Research on intelligent recommendation algorithm of e-commerce based on association rules

NASA Astrophysics Data System (ADS)

Shen, Jiajie; Cheng, Xianyi

2017-09-01

As the commodities of e-commerce are more and more rich, more and more consumers are willing to choose online shopping, because of these rich varieties of commodity information, customers will often appear aesthetic fatigue. Therefore, we need a recommendation algorithm according to the recent behavior of customers including browsing and consuming to predicate and intelligently recommend goods which the customers need, thus to improve the satisfaction of customers and to increase the profit of e-commerce. This paper first discusses recommendation algorithm, then improves Apriori. Finally, using R language realizes a recommendation algorithm of commodities. The result shows that this algorithm provides a certain decision-making role for customers to buy commodities.

Decision making in a multidisciplinary cancer team: does team discussion result in better quality decisions?

PubMed

Kee, Frank; Owen, Tracy; Leathem, Ruth

2004-01-01

To establish whether treatment recommendations made by clinicians concur with the best outcomes predicted from their prognostic estimates and whether team discussion improves the quality or outcome of their decision making, the authors studied real-time decision making by a lung cancer team. Clinicians completed pre- and postdiscussion questionnaires for 50 newly diagnosed patients. For each patient/doctor pairing, a decision model determined the expected patient outcomes from the clinician's prognostic estimates. The difference between the expected utility of the recommended treatment and the maximum utility derived from the clinician's predictions of the outcomes (the net utility loss) following all potential treatment modalities was calculated as an indicator of quality of the decision. The proportion of treatment decisions changed by the multidisciplinary team discussion was also calculated. Insofar as the change in net utility loss brought about by multidisciplinary team discussion was not significantly different from zero, team discussion did not improve the quality of decision making overall. However, given the modest power of the study, these findings must be interpreted with caution. In only 23 of 87 instances (26%) in which an individual specialist's initial treatment preference differed from the final group judgment did the specialist finally concur with the group treatment choice after discussion. This study does not support the theory that team discussion improves decision making by closing a knowledge gap.

Singapore Neonatal Resuscitation Guidelines 2016

PubMed Central

Yeo, Cheo Lian; Biswas, Agnihotri; Ee, Teong Tai Kenny; Chinnadurai, Amutha; Baral, Vijayendra Ranjan; Chang, Alvin Shang Ming; Ereno, Imelda Lustestica; Ho, Kah Ying Selina; Poon, Woei Bing; Shah, Varsha Atul; Quek, Bin Huey

2017-01-01

We present the revised Neonatal Resuscitation Guidelines for Singapore. The 2015 International Liaison Committee on Resuscitation Neonatal Task Force’s consensus on science and treatment recommendations (2015), and guidelines from the American Heart Association and European Resuscitation Council were debated and discussed. The final recommendations of the National Resuscitation Council, Singapore, were derived after the task force had carefully reviewed the current available evidence in the literature and addressed their relevance to local clinical practice. PMID:28741001

Pairing Physician Education With Patient Activation to Improve Shared Decisions in Prostate Cancer Screening: A Cluster Randomized Controlled Trial

PubMed Central

Wilkes, Michael S.; Day, Frank C.; Srinivasan, Malathi; Griffin, Erin; Tancredi, Daniel J.; Rainwater, Julie A.; Kravitz, Richard L.; Bell, Douglas S.; Hoffman, Jerome R.

2013-01-01

BACKGROUND Most expert groups recommend shared decision making for prostate cancer screening. Most primary care physicians, however, routinely order a prostate-specific antigen (PSA) test with little or no discussion about whether they believe the potential benefits justify the risk of harm. We sought to assess whether educating primary care physicians and activating their patients to ask about prostate cancer screening had a synergistic effect on shared decision making, rates and types of discussions about prostate cancer screening, and the physician’s final recommendations. METHODS Our study was a cluster randomized controlled trial among primary care physicians and their patients, comparing usual education (control), with physician education alone (MD-Ed), and with physician education and patient activation (MD-Ed+A). Participants included 120 physicians in 5 group practices, and 712 male patients aged 50 to 75 years. The interventions comprised a Web-based educational program for all intervention physicians and MD-Ed+A patients compared with usual education (brochures from the Centers for Disease Control and Prevention). The primary outcome measure was patients’ reported postvisit shared decision making regarding prostate cancer screening; secondary measures included unannounced standardized patients’ reported shared decision making and the physician’s recommendation for prostate cancer screening. RESULTS Patients’ ratings of shared decision making were moderate and did not differ between groups. MD-Ed+A patients reported that physicians had higher prostate cancer screening discussion rates (MD-Ed+A = 65%, MD-Ed = 41%, control=38%; P <.01). Standardized patients reported that physicians seeing MD-Ed+A patients were more neutral during prostate cancer screening recommendations (MD-Ed+A=50%, MD-Ed=33%, control=15%; P <.05). Of the male patients, 80% had had previous PSA tests. CONCLUSIONS Although activating physicians and patients did not lead to significant changes in all aspects of physician attitudes and behaviors that we studied, interventions that involved physicians did have a large effect on their attitudes toward screening and in the discussions they had with patients, including their being more likely than control physicians to engage in prostate cancer screening discussions and more likely to be neutral in their final recommendations. PMID:23835818

Toward a State of Esteem. The Final Report of the California Task Force to Promote Self-esteem and Personal and Social Responsibility.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento.

This document contains the final report of a California Task Force created to promote self-esteem and personal responsibility. It begins with an executive summary listing key principles of the task force and providing recommendations and discussions in each of six major areas upon which the report focuses. The next section presents the task…

The Quest for Community in a National Republic: A Bicentennial Reappraisal. Final Report and Keynote Address, Virginia Assembly (Richmond, Virginia, April 8-10, 1988).

ERIC Educational Resources Information Center

Virginia Univ., Charlottesville. Center for Public Service.

This Virginia Assembly document focuses on the concept of community as defined by the Founding Fathers of the U.S. Constitution. The final report identifies and discusses problems related to the modern quest for community in a national republic. Recommendations by the Assembly are offered in eight areas: (1) civic responsibility; (2) corporate…

[The alcohol problem in former East Germany--suggestions for necessary discussion].

PubMed

Brieler, P; Rühle, R; Jänisch, C

1993-05-01

Based on publications from the GDR about alcohol-problems and respecting experiences of medical and psychological examinations alcoholism, the abuse of alcohol and its effects will be analysed and discussed. The following aspects will have main attention: meaning of alcohol as a drug, consumption of alcohol and its conditions, alcohol and its consequences in traffic, employment, criminal law and leisure time. Finally open questions will be discussed and recommendation for further research work will be explained.

Mitigating Insider Sabotage and Espionage: A Review of the United States Air Force’s Current Posture

DTIC Science & Technology

2009-03-01

published on ins ider threat, to include the variables that come into play and historical case studies. Existing insider threat models are discussed ...problem, including the initial development of a logical da ta mod el and a system dynamics model. This chapter also discusses the selection of the...Finally, Chapter V provides a summary of the research along with a discussion of its conclusions and impact. Recommendations for future research

Network-based recommendation algorithms: A review

NASA Astrophysics Data System (ADS)

Yu, Fei; Zeng, An; Gillard, Sébastien; Medo, Matúš

2016-06-01

Recommender systems are a vital tool that helps us to overcome the information overload problem. They are being used by most e-commerce web sites and attract the interest of a broad scientific community. A recommender system uses data on users' past preferences to choose new items that might be appreciated by a given individual user. While many approaches to recommendation exist, the approach based on a network representation of the input data has gained considerable attention in the past. We review here a broad range of network-based recommendation algorithms and for the first time compare their performance on three distinct real datasets. We present recommendation topics that go beyond the mere question of which algorithm to use-such as the possible influence of recommendation on the evolution of systems that use it-and finally discuss open research directions and challenges.

Social network supported process recommender system.

PubMed

Ye, Yanming; Yin, Jianwei; Xu, Yueshen

2014-01-01

Process recommendation technologies have gained more and more attention in the field of intelligent business process modeling to assist the process modeling. However, most of the existing technologies only use the process structure analysis and do not take the social features of processes into account, while the process modeling is complex and comprehensive in most situations. This paper studies the feasibility of social network research technologies on process recommendation and builds a social network system of processes based on the features similarities. Then, three process matching degree measurements are presented and the system implementation is discussed subsequently. Finally, experimental evaluations and future works are introduced.

PDF4LHC recommendations for LHC Run II

DOE PAGES

Butterworth, Jon; Carrazza, Stefano; Cooper-Sarkar, Amanda; ...

2016-01-06

We provide an updated recommendation for the usage of sets of parton distribution functions (PDFs) and the assessment of PDF and PDF+αs uncertainties suitable for applications at the LHC Run II. We review developments since the previous PDF4LHC recommendation, and discuss and compare the new generation of PDFs, which include substantial information from experimental data from the Run I of the LHC. We then propose a new prescription for the combination of a suitable subset of the available PDF sets, which is presented in terms of a single combined PDF set. Lastly, we finally discuss tools which allow for themore » delivery of this combined set in terms of optimized sets of Hessian eigenvectors or Monte Carlo replicas, and their usage, and provide some examples of their application to LHC phenomenology.« less

Customized Clinical Practice Guidelines for Management of Adult Cataract in Iran

PubMed Central

Rajavi, Zhaleh; Javadi, Mohammad Ali; Daftarian, Narsis; Safi, Sare; Nejat, Farhad; Shirvani, Armin; Ahmadieh, Hamid; Shahraz, Saeid; Ziaei, Hossein; Moein, Hamidreza; Motlagh, Behzad Fallahi; Feizi, Sepehr; Foroutan, Alireza; Hashemi, Hassan; Hashemian, Seyed Javad; Jabbarvand, Mahmoud; Jafarinasab, Mohammad Reza; Karimian, Farid; Mohammad-Rabei, Hossein; Mohammadpour, Mehrdad; Nassiri, Nader; Panahi-Bazaz, Mahmoodreza; Rohani, Mohammad Reza; Sedaghat, Mohammad Reza; Sheibani, Kourosh

2015-01-01

Purpose: To customize clinical practice guidelines (CPGs) for cataract management in the Iranian population. Methods: First, four CPGs (American Academy of Ophthalmology 2006 and 2011, Royal College of Ophthalmologists 2010, and Canadian Ophthalmological Society 2008) were selected from a number of available CPGs in the literature for cataract management. All recommendations of these guidelines, together with their references, were studied. Each recommendation was summarized in 4 tables. The first table showed the recommendation itself in clinical question components format along with its level of evidence. The second table contained structured abstracts of supporting articles related to the clinical question with their levels of evidence. The third table included the customized recommendation of the internal group respecting its clinical advantage, cost, and complications. In the fourth table, the internal group their recommendations from 1 to 9 based on the customizing capability of the recommendation (applicability, acceptability, external validity). Finally, customized recommendations were sent one month prior to a consensus session to faculty members of all universities across the country asking for their comments on recommendations. Results: The agreed recommendations were accepted as conclusive while those with no agreement were discussed at the consensus session. Finally, all customized recommendations were codified as 80 recommendations along with their sources and levels of evidence for the Iranian population. Conclusion: Customization of CPGs for management of adult cataract for the Iranian population seems to be useful for standardization of referral, diagnosis and treatment of patients. PMID:27051491

Exocrine pancreatic insufficiency in adults: A shared position statement of the Italian association for the study of the pancreas

PubMed Central

Pezzilli, Raffaele; Andriulli, Angelo; Bassi, Claudio; Balzano, Gianpaolo; Cantore, Maurizio; Delle Fave, Gianfranco; Falconi, Massimo; Frulloni, Luca

2013-01-01

This is a medical position statement developed by the Exocrine Pancreatic Insufficiency collaborative group which is a part of the Italian Association for the Study of the Pancreas (AISP). We covered the main diseases associated with exocrine pancreatic insufficiency (EPI) which are of common interest to internists/gastroenterologists, oncologists and surgeons, fully aware that EPI may also occur together with many other diseases, but less frequently. A preliminary manuscript based on an extended literature search (Medline/PubMed, Cochrane Library and Google Scholar) of published reports was prepared, and key recommendations were proposed. The evidence was discussed at a dedicated meeting in Bologna during the National Meeting of the Association in October 2012. Each of the proposed recommendations and algorithms was discussed and an initial consensus was reached. The final draft of the manuscript was then sent to the AISP Council for approval and/or modification. All concerned parties approved the final version of the manuscript in June 2013. PMID:24307787

Working draft of the FDA GMP final rule (Part II).

PubMed

Donawa, M E

1995-11-01

Part I of this two-part series provided information on the proposed design control provisions of the US Food and Drug Administration's (FDA) working draft of the final rule for new good manufacturing practice regulations for medical devices. The final rule could be published in April or May 1996. It would be in force 180 days after the date of publication. Design control requirements may become effective some months later. This article describes recommended modifications of three provisions that have been intensely discussed during recent FDA-sponsored public meetings.

Titan 4 TPS Replacement Implementation Study

NASA Technical Reports Server (NTRS)

Jackson, Charles H.

1996-01-01

This final report documents the overall progress of the study. It is a general discussion of the documents reviewed, recommendations, trips taken, findings/observations, and proposed corrective actions. In addition, cost data for the contract is addressed. The normal abstract and executive summary provided with most final reports is also provided as a part of this report. A conclusion section is provided that addresses the relative completeness of the Titan 4 TPSR project and this contract.

Conducting quantitative synthesis when comparing medical interventions: AHRQ and the Effective Health Care Program.

PubMed

Fu, Rongwei; Gartlehner, Gerald; Grant, Mark; Shamliyan, Tatyana; Sedrakyan, Art; Wilt, Timothy J; Griffith, Lauren; Oremus, Mark; Raina, Parminder; Ismaila, Afisi; Santaguida, Pasqualina; Lau, Joseph; Trikalinos, Thomas A

2011-11-01

This article is to establish recommendations for conducting quantitative synthesis, or meta-analysis, using study-level data in comparative effectiveness reviews (CERs) for the Evidence-based Practice Center (EPC) program of the Agency for Healthcare Research and Quality. We focused on recurrent issues in the EPC program and the recommendations were developed using group discussion and consensus based on current knowledge in the literature. We first discussed considerations for deciding whether to combine studies, followed by discussions on indirect comparison and incorporation of indirect evidence. Then, we described our recommendations on choosing effect measures and statistical models, giving special attention to combining studies with rare events; and on testing and exploring heterogeneity. Finally, we briefly presented recommendations on combining studies of mixed design and on sensitivity analysis. Quantitative synthesis should be conducted in a transparent and consistent way. Inclusion of multiple alternative interventions in CERs increases the complexity of quantitative synthesis, whereas the basic issues in quantitative synthesis remain crucial considerations in quantitative synthesis for a CER. We will cover more issues in future versions and update and improve recommendations with the accumulation of new research to advance the goal for transparency and consistency. Copyright © 2011 Elsevier Inc. All rights reserved.

NASA/USRA advanced design program

NASA Technical Reports Server (NTRS)

1992-01-01

This report analyzes and presents a preliminary design for an experimental hypersonic vehicle. This plane will have a cruise speed of Mach 12 for one minute at an altitude of 120,000 feet. The major design areas of aerodynamics, propulsion, and weights are discussed in depth. An elementary analysis of thermal protection, trajectory, and cost is also presented. Finally, a discussion of future plans and recommendations is given, and overall conclusions are drawn.

Research Integrity of Individual Scientist

NASA Astrophysics Data System (ADS)

Haklak, Rockbill

We are discussing about many aspects of research integrity of individual scientist, who faces the globalization of research ethics in the traditional culture and custom of Japan. Topics are scientific misconduct (fabrication, falsification, and plagiarism) in writing paper and presenting research results. Managements of research material, research record, grant money, authorship, and conflict of interest are also analyzed and discussed. Finally, we make 5 recommendations to improve research integrity in Japan.

Technical Evaluation Motor No. 7 (TEM-7)

NASA Technical Reports Server (NTRS)

Hughes, Phil

1991-01-01

The Technical Evaluation Motor No. 7 (TEM-7) test was a full-scale, full duration static test firing of a high performance motor-configuration solid rocket motor with nozzle vectoring. The final test report documents the procedures, performance, and results of the static test firing of TEM-7. All observations, discussions, conclusions, and recommendations included in the report are complete and final except for the TEM-7 fixed housing unbond investigation. A presentation and discussion of TEM-7 performance, anomalies, and test result concurrence with the objectives outlined in CTP-0107, Rev A, Space Shuttle Technical Evaluation Motor No. 7 (TEM-7) Static Fire Test Plan are included.

Financial Capacity and Financial Exploitation of Older Adults: Research Findings, Policy Recommendations and Clinical Implications

PubMed Central

Wood, Stacey; Lichtenberg, Peter A.

2017-01-01

Financial exploitation (FE) of older adults is a social issue that is beginning to receive the attention that it deserves in the media thanks to some high profile cases, but empirical research and clinical guidelines on the topic are just emerging. Our review describes the significance of the problem, proposes a theoretical model for conceptualizing FE, and summarizes related areas of research that may be useful to consider in the understanding of FE. We discuss structural issues that have limited interventions in the past and make specific public policy recommendations in light of the largest intergenerational transfer of wealth in history. Finally, we discuss implications for clinical practice. PMID:28452630

Healthcare administration education in the 21st century: the case for entrepreneurship.

PubMed

Williams, David R; Duncan, W Jack; Ginter, Peter M

2005-01-01

This paper recommends the broadening of the course content in several of the current required courses within the core curriculum of healthcare management education to include entrepreneurship topics and the inclusion of a separate entrepreneurship course. The current state of entrepreneurship within healthcare is described through the discussion of a healthcare entrepreneurship continuum. Because of the evolution of the healthcare industry in the past ten years, healthcare administration programs must also evolve to make our curriculum more relevant and increase student placement options. The current healthcare administration education shortcomings are discussed and recommendations for curriculum change are presented. Finally, a readings and resources list is provided as a basis for further curriculum development.

Clinical practice guidelines for the management of pregnancy in women with autoimmune rheumatic diseases of the Mexican College of Rheumatology. Part I.

PubMed

Saavedra Salinas, Miguel Ángel; Barrera Cruz, Antonio; Cabral Castañeda, Antonio Rafael; Jara Quezada, Luis Javier; Arce-Salinas, C Alejandro; Álvarez Nemegyei, José; Fraga Mouret, Antonio; Orozco Alcalá, Javier; Salazar Páramo, Mario; Cruz Reyes, Claudia Verónica; Andrade Ortega, Lilia; Vera Lastra, Olga Lidia; Mendoza Pinto, Claudia; Sánchez González, Antonio; Cruz Cruz, Polita Del Rocío; Morales Hernández, Sara; Portela Hernández, Margarita; Pérez Cristóbal, Mario; Medina García, Gabriela; Hernández Romero, Noé; Velarde Ochoa, María Del Carmen; Navarro Zarza, José Eduardo; Portillo Díaz, Verónica; Vargas Guerrero, Angélica; Goycochea Robles, María Victoria; García Figueroa, José Luis; Barreira Mercado, Eduardo; Amigo Castañeda, Mary Carmen

2015-01-01

Pregnancy in women with autoimmune rheumatic diseases is associated with several maternal and fetal complications. The development of clinical practice guidelines with the best available scientific evidence may help standardize the care of these patients. To provide recommendations regarding prenatal care, treatment, and a more effective monitoring of pregnancy in women with lupus erythematosus (SLE), rheumatoid arthritis (RA) and antiphospholipid antibody syndrome (APS). Nominal panels were formed for consensus, systematic search of information, development of clinical questions, processing and grading of recommendations, internal validation by peers, and external validation of the final document. The quality criteria of the AGREE II instrument were followed. The various panels answered the 37 questions related to maternal and fetal care in SLE, RA, and APS, as well as to the use of antirheumatic drugs during pregnancy and lactation. The recommendations were discussed and integrated into a final manuscript. Finally, the corresponding algorithms were developed. We present the recommendations for pregnant women with SLE in this first part. We believe that the Mexican clinical practice guidelines for the management of pregnancy in women with SLE integrate the best available evidence for the treatment and follow-up of patients with these conditions. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Singapore Paediatric Resuscitation Guidelines 2016.

PubMed

Ong, Gene Yong Kwang; Chan, Irene Lai Yeen; Ng, Agnes Suah Bwee; Chew, Su Yah; Mok, Yee Hui; Chan, Yoke Hwee; Ong, Jacqueline Soo May; Ganapathy, Sashikumar; Ng, Kee Chong

2017-07-01

We present the revised 2016 Singapore paediatric resuscitation guidelines. The International Liaison Committee on Resuscitation's Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, as well as the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council released in October 2015, were debated and discussed by the workgroup. The final recommendations for the Singapore Paediatric Resuscitation Guidelines 2016 were derived after carefully reviewing the current available evidence in the literature and balancing it with local clinical practice. Copyright: © Singapore Medical Association.

Final Research Report: Administrative and Legal Issues Associated with a Multi-State VMT-Based Charge System

DOT National Transportation Integrated Search

2010-11-01

In May 2009, the I-95 Coalition convened a workshop of experts to discuss how the Coalition could best contribute to the national dialogue regarding VMT-based charge systems. Following the recommendations of the National Surface Transportation Policy...

Standards of Evidence for Behavioral Counseling Recommendations.

PubMed

McNellis, Robert J; Ory, Marcia G; Lin, Jennifer S; O'Connor, Elizabeth A

2015-09-01

Behavioral counseling interventions to promote healthy behaviors can significantly reduce leading causes of disease and death. Recommendations for delivery of these interventions in primary care have been and continue to be an important part of the U.S. Preventive Services Task Force's portfolio of clinical preventive services recommendations. However, primary and secondary research on the effectiveness of behavioral counseling interventions can be more complex than recommendations for screening or use of preventive medications. The nature of behavior change and interventions to promote it can lead to unique challenges. This paper summarizes and expands upon an extensive discussion held at the U.S. Preventive Services Task Force's Expert Forum on behavioral counseling interventions held in November 2013. The paper describes the foundational challenges for using behavioral outcomes as evidence to support a Task Force recommendation. The paper discusses research design and reporting characteristics needed by behavioral counseling intervention researchers in order for their research to contribute to the evidentiary basis of a Task Force recommendation. Finally, the paper identifies critical issues that need to be considered by the Task Force and other stakeholders to maintain confidence and credibility in the standards of evidence for behavioral counseling recommendations. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Social Network Supported Process Recommender System

PubMed Central

Ye, Yanming; Yin, Jianwei; Xu, Yueshen

2014-01-01

Process recommendation technologies have gained more and more attention in the field of intelligent business process modeling to assist the process modeling. However, most of the existing technologies only use the process structure analysis and do not take the social features of processes into account, while the process modeling is complex and comprehensive in most situations. This paper studies the feasibility of social network research technologies on process recommendation and builds a social network system of processes based on the features similarities. Then, three process matching degree measurements are presented and the system implementation is discussed subsequently. Finally, experimental evaluations and future works are introduced. PMID:24672309

Mixed Messages: Public Communication about Higher Education and Non-Traditional Students in Australia

ERIC Educational Resources Information Center

Snowden, Collette; Lewis, Sally

2015-01-01

Australian Government participation targets recommended in the Review of Australian Higher Education (Bradley In Review of Australian higher education: Final report, Commonwealth of Australia 2008) presented a complex public communication challenge to higher education participation. This research discusses the content of communication messages…

Arizona Women in Poverty Hearings. Final Report.

ERIC Educational Resources Information Center

Coudroglou, Aliki

Prepared at the request of Arizona Governor Bruce Babbit, this report documents the state of poverty among women in Arizona and recommends an action plan that will alleviate their poor economic status. Discussion focuses on three factors identified as influencing conditions of poverty experienced by women: changing family structure, the labor…

Integrating Severely Handicapped Learners: Potential Teacher Liability in Community Based Programs.

