asking about parental smoking patterns, interest in quitting and children’s respiratory symptoms. Data were analyzed with chi-square and multiple logistic regression. Results Thirteen percent were current smokers and 18% had quit. The most common reason for quitting was being pregnant (42%). Children’s respiratory symptoms did not predict quitting. Parents on Medicaid were more likely to smoke than those on private insurance (OR = 5.7, 95% CI = 2.0–16.5) and less likely to quit (OR = 0.2, 95% CI = 0.1–0.9). Conclusion Having a new baby may be a motivator for parents to quit. We must address socioeconomic factors to develop a successful intervention in pediatric practices. PMID:25520365

CO2 Suppression of PMMA Flames In Low-Gravity

NASA Technical Reports Server (NTRS)

Ruff, G. A.; Hicks, M.; Mell, W.; Pettegrew, R.; Malcolm, A.

2003-01-01

Even though much has been learned about the effects of microgravity on material flammability, flame spread, and suppressant effectiveness, uncertainties remain regarding some of the practical aspects of fire protection in spacecraft. The experiments and simulations underway in this project are aimed directly at testing, understanding and improving NASA's existing policies and practices toward fire safety in spacecraft and extraterrestrial habitats. Specifically, the objectives of this research are: 1) Determine systematically the conditions that will ignite onboard flammable materials upon passage of an initial premixed gas, firebrand, or aerosol flame over these materials; 2) Test the effect of firebrands and configuration spacing; and 3) Determine the effectiveness of the flow of CO2 extinguisher or other extinguishing agents. Experimental and computational investigations are planned to achieve each of the three objectives above. Even though progress has been made in all of the areas, the majority of data has been collected for objective (3). Current results from these investigations are discussed.

Fracture healing: A review of clinical, imaging and laboratory diagnostic options.

PubMed

Cunningham, Brian P; Brazina, Sloane; Morshed, Saam; Miclau, Theodore

2017-06-01

A fundamental issue in clinical orthopaedics is the determination of when a fracture is united. However, there are no established "gold standards," nor standardized methods for assessing union, which has resulted in significant disagreement among orthopaedic surgeons in both clinical practice and research. A great deal of investigative work has been directed to addressing this problem, with a number of exciting new techniques described. This review provides a brief summary of the burden of nonunion fractures and addresses some of the challenges related to the assessment of fracture healing. The tools currently available to determine union are discussed, including various imaging modalities, biomechanical testing methods, and laboratory and clinical assessments. The evaluation of fracture healing in the setting of both patient care and clinical research is integral to the orthopaedic practice. Weighted integration of several available metrics must be considered to create a composite outcome measure of patient prognosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reimbursement and costs of pediatric ambulatory diabetes care by using the resource-based relative value scale: is multidisciplinary care financially viable?

PubMed

Melzer, Sanford M; Richards, Gail E; Covington, Maxine L

2004-09-01

The ambulatory care for children with diabetes mellitus (DM) within an endocrinology specialty practice typically includes services provided by a multidisciplinary team. The resource-based relative value scale (RBRVS) is increasingly used to determine payments for ambulatory services in pediatrics. It is not known to what extent resource-based practice expenses and physician work values as allocated through the RBRVS for physician and non-physician practice expenses cover the actual costs of multidisciplinary ambulatory care for children with DM. A pediatric endocrinology and diabetes clinic staffed by faculty physicians and hospital support staff in a children's hospital. Data from a faculty practice plan billing records and income and expense reports during the period from 1 July 2000 to 30 June 2001 were used to determine endocrinologist physician ambulatory productivity, revenue collection, and direct expenses (salary, benefits, billing, and professional liability (PLI)). Using the RBRVS, ambulatory care revenue was allocated between physician, PLI, and practice expenses. Applying the activity-based costing (ABC) method, activity logs were used to determine non-physician and facility practice expenses associated with endocrine (ENDO) or diabetes visits. Of the 4735 ambulatory endocrinology visits, 1420 (30%) were for DM care. Physicians generated $866,582 in gross charges. Cash collections of 52% of gross charges provided revenue of $96 per visit. Using the actual Current Procedural Terminology (CPT)-4 codes reported for these services and the RBRVS system, the revenue associated with the 13,007 total relative value units (TRVUs) produced was allocated, with 58% going to cover physician work expenses and 42% to cover non-physician practice salary, facility, and PLI costs. Allocated revenue of $40.60 per visit covered 16 and 31% of non-physician and facility practice expenses per DM and general ENDO visit, respectively. RBRVS payments ($35/RVU) covered 46% of all expenses ($76.74/RVU), including 132% of physician expenses for the time worked in the clinic ($27/RVU), and only 23% of actual incurred practice expenses ($152/TRVU). Clinical revenues in a pediatric endocrinology practice, allocated by using the RBRVS system, do cover physician expenses for the time spent working in a hospital ENDO and DM clinic, but do not closely approximate non-physician and facility practice expenses while delivering multidisciplinary care to children with DM. Using payment based on the RBRVS system, and without additional payments to compensate for increased practice expenses incurred in the delivery of multidisciplinary care, this care model may not be financially viable.