ERIC Educational Resources Information Center

Brady, Michael P.; Dennis, H. Floyd

1984-01-01

The paper examines elements of negligence and other legal concerns in view of the evolving trend to educate severely handicapped persons in integrated, community based settings. Duty, care, risk, and appropriate placement and instruction are discussed. Finally, recommendations for avoiding teacher liability are presented. (Author/CL)

Multinational evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative.

PubMed

Machado, P; Castrejon, I; Katchamart, W; Koevoets, R; Kuriya, B; Schoels, M; Silva-Fernández, L; Thevissen, K; Vercoutere, W; Villeneuve, E; Aletaha, D; Carmona, L; Landewé, R; van der Heijde, D; Bijlsma, J W J; Bykerk, V; Canhão, H; Catrina, A I; Durez, P; Edwards, C J; Mjaavatten, M D; Leeb, B F; Losada, B; Martín-Mola, E M; Martinez-Osuna, P; Montecucco, C; Müller-Ladner, U; Østergaard, M; Sheane, B; Xavier, R M; Zochling, J; Bombardier, C

2011-01-01

To develop evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis (UPIA). 697 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2008-9 consisting of three separate rounds of discussions and modified Delphi votes. In the first round 10 clinical questions were selected. A bibliographic team systematically searched Medline, Embase, the Cochrane Library and ACR/EULAR 2007-2008 meeting abstracts. Relevant articles were reviewed for quality assessment, data extraction and synthesis. In the second round each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. A total of 39,756 references were identified, of which 250 were systematically reviewed. Ten multinational key recommendations about the investigation and follow-up of UPIA were formulated. One recommendation addressed differential diagnosis and investigations prior to establishing the operational diagnosis of UPIA, seven recommendations related to the diagnostic and prognostic value of clinical and laboratory assessments in established UPIA (history and physical examination, acute phase reactants, autoantibodies, radiographs, MRI and ultrasound, genetic markers and synovial biopsy), one recommendation highlighted predictors of persistence (chronicity) and the final recommendation addressed monitoring of clinical disease activity in UPIA. Ten recommendations on how to investigate and follow-up UPIA in the clinical setting were developed. They are evidence-based and supported by a large panel of rheumatologists, thus enhancing their validity and practical use.

Recommendations to minimize diagnostic nuclear medicine exposure to the embryo, fetus, and infant; availability of final recommendations--FDA. Notice.

PubMed

1986-02-19

Food and Drug Administration (FDA) is announcing the availability of final recommendations to minimize diagnostic nuclear medicine exposure to the embryo, fetus, and breastfeeding infant. The final recommendations, prepared by FDA's Center for Devices and Radiological Health (CDRH), include the agency's rationale for the recommendations as well as the endorsement of the recommendations by several professional organizations. The final recommendations are being published in a pamphlet that is being made available to interested persons.

Psychiatry Resident Training in Cultural Competence: An Educator's Toolkit.

PubMed

Corral, Irma; Johnson, Toni L; Shelton, Pheston G; Glass, Oliver

2017-06-01

Resident physicians training in psychiatry in the U.S. are required to master a body of knowledge related to cultural psychiatry; are expected to adopt attitudes that endorse the principles of cultural competence; and finally are expected to acquire specific cultural competence skills that facilitate working effectively with diverse patients. This article first provides an overview of the Accreditation Council for Graduate Medical Education (ACGME) competencies related to cultural competence, as well as the American Academy of Child and Adolescent Psychiatry's (AACAP) recommendations for the cultural competence training of child/adolescent fellows. Next, numerous print and electronic resources that can be used in cultural competence education in psychiatry are reviewed and discussed. Finally, we conclude by providing recommendations for psychiatry residency programs that we culled from model cultural competence curricula.

Process heat in California: Applications and potential for solar energy in the industrial, agricultural and commercial sectors

NASA Technical Reports Server (NTRS)

Barbieri, R. H.; Bartera, R. E.; Davis, E. S.; Hlavka, G. E.; Pivirotto, D. S.; Yanow, G.

1978-01-01

A summary of the results of a survey of potential applications of solar energy for supplying process heat requirements in the industrial, agricultural, and commercial sectors of California is presented. Technical, economic, and institutional characteristics of the three sectors are examined. Specific applications for solar energy are then discussed. Finally, implications for California energy policy are discussed along with recommendations for possible actions by the State of California.

Clinical practice guidelines for the management of pregnancy in women with autoimmune rheumatic diseases of the Mexican College of Rheumatology. Part II.

PubMed

Saavedra Salinas, Miguel Ángel; Barrera Cruz, Antonio; Cabral Castañeda, Antonio Rafael; Jara Quezada, Luis Javier; Arce-Salinas, C Alejandro; Álvarez Nemegyei, José; Fraga Mouret, Antonio; Orozco Alcalá, Javier; Salazar Páramo, Mario; Cruz Reyes, Claudia Verónica; Andrade Ortega, Lilia; Vera Lastra, Olga Lidia; Mendoza Pinto, Claudia; Sánchez González, Antonio; Cruz Cruz, Polita Del Rocío; Morales Hernández, Sara; Portela Hernández, Margarita; Pérez Cristóbal, Mario; Medina García, Gabriela; Hernández Romero, Noé; Velarde Ochoa, María Del Carmen; Navarro Zarza, José Eduardo; Portillo Díaz, Verónica; Vargas Guerrero, Angélica; Goycochea Robles, María Victoria; García Figueroa, José Luis; Barreira Mercado, Eduardo; Amigo Castañeda, Mary Carmen

2015-01-01

Pregnancy in women with autoimmune rheumatic diseases is associated with several maternal and fetal complications. The development of clinical practice guidelines with the best available scientific evidence may help standardize the care of these patients. To provide recommendations regarding prenatal care, treatment, and a more effective monitoring of pregnancy in women with lupus erythematosus, rheumatoid arthritis (RA) and antiphospholipid syndrome (APS). Nominal panels were formed for consensus, systematic search of information, development of clinical questions, processing and staging of recommendations, internal validation by peers and external validation of the final document. The quality criteria of the AGREE II instrument were followed. The panels answered 37 questions related to maternal and fetal care in lupus erythematosus, RA and APS, as well as for use of antirheumatic drugs during pregnancy and lactation. The recommendations were discussed and integrated into a final manuscript. Finally, the corresponding algorithms were developed. In this second part, the recommendations for pregnant women with RA, APS and the use of antirheumatic drugs during pregnancy and lactation are presented. We believe that the Mexican clinical practice guidelines for the management of pregnancy in women with RA and APS integrate the best available evidence for the treatment and follow-up of patients with these conditions. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

National Task Force on Student Aid Problems. Final Report.

ERIC Educational Resources Information Center

1975

This document presents a full discussion of the activities, findings, and recommendations of the National Task Force on Student Aid Problems. The task force was a voluntary association of concerned and interested agencies and organizations. Its only standing came from the support of those directly concerned with student aid problems. By design and…

Higher Education Equity: The Crisis of Appearance Versus Reality--Revisited. Final Report.

ERIC Educational Resources Information Center

National Advisory Committee on Black Higher Education and Black Colleges and Universities (DHEW), Washington, DC.

The work of the National Advisory Committee on Black Higher Education and Black Colleges and Universities during 1977-1982 is discussed, and information and recommendations on black students and black colleges are presented. After describing the committee's background and functions, the following issues concerning equity for black Americans in…

Concept Paper on Health and Safety Issues in Day Care. Final Manuscript.

ERIC Educational Resources Information Center

Pizzo, Peggy; Aronson, Susan S.

This report discusses the existence and prevention of major health and safety risks for children in day care and makes recommendations for the Federal Interagency Day Care requirements (FIDCR) concerning health and safety. Section I describes varying concepts of risk related to probability and to possibility of adverse events, and discusses…

Excellence within Student Affairs: Understanding the Practice of Integrating Academic and Student Affairs

ERIC Educational Resources Information Center

Ozaki, C. Casey; Hornak, Anne M.

2014-01-01

In this final chapter, the authors synthesize and draw from chapters across this volume to provide concluding remarks and recommendations. The authors suggest that core to the discussion of excellence of student affairs in community colleges are the concepts of integration and collaboration. As professionals tasked with supporting the student…

Space Shuttle/TDRSS communication and tracking systems analysis

NASA Astrophysics Data System (ADS)

Lindsey, W. C.; Chie, C. M.; Cideciyan, R.; Dessouky, K.; Su, Y. T.; Tsang, C. S.

1986-04-01

In order to evaluate the technical and operational problem areas and provide a recommendation, the enhancements to the Tracking and Data Delay Satellite System (TDRSS) and Shuttle must be evaluated through simulation and analysis. These enhancement techniques must first be characterized, then modeled mathematically, and finally updated into LinCsim (analytical simulation package). The LinCsim package can then be used as an evaluation tool. Three areas of potential enhancements were identified: shuttle payload accommodations, TDRSS SSA and KSA services, and shuttle tracking system and navigation sensors. Recommendations for each area were discussed.

Space Shuttle/TDRSS communication and tracking systems analysis

NASA Technical Reports Server (NTRS)

Lindsey, W. C.; Chie, C. M.; Cideciyan, R.; Dessouky, K.; Su, Y. T.; Tsang, C. S.

1986-01-01

In order to evaluate the technical and operational problem areas and provide a recommendation, the enhancements to the Tracking and Data Delay Satellite System (TDRSS) and Shuttle must be evaluated through simulation and analysis. These enhancement techniques must first be characterized, then modeled mathematically, and finally updated into LinCsim (analytical simulation package). The LinCsim package can then be used as an evaluation tool. Three areas of potential enhancements were identified: shuttle payload accommodations, TDRSS SSA and KSA services, and shuttle tracking system and navigation sensors. Recommendations for each area were discussed.

United States Air Force 611th Air Support Group/Civil Engineering Squadron, Elmendorf AFB, Alaska. Decision document for no further response action planned Oliktok Point Radar Installation, Alaska. Final report

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

Karmi, S.

1996-06-03

This Decision Document discusses the selection of no further action as the recommended action for four sites located at the Oliktok Point radar installation. The United States Air Force (Air Force) completed a Remedial Investigation/Feasibility Study and a Risk Assessment for the eight sites located at the Oliktok Point installation (U.S. Air Force 1996a,b). Based on the findings of these activities, four sites are recommended for no further action.

A study of an orbital radar mapping mission to Venus. Volume 2: Configuration comparisons and systems evaluation

NASA Technical Reports Server (NTRS)

1973-01-01

Configuration comparisons and systems evaluation for the orbital radar mapping mission of the planet Venus are discussed. Designs are recommended which best satisfy the science objectives of the Venus radar mapping concept. Attention is given to the interaction and integration of those specific mission-systems recommendations with one another, and the final proposed designs are presented. The feasibility, cost, and scheduling of these configurations are evaluated against assumptions of reasonable state-of-the-art growth and space funding expectations.

A Dermatologist's Perspective on Vitamin D

PubMed Central

Vanchinathan, Veena; Lim, Henry W.

2012-01-01

Vitamin D is a fat-soluble steroid hormone that is crucial for human health and has recently generated controversy regarding its role in human health and disease. In this Special Article, we discuss our dermatologic perspective on vitamin D in a question-and-answer format. We discuss methods of obtaining vitamin D, including cutaneous photobiosynthesis, diet, and supplements and include the recent US Institute of Medicine recommendations. Other reviewed topics include the associations among skin pigmentation, climate, photoprotection, and vitamin D levels. We also elaborate on the popular interest in sun exposure as a method of normalizing vitamin D levels in the context of the risks of solar and artificial radiation. We also discuss groups at risk for vitamin D inadequacy, the need for testing serum vitamin D levels, and the role of phototherapy in patients with malabsorption conditions and hypervitaminosis D, with a focus on patients with sarcoidosis. Finally, we summarize our recommendations on vitamin D. PMID:22425213

Advanced extravehicular protective systems study, volume 2

NASA Technical Reports Server (NTRS)

Sutton, J. G.; Heimlich, P. F.; Tepper, E. H.

1972-01-01

The results of the subsystem studies are presented. Initial identification and evaluation of candidate subsystem concepts in the area of thermal control, humidity control, CO2 control/O2 supply, contaminant control and power supply are discussed. The candidate concepts that were judged to be obviously noncompetitive were deleted from further consideration and the remaining candidate concepts were carried into the go/no go evaluation. A detailed parametric analysis of each of the thermal/humidity control and CO2 control/O2 supply subsystem concepts which passed the go/no go evaluation is described. Based upon the results of the parametric analyses, primary and secondary evaluations of the remaining candidate concepts were conducted. These results and the subsystem recommendations emanating from these results are discussed. In addition, the parametric analyses of the recommended subsystem concepts were updated to reflect the final AEPS specification requirements. A detailed discussion regarding the selection of the AEPS operating pressure level is presented.

Report of the APS Ad-Hoc Committee on LGBT Issues - Presentation of Findings and Recommendations

NASA Astrophysics Data System (ADS)

Falk, Michael

In 2014 the Executive Officer of the American Physical Society (APS), Kate Kirby, created an Ad-Hoc Committee on LGBT Issues (C-LGBT) charged with reporting on the obstacles to inclusion of LGBT physicists, a term which for the purpose of this report refers to persons who self-identify as lesbian, gay, bisexual, transgender, queer, questioning, intersex, or asexual, as well as other sexual and gender minorities. The full charge was as follows: ``The committee will advise the APS on the current status of LGBT issues in physics, provide recommendations for greater inclusion, and engage physicists in laying the foundation for a more inclusive physics community. ?More specifically, the committee will investigate LGBT representation in physics, assess the educational and professional climate in physics, recommend changes in policies and practices that impact LGBT physicists, and address other issues that affect inclusion.'' We will present the findings and recommendations of the C-LGBT final report, and a panel discussion will be held following the presentation to discuss the future of APS efforts toward LGBT inclusion in physics.

Report of the APS Ad-Hoc Committee on LGBT Issues - Presentation of Findings and Recommendations

NASA Astrophysics Data System (ADS)

Long, Elena

2016-03-01

In 2014 the Executive Officer of the American Physical Society (APS), Kate Kirby, created an Ad-Hoc Committee on LGBT Issues (C-LGBT) charged with reporting on the obstacles to inclusion of LGBT physicists, a term which for the purpose of this report refers to persons who self-identify as lesbian, gay, bisexual, transgender, queer, questioning, intersex, or asexual, as well as other sexual and gender minorities. The full charge was as follows: ``The committee will advise the APS on the current status of LGBT issues in physics, provide recommendations for greater inclusion, and engage physicists in laying the foundation for a more inclusive physics community? More specifically, the committee will investigate LGBT representation in physics, assess the educational and professional climate in physics, recommend changes in policies and practices that impact LGBT physicists, and address other issues that affect inclusion.'' We will present the findings and recommendations of the C-LGBT final report, and a panel discussion will be held following the presentation to discuss the future of APS efforts toward LGBT inclusion in physics.

[Consensus statement: recommendations for the management of metabolic bone disease in human immunodeficiency virus patients].

PubMed

Martínez, Esteban; Jódar Gimeno, Esteban; Reyes García, Rebeca; Carpintero, Pedro; Casado, José Luis; Del Pino Montes, Javier; Domingo Pedrol, Pere; Estrada, Vicente; Maalouf, Jorge; Negredo, Eugenia; Ocampo, Antonio; Muñoz-Torres, Manuel

2014-04-01

To provide practical recommendations for the evaluation and treatment of metabolic bone disease in human immunodeficiency virus (HIV) patients. Members of scientific societies related to bone metabolism and HIV: Grupo de Estudio de Sida (GeSIDA), Sociedad Española de Endocrinología y Nutrición (SEEN), Sociedad Española de Investigación Ósea y del Metabolismo Mineral (SEIOMM), and Sociedad Española de Fractura Osteoporótica (SEFRAOS). A systematic search was carried out in PubMed, and papers in English and Spanish with a publication date before 28 May 2013 were included. Recommendations were formulated according to GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) setting both their strength and the quality of supporting evidence. Working groups were established for each major part, and the final resulting document was later discussed in a face-to-face meeting. All the authors reviewed the final written document and agreed with its content. The document provides evidence-based practical recommendations on the detection and treatment of bone disease in HIV-infected patients. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

IMIA Educational Recommendations and Nursing Informatics.

PubMed

Mantas, John; Hasman, Arie

2017-01-01

The updated version of the IMIA educational recommendations has given an adequate guidelines platform for developing educational programs in Biomedical and Health Informatics at all levels of education, vocational training, and distance learning. This chapter will provide a brief introduction of the recommendations pinpointing aspects for developing and assessing educational programs. We will provide a review of the existing feedback we have acquired during the IMIA site visits of accrediting educational programs at a worldwide level and discuss implementations issues. A brief overview of existing academic programs in Europe, North America and in other regions, especially for programs related to Nursing and to Nursing Informatics is provided. Finally, we will draw conclusions as how the IMIA recommendations may be required to be fitted into the specific needs of the Nursing Informatics and the needs of the Nursing professionals when they apply the recommendations to their academic and/or hospital/professional environments.

Concept maps and language: a Turkish experience

NASA Astrophysics Data System (ADS)

Bagci Kilic, Gulsen

2003-11-01

Concept maps are being used by an increasing number of educators in Europe and the US. This paper has four goals. First, it discusses problems in developing Novak's style concept maps in Turkish caused by linguistic differences between Turkish and English. Second, it reports the findings of a research study conducted to adapt concept maps to Turkish. Third, it recommends three methods for the adaptation resulting from research findings. Finally, it discusses the implications of the adaptation for educators worldwide and for future research.

Youth and Work: The Incidence of the Economic Situation on the Access of Young People to Education, Culture and Work. Report, Recommendations and Documents of a European Regional Meeting, Venice, 7-11 November, 1977.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

This document contains materials from a Unesco European regional meeting held in Venice (November 7-11, 1977) to discuss the problem of youth unemployment. The final report of the meeting is composed of (1) a summary of the discussions on background and nature of the problem, remedies, action, education and training, creating jobs, quality of…

Multinational evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative

PubMed Central

Machado, P; Castrejon, I; Katchamart, W; Koevoets, R; Kuriya, B; Schoels, M; Silva-Fernández, L; Thevissen, K; Vercoutere, W; Villeneuve, E; Aletaha, D; Carmona, L; Landewé, R; van der Heijde, D; Bijlsma, J W J; Bykerk, V; Canhão, H; Catrina, A I; Durez, P; Edwards, C J; Mjaavatten, M D; Leeb, B F; Losada, B; Martín-Mola, E M; Martinez-Osuna, P; Montecucco, C; Müller-Ladner, U; Østergaard, M; Sheane, B; Xavier, R M; Zochling, J; Bombardier, C

2011-01-01

Objective To develop evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis (UPIA). Methods 697 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2008–9 consisting of three separate rounds of discussions and modified Delphi votes. In the first round 10 clinical questions were selected. A bibliographic team systematically searched Medline, Embase, the Cochrane Library and ACR/EULAR 2007–2008 meeting abstracts. Relevant articles were reviewed for quality assessment, data extraction and synthesis. In the second round each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. Results A total of 39 756 references were identified, of which 250 were systematically reviewed. Ten multinational key recommendations about the investigation and follow-up of UPIA were formulated. One recommendation addressed differential diagnosis and investigations prior to establishing the operational diagnosis of UPIA, seven recommendations related to the diagnostic and prognostic value of clinical and laboratory assessments in established UPIA (history and physical examination, acute phase reactants, autoantibodies, radiographs, MRI and ultrasound, genetic markers and synovial biopsy), one recommendation highlighted predictors of persistence (chronicity) and the final recommendation addressed monitoring of clinical disease activity in UPIA. Conclusions Ten recommendations on how to investigate and follow-up UPIA in the clinical setting were developed. They are evidence-based and supported by a large panel of rheumatologists, thus enhancing their validity and practical use. PMID:20724311

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

PubMed Central

Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

2015-01-01

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med 2015;11(8):931–952. PMID:26235159

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

PubMed Central

Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

2015-01-01

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. SLEEP 2015;38(8):1161–1183. PMID:26194576

Program for International Student Assessment (PISA) 2006 and Scientific Literacy: A Perspective for Science Education Leaders

ERIC Educational Resources Information Center

Bybee, Rodger W.

2009-01-01

This article describes the idea of scientific literacy as defined in PISA, discusses relevant results of PISA, and clarifies meaningful relationships between PISA data and scientific competencies of U.S. students. Finally, the author includes insights and recommendations for contemporary leadership in science education. (Contains 8 tables and 1…

Incentive and Disincentive to Participation in the Work Incentive Program. Final Report.

ERIC Educational Resources Information Center

Garvin, Charles D., Ed.

Initially this report presents a summary of three Work Incentive Programs (WIN) undertaken by a consortium of schools of social work at the University of Chicago, University of Michigan, and Case Western Reserve University, discussing in detail the design, major findings, and recommendations made. The next two chapters are devoted to discussions…

75 FR 36102 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

... will discuss, make recommendations, and vote on premarket approval application for MelaFind, sponsored by MELA Sciences, Inc. MelaFind is a non-invasive computer vision system intended to assist in the... characteristics of melanoma, before a final decision to biopsy has been rendered. MelaFind acquires and displays...

APA (American Psychological Association) Task Force on Privacy and Confidentiality. Final Report.

ERIC Educational Resources Information Center

American Psychological Association, Washington, DC.

This Task Force on Privacy and Confidentiality is intended to call attention to the central role of the right to privacy in the maintenance and enrichment of a free society. The psychological implications of the changing views of privacy as reflected in political, social, and technological developments are discussed, and recommendations relating…

Psychological Evaluation of Children Who Are Deaf-Blind: An Overview with Recommendations for Practice. Revised

ERIC Educational Resources Information Center

Mar, Harvey

2010-01-01

This fact sheet provides answers to frequently asked questions about psychological evaluations for infants, children and adults who are deaf-blind, we hope to clarify the evaluation process and the active roles that may be taken by everyone who is involved--family members, professionals, educators, and the student. Finally, by discussing quality…

Hacia la Realizacion de la Autoestima. Informe Definitivo del Comite Estatal en Pro de la Autoestima y de la Responsabilidad Personal y Social (Toward a State of Esteem. Final Report of the State Committee to Promote Self-Esteem and Personal and Social Responsibility).

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento.

This is the Spanish version of the final report of a California Task Force created to promote self-esteem and personal responsibility. It begins with an executive summary listing key principles of the task force and providing recommendations and discussions in each of six major areas upon which the report focuses. The next section presents the…

Consensus document on osteoporosis in males.

PubMed

Varsavsky, Mariela; Romero Muñoz, Manuel; Ávila Rubio, Verónica; Becerra, Antonio; García Martín, Antonia; Martínez Díaz-Guerra, Guillermo; Rozas Moreno, Pedro; Jódar Gimeno, Esteban; Muñoz Torres, Manuel

2018-03-01

To provide practical recommendations to assess and treat osteoporosis in males. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in Medline (PubMed) using the following associated terms: «osteoporosis», «men», «fractures», «bone mineral density», «treatment», «hypogonadism», and «prostate cancer». Papers in English and Spanish with publication date before 30 August 2017 were included. Current evidence for each disease was reviewed by 2group members. Finally, recommendations were discussed in a meeting of the working group. The document provides evidence-based practical recommendations for diagnosis, assessment, and management of osteoporosis in men and special situations such as hypogonadism and prostate cancer. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Quality assurance in nuclear medicine facilities; availability of final recommendations--FDA. Notice.

PubMed

1985-05-13

The Food and Drug Administration (FDA) is announcing the availability of final recommendations prepared by its Center for Devices and Radiological Health (CDRH) on quality assurance programs in nuclear medicine facilities. The final recommendations include the agency's rationale for the recommendations as well as references that can be used as well as references that can be used as guides in conducting quality control monitoring. These final recommendations are available as a technical report in CDRH's radiation recommendations series. They are intended to encourage and promote the development of voluntary quality assurance programs in nuclear medicine facilities.

United States Air Force 611th Air Support Group/Civil Engineering Squadron Elmendorf AFB, Alaska. Decision document for no further response action planned: Bullen Point Radar Installation, Alaska. Final report

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

Karmi, S.

1996-05-24

This Decision Document discusses the selection of no further action as the recommended action for two sites located at the Bullen Point radar installation. The United States Air Force (Air Force) completed a Remedial Investigation/Feasibility Study and a Risk Assessment for the five sites located at the Bullen Point installation (U.S. Air Force 1996a,b). Based on the findings of these activities, two sites are recommended for no further action. Sites at the Bullen Point radar installation recommended for no further action are: Old Landfill/Dump Site East (LF06) and Drum Storage Area (SS10).

United States Air Force 611th Air Support Group/Civil Engineering Squadron Elmendorf AFB, Alaska. Decision document for no further response action planned: Barter Island Radar Installation, Alaska. Final report, December 1995-May 1996

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

Karmi, S.; Madden, J.; Borsetti, R.

1996-05-03

This Decision Document discusses the selection of no further action as the recommended action for nine sites located at the Barter Island radar installation. The United States Air Force (Air Force) completed a Remedial Investigation/Feasibility Study and a Risk Assessment for the 14 sites located at the Barter Island installation (U.S. Air Force 1996a,b). Based on the findings of these activities, nine sites are recommended for no further action.

The 100 cm solar telescope primary mirror study

NASA Technical Reports Server (NTRS)

1975-01-01

The manufacturing impact of primary mirror configuration on the performance of a 100 cm aperture solar telescope was studied. Three primary mirror configurations were considered: solid, standard lightweight, and mushroom. All of these are of low expansion material. Specifically, the study consisted of evaluating the mirrors with regard to: manufacturing metrology, manufacturing risk factors and ultimate quality assessment. As a result of this evaluation, a performance comparison of the configurations was made, and a recommendation of mirror configuration is the final output. These evaluations, comparisons and recommendations are discussed in detail. Other investigations were completed and are documented in the appendices.

Evaluating Recommendation Systems

NASA Astrophysics Data System (ADS)

Shani, Guy; Gunawardana, Asela

Recommender systems are now popular both commercially and in the research community, where many approaches have been suggested for providing recommendations. In many cases a system designer that wishes to employ a recommendation system must choose between a set of candidate approaches. A first step towards selecting an appropriate algorithm is to decide which properties of the application to focus upon when making this choice. Indeed, recommendation systems have a variety of properties that may affect user experience, such as accuracy, robustness, scalability, and so forth. In this paper we discuss how to compare recommenders based on a set of properties that are relevant for the application. We focus on comparative studies, where a few algorithms are compared using some evaluation metric, rather than absolute benchmarking of algorithms. We describe experimental settings appropriate for making choices between algorithms. We review three types of experiments, starting with an offline setting, where recommendation approaches are compared without user interaction, then reviewing user studies, where a small group of subjects experiment with the system and report on the experience, and finally describe large scale online experiments, where real user populations interact with the system. In each of these cases we describe types of questions that can be answered, and suggest protocols for experimentation. We also discuss how to draw trustworthy conclusions from the conducted experiments. We then review a large set of properties, and explain how to evaluate systems given relevant properties. We also survey a large set of evaluation metrics in the context of the properties that they evaluate.

Study Partners Recommendation for xMOOCs Learners

PubMed Central

Xu, Bin; Yang, Dan

2015-01-01

Massive open online courses (MOOCs) provide an opportunity for people to access free courses offered by top universities in the world and therefore attracted great attention and engagement from college teachers and students. However, with contrast to large scale enrollment, the completion rate of these courses is really low. One of the reasons for students to quit learning process is problems which they face that could not be solved by discussing them with classmates. In order to keep them staying in the course, thereby further improving the completion rate, we address the task of study partner recommendation for students based on both content information and social network information. By analyzing the content of messages posted by learners in course discussion forum, we investigated the learners' behavior features to classify the learners into three groups. Then we proposed a topic model to measure learners' course knowledge awareness. Finally, a social network was constructed based on their activities in the course forum, and the relationship in the network was then employed to recommend study partners for target learner combined with their behavior features and course knowledge awareness. The experiment results show that our method achieves better performance than recommending method only based on content information. PMID:25663836

Round Table of Bankers, Economists and Financiers on Literacy; Final Report (Rome, Italy, February 11-13, 1969).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

A report on the Round Table of Bankers, Economists and Financiers on Literacy contains a brief summary of discussion, the eleven recommendations of the Round Table, and the opening address given by Mr. Rene Maheu, Director-General of Unesco. The consensus of the participants' opinions was that literacy is essential to development, that functional…

Tax-exempt hospitals and community benefits: a review of state reporting requirements.

PubMed

Hellinger, Fred Joseph

2009-02-01

In June 2007 the Internal Revenue Service proposed a major overhaul of its reporting requirements for tax-exempt hospitals and released draft Form 990 (the IRS form filed by tax-exempt organizations each year). In December 2007 the IRS promulgated the final Form 990 after incorporating some of the recommendations made in the almost seven hundred public comments on the discussion draft. One recommendation adopted in the final Form 990 is the postponement until tax year 2009 (returns filed in 2010) of the requirement for hospitals to submit detailed information on the percentage of total expenses attributable to charity care, unreimbursed Medicaid costs, and community-health improvement programs (the discussion draft required this information for tax year 2007). Although the IRS will not require tax-exempt hospitals to provide detailed information about community benefits until the 2009 tax year, sixteen states have laws requiring tax-exempt hospitals to enumerate the benefits that they provide to the community. Information about the impact of these laws on the provision of community benefits (e.g., charity and uncompensated care) is examined in this study whose primary purpose is to highlight information policy makers may glean from states that have adopted community-benefit reporting laws.

Development of EULAR recommendations for the reporting of clinical trial extension studies in rheumatology

PubMed Central

Buch, Maya H; Silva-Fernandez, Lucia; Carmona, Loreto; Aletaha, Daniel; Christensen, Robin; Combe, Bernard; Emery, Paul; Ferraccioli, Gianfranco; Guillemin, Francis; Kvien, Tore K; Landewe, Robert; Pavelka, Karel; Saag, Kenneth; Smolen, Josef S; Symmons, Deborah; van der Heijde, Désirée; Welling, Joep; Wells, George; Westhovens, Rene; Zink, Angela; Boers, Maarten

2015-01-01

Objectives Our initiative aimed to produce recommendations on post-randomised controlled trial (RCT) trial extension studies (TES) reporting using European League Against Rheumatism (EULAR) standard operating procedures in order to achieve more meaningful output and standardisation of reports. Methods We formed a task force of 22 participants comprising RCT experts, clinical epidemiologists and patient representatives. A two-stage Delphi survey was conducted to discuss the domains of evaluation of a TES and definitions. A ‘0–10’ agreement scale assessed each domain and definition. The resulting set of recommendations was further refined and a final vote taken for task force acceptance. Results Seven key domains and individual components were evaluated and led to agreed recommendations including definition of a TES (100% agreement), minimal data necessary (100% agreement), method of data analysis (agreement mean (SD) scores ranging between 7.9 (0.84) and 9.0 (2.16)) and reporting of results as well as ethical issues. Key recommendations included reporting of absolute numbers at each stage from the RCT to TES with reasons given for drop-out at each stage, and inclusion of a flowchart detailing change in numbers at each stage and focus (mean (SD) agreement 9.9 (0.36)). A final vote accepted the set of recommendations. Conclusions This EULAR task force provides recommendations for implementation in future TES to ensure a standardised approach to reporting. Use of this document should provide the rheumatology community with a more accurate and meaningful output from future TES, enabling better understanding and more confident application in clinical practice towards improving patient outcomes. PMID:24827533

Harnessing Light: Capitalizing on Optical Science Trends and Challenges for Future Research. Final Technical Report

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

Svedberg, Erik

2014-02-06

The committee has during the earlier period finalized their work on the report, Optics and Photonics: Essential Technologies for Our Nation (2013) . The report did undergo review and initial editorial processing. The NRC released a pre-publication report on August 13, 2012. A final report is now available. The study director has been able to practice his skills in running a national academies committee. From a research perspective the grant has generated a report with recommendations to the government. The work itself is the meetings where the committee convened to hear presenters and to discuss the status of optics andmore » photonics as well as writing the report.« less

Identification and management of comorbidity in psoriatic arthritis: evidence- and expert-based recommendations from a multidisciplinary panel from Spain.

PubMed

Torre-Alonso, Juan Carlos; Carmona, Loreto; Moreno, Mireia; Galíndez, Eva; Babío, Jesús; Zarco, Pedro; Linares, Luis; Collantes-Estevez, Eduardo; Barrial, Manuel Fernández; Hermosa, Juan Carlos; Coto, Pablo; Suárez, Carmen; Almodóvar, Raquel; Luelmo, Jesús; Castañeda, Santos; Gratacós, Jordi

2017-08-01

The objective is to establish recommendations, based on evidence and expert opinion, for the identification and management of comorbidities in patients with psoriatic arthritis (PsA). The following techniques were applied: discussion group, systematic review, and Delphi survey for agreement. A panel of professionals from four specialties defined the users, the sections of the document, possible recommendations, and what systematic reviews should be performed. A second discussion was held with the results of the systematic reviews. Recommendations were formulated in the second meeting and voted online from 1 (total disagreement) to 10 (total agreement). Agreement was considered if at least 70% voted ≥7. The level of evidence and grade of recommendation were assigned using the Oxford Centre for Evidence-Based Medicine guidance. The full document was critically appraised by the experts, and the project was supervised at all times by a methodologist. In a final step, the document was reviewed and commented by a patient and a health management specialist. Fourteen recommendations were produced, together with a checklist to facilitate the implementation. The items with the largest support from evidence were those related to cardiovascular disease and risk factors. The panel recommends paying special attention to obesity, smoking, and alcohol consumption, as they are all modifiable factors with an impact on treatment response or complications of PsA. Psychological and organizational aspects were also deemed important. We herein suggest practical recommendations for the management of comorbidities in PsA based on evidence and expert opinion.

[Delivery management for the prevention of shoulder dystocia in case of identified risk factors].

PubMed

Schmitz, T

2015-12-01

To determine the impact of (i) computed tomographic (CT) pelvimetry for the choice of the mode of delivery, (ii) cesarean, (iii) induction of labor, and of (iv) various delivery managements on the risk of shoulder dystocia in case of fetal macrosomia, with or without maternal diabetes, and in women with previous history of shoulder dystocia. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. In case of clinically suspected macrosomia, a sonography should be performed to increase diagnostic performances and to assist in decision-making (Professional consensus). Because CT pelvimetry is associated with high false positive rates and increases cesarean deliveries, its use is not recommended to prevent shoulder dystocia in case of fetal macrosomia (Professional consensus). To avoid the neonatal complications of shoulder dystocia, mainly permanent brachial plexus palsy, cesarean delivery is recommended in case of estimated fetal weight (EFW) greater than 4500 g if associated with maternal diabetes (grade C), and greater than 5000 g in the absence of maternal diabetes (grade C). The published data do not provide definitive evidences to recommend systematic labor induction in case of impending fetal macrosomia (Professional consensus). In case of favourable cervix and gestational age greater than 39 weeks of gestation, labor induction should be promoted (Professional consensus). Prophylactic McRoberts maneuver is not recommended to prevent shoulder dystocia in case of fetal macrosomia (grade C). Because data are lacking, no recommendation is possible regarding the use of episiotomy. In case of fetal macrosomia and failure to progress in the second stage of labor, midpelvic and higher instrumental deliveries are not recommended and a cesarean delivery should be preferred (grade C), if the fetal head is at or lower than a +2 station, cesarean delivery is not recommended and an instrumental delivery should be preferred (grade C). Finally, cesarean delivery should be discussed when history of shoulder dystocia has been associated with severe neonatal or maternal complications (Professional consensus). To avoid shoulder dystocia and its complications, only two measures are proposed. Induction of labor is recommended in case of impending macrosomia if the cervix is favourable and gestational age greater than 39 weeks of gestation (Professional consensus). Cesarean delivery is recommended before labor in case of (i) EFW greater than 4500 g if associated with maternal diabetes (grade C), (ii) EFW greater than 5000 g in the absence of maternal diabetes (grade C), and finally (iii) during labor, in case of fetal macrosomia and failure to progress in the second stage, when the fetal head is above a +2 station (grade C). Finally, cesarean delivery should be discussed when history of shoulder dystocia has been associated with severe neonatal or maternal complications (Professional consensus). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Sport Activity for Health!! The Effects of Karate Participants' Involvement, Perceived Value, and Leisure Benefits on Recommendation Intention.

PubMed

Chang, Ying-Chih; Yeh, Tsu-Ming; Pai, Fan-Yun; Huang, Tai-Peng

2018-05-10

This study intends to discuss the effects of participants’ involvement, perceived value, and leisure benefits on recommendation intention in the sport of karate. The questionnaires were collected online by karate clubs on Facebook and included 369 valid participants. The research findings show that karate participants from different places of residence do not display significant differences in involvement, perceived value, leisure benefits, and recommendation intention. Furthermore, “attraction” in the involvement category reveals the highest mean, “paid spirit and energy being worthy” in perceived value appears as the highest mean, and “physiological benefits” in leisure benefits shows the highest mean. The Pearson correlation analysis result presents significant strong positive correlations between involvement, perceived value, leisure benefits, and recommendation intention. Finally, multiple regression analysis reveals that leisure benefits, except “physiological benefits”, show notably positive effects on recommendation intention. According to the research results, suggestions are proposed for the reference of karate teaching business managers, participants, and future research.

Sport Activity for Health!! The Effects of Karate Participants’ Involvement, Perceived Value, and Leisure Benefits on Recommendation Intention

PubMed Central

Chang, Ying-Chih; Pai, Fan-Yun; Huang, Tai-Peng

2018-01-01

This study intends to discuss the effects of participants’ involvement, perceived value, and leisure benefits on recommendation intention in the sport of karate. The questionnaires were collected online by karate clubs on Facebook and included 369 valid participants. The research findings show that karate participants from different places of residence do not display significant differences in involvement, perceived value, leisure benefits, and recommendation intention. Furthermore, “attraction” in the involvement category reveals the highest mean, “paid spirit and energy being worthy” in perceived value appears as the highest mean, and “physiological benefits” in leisure benefits shows the highest mean. The Pearson correlation analysis result presents significant strong positive correlations between involvement, perceived value, leisure benefits, and recommendation intention. Finally, multiple regression analysis reveals that leisure benefits, except “physiological benefits”, show notably positive effects on recommendation intention. According to the research results, suggestions are proposed for the reference of karate teaching business managers, participants, and future research. PMID:29748459

Effective antenatal education: strategies recommended by expectant and new parents.

PubMed

Svensson, Jane; Barclay, Lesley; Cooke, Margaret

2008-01-01

Antenatal education is a crucial component of antenatal care, yet practice and research demonstrate that women and men now seek far more than the traditional approach of a birth and parenting program attended in the final weeks of pregnancy. Indeed, women and men participating in this study recommended a range of strategies to be provided during the childbearing year, comparable to a "menu in a restaurant." Their strategies included three program types: "Hearing Detail and Asking Questions," "Learning and Discussing," and "Sharing and Supporting Each Other." The characteristics of each type of program are identified in this article. The actual learning methods the study participants recommended to be incorporated into the programs were "Time to Catch Up and Focus," "Seeing and Hearing the Real Experience," "Practicing," and "Discovering."

Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region.

PubMed

Cameron, Donald; Hock, Quak Seng; Kadim, Musal; Mohan, Neelam; Ryoo, Eell; Sandhu, Bhupinder; Yamashiro, Yuichiro; Jie, Chen; Hoekstra, Hans; Guarino, Alfredo

2017-12-07

Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system. Saccharomyces boulardii CNCM I-745 (Sb) and Lactobacillus rhamnosus GG ( LGG ) were strongly recommended as adjunct treatment to oral rehydration therapy for gastroenteritis. Lactobacillus reuteri could also be considered. Probiotics may be considered for prevention of (with the indicated strains): antibiotic-associated diarrhea (LGG or Sb); Clostridium difficile -induced diarrhea (Sb); nosocomial diarrhea (LGG); infantile colic ( L reuteri ) and as adjunct treatment of Helicobacter pylori (Sb and others). Specific probiotics with a history of safe use in preterm and term infants may be considered in infants for prevention of necrotizing enterocolitis. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations apply well to Asia pacific countries. These need to be validated with local randomized-controlled trials.

CEO performance appraisal: review and recommendations.

PubMed

Newman, J F; Tyler, L; Dunbar, D M

2001-01-01

CEO performance appraisal (PA) is very valuable to an organization, but the chances of obtaining a PA of high quality decrease as executive responsibility increases. The realities of CEO PA are that it: (1) is inevitable; (2) is creative and complex; (3) involves politics; and (4) has a significant effect on the organization and the executive. PA is conducted for legal and social requirements, to enhance communication, to provide opportunities for improvement, and to relate performance to compensation. This article discusses several problems with chief executive officer (CEO) PA and the contemporary approaches that seek to improve it. Three fundamental areas for evaluation are identified: (1) organizational success; (2) areawide health status; and (3) professional role fulfillment. These provide an outline for successful healthcare PA. In addition to a discussion of the strategic considerations behind a successful CEO PA system, several recommendations are offered for the implementation of the annual evaluation process. The final goal of CEO PA is to link its results to CEO incentive compensation. It is strongly recommended that some portion of the CEO's salary directly hinge on his performance in two critical areas: organizational effectiveness and community health status.

A robotic exploration mission to Mars and Phobos

NASA Technical Reports Server (NTRS)

Kerr, Justin H.; Defosse, Erin; Ho, Quang; Barriga, Ernisto; Davis, Grant; Mccourt, Steve; Smith, Matt

1993-01-01

This report discusses the design of a robotic exploration to Mars and Phobos. It begins with the mission's background and objectives, followed by a detailed explanation of various elements of Project Aeneas, including science, spacecraft, probes, and orbital trajectories. In addition, a description of Argos Space Endeavours, management procedures, and overall project costs are presented. Finally, a list of recommendations for future design activity is included.

Modular Engine Noise Component Prediction System (MCP) Technical Description and Assessment Document

NASA Technical Reports Server (NTRS)

Herkes, William H.; Reed, David H.

2005-01-01

This report describes an empirical prediction procedure for turbofan engine noise. The procedure generates predicted noise levels for several noise components, including inlet- and aft-radiated fan noise, and jet-mixing noise. This report discusses the noise source mechanisms, the development of the prediction procedures, and the assessment of the accuracy of these predictions. Finally, some recommendations for future work are presented.

Study of optical techniques for the Ames unitary wind tunnel, part 7

NASA Technical Reports Server (NTRS)

Lee, George

1993-01-01

A summary of optical techniques for the Ames Unitary Plan wind tunnels are discussed. Six optical techniques were studied: Schlieren, light sheet and laser vapor screen, angle of attack, model deformation, infrared imagery, and digital image processing. The study includes surveys and reviews of wind tunnel optical techniques, some conceptual designs, and recommendations for use of optical methods in the Ames Unitary Plan wind tunnels. Particular emphasis was placed on searching for systems developed for wind tunnel use and on commercial systems which could be readily adapted for wind tunnels. This final report is to summarize the major results and recommendations.

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion.

PubMed

Watson, Nathaniel F; Badr, M Safwan; Belenky, Gregory; Bliwise, Donald L; Buxton, Orfeu M; Buysse, Daniel; Dinges, David F; Gangwisch, James; Grandner, Michael A; Kushida, Clete; Malhotra, Raman K; Martin, Jennifer L; Patel, Sanjay R; Quan, Stuart F; Tasali, Esra

2015-08-01

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. © 2015 Associated Professional Sleep Societies, LLC.

Consensus and controversies in best practices for molecular genetic testing of spinocerebellar ataxias

PubMed Central

Sequeiros, Jorge; Seneca, Sara; Martindale, Joanne

2010-01-01

Many laboratories worldwide are offering molecular genetic testing for spinocerebellar ataxias (SCAs). This is essential for differential diagnosis and adequate genetic counselling. The European Molecular Genetics Quality Network (EMQN) started an SCA external quality assessment scheme in 2004. There was a clear need for updated laboratory guidelines. EMQN and EuroGentest organized a Best Practice (BP) meeting to discuss current practices and achieve consensus. A pre-meeting survey showed that 36 laboratories (20 countries) conducted nearly 18 000 SCA tests the year before, and identified issues to discuss. Draft guidelines were produced immediately after the meeting and discussed online for several months. The final version was endorsed by EMQN, and harmonized with guidelines from other oligonucleotide repeat disorders. We present the procedures taken to organize the survey, BP meeting, as well as drafting and approval of BP guidelines. We emphasize the most important recommendations on (1) pre-test requirements, (2) appropriate methodologies and (3) interpretation and reporting, and focus on the discussion of controversial issues not included in the final document. In addition, after an extensive review of scientific literature, and responding to recommendations made, we now produce information that we hope will facilitate the activities of diagnostic laboratories and foster quality SCA testing. For the main loci, this includes (1) a list of repeat sequences, as originally published; (2) primers in use; and (3) an evidence-based description of the normal and pathogenic repeat-size ranges, including those of reduced penetrance and those in which there is still some uncertainty. This information will be maintained and updated in http://www.scabase.eu. PMID:20179748

Health Recommender Systems: Concepts, Requirements, Technical Basics and Challenges

PubMed Central

Wiesner, Martin; Pfeifer, Daniel

2014-01-01

During the last decades huge amounts of data have been collected in clinical databases representing patients' health states (e.g., as laboratory results, treatment plans, medical reports). Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS) are meant to centralize an individual's health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS). In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed. PMID:24595212

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

Gaffney, David K., E-mail: david.gaffney@hci.utah.edu; King, Bronwyn; Viswanathan, Akila N.

Purpose: The purpose of this study was to develop a radiation therapy (RT) contouring atlas and recommendations for women with postoperative and locally advanced vulvar carcinoma. Methods and Materials: An international committee of 35 expert gynecologic radiation oncologists completed a survey of the treatment of vulvar carcinoma. An initial set of recommendations for contouring was discussed and generated by consensus. Two cases, 1 locally advanced and 1 postoperative, were contoured by 14 physicians. Contours were compared and analyzed using an expectation-maximization algorithm for simultaneous truth and performance level estimation (STAPLE), and a 95% confidence interval contour was developed. The levelmore » of agreement among contours was assessed using a kappa statistic. STAPLE contours underwent full committee editing to generate the final atlas consensus contours. Results: Analysis of the 14 contours showed substantial agreement, with kappa statistics of 0.69 and 0.64 for cases 1 and 2, respectively. There was high specificity for both cases (≥99%) and only moderate sensitivity of 71.3% and 64.9% for cases 1 and 2, respectively. Expert review and discussion generated consensus recommendations for contouring target volumes and treatment for postoperative and locally advanced vulvar cancer. Conclusions: These consensus recommendations for contouring and treatment of vulvar cancer identified areas of complexity and controversy. Given the lack of clinical research evidence in vulvar cancer radiation therapy, the committee advocates a conservative and consistent approach using standardized recommendations.« less

Recommendations for future development of contractility and obstruction nomograms for women. ICI-RS 2014.