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

PubMed

Hyde, Tiffany D

2014-01-01

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

Validity of Guatemalan Mother's Self-Reported Breast-Feeding Practices of 3-Month-Old Infants.

PubMed

Mazariegos, Monica; Slater, Christine; Ramirez-Zea, Manuel

2016-12-01

Breast-feeding practices (BFPs) can be assessed by interviewing the mother about current feeding practices and with a 24-hour recall. It is crucial to establish the accuracy of these methods, which are commonly used by public health decision makers to design health policies aimed at increasing exclusive breast-feeding rates. We aimed to validate 2 self-report BFP instruments using the dose-to-mother deuterium oxide turnover technique (DMDOT) as the reference method. Breast-feeding practices were assessed by interviewing the mother about current feeding practices and with a 24-hour recall in 36 Guatemalan mother-infant pairs. The validity of these instruments was assessed using DMDOT as the reference method. Both self-report instruments overestimated exclusively breast-fed (EBF) infants. Infants classified as EBF were 50% by the reported current feeding practice, 61% by the 24-hour recall, and only 36% using DMDOT. Sensitivity to detect EBF infants from the mother's self-report was 92% (95% CI: 62%-99%) while from the 24-hour recall was 100% (95% CI: 72%-100%, P < .01). However, specificity for both instruments was low, at 74% (95% CI: 51%-89%) for reported current feeding practice and at 61% (95% CI: 39%-79%) for the 24-hour recall (P < .01). Both reported current feeding practice and the 24-hour recall instruments overestimated exclusive breast-feeding. Nevertheless, the use of reported current feeding practice provided more accurate data to assess BFPs in a public health setting. Furthermore, population-based surveys should consider the overestimation of exclusive breast-feeding caused when using these BFP instruments. © The Author(s) 2016.

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 manufacturing...

NASA-Langley Research Center's participation in a round-robin comparison between some current crack-propagation prediction methods

NASA Technical Reports Server (NTRS)

Hudson, C. M.; Lewis, P. E.

1979-01-01

A round-robin study was conducted which evaluated and compared different methods currently in practice for predicting crack growth in surface-cracked specimens. This report describes the prediction methods used by the Fracture Mechanics Engineering Section, at NASA-Langley Research Center, and presents a comparison between predicted crack growth and crack growth observed in laboratory experiments. For tests at higher stress levels, the correlation between predicted and experimentally determined crack growth was generally quite good. For tests at lower stress levels, the predicted number of cycles to reach a given crack length was consistently higher than the experimentally determined number of cycles. This consistent overestimation of the number of cycles could have resulted from a lack of definition of crack-growth data at low values of the stress intensity range. Generally, the predicted critical flaw sizes were smaller than the experimentally determined critical flaw sizes. This underestimation probably resulted from using plane-strain fracture toughness values to predict failure rather than the more appropriate values based on maximum load.

Best Practices for Evaluating the Capability of Nondestructive Evaluation (NDE) and Structural Health Monitoring (SHM) Techniques for Damage Characterization (Post-Print)

DTIC Science & Technology

2016-02-10

a wide range of part, environmental and damage conditions. Best practices of using models are presented for both an eddy current NDE sizing and...to assess the reliability of NDE and SHM characterization capability. Best practices of using models are presented for both an eddy current NDE... EDDY CURRENT NDE CASE STUDY An eddy current crack sizing case study is presented to highlight examples of some of these complex characteristics of

Career retention in the dental hygiene workforce in Texas.