PubMed

Rademakers, Kevin; Apostolidis, Apostolos; Constantinou, Christos; Fry, Christopher; Kirschner-Hermanns, Ruth; Oelke, Matthias; Parsons, Brian; Nelson, Pierre; Valentini, Françoise; Gammie, Andrew

2016-02-01

At present, existing bladder outlet obstruction (BOO) nomograms for women are still not universally accepted. Moreover, only limited information is available regarding bladder contractility in women. The aim is to present the discussions and recommendations from the think tank session "Can we construct and validate contractility and obstruction nomograms for women?" held at the 2014 International Consultation on Incontinence-Research Society (ICI-RS) meeting in Bristol, UK. An overview of clinical significance, bladder mechanics and modelling, lack of existing nomograms for women, and development of new nomograms were presented and discussed in a multidisciplinary think tank session. This think tank session was based on a collaboration between physicians, engineers, and researchers and consensus was achieved on future research initiatives. Based on the think tank discussion, the ICI-RS panel put forward the following recommendations: the need to acquire normative age-matched data in women to define "normal" and "pathological" values of urodynamic parameters; the inclusion of additional clinical data in new nomograms and the use of this extra dimension to develop clinically applicable nomograms for female BOO and contractility; and finally, the need to take into account the variability of BOO in women when developing female bladder contractility nomograms. © 2016 Wiley Periodicals, Inc.

Development of EULAR recommendations for the reporting of clinical trial extension studies in rheumatology.

PubMed

Buch, Maya H; Silva-Fernandez, Lucia; Carmona, Loreto; Aletaha, Daniel; Christensen, Robin; Combe, Bernard; Emery, Paul; Ferraccioli, Gianfranco; Guillemin, Francis; Kvien, Tore K; Landewe, Robert; Pavelka, Karel; Saag, Kenneth; Smolen, Josef S; Symmons, Deborah; van der Heijde, Désirée; Welling, Joep; Wells, George; Westhovens, Rene; Zink, Angela; Boers, Maarten

2015-06-01

Our initiative aimed to produce recommendations on post-randomised controlled trial (RCT) trial extension studies (TES) reporting using European League Against Rheumatism (EULAR) standard operating procedures in order to achieve more meaningful output and standardisation of reports. We formed a task force of 22 participants comprising RCT experts, clinical epidemiologists and patient representatives. A two-stage Delphi survey was conducted to discuss the domains of evaluation of a TES and definitions. A '0-10' agreement scale assessed each domain and definition. The resulting set of recommendations was further refined and a final vote taken for task force acceptance. Seven key domains and individual components were evaluated and led to agreed recommendations including definition of a TES (100% agreement), minimal data necessary (100% agreement), method of data analysis (agreement mean (SD) scores ranging between 7.9 (0.84) and 9.0 (2.16)) and reporting of results as well as ethical issues. Key recommendations included reporting of absolute numbers at each stage from the RCT to TES with reasons given for drop-out at each stage, and inclusion of a flowchart detailing change in numbers at each stage and focus (mean (SD) agreement 9.9 (0.36)). A final vote accepted the set of recommendations. This EULAR task force provides recommendations for implementation in future TES to ensure a standardised approach to reporting. Use of this document should provide the rheumatology community with a more accurate and meaningful output from future TES, enabling better understanding and more confident application in clinical practice towards improving patient outcomes. 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.

Ocean and coastal data management

USGS Publications Warehouse

de La Beaujardière, Jeff; Beegle-Krause, C; Bermudez, Luis; Hankin, Steven C.; Hazard, Lisa; Howlett, Eoin; Le, Steven; Proctor, Roger; Signell, Richard P.; Snowden, Derrick P.; Thomas, Julie

2010-01-01

We introduce data management concepts, including what we mean by "data" and its "management," sources of data, interoperability, and data geometry. We then discuss various components of a data management system. Finally, we summarize some existing ocean and coastal data management efforts. We make specific recommendations throughout the paper. We are generally optimistic that ocean and coastal data management is an interesting and solvable challenge that will provide great benefit to society.

American Productivity Center Computer Conference on Training and Productivity for the White House Conference on Productivity (Washington, D.C., September 22-23, 1983). Final Report.

ERIC Educational Resources Information Center

1983

Delegates to this training computer conference agreed that the scope of economic change is both accelerating and profound and, therefore, will require a wide variety of approaches to human resource development. Training is only a small part of this development. To meet future needs, the conferees discussed and made recommendations in four areas:…

USSR Report, Agriculture

DTIC Science & Technology

1985-02-02

in a decrease in continuous cross- sections and finally, in poor milking, trauma to the milk glands and in mastitis in cows . The use of milk storage...Seek Solution Quality Upgrading Discussed -a - [III - USSR - 7] Culling Nonproductive Cows From Herds Recommended (G. Bembinov; SOVETSKAYA ROSSIYA...was lost prior to use of the preparation). At the same time, it was noted that the preserved forage raised the productivity of the cows and the fat

How to benefit from the coming RBRVS changes.

PubMed

Doherty, R B; Ogrod, E S

1989-09-01

The Physician Payment Review Commission's endorsement of the Resource-Based Relative Value Scale (RBRVS) represents a major step in reform of the Medicare payment system. Under this plan, cognitive services finally would be reimbursed at the same level for the work involved. The authors present a closer look at the commission's recommendations and discuss how these might substantially improve payment of primary care physicians. They also describe how to get ready.

Review of digital holography reconstruction methods

NASA Astrophysics Data System (ADS)

Dovhaliuk, Rostyslav Yu.

2018-01-01

Development of digital holography opened new ways of both transparent and opaque objects non-destructive study. In this paper, a digital hologram reconstruction process is investigated. The advantages and limitations of common wave propagation methods are discussed. The details of a software implementation of a digital hologram reconstruction methods are presented. Finally, the performance of each wave propagation method is evaluated, and recommendations about possible use cases for each of them are given.

A Review of Texture Evolution Mechanisms During Deformation by Rolling in Aluminum Alloys

NASA Astrophysics Data System (ADS)

Li, Shasha; Zhao, Qi; Liu, Zhiyi; Li, Fudong

2018-06-01

The current understanding of texture evolution during deformation by rolling in aluminum alloys was summarized. This included understanding the evolution mechanisms and several key factors of initial texture, microstructure, alloy composition, deformation temperature, stress-strain condition, and rolling geometry. Related models on predicting texture evolution during rolling were also discussed. Finally, for this research field, the recommendations for controlling the formation of rolling textures were proposed.

Atmospheric Reanalyses-Recent Progress and Prospects for the Future. A Report from a Technical Workshop, April 2010. Volume 29

NASA Technical Reports Server (NTRS)

Rienecker, Michele M.; Dee, Dick; Woollen, Jack; Compo, Gilbert P.; Onogi, Kazutoshi; Gelaro, Ron; Bosilovich, Michael G.; daSilva, Arlindo; Pawson, Steven; Schubert, Siegfried;

Research Update: The materials genome initiative: Data sharing and the impact of collaborative ab initio databases

DOE PAGES

Jain, Anubhav; Persson, Kristin A.; Ceder, Gerbrand

2016-03-24

Materials innovations enable new technological capabilities and drive major societal advancements but have historically required long and costly development cycles. The Materials Genome Initiative (MGI) aims to greatly reduce this time and cost. Here, we focus on data reuse in the MGI and, in particular, discuss the impact of three different computational databases based on density functional theory methods to the research community. Finally, we discuss and provide recommendations on technical aspects of data reuse, outline remaining fundamental challenges, and present an outlook on the future of MGI's vision of data sharing.

NASA and COTS Electronics: Past Approach and Successes - Future Considerations

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.

2018-01-01

NASA has a long history of using commercial grade electronics in space. In this talk, a brief history of NASAâ's trends and approaches to commercial grade electronics focusing on processing and memory systems will be presented. This will include providing summary information on the space hazards to electronics as well as NASA mission trade space. We will also discuss developing recommendations for risk management approaches to Electrical, Electronic and Electromechanical (EEE) parts and reliability in space. The final portion of the talk will discuss emerging aerospace trends and the future for Commercial Off The Shelf (COTS) usage.

Human response to aircraft noise

NASA Technical Reports Server (NTRS)

Powell, Clemans A.; Fields, James M.

1991-01-01

The human auditory system and the perception of sound are discussed. The major concentration is on the annnoyance response and methods for relating the physical characteristics of sound to those psychosociological attributes associated with human response. Results selected from the extensive laboratory and field research conducted on human response to aircraft noise over the past several decades are presented along with discussions of the methodology commonly used in conducting that research. Finally, some of the more common criteria, regulations, and recommended practices for the control or limitation of aircraft noise are examined in light of the research findings on human response.

Gentrification and urban children's well-being: tipping the scales from problems to promise.

PubMed

Formoso, Diana; N Weber, Rachel; S Atkins, Marc

2010-12-01

Gentrification changes the neighborhood and family contexts in which children are socialized-for better and worse-yet little is known about its consequences for youth. This review, drawn from research in urban planning, sociology, and psychology, maps out mechanisms by which gentrification may impact children. We discuss indicators of gentrification and link neighborhood factors, including institutional resources and collective socialization, to family processes more proximally related to child development. Finally, we discuss implications for intervention and public policy recommendations that are intended to tip the scales toward better outcomes for low-income youth in gentrifying areas.

Determination of atmospheric dilution for emergency preparedness: a joint EPA-DOE (Environmental Protection Agency-Department of Energy) technical workshop held on October 15-17, 1986

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

Rogers, S.E.

1988-10-01

This workshop was held in Research Triangle Park, NC in October of 1986. The objectives of the workshop were to review the current methods of determining atmospheric dilution for use in hazard identification, emergency-preparedness planning, and emergency response; to provide recommendations for choosing among these methods; and, finally, to define the role of the meteorologist in hazard identification, emergency planning, etc. Several invited papers were presented, and panel discussions were held to meet the objectives. The results are presented and discussed.

Coalbed-methane pilots - timing, design, and analysis

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

Roadifer, R.D.; Moore, T.R.

2009-10-15

Four distinct sequential phases form a recommended process for coalbed-methane (CBM)-prospect assessment: initial screening reconnaissance, pilot testing, and final appraisal. Stepping through these four phases provides a program of progressively ramping work and cost, while creating a series of discrete decision points at which analysis of results and risks can be assessed. While discussing each of these phases in some degree, this paper focuses on the third, the critically important pilot-testing phase. This paper contains roughly 30 specific recommendations and the fundamental rationale behind each recommendation to help ensure that a CBM pilot will fulfill its primary objectives of (1)more » demonstrating whether the subject coal reservoir will desorb and produce consequential gas and (2) gathering the data critical to evaluate and risk the prospect at the next-often most critical-decision point.« less

Senate Select Committee on Higher Education To Study Tuition Policy at Michigan Colleges and Universities: Final Report.

ERIC Educational Resources Information Center

Michigan State Legislature, Lansing.

This report contains the final recommendations of the Michigan Senate Select Committee on Higher Education on tuition policy at Michigan public colleges and universities. The report presents its findings and recommendations in three large parts. The first section contains the final recommendations of the Committee including goals of affordability…

Analyzing after-action reports from Hurricanes Andrew and Katrina: repeated, modified, and newly created recommendations.

PubMed

Knox, Claire Connolly

2013-01-01

Thirteen years after Hurricane Andrew struck Homestead, FL, Hurricane Katrina devastated the Gulf Coast of Mississippi, Alabama, and southeastern Louisiana. Along with all its destruction, the term "catastrophic" was redefined. This article extends the literature on these hurricanes by providing a macrolevel analysis of The Governor's Disaster Planning and Response Review Committee Final Report from Hurricane Andrew and three federal after-action reports from Hurricane Katrina, as well as a cursory review of relevant literature. Results provide evidence that previous lessons have not been learned or institutionalized with many recommendations being repeated or modified. This article concludes with a discussion of these lessons, as well as new issues arising during Hurricane Katrina.

The Rated Voltage Determination of DC Building Power Supply System Considering Human Beings Safety

NASA Astrophysics Data System (ADS)

Wang, Zhicheng; Yu, Kansheng; Xie, Guoqiang; Zou, Jin

2018-01-01

Generally two-level voltages are adopted for DC building power supply system. From the point of view of human beings safety, only the lower level voltage which may be contacted barehanded is discussed in this paper based on the related safety thresholds of human beings current effect. For several voltage levels below 100V recommended by IEC, the body current and current density of human electric shock under device normal work condition, as well as effect of unidirectional single impulse currents of short durations are calculated and analyzed respectively. Finally, DC 60V is recommended as the lower level rating voltage through the comprehensive consideration of technical condition and cost of safety criteria.

Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region

PubMed Central

Cameron, Donald; Hock, Quak Seng; Kadim, Musal; Mohan, Neelam; Ryoo, Eell; Sandhu, Bhupinder; Yamashiro, Yuichiro; Jie, Chen; Hoekstra, Hans; Guarino, Alfredo

2017-01-01

Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system. Saccharomyces boulardii CNCM I-745 (Sb) and Lactobacillus rhamnosus GG (LGG) were strongly recommended as adjunct treatment to oral rehydration therapy for gastroenteritis. Lactobacillus reuteri could also be considered. Probiotics may be considered for prevention of (with the indicated strains): antibiotic-associated diarrhea (LGG or Sb); Clostridium difficile-induced diarrhea (Sb); nosocomial diarrhea (LGG); infantile colic (L reuteri) and as adjunct treatment of Helicobacter pylori (Sb and others). Specific probiotics with a history of safe use in preterm and term infants may be considered in infants for prevention of necrotizing enterocolitis. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations apply well to Asia pacific countries. These need to be validated with local randomized-controlled trials. PMID:29259371

Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on women in academic emergency medicine.

PubMed

Kuhn, Gloria J; Abbuhl, Stephanie B; Clem, Kathleen J

2008-08-01

The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.

Evidence-Based Recommendations for Fertility Preservation Options for Inclusion in Treatment Protocols for Pediatric and Adolescent Patients Diagnosed With Cancer.

PubMed

Fernbach, Alison; Lockart, Barbara; Armus, Cheryl L; Bashore, Lisa M; Levine, Jennifer; Kroon, Leah; Sylvain, Genevieve; Rodgers, Cheryl

2014-07-01

As survival rates improve for pediatric cancers, increased attention has been paid to late effects of cancer therapy, in particular, infertility. Fertility preservation options are available for pre- and postpubertal cancer patients; however, many providers lack knowledge regarding options. The aim of this article is to provide a comprehensive synthesis of current evidence and recommendations regarding fertility preservation options for children, adolescents, and young adults undergoing cancer treatment. A systematic search was performed to identify fertility preservation evidence. Fifty-three studies and 4 clinical guidelines were used for the review. Final recommendations consisted of 2 strong and 1 weak recommendation for both female and male fertility preservation options. The treatment team should be knowledgeable about fertility preservation so that they can educate patients and families about available fertility preservation options. It is important to consider and discuss all available fertility options with patients at the time of diagnosis. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

Group interventions for patients with cancer and HIV disease: part IV. Clinical and policy recommendations.

PubMed

Leszcz, Molyn; Sherman, Allen; Mosier, Julie; Burlingame, Gary M; Cleary, Trish; Ulman, Kathleen Hubbs; Simonton, Stephanie; Latif, Umaira; Strauss, Bernhard; Hazelton, Lara

2004-10-01

Group interventions have assumed a growing role in primary prevention and supportive care for cancer and HIV disease. Earlier sections of this Special Report examined empirical findings for these interventions and provided recommendations for future research. The current section offers brief recommendations for service providers, policymakers, and stakeholders. Group services now occupy an increasingly prominent place in primary prevention programs and medical settings. In previous sections of this Special Report (Sherman, Leszcz et al., 2004; Sherman, Mosier et al., 2004a, 2004b) we examined the efficacy of different group interventions at different phases of cancer or HIV disease, considered characteristics of the intervention and the participants that might influence outcomes, and discussed mechanisms of action. Methodological challenges and priorities for future research were highlighted. In this, the final section, we offer brief recommendations for service providers, policymakers, and other stakeholders. We consider some of the barriers that constrain use of empirically-based group interventions and note how these programs might be implemented more widely and effectively.

Recommendation for the review of biological reference intervals in medical laboratories.

PubMed

Henny, Joseph; Vassault, Anne; Boursier, Guilaine; Vukasovic, Ines; Mesko Brguljan, Pika; Lohmander, Maria; Ghita, Irina; Andreu, Francisco A Bernabeu; Kroupis, Christos; Sprongl, Ludek; Thelen, Marc H M; Vanstapel, Florent J L A; Vodnik, Tatjana; Huisman, Willem; Vaubourdolle, Michel

2016-12-01

This document is based on the original recommendation of the Expert Panel on the Theory of Reference Values of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), updated guidelines were recently published under the auspices of the IFCC and the Clinical and Laboratory Standards Institute (CLSI). This document summarizes proposals for recommendations on: (i) The terminology, which is often confusing, noticeably concerning the terms of reference limits and decision limits. (ii) The method for the determination of reference limits according to the original procedure and the conditions, which should be used. (iii) A simple procedure allowing the medical laboratories to fulfill the requirements of the regulation and standards. The updated document proposes to verify that published reference limits are applicable to the laboratory involved. Finally, the strengths and limits of the revised recommendations (especially the selection of the reference population, the maintenance of the analytical quality, the choice of the statistical method used…) will be briefly discussed.

Optimising the Inflammatory Bowel Disease Unit to Improve Quality of Care: Expert Recommendations.

PubMed

Louis, Edouard; Dotan, Iris; Ghosh, Subrata; Mlynarsky, Liat; Reenaers, Catherine; Schreiber, Stefan

2015-08-01

The best care setting for patients with inflammatory bowel disease [IBD] may be in a dedicated unit. Whereas not all gastroenterology units have the same resources to develop dedicated IBD facilities and services, there are steps that can be taken by any unit to optimise patients' access to interdisciplinary expert care. A series of pragmatic recommendations relating to IBD unit optimisation have been developed through discussion among a large panel of international experts. Suggested recommendations were extracted through systematic search of published evidence and structured requests for expert opinion. Physicians [n = 238] identified as IBD specialists by publications or clinical focus on IBD were invited for discussion and recommendation modification [Barcelona, Spain; 2014]. Final recommendations were voted on by the group. Participants also completed an online survey to evaluate their own experience related to IBD units. A total of 60% of attendees completed the survey, with 15% self-classifying their centre as a dedicated IBD unit. Only half of respondents indicated that they had a defined IBD treatment algorithm in place. Key recommendations included the need to develop a multidisciplinary team covering specifically-defined specialist expertise in IBD, to instil processes that facilitate cross-functional communication and to invest in shared care models of IBD management. Optimising the setup of IBD units will require progressive leadership and willingness to challenge the status quo in order to provide better quality of care for our patients. IBD units are an important step towards harmonising care for IBD across Europe and for establishing standards for disease management programmes. © European Crohn’s and Colitis Organisation 2015.

Optimising the Inflammatory Bowel Disease Unit to Improve Quality of Care: Expert Recommendations

PubMed Central

Dotan, Iris; Ghosh, Subrata; Mlynarsky, Liat; Reenaers, Catherine; Schreiber, Stefan

2015-01-01

Introduction: The best care setting for patients with inflammatory bowel disease [IBD] may be in a dedicated unit. Whereas not all gastroenterology units have the same resources to develop dedicated IBD facilities and services, there are steps that can be taken by any unit to optimise patients’ access to interdisciplinary expert care. A series of pragmatic recommendations relating to IBD unit optimisation have been developed through discussion among a large panel of international experts. Methods: Suggested recommendations were extracted through systematic search of published evidence and structured requests for expert opinion. Physicians [n = 238] identified as IBD specialists by publications or clinical focus on IBD were invited for discussion and recommendation modification [Barcelona, Spain; 2014]. Final recommendations were voted on by the group. Participants also completed an online survey to evaluate their own experience related to IBD units. Results: A total of 60% of attendees completed the survey, with 15% self-classifying their centre as a dedicated IBD unit. Only half of respondents indicated that they had a defined IBD treatment algorithm in place. Key recommendations included the need to develop a multidisciplinary team covering specifically-defined specialist expertise in IBD, to instil processes that facilitate cross-functional communication and to invest in shared care models of IBD management. Conclusions: Optimising the setup of IBD units will require progressive leadership and willingness to challenge the status quo in order to provide better quality of care for our patients. IBD units are an important step towards harmonising care for IBD across Europe and for establishing standards for disease management programmes. PMID:25987349

Towards adaptation in e-learning 2.0

NASA Astrophysics Data System (ADS)

Cristea, Alexandra I.; Ghali, Fawaz

2011-04-01

This paper presents several essential steps from an overall study on shaping new ways of learning and teaching, by using the synergetic merger of three different fields: Web 2.0, e-learning and adaptation (in particular, personalisation to the learner). These novel teaching and learning ways-the latter focus of this paper-are reflected in and finally adding to various versions of the My Online Teacher 2.0 adaptive system. In particular, this paper focuses on a study of how to more effectively use and combine the recommendation of peers and content adaptation to enhance the learning outcome in e-learning systems based on Web 2.0. In order to better isolate and examine the effects of peer recommendation and adaptive content presentation, we designed experiments inspecting collaboration between individuals based on recommendation of peers who have greater knowledge, and compare this to adaptive content recommendation, as well as to "simple" learning in a system with a minimum of Web 2.0 support. Overall, the results of adding peer recommendation and adaptive content presentation were encouraging, and are further discussed in detail in this paper.

Science sequence design

NASA Technical Reports Server (NTRS)

Koskela, P. E.; Bollman, W. E.; Freeman, J. E.; Helton, M. R.; Reichert, R. J.; Travers, E. S.; Zawacki, S. J.

1973-01-01

The activities of the following members of the Navigation Team are recorded: the Science Sequence Design Group, responsible for preparing the final science sequence designs; the Advanced Sequence Planning Group, responsible for sequence planning; and the Science Recommendation Team (SRT) representatives, responsible for conducting the necessary sequence design interfaces with the teams during the mission. The interface task included science support in both advance planning and daily operations. Science sequences designed during the mission are also discussed.

A comparative study of electric power distribution systems for spacecraft

NASA Technical Reports Server (NTRS)

Stuart, Thomas A.; King, Roger J.

1990-01-01

The electric power distribution systems for spacecraft are compared concentrating on two interrelated issues: the choice between dc and high frequency ac, and the converter/inverter topology to be used at the power source. The relative merits of dc and ac distribution are discussed. Specific converter and inverter topologies are identified and analyzed in detail for the purpose of detailed comparison. Finally, specific topologies are recommended for use in dc and ac systems.

Extreme winds and tornadoes: design and evaluation of buildings and structures

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

McDonald, J.R.

1985-01-01

The general provisions of ANSI A58.1-1982 are explained in detail. As mentioned above, these procedures may be used to determine design wind loads on structures from extreme winds, hurricane and tornado winds. Treatment of atmospheric pressure change loads are discussed, including recommendations for venting a building, if necessary, and the effects of rate of pressure change on HVAC systems. Finally, techniques for evaluating existing facilities are described.

Students with Disabilities in Juvenile Justice Programs: Directions for Federal Support. Policy Forum. Proceedings Document (Alexandria, Virginia, October 26-27, 1998). Final Report, Deliverable-Task 2-3.1a.

ERIC Educational Resources Information Center

National Association of State Directors of Special Education, Alexandria, VA.

This proceedings discusses the role for federal policy in achieving the best possible short and long-term educational results for youth with disabilities in juvenile justice programs. Participants identified the 11 issues regarding students with disabilities in juvenile justice programs and developed a set of recommendations as to how the federal…

Performance of a commercial transport under typical MLS noise environment

NASA Technical Reports Server (NTRS)

Ho, J. K.

1986-01-01

The performance of a 747-200 automatic flight control system (AFCS) subjected to typical Microwave Landing System (MLS) noise is discussed. The performance is then compared with the results from a previous study which had a B747 AFCS subjected to the MLS standards and recommended practices (SARPS) maximum allowable noise. A glide slope control run with Instrument Landing System (ILS) noise is also conducted. Finally, a linear covariance analysis is presented.

[Recommendations for overcoming interface problems in medical rehabilitation of federal pension funds and statutory health insurance].

PubMed

Pohontsch, N; Träder, J-M; Scherer, M; Deck, R

2013-10-01

Interface problems in medical rehabilitation are a consequence of problems with communication and cooperation, lack of information and transparency. Different stakeholders are trying to solve these problems since many years or decades respectively. Following a series of deficit-oriented studies we tried to develop recommendations for possible solutions of important interface problems together with affected people based on a qualitative analysis of main problem areas. 10 separate group discussions with rehabilitation patients, general practitioners and specialists in private practices, representatives of the federal pension fund and statutory health insurance as well as clinicians from rehabilitation clinics and 3 mixed group discussions (all before mentioned groups excluding rehabilitation patients) were conducted. These group discussions served to prepare a semidiurnal final conference. All meetings were recorded and content analyzed or summarized in protocols respectively. Results are recommendations on strategies to reduce interface problems in medical rehabilitation. Those are: development of a rehabilitation-information-website for insurees and general practitioners and specialists in private practices; changes in forms, applications, notifications; advanced training for general practitioners and specialists in private practices und support in detecting rehabilitation need. Due to divided structures of care provision and increasing specialization, overcoming interface problems is one of the main challenges in the provision of medical rehabilitation. It can be met if different stakeholder approach each other without prejudices, share instead of demarcate competencies and are willing to strike new paths. Our recommendations represent the first step to reaching this goal. © Georg Thieme Verlag KG Stuttgart · New York.

Reporting nuclear cardiology: a joint position paper by the European Association of Nuclear Medicine (EANM) and the European Association of Cardiovascular Imaging (EACVI).

PubMed

Trägårdh, Elin; Hesse, Birger; Knuuti, Juhani; Flotats, Albert; Kaufmann, Philipp A; Kitsiou, Anastasia; Hacker, Marcus; Verberne, Hein J; Edenbrandt, Lars; Delgado, Victoria; Donal, Erwan; Edvardsen, Thor; Galderisi, Maurizio; Habib, Gilbert; Lancellotti, Patrizio; Nieman, Koen; Rosenhek, Raphael; Agostini, Denis; Gimelli, Alessia; Lindner, Oliver; Slart, Riemert; Ubleis, Christopher

2015-03-01

The report of an imaging procedure is a critical component of an examination, being the final and often the only communication from the interpreting physician to the referring or treating physician. Very limited evidence and few recommendations or guidelines on reporting imaging studies are available; therefore, an European position statement on how to report nuclear cardiology might be useful. The current paper combines the limited existing evidence with expert consensus, previously published recommendations as well as current clinical practices. For all the applications discussed in this paper (myocardial perfusion, viability, innervation, and function as acquired by single photon emission computed tomography and positron emission tomography or hybrid imaging), headings cover laboratory and patient demographics, clinical indication, tracer administration and image acquisition, findings, and conclusion of the report. The statement also discusses recommended terminology in nuclear cardiology, image display, and preliminary reports. It is hoped that this statement may lead to more attention to create well-written and standardized nuclear cardiology reports and eventually lead to improved clinical outcome. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Population biology of the Florida manatee: An overview

USGS Publications Warehouse

O'Shea, Thomas J.; Ackerman, B.B.; O'Shea, Thomas J.; Ackerman, B.B.; Percival, H. Franklin

1995-01-01

In the following overview we discuss progress toward meeting the three objectives of the 1992 workshop: to provide a synthesis of existing information about manatee population biology; to evaluate the strengths and weaknesses of current data sets and approaches to research on manatee population biology; and to provide recommendations for research. We discuss progress in six topics that were assigned to working groups at the workshop: aerial survey and estimation of population size, reproduction, age structure, mortality, photoidentification and estimation of survival, and integration and modeling of population data. The overview includes recommendations by working group participants (*2 0'Shea et al. 1992). This workshop on manatee population biology was the most recent conference on the topic since 1978 (*BrowneIl and Rails 1981). Partly as a result of recommendations made at the 1978 workshop, several long-term population-related research projects were established. Therefore, we also measure progress in relation to knowledge available at the time of the earlier workshop. Finally, we provide a brief synopsis of pertinent new information on manatee population biology that became available between the 1992 workshop and publication of the proceedings and our conclusions about the status of the Florida manatee.

The New US Preventive Services Task Force "C" Draft Recommendation for Prostate Cancer Screening.

PubMed

Cooperberg, Matthew R

2017-09-01

The US Preventive Services Task Force has issued a new draft guideline, with a "C" recommendation that men aged 55-69 yr should be informed about the benefits and harms of screening for prostate cancer, and offered prostate-specific antigen testing if they choose it. For men aged ≥70 yr, the recommendation remains "D", or "do not screen." This draft represents substantial progress in the right direction towards offering men a fair opportunity to discuss the risks and benefits of screening with their primary care providers. However, the evidence review underlying the draft remains fundamentally inadequate, leading to biased presentations of both benefits and harms of screening. The final guideline and future revisions should reflect formal engagement with subject matter experts to optimize the advise given to men and their physicians. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

The Impact of Youth and Family Risk Factors on Service Recommendations and Delivery in a School-Based System of Care

PubMed Central

Whitson, Melissa L.; Connell, Christian M.; Bernard, Stanley; Kaufman, Joy S.

2010-01-01

The present study examines the impact of child and family risk factors on service access for youth and families in a school-based system of care. Regression analyses examined the relationships between risk factors and services recommended, services received, and dosage of services received. Logistic regression analyses examined the relationship between risk factors and whether or not youth received specific types of services within the system of care. Results revealed that youth with a personal or family history of substance use had more services recommended than youth without these risk factors, while youth with a family history of substance use received more services. Youth with a history of substance use received a significantly higher dosage of services overall. Finally, history of family mental illness was associated with receiving mental health and operational services (e.g., family advocacy, emergency funds). Implications and limitations are discussed. PMID:20165927

The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo.

PubMed

Mohammad, Tasneem F; Al-Jamal, Mohammed; Hamzavi, Iltefat H; Harris, John E; Leone, Giovanni; Cabrera, Raúl; Lim, Henry W; Pandya, Amit G; Esmat, Samia M

2017-05-01

Treatment of vitiligo with narrowband ultraviolet B light (NBUVB) is an important component of the current standard of care. However, there are no consistent guidelines regarding the dosing and administration of NBUVB in vitiligo, reflected by varied treatment practices around the world. To create phototherapy recommendations to facilitate clinical management and identify areas requiring future research. The Vitiligo Working Group (VWG) Phototherapy Committee addressed 19 questions regarding the administration of phototherapy over 3 conference calls. Members of the Photomedicine Society and a group of phototherapy experts were surveyed regarding their phototherapy practices. Based on comparison and analysis of survey results, expert opinion, and discussion held during conference calls, expert recommendations for the administration of NBUVB phototherapy in vitiligo were created. There were several areas that required further research before final recommendations could be made. In addition, no standardized methodology was used during literature review and to assess the strength of evidence during the development of these recommendations. This set of expert recommendations by the VWG is based on the prescribing practices of phototherapy experts from around the world to create a unified, broadly applicable set of recommendations on the use of NBUVB in vitiligo. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Robot welding process control

NASA Technical Reports Server (NTRS)

Romine, Peter L.

1991-01-01

This final report documents the development and installation of software and hardware for Robotic Welding Process Control. Primary emphasis is on serial communications between the CYRO 750 robotic welder, Heurikon minicomputer running Hunter & Ready VRTX, and an IBM PC/AT, for offline programming and control and closed-loop welding control. The requirements for completion of the implementation of the Rocketdyne weld tracking control are discussed. The procedure for downloading programs from the Intergraph, over the network, is discussed. Conclusions are made on the results of this task, and recommendations are made for efficient implementation of communications, weld process control development, and advanced process control procedures using the Heurikon.

Social Work Practice with Latinos: Key Issues for Social Workers

PubMed Central

Furman, Rich; Negi, Nalini Junko; Iwamoto, Derek Kenji; Rowan, Diana; Shukraft, Allison; Gragg, Jennifer

2010-01-01

The Latino population is the fastest growing group in the United States; thus, it is imperative that social workers and other mental health practitioners be knowledgeable about the current literature on how to effectively serve this population. This article elucidates key issues and knowledge, such as immigration and migration concerns; discusses how to assess for levels of acculturation; examines cultural values; and highlights salient work issues and health disparities that Latinos experience. Recommendations on how agencies and universities can recruit and promote bilingual practitioners are introduced. Finally, culturally responsive strategies for professional use of self and fostering the therapeutic alliance are discussed. PMID:19366165

Manual of Scaling Methods

NASA Technical Reports Server (NTRS)

Bond, Thomas H. (Technical Monitor); Anderson, David N.

2004-01-01

This manual reviews the derivation of the similitude relationships believed to be important to ice accretion and examines ice-accretion data to evaluate their importance. Both size scaling and test-condition scaling methods employing the resulting similarity parameters are described, and experimental icing tests performed to evaluate scaling methods are reviewed with results. The material included applies primarily to unprotected, unswept geometries, but some discussion of how to approach other situations is included as well. The studies given here and scaling methods considered are applicable only to Appendix-C icing conditions. Nearly all of the experimental results presented have been obtained in sea-level tunnels. Recommendations are given regarding which scaling methods to use for both size scaling and test-condition scaling, and icing test results are described to support those recommendations. Facility limitations and size-scaling restrictions are discussed. Finally, appendices summarize the air, water and ice properties used in NASA scaling studies, give expressions for each of the similarity parameters used and provide sample calculations for the size-scaling and test-condition scaling methods advocated.

Evaluation of antibiotics for racing pigeons (Columba livia var. domestica) available in The Netherlands.

PubMed

Zwijnenberg, R J; Vulto, A G; van Miert, A S; Lumeij, J T

1992-12-01

Antibiotics and chemotherapeutics marketed for use in racing pigeons (Columba livia var. domestica) were evaluated by comparing the dosages and indications given by the manufacturers with the data obtained by pharmacokinetic, bacteriological and efficacy studies. This comparison showed that only three of the recommended dosages and indications of the 60 formulations marketed in The Netherlands are scientifically sound and in accordance with the literature. It is to be expected that the majority of the antimicrobials for pigeons will not satisfy the requirements for final registration as a pigeon therapeutic under the Dutch Veterinary Medicines Act of 1985. Several factors affecting drug availability are discussed, such as the different routes of administration and the influence of food. The public health aspects of the consumption of medicated pigeons is also discussed. Although there is no legislation with regard to this subject, a recommended withdrawal time of 10 days for the majority of the antimicrobials seems advisable.

Use of antidepressants for major depressive disorder in children and adolescents: clinical considerations.

PubMed

Picouto, María Dolores; Braquehais, María Dolores

2013-01-01

Major depressive disorder (MDD) is a frequent condition among children and, especially, among adolescents. However, its clinical presentation usually differs from that of adults. It is also associated with other diagnoses and with an increased morbidity and mortality. However, MDD in this population remains underrecognized and undertreated. Antidepressants (ATDs) are chosen when psychoeducational, psychosocial and/or psychotherapeutic approaches have failed. ATDs are generally used in severe cases, and are always combined with psychological treatments. The objective of this work is to discuss the role of ATD in child and adolescent MDD. We focus on the recommendations of the most cited and updated clinical guidelines and discuss some controversial aspects with regards efficacy and safety issues that have been raised based on the information obtained from clinical trials. Finally, we offer some practical recommendations for clinicians. All these findings also pose some doubt on the hypothesis of MDD as a homogeneous phenomenon during the human life cycle.

Age and Impulsive Behavior in Drug Addiction: A Review of Past Research and Future Directions

PubMed Central

Argyriou, Evangelia; Um, Miji; Carron, Clair; Cyders, Melissa A.

2018-01-01

Impulsive behavior is implicated in the initiation, maintenance, and relapse of drug-seeking behaviors involved in drug addiction. Research shows that changes in impulsive behavior across the lifespan contribute to drug use and addiction. The goal of this review is to examine existing research on the relationship between impulsive behavior and drug use across the lifespan and to recommend directions for future research. Three domains of impulsive behavior are explored in this review: impulsive behavior-related personality traits, delay discounting, and prepotent response inhibition. First, we present previous research on these three domains of impulsive behavior and drug use across developmental stages. Then, we discuss how changes in impulsive behavior across the lifespan are implicated in the progression of drug use and addiction. Finally, we discuss the relatively limited attention given to middle-to-older adults in the current literature, consider the validity of the measures used to assess impulsive behavior in middle-to-older adulthood, and suggest recommendations for future research. PMID:28778737

Assessment of Options for the Treatment of Nitrate Salt Wastes at Los Alamos National Laboratory

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

Robinson, Bruce Alan; Funk, David John; Stevens, Patrice Ann

2016-03-17

This paper summarizes the methodology used to evaluate options for treatment of the remediated nitrate salt waste containers at Los Alamos National Laboratory. The method selected must enable treatment of the waste drums, which consist of a mixture of complex nitrate salts (oxidizer) improperly mixed with sWheat Scoop®1, an organic kitty litter and absorbent (fuel), in a manner that renders the waste safe, meets the specifications of waste acceptance criteria, and is suitable for transport and final disposal in the Waste Isolation Pilot Plant located in Carlsbad, New Mexico. A Core Remediation Team was responsible for comprehensively reviewing the options,more » ensuring a robust, defensible treatment recommendation. The evaluation process consisted of two steps. First, a prescreening process was conducted to cull the list on the basis for a decision of feasibility of certain potential options with respect to the criteria. Then, the remaining potential options were evaluated and ranked against each of the criteria in a consistent methodology. Numerical scores were established by consensus of the review team. Finally, recommendations were developed based on current information and understanding of the scientific, technical, and regulatory situation. A discussion of the preferred options and documentation of the process used to reach the recommended treatment options are presented.« less

75 FR 31431 - East Texas Electric Cooperative, Inc. (Cooperative); Notice Soliciting Comments and Final...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-03

... Electric Cooperative, Inc. (Cooperative); Notice Soliciting Comments and Final Recommendations, Terms and... recommendations, terms and conditions, and prescriptions is 60 days from the issuance of this notice; reply... ``COMMENTS,'' ``REPLY COMMENTS,'' ``RECOMMENDATIONS,'' ``TERMS AND CONDITIONS,'' or ``PRESCRIPTIONS;'' (2...

Electronic toll collection interoperability study in Brazil. Task 4 : recommendations and final report

DOT National Transportation Integrated Search

1998-05-01

The report examines the potential for developing electronic toll collection systems in Brazil. This is Volume III and it is 'Task-Recommendations and Final Report'. The report is made up of the following subtasks: (1) Issue Recommended Installation S...

Methodological Issues in Questionnaire Design.

PubMed

Song, Youngshin; Son, Youn Jung; Oh, Doonam

2015-06-01

The process of designing a questionnaire is complicated. Many questionnaires on nursing phenomena have been developed and used by nursing researchers. The purpose of this paper was to discuss questionnaire design and factors that should be considered when using existing scales. Methodological issues were discussed, such as factors in the design of questions, steps in developing questionnaires, wording and formatting methods for items, and administrations methods. How to use existing scales, how to facilitate cultural adaptation, and how to prevent socially desirable responding were discussed. Moreover, the triangulation method in questionnaire development was introduced. Steps were recommended for designing questions such as appropriately operationalizing key concepts for the target population, clearly formatting response options, generating items and confirming final items through face or content validity, sufficiently piloting the questionnaire using item analysis, demonstrating reliability and validity, finalizing the scale, and training the administrator. Psychometric properties and cultural equivalence should be evaluated prior to administration when using an existing questionnaire and performing cultural adaptation. In the context of well-defined nursing phenomena, logical and systematic methods will contribute to the development of simple and precise questionnaires.

Cyber Warfare as an Operational Fire

DTIC Science & Technology

2010-04-03

This paper explores cyber warfare as an option for creating operational fires effects. Initially, cyberspace is defined and explained from the...fires are defined and the advantages of their use are explained. From there, discussion focuses on how cyber warfare fulfills the purposes of...operational fires. Finally, the paper draws conclusions about the viability of cyber warfare as an operational fire and makes recommendations about how to prioritize the activities of the newly approved U.S. Cyber Command.

An optical profilometer for spatial characterization of three-dimensional surfaces

NASA Technical Reports Server (NTRS)

Kelly, W. L., IV; Burcher, E. E.; Skolaut, M. W., Jr.

1977-01-01

The design concept and system operation of an optical profilometer are discussed, and a preliminary evaluation of a breadboard system is presented to demonstrate the feasibility of the optical profilometer technique. Measurement results are presented for several test surfaces; and to illustrate a typical application, results are shown for a cleft palate cast used by dental surgeons. Finally, recommendations are made for future development of the optical profilometer technique for specific engineering or scientific applications.

Enhancing emergency care in low-income countries using mobile technology-based training tools

PubMed Central

Edgcombe, Hilary; Paton, Chris; English, Mike

2016-01-01

In this paper, we discuss the role of mobile technology in developing training tools for health workers, with particular reference to low-income countries (LICs). The global and technological context is outlined, followed by a summary of approaches to using and evaluating mobile technology for learning in healthcare. Finally, recommendations are made for those developing and using such tools, based on current literature and the authors' involvement in the field. PMID:27658948

Student views on continuous assessment at Birmingham University Medical School.

PubMed Central

Cruickshank, J K; Barritt, P W; Mcbesag, F; Waterhouse, N; Goldman, L H

1975-01-01

Student opinion on the system of continuous assessment used at Birmingham Medical School was sampled by distributing questionnaires to 621 students in the first four years of the course; 482 questionnaires (78%) were returned. Many comments and criticisms of the system were received but the vast majority of students (92%) said they preferred the present style of assessment to conventional final examinations. These criticisms are discussed and recommendations are made to improve the existing scheme. PMID:1192017

A preliminary review of coal exploration activities conducted by the government of Armenia and the coal resource potential of Armenia

USGS Publications Warehouse

Warwick, Peter D.; Pierce, B.S.; Landis, E.R.

1993-01-01

A coal resource assessment team from the U.S. Geological Survey (USGS), in cooperation with the Armenian Department of Underground Resources (DUR) and elements of the Ministry of Energy and Fuel, has completed an initial visit to Armenia under the auspices of the U.S. Agency for International Development JUSAID). The visit included discussions of the coal resources, identification of problems associated with on-going exploration and development activities, and field visits to selected solid fuel areas. The USGS team will return in November with a draft of the final report for discussion of conclusions and recommendations with Armenian counterparts, representatives of USAID, and the American Embassy. The final report, which will contain tabulated coal-sample analytical results and detailed recommendations, will be submitted to the USAID by the end of December 1993.Preliminary conclusions are that: 1) Armenia has usable deposits of coal that could form a viable, though relatively small, component of Armenia's energy budget; 2) on-going exploration and development activities must be augmented and expedited to increase understanding of the coal resource potential and subsequent utilization; 3) deficiencies in supplies (primarily fuel) and equipment (replacement of aging parts and units) have greatly reduced the gathering of necessary resource data; and 4) training of Armenian counterparts in conducting and managing coal exploration activities is desirable.

[Clinical practice guidelines for evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions. Bone Metabolism Working Group of the Spanish Society of Endocrinology].

PubMed

Reyes García, Rebeca; Jódar Gimeno, Esteban; García Martín, Antonia; Romero Muñoz, Manuel; Gómez Sáez, José Manuel; Luque Fernández, Inés; Varsavsky, Mariela; Guadalix Iglesias, Sonsoles; Cano Rodriguez, Isidoro; Ballesteros Pomar, María Dolores; Vidal Casariego, Alfonso; Rozas Moreno, Pedro; Cortés Berdonces, María; Fernández García, Diego; Calleja Canelas, Amparo; Palma Moya, Mercedes; Martínez Díaz-Guerra, Guillermo; Jimenez Moleón, José J; Muñoz Torres, Manuel

2012-03-01

To provide practical recommendations for evaluation and treatment of osteoporosis associated to endocrine diseases and nutritional conditions. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, a methodologist, and a documentalist. Recommendations were formulated according to the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed), using the following terms associated to the name of each condition: AND "osteoporosis", "fractures", "bone mineral density", and "treatment". Papers in English with publication date before 18 October 2011 were included. Current evidence for each disease was reviewed by two group members, and doubts related to the review process or development of recommendations were resolved by the methodologist. Finally, recommendations were discussed in a meeting of the Working Group. The document provides evidence-based practical recommendations for evaluation and management of endocrine and nutritional diseases associated to low bone mass or an increased risk of fracture. For each disease, the associated risk of low bone mass and fragility fractures is given, recommendations for bone mass assessment are provided, and treatment options that have shown to be effective for increasing bone mass and/or to decreasing fragility fractures are listed. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

[The Latin-American Consensus on Chronic Constipation].

PubMed

Schmulson Wasserman, Max; Francisconi, Carlos; Olden, Kevin; Aguilar Paíz, Luis; Bustos-Fernández, Luis; Cohen, Henry; Passos, Maria Carmo; González-Martínez, Marina Alejandra; Iade, Beatriz; Iantorno, Guido; Ledesma Ginatta, Carlos; López-Colombo, Aurelio; Pérez, Cesar Louis; Madrid-Silva, Ana María; Quilici, Flavio; Quintero Samudio, Isaac; Rodríguez Varón, Alberto; Suazo, Jorge; Valenzuela, Jorge; Zolezzi, Alberto

2008-02-01

The Latin-American Consensus on Chronic Constipation aimed to establish guidelines to improve the identification, diagnosis and treatment of this disorder in the region. Two coordinators and an honorary coordinator established the process and the topics to be discussed, based on a systematic review of the literature published in the previous 10 years, since 1995. Seventeen members participated with the support of their local gastroenterology societies. The members reviewed the different subjects based on the levels of evidence and grades of recommendation; the topics were then discussed in a plenary session. A written report was drafted and the coordinators prepared the final declarations to be submitted to a vote by all the members in October 2006. The consensus concluded that chronic constipation has an estimated prevalence of 5-21% in the region, with a female-to-male ratio of 3:1. Among individuals with constipation, 75% use some type of medication, with more than 50% using home remedies. A diagnosis based on Rome Criteria was recommended and diagnostic testing only in persons older than 50 years or with alarm symptoms. The use of barium enema as an initial investigation was recommended only in countries with a high prevalence of idiopathic megacolon or Chagas' disease. Recommendations on treatment included an increase in dietary fiber of up to 25-30 g/day (grade C). No evidence was found to recommend measures such as exercise, increased water intake, or frequent visits to the toilet. Fiber supplements such as Psyllium received a grade B and pharmacological treatments such as tegaserod and polyethylene glycol, both grade A. There was insufficient evidence to recommend lactulose, but the consensus did not disadvise its use when necessary. Complementary investigations such as colonic transit followed by anorectal manometry and defecography were only recommended to rule out colonic inertia and/or obstructive defecation in patients not responding to treatment. Biofeedback was recommended (grade B) for those with pelvic dyssynergia.