PubMed

Johns, G H; Gutmann, M E; DeWald, J P; Nunn, M E

2001-01-01

The purpose of this study was to determine the factors that influence the retention and attrition of dental hygienists within the workforce in Texas. Respondents' perception of the role of employee benefits and practice of dental hygiene on career retention were explored. Demographic descriptors, including educational level, marital status, age, employment setting, and practice statuses, were also examined. A questionnaire modified from the American Dental Hygienists' Association Extension Study: Retention of Dental Hygienists in the Workforce Final Report, April 1992, was mailed to a systematic sample of licensed Texas dental hygienists in March 1999. Descriptive statistics were computed for dental hygienists currently in practice in Texas and those not in practice at the time of the survey. Differences in demographics, benefits, and attitudes between dental hygienists currently in practice in Texas and dental hygienists not in practice at the time of the survey were tested using independent t-tests for interval data and chi-squared tests for categorical data. All statistical analyses were conducted using the Statistical Package for Social Scientists (SPSS v. 9, Chicago, Illinois). A response rate of 68.1% was obtained. Results revealed the primary reasons for remaining in the practice of dental hygiene were salary, family responsibility, professional collaboration, and variety of work. The primary reasons for leaving dental hygiene practice were family responsibility, boredom, salary, and lack of benefits. Secondary and tertiary reasons stated for staying in clinical practice revealed additional factors including benefits, participation in decision-making, and a safe environment. Dental hygienists in clinical practice were more likely to be employed by a dentist in a single practice and see more patients per day, have a certificate or associate's degree, be unmarried, have fewer children, and be younger than dental hygienists not in practice. The findings suggest that dental hygienists in Texas who remain in the workforce are positively influenced primarily by salary. Dental hygienists in Texas who had left the workforce were primarily influenced to leave practice because of family responsibility. Boredom and lack of benefits were also important factors in deciding to leave clinical practice. Employers of dental hygienists need to be aware of these factors in the hiring process. In addition, dental hygiene educators should prepare students in interviewing techniques for better communication regarding retention factors.

Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: a qualitative study.

PubMed

Brata, Cecilia; Fisher, Colleen; Marjadi, Brahmaputra; Schneider, Carl R; Clifford, Rhonda M

2016-05-13

Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.

Sex selection and restricting abortion and sex determination.

PubMed

Zilberberg, Julie

2007-11-01

Sex selection in India and China is fostered by a limiting social structure that disallows women from performing the roles that men perform, and relegates women to a lower status level. Individual parents and individual families benefit concretely from having a son born into the family, while society, and girls and women as a group, are harmed by the widespread practice of sex selection. Sex selection reinforces oppression of women and girls. Sex selection is best addressed by ameliorating the situations of women and girls, increasing their autonomy, and elevating their status in society. One might argue that restricting or prohibiting abortion, prohibiting sex selection, and prohibiting sex determination would eliminate sex selective abortion. But this decreases women's autonomy rather than increases it. Such practices will turn underground. Sex selective infanticide, and slower death by long term neglect, could increase. If abortion is restricted, the burden is placed on women seeking abortions to show that they have a legally acceptable or legitimate reason for a desired abortion, and this seriously limits women's autonomy. Instead of restricting abortion, banning sex selection, and sex determination, it is better to address the practice of sex selection by elevating the status of women and empowering women so that giving birth to a girl is a real and positive option, instead of a detriment to the parents and family as it is currently. But, if a ban on sex selective abortion or a ban on sex determination is indeed instituted, then wider social change promoting women's status in society should be instituted simultaneously.

Parallel Approach Separation and Controller Performance

DTIC Science & Technology

1989-11-01

adjacent runways from the current minimum of 2.0 to 1.5 nautical miles (nmi). The possible impact of this alteration included changes in the nature and...for aircraft in trail on the same approach. 4. Determine if a change in separation standard affects controller work effort and if so, how. SIMULATION...practice effects should be minimal. 2. They can evaluate the realism of the simulation. 3. They are better able to evaluate the impact of any changes

GWOT Vascular Injury Study 2 Supplemental Project: Impact of Prophylactic Fasciotomy

DTIC Science & Technology

2017-10-01

of the project ? The overall goal is to determine the impact of the widespread use of fasciotomies on current medical/surgical practices, management ...Diane Miller Project Role: Program Manager Nearest person month worked: 12 Contribution to Project : Ms. Miller is responsible for the day-to-day...each branch of service. Goals/Milestones CY14 Goal – Protocol/Staffing  Write and submit protocol to IRB  Hire project manager CY15 Goals – Data

A Review of Navy Stock Fund Accounting Practices for Procurements from Commercial Sources.

DTIC Science & Technology

1987-06-01

determine if these systems can be improved through the application of accounting procedures currently in D S R 3’ 01 AVAILAILITY 0 ABSTRACT 21 ABSTRACT...system( s )1 and the resultant need for reconciliation between levels. The various management levels of the NSF .se different accounting systems to...purposes. 3. The cost of maintaining the inventory is reflected in a single account , the Navy Stock Account (NSA), rather than in costs associated

Revisiting nurse turnover costs: adjusting for inflation.

PubMed

Jones, Cheryl Bland

2008-01-01

Organizational knowledge of nurse turnover costs is important, but gathering these data frequently may not always be feasible in today's fast-paced and complex healthcare environment. The author presents a method to inflation adjust baseline nurse turnover costs using the Consumer Price Index. This approach allows nurse executives to gain current knowledge of organizational nurse turnover costs when primary data collection is not practical and to determine costs and potential savings if nurse retention investments are made.

Current challenges in European oncology pharmacy practice.

PubMed

Hoppe-Tichy, Torsten

2010-03-01

The demand for pharmacy cancer services is expected to at least double over the next 10 years, as the population ages and new treatments are introduced. Safe and efficient handling of cytotoxic products minimises risks to staff and reduces medication errors. To identify and describe strategies for coping safely and effectively with heavier workloads in the hospital oncology pharmacy, currently and in the future. The PubMed database was searched for literature on approaches to safe handling of antineoplastic agents and to decreasing medication errors in the hospital pharmacy. Articles that were judged to be of prime importance to the hospital oncologist were reviewed. These safety concepts are put into the context of contemporary hospital oncology pharmacy practice through discussion of key issues, including increased demand, the role of the pharmacist in determining the hospital formulary, and growth in patient preferences for oral chemotherapy. Recommendations on best practices are also provided, based on relevant literature and author experience. Efficient, safe hospital pharmacy operations can be aided by capacity planning, dose banding, and knowledge of novel products and procedures that can reduce risks to health while increasing the number of patients who are safely treated. Consideration may also be given to the economic role of oncology pharmacists in formulary development.

A Window Into Clinical Next-Generation Sequencing-Based Oncology Testing Practices.

PubMed

Nagarajan, Rakesh; Bartley, Angela N; Bridge, Julia A; Jennings, Lawrence J; Kamel-Reid, Suzanne; Kim, Annette; Lazar, Alexander J; Lindeman, Neal I; Moncur, Joel; Rai, Alex J; Routbort, Mark J; Vasalos, Patricia; Merker, Jason D

2017-12-01

- Detection of acquired variants in cancer is a paradigm of precision medicine, yet little has been reported about clinical laboratory practices across a broad range of laboratories. - To use College of American Pathologists proficiency testing survey results to report on the results from surveys on next-generation sequencing-based oncology testing practices. - College of American Pathologists proficiency testing survey results from more than 250 laboratories currently performing molecular oncology testing were used to determine laboratory trends in next-generation sequencing-based oncology testing. - These presented data provide key information about the number of laboratories that currently offer or are planning to offer next-generation sequencing-based oncology testing. Furthermore, we present data from 60 laboratories performing next-generation sequencing-based oncology testing regarding specimen requirements and assay characteristics. The findings indicate that most laboratories are performing tumor-only targeted sequencing to detect single-nucleotide variants and small insertions and deletions, using desktop sequencers and predesigned commercial kits. Despite these trends, a diversity of approaches to testing exists. - This information should be useful to further inform a variety of topics, including national discussions involving clinical laboratory quality systems, regulation and oversight of next-generation sequencing-based oncology testing, and precision oncology efforts in a data-driven manner.

Planning primary health-care services for South Australian young offenders: a preliminary study.