Management of Organic Mitral Regurgitation: Guideline Recommendations and Controversies

PubMed Central

Gurzun, Maria-Magdalena; Popescu, Andreea C.; Ginghina, Carmen

2015-01-01

Mitral regurgitation (MR) represents the second most frequent valvular heart disease. The appropriate management of organic MR remains unclear in many aspects, especially in several specific clinical scenarios. This review aims to discuss the current guideline recommendations regarding the management of organic MR, while highlighting the controversial aspects encountered in daily clinical practice. The role of imaging is essential in establishing the most appropriate type of surgical treatment (repair or replace), which is based on morphological mitral valve (MV) characteristics (reparability of the valve) and local surgical expertise in valve repair. The potential advantages of 3-dimensional echocardiography in assessing the MV are discussed. Other modern imaging techniques (tissue Doppler and speckle tracking) may provide additional useful information in borderline cases. Exercise echocardiography (evaluating MR severity, pulmonary pressure, or right ventricular function) may have an important role in the management of difficult cases. Finally, the moment when surgery is no longer an option and alternative solutions should be sought is also discussed. Although in everyday clinical practice the timing of surgery is not always straightforward, some newer clinical and echocardiographic indicators can guide this decision and help improve the outcome of these patients. PMID:25810729

Korean clinical practice guideline for benign prostatic hyperplasia

PubMed Central

Yeo, Jeong Kyun; Choi, Hun; Bae, Jae Hyun; Kim, Jae Heon; Yang, Seong Ok; Oh, Chul Young; Cho, Young Sam; Kim, Kyoung Woo

2016-01-01

In 2014, the Korean Urological Association organized the Benign Prostatic Hyperplasia Guideline Developing Committee composed of experts in the field of benign prostatic hyperplasia (BPH) with the participation of the Korean Academy of Family Medicine and the Korean Continence Society to develop a Korean clinical practice guideline for BPH. The purpose of this clinical practice guideline is to provide current and comprehensive recommendations for the evaluation and treatment of BPH. The committee developed the guideline mainly by adapting existing guidelines and partially by using the de novo method. A comprehensive literature review was carried out primarily from 2009 to 2013 by using medical search engines including data from Korea. Based on the published evidence, recommendations were synthesized, and the level of evidence of the recommendations was determined by using methods adapted from the 2011 Oxford Centre for Evidence-Based Medicine. Meta-analysis was done for one key question and four recommendations. A draft guideline was reviewed by expert peer reviewers and discussed at an expert consensus meeting until final agreement was achieved. This evidence-based guideline for BPH provides recommendations to primary practitioners and urologists for the diagnosis and treatment of BPH in men older than 40 years. PMID:26966724

[Clinical recommendations for sport practice in diabetic patients (RECORD Guide). Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN)].

PubMed

Gargallo-Fernández, Manuel; Escalada San Martín, Javier; Gómez-Peralta, Fernando; Rozas Moreno, Pedro; Marco Martínez, Amparo; Botella-Serrano, Marta; Tejera Pérez, Cristina; López Fernández, Judith

2015-01-01

Sporting activity is becoming a common practice in patients with diabetes mellitus (DM). This situation requires both a preliminary medical assessment and a wide range of changes in treatment which have scarcely been addressed in medical literature. To prepare a clinical guideline on the medical approach to patients with diabetes who practice sport regularly. An expert panel from the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN) reviewed the most relevant literature in each of the sections. Based both on this review and on data from the experience of a number of athletes with DM, a number of recommendations were agreed within each section. Finally, the Working Group and representatives of the SEEN jointly discussed all these recommendations. The guideline provides recommendations ranging from medical assessment before patients with DM start to practice sport to actions during and after physical activity. Recommendations are also given on aspects such as the impact of sport on blood glucose control, training schemes, or special risk situations. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

A “Hybrid” Bacteriology Course: The Professor’s Design and Expectations; The Students’ Performance and Assessment

PubMed Central

KRAWIEC, STEVEN; SALTER, DIANE; KAY, EDWIN J.

2005-01-01

A basic bacteriology course was offered in two successive academic years, first in a conventional format and subsequently as a “hybrid” course. The latter combined (i) online presentation of content, (ii) an emphasis on online resources, (iii) thrice-weekly, face-to-face conversations to advance understanding, and (iv) frequent student postings on an electronic discussion board. We compared the two courses through statistical analysis of student performances on the final examinations and the course overall and student assessment of teaching. The data indicated that there was no statistical difference in performance on the final examinations or the course overall. Responses on an instrument of evaluation revealed that students less strongly affirmed the following measures in the hybrid course: (i) The amount of work was appropriate for the credit received, (ii) Interactions between students and instructor were positive, (iii) I learned a great deal in this course, and (iv) I would recommend this course to other students. We recommend clear direction about active learning tasks and relevant feedback to enhance learning in a hybrid course. PMID:23653558

ASCCP Colposcopy Standards: Colposcopy Quality Improvement Recommendations for the United States.

PubMed

Mayeaux, Edward J; Novetsky, Akiva P; Chelmow, David; Garcia, Francisco; Choma, Kim; Liu, Angela H; Papasozomenos, Theognosia; Einstein, Mark H; Massad, L Stewart; Wentzensen, Nicolas; Waxman, Alan G; Conageski, Christine; Khan, Michelle J; Huh, Warner K

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. The ASCCP Quality Improvement Working Group developed evidence-based guidelines to promote best practices and reduce errors in colposcopy and recommended indicators to measure colposcopy quality. The working group performed a systematic review of existing major society and national guidelines and quality indicators. An initial list of potential quality indicators was developed and refined through successive iterative discussions, and draft quality indicators were proposed. The draft recommendations were then reviewed and commented on by the entire Colposcopy Standards Committee, posted online for public comment, and presented at the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered, additional adjustments made, and the final recommendations approved by the entire Task Force. Eleven quality indicators were selected spanning documentation, biopsy protocols, and time intervals between index screening tests and completion of diagnostic evaluation. The proposed quality indicators are intended to serve as a starting point for quality improvement in colposcopy at a time when colposcopy volume is decreasing and individual procedures are becoming technically more difficult to perform.

Apollo experience report: Mission evaluation team postflight documentation

NASA Technical Reports Server (NTRS)

Dodson, J. W.; Cordiner, D. H.

1975-01-01

The various postflight reports prepared by the mission evaluation team, including the final mission evaluation report, report supplements, anomaly reports, and the 5-day mission report, are described. The procedures for preparing each report from the inputs of the various disciplines are explained, and the general method of reporting postflight results is discussed. Recommendations for postflight documentation in future space programs are included. The official requirements for postflight documentation and a typical example of an anomaly report are provided as appendixes.

Mooring and ground handling rigid airships

NASA Technical Reports Server (NTRS)

Walker, H., Jr.

1975-01-01

The problems of mooring and ground handling rigid airships are discussed. A brief history of Mooring and Ground Handling Rigid Airships from July 2, 1900 through September 1, 1939 is included. Also a brief history of ground handling developments with large U. S. Navy nonrigid airships between September 1, 1939 and August 31, 1962 is included wherein developed equipment and techniques appear applicable to future large rigid airships. Finally recommendations are made pertaining to equipment and procedures which appear desirable and feasible for future rigid airship programs.

Health promotion, environmental health and Agenda 21.

PubMed

Scriven, A; Young, S

1998-04-01

In 1992, at the Rio Earth Summit, many governments, including our own, committed themselves to developing local strategies for sustainable development in the form of Local Agenda 21. Sustainable development is discussed, as is the philosophy and practice of health promotion and environmental health. Common approaches are identified and the links in relation to key areas of activities, strategies, values and principles are outlined. Finally, recommendations are made and conclusions drawn in relation to the overlap between environmental health action, Agenda 21 strategies and health promotion practice.

Risk analysis and the law: international law, the World Trade Organization, Codex Alimentarius and national legislation.

PubMed

Horton, L R

2001-12-01

This paper discusses the place of risk analysis in international trade from a US perspective, through looking at the activities of the World Trade Organization and the Codex Alimentarius Commission. After examining what the trade agreements say about risk analysis and how international bodies are advancing and using risk analysis, the paper goes on to assess how risk analysis is used at a national level. Finally, recommendations are made for strengthening international food safety initiatives.

ANSYS duplicate finite-element checker routine

NASA Technical Reports Server (NTRS)

Ortega, R.

1995-01-01

An ANSYS finite-element code routine to check for duplicated elements within the volume of a three-dimensional (3D) finite-element mesh was developed. The routine developed is used for checking floating elements within a mesh, identically duplicated elements, and intersecting elements with a common face. A space shuttle main engine alternate turbopump development high pressure oxidizer turbopump finite-element model check using the developed subroutine is discussed. Finally, recommendations are provided for duplicate element checking of 3D finite-element models.

National Labor Relations Board: Action Needed to Improve Case-Processing Time at Headquarters

DTIC Science & Technology

1991-01-01

Board more than 2 years. The Board agreed with the report regarding (1) the disruptive impact of Board-member turnover and vacancies, (2) Board...establish) and the impact of lead case delays were signifi- cant factors that warrant the extent of discussion in the report. ’’A Staff Report on the...of course, too early to evaluate the final impact of the Draft Report’s recommendations on action needed to improve case-processing time at the five

Predesign study for a modern 4-bladed rotor for the NASA rotor systems research aircraft

NASA Technical Reports Server (NTRS)

Bishop, H. E.; Burkam, J. E.; Heminway, R. C.; Keys, C. N.; Smith, K. E.; Smith, J. H.; Staley, J. A.

1981-01-01

Trade-off study results and the rationale for the final selection of an existing modern four-bladed rotor system that can be adapted for installation on the Rotor Systems Research Aircraft (RSRA) are reported. The results of the detailed integration studies, parameter change studies, and instrumentation studies and the recommended plan for development and qualification of the rotor system is also given. Its parameter variants, integration on the RSRA, and support of ground and flight test programs are also discussed.

Investigation of current university research concerning energy conversion and conservation in small single-family dwellings

NASA Technical Reports Server (NTRS)

Grossman, G. R.; Roberts, A. S., Jr.

1975-01-01

An investigation was made of university research concerning energy conversion and conservation techniques which may be applied in small single-family residences. Information was accumulated through published papers, progress reports, telephone conversations, and personal interviews. A synopsis of each pertinent investigation is given. Finally, a discussion of the synopses is presented and recommendations are made concerning the applicability of concepts for the design and construction of NASA-Langley Research Center's proposed Technology Utilization House in Hampton, Virginia.

The Washington State Technology Plan for the K-12 Common School System. Sections 701-703, Chapter 336, Laws of 1993 (Engrossed Substitute House Bill 1209) as Amended by Chapter 245, Laws of 1994. Report to the Legislature.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia.

This final report for the Washington State Technology Plan for K-12 Common Schools provides a vision, long-term framework, and recommendations for implementation. Following an executive summary and a list of committee members, the first section of the report discusses technology in K-12 schools of tomorrow, including legislative charge, vision,…

Cyber Technology for Materials and Structures in Aeronautics and Aerospace

NASA Technical Reports Server (NTRS)

Pipes, R. Byron

2002-01-01

The evolution of composites applications in aeronautics from 1970 to the present is discussed. The barriers and challenges to economic application and to certification are presented and recommendations for accelerated development are outlined. The potential benefits of emerging technologies to aeronautics and their foundation in composite materials are described and the resulting benefits in vehicle take off gross weight are quantified. Finally, a 21st century vision for aeronautics in which human mobility is increased by an order of magnitude is articulated.

A modified Delphi method toward multidisciplinary consensus on functional convalescence recommendations after abdominal surgery.

PubMed

van Vliet, Daphne C R; van der Meij, Eva; Bouwsma, Esther V A; Vonk Noordegraaf, Antonie; van den Heuvel, Baukje; Meijerink, Wilhelmus J H J; van Baal, W Marchien; Huirne, Judith A F; Anema, Johannes R

2016-12-01

Evidence-based information on the resumption of daily activities following uncomplicated abdominal surgery is scarce and not yet standardized in medical guidelines. As a consequence, convalescence recommendations are generally not provided after surgery, leading to patients' insecurity, needlessly delayed recovery and prolonged sick leave. The aim of this study was to generate consensus-based multidisciplinary convalescence recommendations, including advice on return to work, applicable for both patients and physicians. Using a modified Delphi method among a multidisciplinary panel of 13 experts consisting of surgeons, occupational physicians and general practitioners, detailed recommendations were developed for graded resumption of 34 activities after uncomplicated laparoscopic cholecystectomy, laparoscopic and open appendectomy, laparoscopic and open colectomy and laparoscopic and open inguinal hernia repair. A sample of occupational physicians, general practitioners and surgeons assessed the recommendations on feasibility in daily practice. The response of this group of care providers was discussed with the experts in the final Delphi questionnaire round. Out of initially 56 activities, the expert panel selected 34 relevant activities for which convalescence recommendations were developed. After four Delphi rounds, consensus was reached for all of the 34 activities for all the surgical procedures. A sample of occupational physicians, general practitioners and surgeons regarded the recommendations as feasible in daily practice. Multidisciplinary convalescence recommendations regarding uncomplicated laparoscopic cholecystectomy, appendectomy (laparoscopic, open), colectomy (laparoscopic, open) and inguinal hernia repair (laparoscopic, open) were developed by a modified Delphi procedure. Further research is required to evaluate whether these recommendations are realistic and effective in daily practice.

Final Report: Summary of Findings and Recommendations for Suction Devices for Management of Prehospital Combat Casualty Care Injuries

DTIC Science & Technology

2017-11-13

information and proposes a series of findings and recommendations to improved airway management in the prehospital combat environment. The key...Airway Final Report: Summary of Findings and Recommendations for Suction Devices for Management of Prehospital Combat Casualty Care Injuries...75 General Information and Device Usability

Youth Employment. Final Recommendations of the State Superintendent's Task Force.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison.

This report contains the final recommendations of the task force on youth employment for the state of Wisconsin. The task force was specifically charged with studying issues related to working teenagers, reviewing existing laws and regulations on child labor, and developing recommendations to ensure that when teenagers work, their jobs do not…

The impact of suicide on the family.

PubMed

Cerel, Julie; Jordan, John R; Duberstein, Paul R

2008-01-01

Little research has examined the consequences of a suicide for social or family networks. Because suicide occurs within families, the focus on the aftermath of suicide within families is an important next step to determine exactly how to help survivors. In this article, we review and summarize the research on the impact of suicide on individuals within families and on family and social networks. We begin with a discussion of family changes following suicide. Next, we discuss the effects of suicide on social networks overall and responses of children and the elderly to a suicide in the family. Finally, we identify key issues that remain to be resolved in family survivor research and make recommendations for future studies.

Severe mitral stenosis with atypical presentation: hemorrhagic pleural effusion--a case report and literature review.

PubMed

Albalbissi, Kais A; Burress, Jonathan W; Garcia, Israel D; Iskandar, Said B

2009-02-01

Mitral stenosis is a well-described valvular heart disease. We report a 68-year-old patient with an unusual presentation of mitral stenosis. He presented with recurrent episodes of hemorrhagic pleural effusion. Afterwards, an extensive atrial thrombosis complicated his course of illness. We will discuss how the clinical presentation of mitral stenosis is mainly dictated by the underlying pathophysiology of the disease. Also, the need for anticoagulation in the setting of mitral stenosis is often linked to the presence of atrial fibrillation. We will discuss the independent risk factors for thromboembolism in the setting of mitral stenosis. Finally, a review of the current recommendation for anticoagulation is conferred.

NASA Past, Present, and Future: The Use of Commercial Off The Shelf (COTS) Electronics in Space

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.; Guertin, Steven M.

2017-01-01

NASA has a long history of using commercial grade electronics in space. In this presentation we will provide a brief history of NASA's trends and approaches to commercial grade electronics focusing on processing and memory systems. This will include providing summary information on the space hazards to electronics as well as NASA mission trade space. We will also discuss developing recommendations for risk management approaches to Electrical, Electronic and Electromechanical (EEE) parts usage in space. Two examples will be provided focusing on a near-earth Polar-orbiting spacecraft as well as a mission to Mars. The final portion will discuss emerging trends impacting usage.

Public health approaches to family maltreatment prevention: resetting family psychology's sights from the home to the community.

PubMed

Slep, Amy M Smith; Heyman, Richard E

2008-08-01

The authors review recent trends within the family maltreatment research field toward a public health approach, discuss the rationale for community-level interventions for family maltreatment, and sketch the history and development of community-level prevention approaches. Next, to illustrate the both the logistic and the scientific challenges of such work, the authors discuss the development and testing of an empirically guided, research-community partnership for the prevention of family maltreatment, the United States Air Force's NORTH STAR initiative (New Orientation to Reduce Threats to Health From Secretive Problems That Affect Readiness). Finally, recommendations are made for effective and disseminable family maltreatment prevention interventions.

Study of rainfall-induced landslide: a review

NASA Astrophysics Data System (ADS)

Tohari, A.

2018-02-01

Rainfall-induced landslides pose a substantial risk to people and infrastructure. For this reason, there have been numerous studies to understand the landslide mechanism. Most of them were performed on the numerical analysis and laboratory experiment. This paper presents a review of existing research on field hydrological condition of soil slopes leading to the initiation of rainfall-induced landslide. Existing methods to study field hydrological response of slopes are first reviewed, emphasizing their limitations and suitability of application. The typical hydrological response profiles in the slope are then discussed. Subsequently, some significant findings on hydrological condition leading to rainfall-induced landslides are summarized and discussed. Finally, several research topics are recommended for future study.

Twitter as a tool for communication and knowledge exchange in academic medicine: A guide for skeptics and novices.

PubMed

Choo, Esther K; Ranney, Megan L; Chan, Teresa M; Trueger, N Seth; Walsh, Amy E; Tegtmeyer, Ken; McNamara, Shannon O; Choi, Ricky Y; Carroll, Christopher L

2015-05-01

Twitter is a tool for physicians to increase engagement of learners and the public, share scientific information, crowdsource new ideas, conduct, discuss and challenge emerging research, pursue professional development and continuing medical education, expand networks around specialized topics and provide moral support to colleagues. However, new users or skeptics may well be wary of its potential pitfalls. The aims of this commentary are to discuss the potential advantages of the Twitter platform for dialogue among physicians, to explore the barriers to accurate and high-quality healthcare discourse and, finally, to recommend potential safeguards physicians may employ against these threats in order to participate productively.

Long-term treatment of an addictive personality.

PubMed

Seymour, Peter M

2003-01-01

There is infrequent discussion of long-term psychotherapy of persons with addiction, particularly in the self-psychology literature. In addition, some question whether long-term psychotherapy can be helpful in severe psychiatric disorders. The author describes the treatment of a woman with multiple diagnoses, including bulimia and alcohol and drug addiction, which took place over a period of almost 7 years. These issues are addressed from a self-psychological perspective, with progression of the treatment from early facilitation of a selfobject transference to more intense selfobject transference-countertransference states. Behavioral interventions (e.g., recommendation of inpatient chemical dependency treatment) are also discussed. The author describes the patient's dramatic progress and subsequent regression. Finally, there is a discussion of the addiction from self-psychological and biological perspectives of this woman's particular developmental and treatment issues, as well as a discussion of the confrontation and limit setting in a self-psychologically oriented treatment.

[Recommendations for the diagnosis, staging and treatment of pre-malignant lesions and pancreatic adenocarcinoma].

PubMed

Martin-Richard, Marta; Ginès, Angels; Ayuso, Juan Ramón; Sabater, Luis; Fabregat, Joan; Mendez, Ramiro; Fernández-Esparrach, Glòria; Molero, Xavier; Vaquero, Eva C; Cuatrecasas, Miriam; Ferrández, Antonio; Maurel, Joan

2016-11-18

Clinical management of adenocarcinoma of the pancreas is complex, and requires a multidisciplinary approach. The same applies for the premalignant lesions that are increasingly being diagnosed. The current document is an update on the diagnosis and management of premalignant lesions and adenocarcinoma of the pancreas. A conference to establish the basis of the literature review and manuscript redaction was organized by the Grupo Español Multidisciplinar en Cáncer Digestivo. Experts in the field from different specialties (Gastroenterology, Surgery, Radiology, Pathology, Medical Oncology and Radiation Oncology) met to prepare the present document. The current literature was reviewed and discussed, with subsequent deliberation on the evidence. Final recommendations were established in view of all the above. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Plan of Action for Inherited Cardiovascular Diseases: Synthesis of Recommendations and Action Algorithms.

PubMed

Barriales-Villa, Roberto; Gimeno-Blanes, Juan Ramón; Zorio-Grima, Esther; Ripoll-Vera, Tomás; Evangelista-Masip, Artur; Moya-Mitjans, Angel; Serratosa-Fernández, Luis; Albert-Brotons, Dimpna C; García-Pinilla, José Manuel; García-Pavía, Pablo

2016-03-01

The term inherited cardiovascular disease encompasses a group of cardiovascular diseases (cardiomyopathies, channelopathies, certain aortic diseases, and other syndromes) with a number of common characteristics: they have a genetic basis, a familial presentation, a heterogeneous clinical course, and, finally, can all be associated with sudden cardiac death. The present document summarizes some important concepts related to recent advances in sequencing techniques and understanding of the genetic bases of these diseases. We propose diagnostic algorithms and clinical practice recommendations and discuss controversial aspects of current clinical interest. We highlight the role of multidisciplinary referral units in the diagnosis and treatment of these conditions. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Antenatal Testing – A Reevaluation

PubMed Central

Signore, Caroline; Freeman, Roger K.; Spong, Catherine Y.

2009-01-01

In August 2007, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institutes of Health Office of Rare Diseases, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics cosponsored a 2-day workshop to reassess the body of evidence supporting antepartum assessment of fetal well-being, identify key gaps in the evidence, and formulate recommendations for further research. Participants included experts in obstetrics and fetal physiology, and representatives from relevant stakeholder groups and organizations. This article is a summary of the discussions at the workshop, including synopses of oral presentations on the epidemiology of stillbirth and fetal neurological injury, fetal physiology, techniques for antenatal monitoring, and maternal and fetal indications for monitoring. Finally, a synthesis of recommendations for further research compiled from three breakout workgroups is presented. PMID:19300336

Choosing the Right Systems Integration

NASA Astrophysics Data System (ADS)

Péči, Matúš; Važan, Pavel

2014-12-01

The paper examines systems integration and its main levels at higher levels of control. At present, the systems integration is one of the main aspects participating in the consolidation processes and financial flows of a company. Systems Integration is a complicated emotionconsuming process and it is often a problem to choose the right approach and level of integration. The research focused on four levels of integration, while each of them is characterized by specific conditions. At each level, there is a summary of recommendations and practical experience. The paper also discusses systems integration between the information and MES levels. The main part includes user-level integration where we describe an example of such integration. Finally, we list recommendations and also possible predictions of the systems integration as one of the important factors in the future.

Reframing the Dissemination Challenge: A Marketing and Distribution Perspective

PubMed Central

Bernhardt, Jay M.

2009-01-01

A fundamental obstacle to successful dissemination and implementation of evidence-based public health programs is the near-total absence of systems and infrastructure for marketing and distribution. We describe the functions of a marketing and distribution system, and we explain how it would help move effective public health programs from research to practice. Then we critically evaluate the 4 dominant strategies now used to promote dissemination and implementation, and we explain how each would be enhanced by marketing and distribution systems. Finally, we make 6 recommendations for building the needed system infrastructure and discuss the responsibility within the public health community for implementation of these recommendations. Without serious investment in such infrastructure, application of proven solutions in public health practice will continue to occur slowly and rarely. PMID:19833993

Survey of selected topics relevant to bioprocess engineering. Technical note (Final)

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

Hubbard, J.B.; Clark, E.J.; Levelt Sengers, J.M.H.

1990-05-01

The following is a collection of reports on topics considered important and generic in biotechnology and bioprocess engineering: (1) Isoelectric points of proteins; (2) Solubility and mass transfer of oxygen in bioreactors; (3) Solubility and mass transfer of carbon dioxide in bioreactors. The reports arose from a survey of the past and current biotechnology literature with special effort given to a critique of data measurement quality. The format is as follows. The technological importance of a topic is briefly discussed, followed by a critical review of relevant physical properties, data presentation, and measurement techniques. A conclusions and recommendations section summarizesmore » the findings and contains specific recommendations for future research projects. The last section consists of an annotated bibliography and references pertaining to the survey.« less

Reframing the dissemination challenge: a marketing and distribution perspective.

PubMed

Kreuter, Matthew W; Bernhardt, Jay M

2009-12-01

A fundamental obstacle to successful dissemination and implementation of evidence-based public health programs is the near-total absence of systems and infrastructure for marketing and distribution. We describe the functions of a marketing and distribution system, and we explain how it would help move effective public health programs from research to practice. Then we critically evaluate the 4 dominant strategies now used to promote dissemination and implementation, and we explain how each would be enhanced by marketing and distribution systems. Finally, we make 6 recommendations for building the needed system infrastructure and discuss the responsibility within the public health community for implementation of these recommendations. Without serious investment in such infrastructure, application of proven solutions in public health practice will continue to occur slowly and rarely.