PubMed

Wilson, Anne

2007-10-01

Although many young offenders receive health care during periods of detention, addressing their health needs after release from secure care is a key strategy for successful rehabilitation and reintegration into the community. The purpose of this preliminary study was to examine current discharge planning practices for young offenders in Youth Training Centres in South Australia with a view to improving offenders' connection with primary health-care services on discharge. To determine the strengths and weaknesses of current discharge planning practices, this exploratory study involved in-depth review of literature and a semistructured focus group of stakeholders. Findings were discussed with an expert advisory group before final recommendations were made. This study identified a service model approach to discharge planning that recommended a nurse located within the Divisions of General Practice as the coordinator. The study found that trusted staff in detention centres, with an awareness of services available in the location of release, influence young offenders' decision-making in relation to health-care services. Awareness and recognition of young offenders' health beyond periods of juvenile detention and into their adult lives is valuable in that it has the potential to establish lifelong healthy behaviours. Bonding with young offenders and gaining their trust increases their likelihood of attending primary health-care services.

Teamwork Training Needs Analysis for Long-Duration Exploration Missions

NASA Technical Reports Server (NTRS)

Smith-Jentsch, Kimberly A.; Sierra, Mary Jane

2016-01-01

The success of future long-duration exploration missions (LDEMs) will be determined largely by the extent to which mission-critical personnel possess and effectively exercise essential teamwork competencies throughout the entire mission lifecycle (e.g., Galarza & Holland, 1999; Hysong, Galarza, & Holland, 2007; Noe, Dachner, Saxton, & Keeton, 2011). To ensure that such personnel develop and exercise these necessary teamwork competencies prior to and over the full course of future LDEMs, it is essential that a teamwork training curriculum be developed and put into place at NASA that is both 1) comprehensive, in that it targets all teamwork competencies critical for mission success and 2) structured around empirically-based best practices for enhancing teamwork training effectiveness. In response to this demand, the current teamwork-oriented training needs analysis (TNA) was initiated to 1) identify the teamwork training needs (i.e., essential teamwork-related competencies) of future LDEM crews, 2) identify critical gaps within NASA’s current and future teamwork training curriculum (i.e., gaps in the competencies targeted and in the training practices utilized) that threaten to impact the success of future LDEMs, and to 3) identify a broad set of practical nonprescriptive recommendations for enhancing the effectiveness of NASA’s teamwork training curriculum in order to increase the probability of future LDEM success.

Organ donor screening practices for Strongyloides stercoralis infection among US organ procurement organizations.

PubMed

Abanyie, Francisca A; Valice, Emily; Delli Carpini, Kristin W; Gray, Elizabeth B; McAuliffe, Isabel; Chin-Hong, Peter V; Handali, Sukwan; Montgomery, Susan P; Huprikar, Shirish

2018-03-07

Targeted donor screening for strongyloidiasis performed at the time of organ procurement can prevent this life-threatening donor-derived infection. The Association of Organ Procurement Organizations surveyed members to determine the number of US organ procurement organizations (OPOs) performing donor screening for Strongyloides infection and their screening practices. All 58 OPOs responded to the survey. Only 6 (10%) currently screen donors for strongyloidiasis; most OPOs started 6-36 months before the survey and one started 6 years prior. All used risk-based criteria to determine which donors to screen, though the criteria varied among OPOs. A median of 56 donors have been screened at each OPO since initiating their screening programs, with a median of 2 infected donors (range 0-13) identified. Overall, 53 organs have been transplanted from 22 infected donors, including hearts, lungs, kidneys, and livers. Of 52 OPOs not currently screening, 20 had considered screening and one plans to start screening in the near future. Of those considering risk-based screening, most had not decided on the criteria. Uncertainty about the benefits of and guidelines for screening and misconceptions about the interpretation of test results were concerns shared by non-screening OPOs. Continued education and advocacy on the importance of targeted donor screening are needed. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Current-voltage characteristics of dendrimer light-emitting diodes

NASA Astrophysics Data System (ADS)

Stevenson, S. G.; Samuel, I. D. W.; Staton, S. V.; Knights, K. A.; Burn, P. L.; Williams, J. H. T.; Walker, Alison B.

2010-09-01

We have investigated current-voltage (I-V) characteristics of unipolar and bipolar organic diodes that use phosphorescent dendrimers as the emissive organic layer. Through simulation of the measured I-V characteristics we were able to determine the device parameters for each device structure studied, leading to a better understanding of injection and transport behaviour in these devices. It was found that the common practice of assuming injection barriers are equal to the difference between bare electrode work functions and molecular orbital levels is unsuitable for the devices considered here, particularly for gold contacts. The studies confirm that different aromatic units in the dendrons can give significant differences in the charge transporting properties of the dendrimers.

Opinion survey: materials management and purchasing habits.

PubMed

1988-01-01

This opinion survey was undertaken to gauge the current status of materials management and purchasing departments at hospitals throughout the southern and southeastern United States. The survey was based on lengthy telephone interviews (from 30 to 60 minutes) and followup discussions with materials managers, purchasing agents and administrators. Interviews covered a variety of topics, including: cost-containment strategies; group purchasing and consignment purchasing; and current and anticipated trends in materials management. Many questions were left open-ended, so the survey could gauge attitudes, as well as determine contemporary practices and procedures. (In some cases, respondents were also given the opportunity to comment on the statements of their peers, in order to corroborate and substantiate data.)

Humidity sensing properties of morphology-controlled ordered silicon nanopillar

NASA Astrophysics Data System (ADS)

Li, Wei; Hu, Mingyue; Ge, Pengpeng; Wang, Jing; Guo, YanYan

2014-10-01

Ordered silicon nanopillar array (Si-NPA) was fabricated by nanosphere lithography. The size of silicon nanopillars can be easily controlled by an etching process. The period and density of nanopillar arrays are determined by the initial diameter of polystyrene (PS) spheres. It was studied as a sensing material to detect humidity. Room temperature current sensitivity of Si-NPA sensor was investigated at a relative humidity (RH) ranging from 50 to 70%. As a result, the measured current showed there was a significant increase at 70% RH. The response and recovery time was about 10 s and 15 s. These excellent sensing characteristics indicate that Si-NPA might be a practical sensing material.

Phage therapy.

PubMed

Housby, John N; Mann, Nicholas H

2009-06-01

There is a renaissance of interest in the antimicrobial potential of phages as more pathogens become multiply antibiotic resistant. Phage therapy is not a new concept, and it is important to ask why it is not part of the current repertoire of western medicine despite the fact that it has been continuously and extensively used in Eastern Europe for almost a century. Answering this question successfully will, largely, determine whether phage therapy can gain the credibility needed to overcome the scientific, financial and regulatory hurdles facing its adoption in mainstream clinical practice. Despite a paucity of such information from human studies, pharmacokinetic data and clinical outcomes from animal studies are currently providing convincing evidence for the safety and efficacy of phage therapy.

Ultrahigh-density nanowire arrays grown in self-assembled diblock copolymer templates.

PubMed

Thurn-Albrecht, T; Schotter, J; Kästle, G A; Emley, N; Shibauchi, T; Krusin-Elbaum, L; Guarini, K; Black, C T; Tuominen, M T; Russell, T P

2000-12-15

We show a simple, robust, chemical route to the fabrication of ultrahigh-density arrays of nanopores with high aspect ratios using the equilibrium self-assembled morphology of asymmetric diblock copolymers. The dimensions and lateral density of the array are determined by segmental interactions and the copolymer molecular weight. Through direct current electrodeposition, we fabricated vertical arrays of nanowires with densities in excess of 1.9 x 10(11) wires per square centimeter. We found markedly enhanced coercivities with ferromagnetic cobalt nanowires that point toward a route to ultrahigh-density storage media. The copolymer approach described is practical, parallel, compatible with current lithographic processes, and amenable to multilayered device fabrication.

The Profile of Patients and Current Practice of Treatment of Upper Limb Muscle Spasticity with Botulinum Toxin Type A: An International Survey

ERIC Educational Resources Information Center

Bakheit, Abdel Magid

2010-01-01

To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31…

The positive effect of targeted marketing on an existing uterine fibroid embolization practice.