Enrolling adolescents in asthma research: adolescent, parent, and physician influence in the decision-making process.

PubMed

Brody, Janet L; Annett, Robert D; Scherer, David G; Turner, Charles; Dalen, Jeanne

2009-06-01

The factors influencing family decisions to participate in adolescent asthma research are not well understood. Legal and ethical imperatives require adolescent research participation to be voluntary. While parents and adolescents often agree about research decisions, disagreements may also occur with relative frequency. Physician recommendations are also known to influence research participation decisions. Little attention has been given to how these dynamics may affect adolescents' involvement in decisions to participate in research. To examine the influence of family and physician-investigator relationships and recommendations on adolescent asthma clinical research participation decisions. A statewide community sample of 111 adolescents 11 to 17 years of age, with a diagnosis of asthma, and their parents participated in this study. Adolescents received a medical evaluation from an asthma specialist and then the family was offered participation in a hypothetical asthma clinical trial. By random assignment, the research study was presented by either the same or an unknown asthma specialist, and half the families in each group also received affirmative recommendations from the asthma specialist to participate in the hypothetical asthma clinical trial. Parents and adolescents made initial private decisions about participating in the trial. Then, following a family discussion of the clinical trial, a final research participation decision was made. Thirty-three percent of parents and adolescents initially disagreed about the research participation decision. When disagreements occurred, final decisions followed the parents' initial views except when the physician-investigator was known and a recommendation was made. Families with initial disagreement about participating were less likely to enroll when the investigator was unknown or when no recommendation was made. Adolescents who initially disagreed with parents' views were less likely to concur with the final research participation decision, felt less comfortable, and were less likely to feel they influenced the decision. Parents' views on research decisions take precedence over adolescents' views in most circumstances. Physician-investigator relationships may reduce parental resistance to participation and enhance adolescent decision-making autonomy when research participation is desired by the adolescent.

Enrolling adolescents in asthma research: Adolescent, parent, and physician influence in the decision-making process

PubMed Central

Brody, Janet L.; Annett, Robert D.; Scherer, David G.; Turner, Charles; Dalen, Jeanne

2009-01-01

Background The factors influencing family decisions to participate in adolescent asthma research are not well understood. Legal and ethical imperatives require adolescent research participation to be voluntary. While parents and adolescents often agree about research decisions, disagreements may also occur with relatively frequency. Physician recommendations are also known to influence research participation decisions. Little attention has been given to how these dynamics may affect adolescents’ involvement in decisions to participate in research. Objective To examine the influence of family and physician-investigator relationships and recommendations on adolescent asthma clinical research participation decisions. Methods A statewide community sample of 111 adolescents aged 11–17, with a diagnosis of asthma, and their parents participated in this study. Adolescents received a medical evaluation from an asthma specialist and then the family was offered participation in a hypothetical asthma clinical trial. By random assignment, the research study was presented by either the same or an unknown asthma specialist and half the families in each group also received affirmative recommendations from the asthma specialist to participate in the hypothetical asthma clinical trial. Parents and adolescent made initial private decisions about participating in the trial. Then, following a family discussion of the clinical trial, a final research participation decision was made. Results Thirty three percent of parents and adolescents initially disagreed about the research participation decision. When disagreements occurred, final decisions followed the parents’ initial views except when the physician-investigator was known and a recommendation was made. Families with initial disagreement about participating were less likely to enroll when the investigator was unknown or when no recommendation was made. Adolescents who initially disagreed with parents’ views were less likely to concur with the final research participation decision, felt less comfortable, and were less likely to feel they influenced the decision. Conclusions Parents’ views on research decisions take precedence over adolescents’ views in most circumstances. Physician-investigator relationships may reduce parental resistance to participation and enhance adolescent decision-making autonomy when research participation is desired by the adolescent. PMID:19544171

The AAS Taskforce on Diversity and Inclusion in Graduate Education: a Proposed White Paper

NASA Astrophysics Data System (ADS)

Rudolph, Alexander L.

2018-06-01

At the January 2017 AAS meeting in Texas, the AAS Council approved the creation of a Graduate Education Taskforce focusing on Diversity and Inclusion. This task force is conducting a review of practices in recruiting, admissions, and retention in PhD programs in astronomy (including astronomy programs in departments of physics and astronomy). It is also engaging the broader astronomical community and selected outside experts in diversity in STEM in a discussion of best practices in these activities, with the goal of promoting diversity (race/ethnicity, gender, LGBTQ+, disability status, etc.) and inclusion in astronomy PhD programs. Building on the Nashville Recommendations from the Inclusive Astronomy 2015 meeting, the task force is developing a set of specific recommendations with the aim of endorsement by the AAS, in parallel with a campaign to get them adopted by astronomy departments. Finally, the task force will suggest and push adoption of a set of permanent measurements to be collected by the AAS to track progress on these goals. There is a separate special session at this meeting intended to report on the task force’s progress and to solicit community input on its draft recommendations to date.This presentation will give a brief overview of the task force's charge and activities and their plans to turn their final report into a White Paper for the Decadal Survey.

The Development of Best Practice Recommendations to Support the Hiring, Recruitment, and Advancement of Women Physicians in Emergency Medicine.

PubMed

Choo, Esther K; Kass, Dara; Westergaard, Mary; Watts, Susan H; Berwald, Nicole; Regan, Linda; Promes, Susan B; Clem, Kathleen J; Schneider, Sandra M; Kuhn, Gloria J; Abbuhl, Stephanie; Nobay, Flavia

2016-11-01

Women in medicine continue to experience disparities in earnings, promotion, and leadership roles. There are few guidelines in place defining organization-level factors that promote a supportive workplace environment beneficial to women in emergency medicine (EM). We assembled a working group with the goal of developing specific and feasible recommendations to support women's professional development in both community and academic EM settings. We formed a working group from the leadership of two EM women's organizations, the Academy of Women in Academic Emergency Medicine (AWAEM) and the American Association of Women Emergency Physicians (AAWEP). Through a literature search and discussion, working group members identified four domains where organizational policies and practices supportive of women were needed: 1) global approaches to supporting the recruitment, retention, and advancement of women in EM; 2) recruitment, hiring, and compensation of women emergency physicians; 3) supporting development and advancement of women in EM; and 4) physician health and wellness (in the context of pregnancy, childbirth, and maternity leave). Within each of these domains, the working group created an initial set of specific recommendations. The working group then recruited a stakeholder group of EM physician leaders across the country, selecting for diversity in practice setting, geographic location, age, race, and gender. Stakeholders were asked to score and provide feedback on each of the recommendations. Specific recommendations were retained by the working group if they achieved high rates of approval from the stakeholder group for importance and perceived feasibility. Those with >80% agreement on importance and >50% agreement on feasibility were retained. Finally, recommendations were posted in an open online forum (blog) and invited public commentary. An initial set of 29 potential recommendations was created by the working group. After stakeholder voting and feedback, 16 final recommendations were retained. Recommendations were refined through qualitative comments from stakeholders and blog respondents. Using a consensus building process that included male and female stakeholders from both academic and community EM settings, we developed recommendations for organizations to implement to create a workplace environment supportive of women in EM that were perceived as acceptable and feasible. This process may serve as a model for other medical specialties to establish clear, discrete organization-level practices aimed at supporting women physicians. © 2016 by the Society for Academic Emergency Medicine.

Age and impulsive behavior in drug addiction: A review of past research and future directions.

PubMed

Argyriou, Evangelia; Um, Miji; Carron, Claire; Cyders, Melissa A

2018-01-01

Impulsive behavior is implicated in the initiation, maintenance, and relapse of drug-seeking behaviors involved in drug addiction. Research shows that changes in impulsive behavior across the lifespan contribute to drug use and addiction. The goal of this review is to examine existing research on the relationship between impulsive behavior and drug use across the lifespan and to recommend directions for future research. Three domains of impulsive behavior are explored in this review: impulsive behavior-related personality traits, delay discounting, and prepotent response inhibition. First, we present previous research on these three domains of impulsive behavior and drug use across developmental stages. Then, we discuss how changes in impulsive behavior across the lifespan are implicated in the progression of drug use and addiction. Finally, we discuss the relatively limited attention given to middle-to-older adults in the current literature, consider the validity of the measures used to assess impulsive behavior in middle-to-older adulthood, and suggest recommendations for future research. Copyright © 2017 Elsevier Inc. All rights reserved.

Addendum to the AAPM's TG-51 protocol for clinical reference dosimetry of high-energy photon beams

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

McEwen, Malcolm, E-mail: malcolm.mcewen@nrc-cnrc.gc.ca; DeWerd, Larry; Ibbott, Geoffrey

2014-04-15

An addendum to the AAPM's TG-51 protocol for the determination of absorbed dose to water in megavoltage photon beams is presented. This addendum continues the procedure laid out in TG-51 but new k{sub Q} data for photon beams, based on Monte Carlo simulations, are presented and recommendations are given to improve the accuracy and consistency of the protocol's implementation. The components of the uncertainty budget in determining absorbed dose to water at the reference point are introduced and the magnitude of each component discussed. Finally, the consistency of experimental determination of N{sub D,w} coefficients is discussed. It is expected thatmore » the implementation of this addendum will be straightforward, assuming that the user is already familiar with TG-51. The changes introduced by this report are generally minor, although new recommendations could result in procedural changes for individual users. It is expected that the effort on the medical physicist's part to implement this addendum will not be significant and could be done as part of the annual linac calibration.« less

2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis.

PubMed

Tuncer, Tiraje; Cay, Fatih Hasan; Altan, Lale; Gurer, Gulcan; Kacar, Cahit; Ozcakir, Suheda; Atik, Sahap; Ayhan, Figen; Durmaz, Berrin; Eskiyurt, Nurten; Genc, Hakan; GokceKutsal, Yesim; Gunaydin, Rezzan; Hepguler, Simin; Hizmetli, Sami; Kaya, Taciser; Kurtais, Yesim; Saridogan, Merih; Sindel, Dilsad; Sutbeyaz, Serap; Sendur, Omer Faruk; Ugurlu, Hatice; Unlu, Zeliha

2018-05-17

In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease.

Autism Spectrum Disorder: consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology

PubMed Central

Howes, Oliver D; Charman, Tony; King, Bryan H.; Loth, Eva; McAlonan, Gráinne M.; McCracken, James T.; Parr, Jeremy R; Santosh, Paramala; Wallace, Simon; Murphy, Declan G.

2018-01-01

An expert review of the aetiology, assessment, and treatment of autism spectrum disorder (ASD), and recommendations for diagnosis, management and service provision was coordinated by the British Association for Psychopharmacology, and evidence graded. The aetiology of ASD involves genetic and environmental contributions, and implicates a number of brain systems, in particular the gamma-aminobutyric acid (GABA), serotonergic and glutamatergic systems. The presentation of ASD varies widely and co-occurring health problems (in particular epilepsy, sleep disorders, anxiety, depression, attention deficit/hyperactivity disorder (ADHD), and irritability) are common. We did not recommend the routine use of any pharmacological treatment for the core symptoms of ASD. In children, melatonin may be useful to treat sleep problems, dopamine blockers for irritability, and methylphenidate, atomoxetine and guanfacine for ADHD. The evidence for use of medication in adults is limited and recommendations are largely based on extrapolations from studies in children and patients without ASD. We discuss the conditions for considering and evaluating a trial of medication treatment, when non-pharmacological interventions should be considered, and make recommendations on service delivery. Finally, we identify key gaps and limitations in the current evidence base and make recommendations for future research and the design of clinical trials. PMID:29237331

Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology.

PubMed

Howes, Oliver D; Rogdaki, Maria; Findon, James L; Wichers, Robert H; Charman, Tony; King, Bryan H; Loth, Eva; McAlonan, Gráinne M; McCracken, James T; Parr, Jeremy R; Povey, Carol; Santosh, Paramala; Wallace, Simon; Simonoff, Emily; Murphy, Declan G

2018-01-01

An expert review of the aetiology, assessment, and treatment of autism spectrum disorder, and recommendations for diagnosis, management and service provision was coordinated by the British Association for Psychopharmacology, and evidence graded. The aetiology of autism spectrum disorder involves genetic and environmental contributions, and implicates a number of brain systems, in particular the gamma-aminobutyric acid, serotonergic and glutamatergic systems. The presentation of autism spectrum disorder varies widely and co-occurring health problems (in particular epilepsy, sleep disorders, anxiety, depression, attention deficit/hyperactivity disorder and irritability) are common. We did not recommend the routine use of any pharmacological treatment for the core symptoms of autism spectrum disorder. In children, melatonin may be useful to treat sleep problems, dopamine blockers for irritability, and methylphenidate, atomoxetine and guanfacine for attention deficit/hyperactivity disorder. The evidence for use of medication in adults is limited and recommendations are largely based on extrapolations from studies in children and patients without autism spectrum disorder. We discuss the conditions for considering and evaluating a trial of medication treatment, when non-pharmacological interventions should be considered, and make recommendations on service delivery. Finally, we identify key gaps and limitations in the current evidence base and make recommendations for future research and the design of clinical trials.

Report from a consensus conference on antibody-mediated rejection in heart transplantation

PubMed Central

Kobashigawa, Jon; Crespo-Leiro, Maria G.; Ensminger, Stephan M.; Reichenspurner, Hermann; Angelini, Annalisa; Berry, Gerald; Burke, Margaret; Czer, Lawrence; Hiemann, Nicola; Kfoury, Abdallah G.; Mancini, Donna; Mohacsi, Paul; Patel, Jignesh; Pereira, Naveen; Platt, Jeffrey L.; Reed, Elaine F.; Reinsmoen, Nancy; Rodriguez, E. Rene; Rose, Marlene L.; Russell, Stuart D.; Starling, Randy; Suciu-Foca, Nicole; Tallaj, Jose; Taylor, David O.; Van Bakel, Adrian; West, Lori; Zeevi, Adriana; Zuckermann, Andreas

2012-01-01

BACKGROUND The problem of AMR remains unsolved because standardized schemes for diagnosis and treatment remains contentious. Therefore, a consensus conference was organized to discuss the current status of antibody-mediated rejection (AMR) in heart transplantation. METHODS The conference included 83 participants (transplant cardiologists, surgeons, immunologists and pathologists) representing 67 heart transplant centers from North America, Europe, and Asia who all participated in smaller break-out sessions to discuss the various topics of AMR and attempt to achieve consensus. RESULTS A tentative pathology diagnosis of AMR was established, however, the pathologist felt that further discussion was needed prior to a formal recommendation for AMR diagnosis. One of the most important outcomes of this conference was that a clinical definition for AMR (cardiac dysfunction and/or circulating donor-specific antibody) was no longer believed to be required due to recent publications demonstrating that asymptomatic (no cardiac dysfunction) biopsy-proven AMR is associated with subsequent greater mortality and greater development of cardiac allograft vasculopathy. It was also noted that donor-specific antibody is not always detected during AMR episodes as the antibody may be adhered to the donor heart. Finally, recommendations were made for the timing for specific staining of endomyocardial biopsy specimens and the frequency by which circulating antibodies should be assessed. Recommendations for management and future clinical trials were also provided. CONCLUSIONS The AMR Consensus Conference brought together clinicians, pathologists and immunologists to further the understanding of AMR. Progress was made toward a pathology AMR grading scale and consensus was accomplished regarding several clinical issues. PMID:21300295

Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.

PubMed

Wahlgren, Nils; Moreira, Tiago; Michel, Patrik; Steiner, Thorsten; Jansen, Olav; Cognard, Christophe; Mattle, Heinrich P; van Zwam, Wim; Holmin, Staffan; Tatlisumak, Turgut; Petersson, Jesper; Caso, Valeria; Hacke, Werner; Mazighi, Mikael; Arnold, Marcel; Fischer, Urs; Szikora, Istvan; Pierot, Laurent; Fiehler, Jens; Gralla, Jan; Fazekas, Franz; Lees, Kennedy R

2016-01-01

The original version of this consensus statement on mechanical thrombectomy was approved at the European Stroke Organisation (ESO)-Karolinska Stroke Update conference in Stockholm, 16-18 November 2014. The statement has later, during 2015, been updated with new clinical trials data in accordance with a decision made at the conference. Revisions have been made at a face-to-face meeting during the ESO Winter School in Berne in February, through email exchanges and the final version has then been approved by each society. The recommendations are identical to the original version with evidence level upgraded by 20 February 2015 and confirmed by 15 May 2015. The purpose of the ESO-Karolinska Stroke Update meetings is to provide updates on recent stroke therapy research and to discuss how the results may be implemented into clinical routine. Selected topics are discussed at consensus sessions, for which a consensus statement is prepared and discussed by the participants at the meeting. The statements are advisory to the ESO guidelines committee. This consensus statement includes recommendations on mechanical thrombectomy after acute stroke. The statement is supported by ESO, European Society of Minimally Invasive Neurological Therapy (ESMINT), European Society of Neuroradiology (ESNR), and European Academy of Neurology (EAN). © 2016 World Stroke Organization.

Emerging analgesic drugs for Parkinson's disease.

PubMed

Perez-Lloret, Santiago; Rey, María Verónica; Dellapina, Estelle; Pellaprat, Jean; Brefel-Courbon, Christine; Rascol, Olivier

2012-06-01

Pain affects between 40 and 85% of Parkinson's disease (PD) patients. It is a frequently disabling and overlooked feature, which can significantly reduce health-related quality of life. Unfortunately, there are no universally recommended treatments for this condition. Evidence about the efficacy and safety of available analgesic treatments is summarized in this review. Potential targets for upcoming therapies are then discussed in light of what is currently known about the physiopathology of pain in PD. Protocols for efficacy and safety assessment of novel analgesic therapies are discussed. Finally, critical aspects of study protocol design such as patient selection or outcomes to be evaluated are discussed. Preliminary results indicate that duloxetine, cranial electrotherapy stimulation, rotigotine, subthalamic or pallidum nuclei stimulation or lesion or levodopa could be effective for treating pain in PD. Similarly, some case reports indicate that repetitive transcranial magnetic stimulation (rTMS) or apomorphine could be effective for relieving painful off-period dystonia. Clinical trials with rTMS or oxycodone/naloxone prolonged-release tablets for neuropathic pain or botulinum toxin for off-period dystonia are underway. Success of clinical trials about analgesic strategies in PD will depend on the selection of the right PD population to be treated, according to the type of pain, and the proper selection of study outcomes and follow-up of international recommendations.

The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations

PubMed Central

Kumar, Ashish; Acharya, Subrat K.; Singh, Shivaram P.; Saraswat, Vivek A.; Arora, Anil; Duseja, Ajay; Goenka, Mahesh K.; Jain, Deepali; Kar, Premashish; Kumar, Manoj; Kumaran, Vinay; Mohandas, Kunisshery M.; Panda, Dipanjan; Paul, Shashi B.; Ramachandran, Jeyamani; Ramesh, Hariharan; Rao, Padaki N.; Shah, Samir R.; Sharma, Hanish; Thandassery, Ragesh B.

2014-01-01

Hepatocellular carcinoma (HCC) is one of the major causes of morbidity, mortality and healthcare expenditure in patients with chronic liver disease. There are no consensus guidelines on diagnosis and management of HCC in India. The Indian National Association for Study of the Liver (INASL) set up a Task-Force on HCC in 2011, with a mandate to develop consensus guidelines for diagnosis and management of HCC, relevant to disease patterns and clinical practices in India. The Task-Force first identified various contentious issues on various aspects of HCC and these issues were allotted to individual members of the Task-Force who reviewed them in detail. The Task-Force used the Oxford Center for Evidence Based Medicine—Levels of Evidence of 2009 for developing an evidence-based approach. A 2-day round table discussion was held on 9th and 10th February, 2013 at Puri, Odisha, to discuss, debate, and finalize the consensus statements. The members of the Task-Force reviewed and discussed the existing literature at this meeting and formulated the INASL consensus statements for each of the issues. We present here the INASL consensus guidelines (The Puri Recommendations) on prevention, diagnosis and management of HCC in India. PMID:25755608

The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations.

PubMed

Kumar, Ashish; Acharya, Subrat K; Singh, Shivaram P; Saraswat, Vivek A; Arora, Anil; Duseja, Ajay; Goenka, Mahesh K; Jain, Deepali; Kar, Premashish; Kumar, Manoj; Kumaran, Vinay; Mohandas, Kunisshery M; Panda, Dipanjan; Paul, Shashi B; Ramachandran, Jeyamani; Ramesh, Hariharan; Rao, Padaki N; Shah, Samir R; Sharma, Hanish; Thandassery, Ragesh B

2014-08-01

Hepatocellular carcinoma (HCC) is one of the major causes of morbidity, mortality and healthcare expenditure in patients with chronic liver disease. There are no consensus guidelines on diagnosis and management of HCC in India. The Indian National Association for Study of the Liver (INASL) set up a Task-Force on HCC in 2011, with a mandate to develop consensus guidelines for diagnosis and management of HCC, relevant to disease patterns and clinical practices in India. The Task-Force first identified various contentious issues on various aspects of HCC and these issues were allotted to individual members of the Task-Force who reviewed them in detail. The Task-Force used the Oxford Center for Evidence Based Medicine-Levels of Evidence of 2009 for developing an evidence-based approach. A 2-day round table discussion was held on 9th and 10th February, 2013 at Puri, Odisha, to discuss, debate, and finalize the consensus statements. The members of the Task-Force reviewed and discussed the existing literature at this meeting and formulated the INASL consensus statements for each of the issues. We present here the INASL consensus guidelines (The Puri Recommendations) on prevention, diagnosis and management of HCC in India.

Relating Health Technology Assessment recommendations and reimbursement decisions in Poland in years 2012-2014, a retrospective analysis.

PubMed

Kawalec, Paweł; Malinowski, Krzysztof Piotr

2016-11-01

The aim of the study was to assess the influence of public advisory bodies (the Transparency Council and the President of AOTMiT, the Polish Agency for Health Technology Assessment and Tariff System) involved in the process on final reimbursement decisions performed by the Ministry of Health. We have analysed all statements of the Transparency Council as well as the President of the AOTMiT recommendations and final reimbursement decisions in Poland for the period of three years: 2012 till 2014. For each recommendation we collected data on decisions as well as potential additional requirements regarding the reimbursement; data was presented for the whole analysed period and separately for each year, to assess the general tendencies in the reimbursement decision-making in Poland. We collected all data accessible at February 2015. The kappa measurement of agreement was used to assess the compliance between statements, recommendations and reimbursement decisions. We collected data on 238 drugs evaluated by the Agency. The compliance between the Transparency Council and the President of the AOTMiT was 95% and remained constant in the analysed period. The agreement between the President of the AOTMiT recommendations and final reimbursement decisions was only fairly represented by a kappa coefficient of 0.23 and decreased in the subsequent years. We observed an increasing proportion of positive-conditional recommendations, with the introduction of a risk sharing scheme being the most common condition of a reimbursement recommendation. We observed that final reimbursement decisions did not reflect statements and recommendations issued by the advisory boards. Positive recommendations issued by the AOTMiT did not guarantee positive reimbursement status, and negative recommendations in some cases did not result in the lack of reimbursement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Commentary: ambiguity and uncertainty: neglected elements of medical education curricula?

PubMed

Luther, Vera P; Crandall, Sonia J

2011-07-01

Despite significant advances in scientific knowledge and technology, ambiguity and uncertainty are still intrinsic aspects of contemporary medicine. To practice confidently and competently, a physician must learn rational approaches to complex and ambiguous clinical scenarios and must possess a certain degree of tolerance of ambiguity. In this commentary, the authors discuss the role that ambiguity and uncertainty play in medicine and emphasize why openly addressing these topics in the formal medical education curriculum is critical. They discuss key points from original research by Wayne and colleagues and their implications for medical education. Finally, the authors offer recommendations for increasing medical student tolerance of ambiguity and uncertainty, including dedicating time to attend candidly to ambiguity and uncertainty as a formal part of every medical school curriculum.