PubMed

Chrisman, Howard B; Basu, Pat Auveek; Omary, Reed A

2006-03-01

Although uterine fibroid embolization is an effective treatment option for symptomatic women, it is unclear what methods can be used to expand referrals in an already established practice. The authors tested the hypothesis that an advertising strategy focused on a defined target market can expand an existing uterine fibroid embolization practice. A market-driven planning sequence was employed. This included a determination of goals, an examination of current competition, determination of target market based on local environment and previous consumer use, pretest of product sample, and implementation of advertisement. Based on the analysis the authors determined that the target audience was professional black women aged 35 to 45. A specific weekly magazine was selected due to readership demographics. An advertisement was run for 8 consecutive weeks. The authors prospectively tracked patient inquiries, clinic visits, cases performed, and revenues generated for 3 months following the initial advertisement. All patients were seen in a fully staffed, preexisting fibroid clinic located within an urban, university-based academic practice performing 250 uterine fibroid embolizations annually. Ninety calls were received directly related to the advertisement. There were 35 clinic visits, which resulted in 17 uterine fibroid embolizations and 52 total MR imaging procedures. Eighteen patients were not considered candidates based on established protocols. The 17 extra cases performed over 3 months represented a 27% increase in case volume. Total professional cash collections for these cases (including MR imaging) were 58,317 US dollars. The cost of advertising was 8,000 US dollars. As a result of existing infrastructure, no additional costs were necessary. This resulted in a net revenue gain 50,317 US dollars and a nonannualized rate of return of approximately 625%. As Interventional Radiologists look to develop and expand existing practices, traditional marketing tools such as those utilized in this study can be used to facilitate practice growth for specific clinical programs, such as uterine artery embolization. Defining a target market can significantly expand an existing uterine fibroid embolization practice. The optimal choice of targeted media awaits verification from future studies.

Enhanced electrocatalytic oxidation of isoniazid at electrochemically modified rhodium electrode for biological and pharmaceutical analysis.

PubMed

Cheemalapati, Srikanth; Chen, Shen-Ming; Ali, M Ajmal; Al-Hemaid, Fahad M A

2014-09-01

A simple and sensitive electrochemical method has been proposed for the determination of isoniazid (INZ). For the first time, rhodium (Rh) modified glassy carbon electrode (GCE) has been employed for the determination of INZ by linear sweep voltammetry technique (LSV). Compared with the unmodified electrode, the proposed Rh modified electrode provides strong electrocatalytic activity toward INZ with significant enhancement in the anodic peak current. Scanning electron microscopy (SEM) and field emission scanning electron microscopy (FESEM) results reveal the morphology of Rh particles. With the advantages of wide linearity (70-1300μM), good sensitivity (0.139μAμM(-1)cm(-2)) and low detection limit (13μM), this proposed sensor holds great potential for the determination of INZ in real samples. The practicality of the proposed electrode for the detection of INZ in human urine and blood plasma samples has been successfully demonstrated using LSV technique. Through the determination of INZ in commercially available pharmaceutical tablets, the practical applicability of the proposed method has been validated. The recovery results are found to be in good agreement with the labeled amounts of INZ in tablets, thus showing its great potential for use in clinical and pharmaceutical analysis. Copyright © 2014 Elsevier B.V. All rights reserved.

Perceptions of current and potential public health involvement of pharmacists in developing nations: The case of Zimbabwe.

PubMed

Mdege, Noreen Dadirai; Chevo, Tafadzwa; Toner, Paul

There is increasing recognition of the potential significant contribution that pharmacy personnel can make to improve the public's health. However, there is an evidence gap in developing countries on the public health role of pharmacy personnel. This study aimed to explore the current public health activities that pharmacy professionals in Zimbabwe are currently involved in, and the potential of expanding this role. The study utilized individual, face-to-face, semi-structured qualitative interviews with 9 key informants. The sample reflected the diversity of pharmacy practice groups and levels as well as professional experience, and included a representative from a patient group, and a non-pharmacist national level public health expert. Data collection and analysis was an iterative process informed both by the currently available literature on the topic, as well as themes emerging from the data. Framework analysis was utilized with two independent analyses performed. There was a general consensus among participants that pharmacy practice in Zimbabwe was mainly focused on curative services, with very limited involvement in public health oriented activities. The following were identified as pharmacists' current public health activities: supply chain management of pharmaceutical products, provision of medications and other pharmaceutical products to patients, therapy monitoring, identification and monitoring of chronic illnesses, information provision and training of pharmacists. Nevertheless, there were concerns regarding the quality of some of these services, and lack of consistency in provision across pharmacies. Other potential areas for pharmacists' public health practice were identified as emergency response, drug abuse, addressing social determinants of health particularly promoting healthy lifestyles, applied health research, counterfeit and substandard medicines, and advocacy. There is perceived potential for Zimbabwean pharmacists to become more involved in public health oriented services. However, concerns regarding the quality of services and lack of consistency in provision need to be addressed. Copyright © 2015 Elsevier Inc. All rights reserved.

Karst topography : noninvasive geophysical detection methods and construction techniques.

DOT National Transportation Integrated Search

2013-10-01

The objective of this project was to investigate the current state of the practice with regards to karst detection : methods and current karst construction practices and to recommend the best practices for use by the Virginia : Department of Transpor...

Community perceptions on malaria and care-seeking practices in endemic Indian settings: policy implications for the malaria control programme.

PubMed

Das, Ashis; Das Gupta, R K; Friedman, Jed; Pradhan, Madan M; Mohapatra, Charu C; Sandhibigraha, Debakanta

2013-01-29

The focus of India's National Malaria Programme witnessed a paradigm shift recently from health facility to community-based approaches. The current thrust is on diagnosing and treating malaria by community health workers and prevention through free provision of long-lasting insecticidal nets. However, appropriate community awareness and practice are inevitable for the effectiveness of such efforts. In this context, the study assessed community perceptions and practice on malaria and similar febrile illnesses. This evidence base is intended to direct the roll-out of the new strategies and improve community acceptance and utilization of services. A qualitative study involving 26 focus group discussions and 40 key informant interviews was conducted in two districts of Odisha State in India. The key points of discussion were centred on community perceptions and practice regarding malaria prevention and treatment. Thematic analysis of data was performed. The 272 respondents consisted of 50% females, three-quarter scheduled tribe community and 30% students. A half of them were literates. Malaria was reported to be the most common disease in their settings with multiple modes of transmission by the FGD participants. Adoption of prevention methods was seasonal with perceived mosquito density. The reported use of bed nets was low and the utilization was determined by seasonality, affordability, intoxication and alternate uses of nets. Although respondents were aware of malaria-related symptoms, care-seeking from traditional healers and unqualified providers was prevalent. The respondents expressed lack of trust in the community health workers due to frequent drug stock-outs. The major determinants of health care seeking were socio-cultural beliefs, age, gender, faith in the service provider, proximity, poverty, and perceived effectiveness of available services. Apart from the socio-cultural and behavioural factors, the availability of acceptable care can modulate the community perceptions and practices on malaria management. The current community awareness on symptoms of malaria and prevention is fair, yet the prevention and treatment practices are not optimal. Promoting active community involvement and ownership in malaria control and management through strengthening community based organizations would be relevant. Further, timely availability of drugs and commodities at the community level can improve their confidence in the public health system.

Novice designers’ use of prototypes in engineering design

PubMed Central

Deininger, Michael; Daly, Shanna R.; Sienko, Kathleen H.; Lee, Jennifer C.

2017-01-01

Prototypes are essential tools in product design processes, but are often underutilized by novice designers. To help novice designers use prototypes more effectively, we must first determine how they currently use prototypes. In this paper, we describe how novice designers conceptualized prototypes and reported using them throughout a design project, and compare reported prototyping use to prototyping best practices. We found that some of the reported prototyping practices by novice designers, such as using inexpensive prototypes early and using prototypes to define user requirements, occurred infrequently and lacked intentionality. Participants’ initial descriptions of prototypes were less sophisticated than how they later described using them and only upon prompted reflection did participants recognize more specific benefits of using prototypes. PMID:29398740

A young surgeon's perspective.

PubMed

Bold, Richard J

2005-03-01

The environment of health care delivery is responding to a variety of external forces that are changing the practice of surgery. Only when we look back at this period can any assessments be made to determine whether the changes were beneficial or detrimental. The observation that surgeons are retiring at an earlier age may be a reflection of the negative effect of the changing culture of surgery on career satisfaction. As a young surgeon who anticipates an additional 20+ years of a surgical career, these changes are important to me and will clearly affect my practice as well as my satisfaction. This special article provides my personal perspective on some of the current and anticipated changes in surgery that are a manifestation of cultural changes in health care delivery.