Apollo experience report: Television system

NASA Technical Reports Server (NTRS)

Coan, P. P.

1973-01-01

The progress of the Apollo television systems from the early definition of requirements through the development and inflight use of color television hardware is presented. Television systems that have been used during the Apollo Program are discussed, beginning with a description of the specifications for each system. The document describes the technical approach taken for the development of each system and discusses the prototype and engineering hardware built to test the system itself and to perform the testing to verify compatibility with the spacecraft systems. Problems that occurred during the design and development phase are described. Finally, the flight hardware, operational characteristics, and performance during several Apollo missions are described, and specific recommendations for the remaining Apollo flights and future space missions are made.

Extracorporeal treatment for valproic acid poisoning: systematic review and recommendations from the EXTRIP workgroup.

PubMed

Ghannoum, Marc; Laliberté, Martin; Nolin, Thomas D; MacTier, Robert; Lavergne, Valery; Hoffman, Robert S; Gosselin, Sophie

2015-06-01

The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup presents its systematic review and clinical recommendations on the use of extracorporeal treatment (ECTR) in valproic acid (VPA) poisoning. The lead authors reviewed all of the articles from a systematic literature search, extracted the data, summarized the key findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and the RAND/UCLA Appropriateness Method was used to quantify disagreement. Anonymous votes were compiled, returned, and discussed in person. A second vote was conducted to determine the final workgroup recommendations. The latest literature search conducted in November 2014 retrieved a total of 79 articles for final qualitative analysis, including one observational study, one uncontrolled cohort study with aggregate analysis, 70 case reports and case series, and 7 pharmacokinetic studies, yielding a very low quality of evidence for all recommendations. Clinical data were reported for 82 overdose patients while pharmaco/toxicokinetic grading was performed in 55 patients. The workgroup concluded that VPA is moderately dialyzable (level of evidence = B) and made the following recommendations: ECTR is recommended in severe VPA poisoning (1D); recommendations for ECTR include a VPA concentration > 1300 mg/L (9000 μmol/L)(1D), the presence of cerebral edema (1D) or shock (1D); suggestions for ECTR include a VPA concentration > 900 mg/L (6250 μmol/L)(2D), coma or respiratory depression requiring mechanical ventilation (2D), acute hyperammonemia (2D), or pH ≤ 7.10 (2D). Cessation of ECTR is indicated when clinical improvement is apparent (1D) or the serum VPA concentration is between 50 and 100 mg/L (350-700 μmol/L)(2D). Intermittent hemodialysis is the preferred ECTR in VPA poisoning (1D). If hemodialysis is not available, then intermittent hemoperfusion (1D) or continuous renal replacement therapy (2D) is an acceptable alternative. VPA is moderately dialyzable in the setting of overdose. ECTR is indicated for VPA poisoning if at least one of the above criteria is present. Intermittent hemodialysis is the preferred ECTR modality in VPA poisoning.

Upper stage alternatives for the shuttle era

NASA Technical Reports Server (NTRS)

1981-01-01

The status and general characteristics of Space Shuttle upper stages now in use or in development, as well as new vehicle possibilities are examined. Upper stage requirements for both civil and Department of Defense missions, categorized generally into near-term (early and mid-1980's), mid-term (late 1980's to mid-1990's), and far-term (late 1990's and beyond) are discussed. Finally, the technical, schedule and cost impact of alternative ways in which these requirements could be met are examined, and a number of conclusions and recommendations are reached.

Biofouling and corrosion studies. Final report, Part I, May 1, 1976-December 1977

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

Mahalingam, L. M.

1978-01-01

Three sets of biofouling experiments were conducted. Two of these sets were done in the Pacific Ocean at Keahole Point, Hawaii, and one was in the Caribbean at St. Croix, Virgin Islands. Data and results from these experiments are presented and discussed. Heat transfer, biological, and metallurgical measurements are presented. A brief account of the data analysis procedures, and an assessment of the hardware performance are given. Recommendations are made to improve the quality of the current efforts in the OTEC Biofouling, Corrosion and Materials program.

Computer generated animation and movie production at LARC: A case study

NASA Technical Reports Server (NTRS)

Gates, R. L.; Matthews, C. G.; Vonofenheim, W. H.; Randall, D. P.; Jones, K. H.

1984-01-01

The process of producing computer generated 16mm movies using the MOVIE.BYU software package developed by Brigham Young University and the currently available hardware technology at the Langley Research Center is described. A general overview relates the procedures to a specific application. Details are provided which describe the data used, preparation of a storyboard, key frame generation, the actual animation, title generation, filming, and processing/developing the final product. Problems encountered in each of these areas are identified. Both hardware and software problems are discussed along with proposed solutions and recommendations.

Community access to health information in Ireland.

PubMed

Macdougall, J

1999-06-01

This paper is based on a research project conducted on consumer health information (CHI) in the Republic of Ireland, the results of which were published in a report entitled Well Read: Developing Consumer Health Information in Ireland. The paper describes the research methodology and the Irish experience in relation to CHI followed by a discussion of access problems, illustrated with examples from the special needs and primary care sectors. The role of information providers in relation to primary healthcare and libraries is examined briefly, and finally the main research conclusions and recommendations are highlighted.

Semantic e-Learning: Next Generation of e-Learning?

NASA Astrophysics Data System (ADS)

Konstantinos, Markellos; Penelope, Markellou; Giannis, Koutsonikos; Aglaia, Liopa-Tsakalidi

Semantic e-learning aspires to be the next generation of e-learning, since the understanding of learning materials and knowledge semantics allows their advanced representation, manipulation, sharing, exchange and reuse and ultimately promote efficient online experiences for users. In this context, the paper firstly explores some fundamental Semantic Web technologies and then discusses current and potential applications of these technologies in e-learning domain, namely, Semantic portals, Semantic search, personalization, recommendation systems, social software and Web 2.0 tools. Finally, it highlights future research directions and open issues of the field.

The Most Efficient Organization: A Strategic Issue Management Case Study

DTIC Science & Technology

1991-12-01

let’s discuss any problems or concerns specific to PWD, NAS Kensington. I am particularly interested in this package on my desk." "Yes sir," replied...explanation of the OMB A-76 program see Exhibit 1-5.) "The package on your desk contains the outcome of the last five years, and CDR Atwood’s (previous PWO...recommendation for the department’s MEO (Exhibit 1-6). The deadline for submission of the final package is only a few months away." During his first few

Cognitive and neuropsychiatric impairments in Alzheimer's disease: current treatment strategies.

PubMed

Borisovskaya, Anna; Pascualy, Marcella; Borson, Soo

2014-09-01

This update on Alzheimer's disease (AD) discusses treatment strategies for cognitive and neuropsychiatric symptoms (such as agitation, psychosis, anxiety, and depression) common in this illness, emphasizing in particular nonpharmacologic strategies such as cognitive interventions, physical exercise, and psychotherapy. We provide an overview of cognitive enhancers and their combination strategies and medications commonly used for treatment of neuropsychiatric symptoms in AD. Finally, we give recommendations for providing support to caregivers and suggest how to identify caregiver/patient pairs most in need of intensive dementia care services.

Criteria-based evaluation of group 3 level memory telefacsimile equipment for interlibrary loan.

PubMed Central

Bennett, V M; Wood, M S; Malcom, D L

1990-01-01

The Interlibrary Loan, Document Delivery, and Union List Task Force of the Health Sciences Libraries Consortium (HSLC)--with nineteen libraries located in Philadelphia, Pittsburgh, and Hershey, Pennsylvania, and Delaware--accepted the charge of evaluating and recommending for purchase telefacsimile hardware to further interlibrary loan among HSLC members. To allow a thorough and scientific evaluation of group 3 level telefacsimile equipment, the task force identified ninety-six hardware features, which were grouped into nine broad criteria. These features formed the basis of a weighted analysis that identified three final candidates, with one model recommended to the HSLC board. This article details each of the criteria and discusses features in terms of library applications. The evaluation grid developed in the weighted analysis process should aid librarians charged with the selection of level 3 telefacsimile equipment. PMID:2328361

Extracorporeal treatment for thallium poisoning: recommendations from the EXTRIP Workgroup.

PubMed

Ghannoum, Marc; Nolin, Thomas D; Goldfarb, David S; Roberts, Darren M; Mactier, Robert; Mowry, James B; Dargan, Paul I; Maclaren, Robert; Hoegberg, Lotte C; Laliberté, Martin; Calello, Diane; Kielstein, Jan T; Anseeuw, Kurt; Winchester, James F; Burdmann, Emmanuel A; Bunchman, Timothy E; Li, Yi; Juurlink, David N; Lavergne, Valery; Megarbane, Bruno; Gosselin, Sophie; Liu, Kathleen D; Hoffman, Robert S

2012-10-01

The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl). After an extensive search, the co-chairs reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND/UCLA Appropriateness Method to quantify disagreement. Blinded votes were compiled, returned, and discussed during a conference call. A second vote determined the final recommendations. Forty-five articles met inclusion criteria. Only case reports and case series were identified, yielding a very low quality of evidence for all recommendations. Data on 74 patients, including 11 who died, were abstracted. The workgroup concluded that Tl is slightly dialyzable and made the following recommendations: ECTR is recommended in severe Tl poisoning (1D). ECTR is indicated if Tl exposure is highly suspected on the basis of history or clinical features (2D) or if the serum Tl concentration is >1.0 mg/L (2D). ECTR should be initiated as soon as possible, ideally within 24-48 hours of Tl exposure (1D), and be continued until the serum Tl concentration is <0.1 mg/L for a minimal duration of 72 hours (2D). Despite Tl's low dialyzability and the limited evidence, the workgroup strongly recommended extracorporeal removal in the case of severe Tl poisoning.

Geostationary platform systems concepts definition study. Volume 2: Technical, book 1

NASA Technical Reports Server (NTRS)

1980-01-01

The initial selection and definition of operational geostationary platform concepts is discussed. Candidate geostationary platform missions and payloads were identified from COMSAT, Aerospace, and NASA studies. These missions and payloads were cataloged; classified with to communications, military, or scientific uses; screened for application and compatibility with geostationary platforms; and analyzed to identify platform requirements. Two platform locations were then selected (Western Hemisphere - 110 deg W, and Atlantic - 15 deg W), and payloads allocated based on nominal and high traffic models. Trade studies were performed leading to recommendation of selected concepts. Of 30 Orbit Transfer Vehicle (0TV) configuration and operating mode options identified, 18 viable candidates compatible with the operational geostationary platform missions were selected for analysis. Each was considered using four platform operational modes - 8 or 16 year life, and serviced or nonserviced, providing a total of 72 OTV/platform-mode options. For final trade study concept selection, a cost program was developed considering payload and platform costs and weight; transportation unit and total costs for the shuttle and OTV; and operational costs such as assembly or construction time, mating time, and loiter time. Servicing costs were added for final analysis and recommended selection.

Multidrug-resistant bacterial microorganisms (MDRO) in end-of-life care: development of recommendations for hospitalized patients using a mixed-methods approach.

PubMed

Heckel, Maria; Stiel, Stephanie; Herbst, Franziska A; Tiedtke, Johanna M; Sturm, Alexander; Adelhardt, Thomas; Bogdan, Christian; Sieber, Cornel; Schöffski, Oliver; Lang, Frieder R; Ostgathe, Christoph

2018-03-16

Palliative care professionals are frequently confronted with patients colonized or infected with MDRO. One major challenge is how to balance necessary isolation measures and social inclusion as one of the main principles of palliative and end-of-life care. To date, MDRO-specific policies and protocols vary widely between institutions. provide empirical recommendations on how to deal with hospitalized MDRO patients in end-of-life care. Recommendations were developed based on (i) initial results of face-to-face interviews and focus groups, (ii) impartial experts' comments and consensus on the draft via online survey and (iii) a face-to-face meeting with consortium members to finalize recommendations. Findings of 158 interviews and six focus groups (39 participants) with patients, family caregivers, staff members and institutional stakeholders contributed to the recommendations. The assessments of 17 experts were considered. In total, 21 recommendations were approved. The recommended strategy in dealing with MDRO at the end of life allows case-based application of protection and isolation measures. MDRO diagnostics and therapy involve screening at admission. The recommendations suggest consideration of required accommodation facilities, provided material as well as staff and time resources. The recommendations further highlight the importance of providing for strategies enabling the patient's social inclusion and provision of verbal and written information about MDRO for patients and family caregivers, transparent medical documentation, and staff member training. The recommendations summarize the perspectives of individuals and groups affected by MDRO at the end of life and provide practical guidance for clinical routine. Further dissemination and implementation requirements are discussed and should contain the evaluation of the knowledge, views, worries, and anxieties of the target groups.

75 FR 45606 - Interagency Ocean Policy Task Force-Final Recommendations of the Interagency Ocean Policy Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... COUNCIL ON ENVIRONMENTAL QUALITY Interagency Ocean Policy Task Force--Final Recommendations of the Interagency Ocean Policy Task Force AGENCY: Council on Environmental Quality. ACTION: Notice of Availability, Interagency Ocean Policy Task Force's [[Page 45607

European Society for Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Neurological Impairment.

PubMed

Romano, Claudio; van Wynckel, Myriam; Hulst, Jessie; Broekaert, Ilse; Bronsky, Jiri; Dall'Oglio, Luigi; Mis, Nataša F; Hojsak, Iva; Orel, Rok; Papadopoulou, Alexandra; Schaeppi, Michela; Thapar, Nikhil; Wilschanski, Michael; Sullivan, Peter; Gottrand, Frédéric

2017-08-01

Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment. Thirty-one clinical questions addressing the diagnosis, treatment, and prognosis of common gastrointestinal and nutritional problems in neurological impaired children were formulated. Questions aimed to assess the nutritional management including nutritional status, identifying undernutrition, monitoring nutritional status, and defining nutritional requirements; to classify gastrointestinal issues including oropharyngeal dysfunctions, motor and sensory function, gastroesophageal reflux disease, and constipation; to evaluate the indications for nutritional rehabilitation including enteral feeding and percutaneous gastrostomy/jejunostomy; to define indications for surgical interventions (eg, Nissen Fundoplication, esophagogastric disconnection); and finally to consider ethical issues related to digestive and nutritional problems in the severely neurologically impaired children. A systematic literature search was performed from 1980 to October 2015 using MEDLINE. The approach of the Grading of Recommendations Assessment, Development, and Evaluation was applied to evaluate the outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation using the nominal voting technique. Expert opinion was applied to support the recommendations where no randomized controlled trials were available.

[Governance of innovative cardiovascular devices: when evidence is not enough].

PubMed

Addis, Antonio; Davoli, Marina

2016-01-01

Aortic stenosis is the most common valve disease and transcatheter aortic valve implantation (TAVI) is considered as an alternative to surgical valve replacement or to medical treatment in inoperable or high-risk patients. Although physicians have learned how to care for critically ill old patients and enable many to survive, major surgical procedures, operating on patients at very high risk, are often not suitable. Studies showed that selected cohorts of patients undergoing TAVI might have better outcomes in terms of survival and quality of life. However, mortality and safety data associated with the less invasive intervention do not always justify such new technologies for all patients with severe aortic stenosis, taking into account also the high cost associated. A systematic review of the available scientific literature has been performed. In this context, a DECIDE framework has been used providing a systematic and transparent approach for going from evidence to healthcare decisions. Before suggesting final recommendations, historical data of interventions done at regional level and regulatory decisions adopted in other countries following health technology assessment analysis, have been analyzed. All final recommendations based on this document have been discussed and reviewed with a working group done by the health operators directly involved in this technology within the regional health service context. Recommendations for the identification of patients suitable for TAVI are given together with a list of characteristics that should be required to all centers eligible for the performance of TAVI and with a procedure able to allow better quality assurance and prospective monitoring process of all new cases enrolled for such intervention. Impact of these recommendations will be measured using a regional registry collecting data on new patients undergoing TAVI.

48 CFR 2415.308 - Source selection decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Source selection decision. 2415.308 Section 2415.308 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND URBAN... document its selection recommendation(s) in a final written report. The final report shall include...

Are conservation organizations configured for effective adaptation to global change?

USGS Publications Warehouse

Armsworth, Paul R.; Larson, Eric R.; Jackson, Stephen T.; Sax, Dov F.; Simonin, Paul W.; Blossey, Bernd; Green, Nancy; Lester, Liza; Klein, Mary L.; Ricketts, Taylor H.; Runge, Michael C.; Shaw, M. Rebecca

2015-01-01

Conservation organizations must adapt to respond to the ecological impacts of global change. Numerous changes to conservation actions (eg facilitated ecological transitions, managed relocations, or increased corridor development) have been recommended, but some institutional restructuring within organizations may also be needed. Here we discuss the capacity of conservation organizations to adapt to changing environmental conditions, focusing primarily on public agencies and nonprofits active in land protection and management in the US. After first reviewing how these organizations anticipate and detect impacts affecting target species and ecosystems, we then discuss whether they are sufficiently flexible to prepare and respond by reallocating funding, staff, or other resources. We raise new hypotheses about how the configuration of different organizations enables them to protect particular conservation targets and manage for particular biophysical changes that require coordinated management actions over different spatial and temporal scales. Finally, we provide a discussion resource to help conservation organizations assess their capacity to adapt.

Characterizing Safety-net Providers’ HPV Vaccine Recommendations to Undecided Parents: A Pilot Study

PubMed Central

Shay, L. Aubree; Street, Richard L.; Baldwin, Austin S.; Marks, Emily G.; Lee, Simon Craddock; Higashi, Robin T.; Skinner, Celette Sugg; Fuller, Sobha; Persaud, Donna; Tiro, Jasmin A.

2016-01-01

Objective Although provider recommendation is a key predictor of HPV vaccination, how providers verbalize recommendations particularly strong ones is unknown. We developed a tool to describe strength and content of provider recommendations. Methods We used electronic health records to identify unvaccinated adolescents with appointments at six safety-net clinics in Dallas, Texas. Clinic visit audio-recordings were qualitatively analyzed to identify provider recommendation types (presumptive vs. participatory introduction; strong vs. weak), describe content communicated, and explore patterns between recommendation type and vaccination. Results We analyzed 43 audio-recorded discussions between parents and 12 providers. Most providers used a participatory introduction (42 discussions) and made weak recommendations (24 discussions) by using passive voice or adding a qualification (e.g., not school required). Few providers (11 discussions) gave strong recommendations (clear, personally-owned endorsement). HPV vaccination was lowest for those receiving only weak recommendations and highest when providers coupled the recommendation with an adjacent rationale. Conclusion Our new tool provides initial evidence of how providers undercut their recommendations through qualifications or support them with a rationale. Most providers gave weak HPV vaccine recommendations and used a participatory introduction. Practice Implications Providers would benefit from communication skills training on how to make explicit recommendations with an evidence-based rationale. PMID:27401828

Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening

PubMed Central

Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

2018-01-01

Background Primary-care providers may contribute to the use of low-value cancer screening. Objective We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. Patients and methods This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers’ attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Results Providers reported they would discuss cancer screening more often than they would recommend it (P<0.001). More providers would discuss and recommend screening for CRC than prostate cancer (P<0.001), for younger than older patients (P<0.001), and when the patient requested it than when not (P<0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). Discussion While most providers’ reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. Conclusion More work appears to be needed to help providers to discuss and recommend screening that aligns with value. PMID:29844698

Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology

PubMed Central

Hjerpe, Anders; Ascoli, Valeria; Bedrossian, Carlos; Boon, Mathilde; Creaney, Jenette; Davidson, Ben; Dejmek, Annika; Dobra, Katalin; Fassina, Ambrogio; Field, Andrew; Firat, Pinar; Kamei, Toshiaki; Kobayashi, Tadao; Michael, Claire W.; Önder, Sevgen; Segal, Amanda; Vielh, Philippe

2015-01-01

To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma (MM). Cytopathologists involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC), who have an interest in the field contributed to this update. Reference material includes peer-reviewed publications and textbooks. This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists, who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in cape town. During the previous IMIG biennial meetings, thorough discussions have resulted in published guidelines for the pathologic diagnosis of MM. However, previous recommendations have stated that the diagnosis of MM should be based on histological material only.[12] Accumulating evidence now indicates that the cytological diagnosis of MM supported by ancillary techniques is as reliable as that based on histopathology, although the sensitivity with cytology may be somewhat lower.[345] Recognizing that noninvasive diagnostic modalities benefit both the patient and the health system, future recommendations should include cytology as an accepted method for the diagnosis of this malignancy.[67] The article describes the consensus of opinions of the authors on how cytology together with ancillary testing can be used to establish a reliable diagnosis of MM. PMID:26681974

[Evaluation of preliminary grades and credits in nurse training programs].

PubMed

Darmann-Finck, Ingrid; Duveneck, Nicole

2016-01-01

In the federal state of Bremen preliminary grades were included to the extent of 25 % in written, oral and practical final grades during the time period 2009-2014. The evaluation focuses on the effects of preliminary grades on the scale of final grades and the performance of learners as well as on the assessment of the appropriateness of final grades. A mixed-methods design was employed that consisted of a quasi-experimental study comprising of surveys of students and teachers of comparative and model courses as well as a qualitative study using group discussions. The results confirm that preliminary grades lead to a minimal improvement of the final grades of some exclusively low-achieving students. The assessment of appropriateness hardly changed. From both learners' and teachers' point of view there is still great dissatisfaction concerning the practical final grades. With regard to learning habits an increased willingness to learn new skills on the one hand and a partly increased performance pressure on the other hand were demonstrated. On the basis of these research results, the authors recommend the regular introduction of preliminary marks into the nursing training. Copyright © 2016. Published by Elsevier GmbH.

Implementing and expanding HIV testing in immigrant populations in Europe: Comparing guideline's recommendations and expert's opinions.

PubMed

Álvarez-Del Arco, Débora; Monge, Susana; Rivero-Montesdeoca, Yaiza; Burns, Fiona; Noori, Teymur; Del Amo, Julia

2017-01-01

Immigrant populations, especially those from endemic countries, living in the European Union (EU) suffer a disproportionate burden of HIV, delayed diagnosis and poorer access to antiretroviral treatment. While International Organisations are developing recommendations aimed at increasing the uptake of HIV testing, the feasibility and real outcomes of these measures remain unexplored. The aim of this review was, firstly to identify the recommendations of the main International Organisations (IO) on HIV testing in immigrants. Secondly, to describe the challenges for implementing and expanding HIV testing and counselling interventions targeting immigrants by interviewing key informants. The importance of HIV testing in immigrants is discussed, along with the appropriateness of universal HIV testing approaches vs most at risk targeted approaches. Also addressed is, pre- and post-HIV test counselling characteristics and community initiatives suitable to reach this population and, finally the legal issues regarding access to treatment for illegal immigrants. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome].

PubMed

López-Jaramillo, Patricio; Sánchez, Ramiro A; Diaz, Margarita; Cobos, Leonardo; Bryce, Alfonso; Parra-Carrillo, Jose Z; Lizcano, Fernando; Lanas, Fernando; Sinay, Isaac; Sierra, Iván D; Peñaherrera, Ernesto; Bendersky, Mario; Schmid, Helena; Botero, Rodrigo; Urina, Manuel; Lara, Joffre; Foss, Milton C; Márquez, Gustavo; Harrap, Stephen; Ramírez, Agustín J; Zanchetti, Alberto

2014-04-01

The present document has been prepared by a group of experts, members of cardiology, endocrinology, internal medicine, nephrology and diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is a useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high-risk population, usually underestimated and undertreated. These recommendations result from presentations and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming knowledge, attitude and behavioural barriers, preventing both physicians and patients from effectively adhering to guideline recommendations.

Development of the Chronic Pain Coding System (CPCS) for Characterizing Patient-Clinician Discussions About Chronic Pain and Opioids

PubMed Central

Chen, Meng; Matthias, Marianne S.; Bell, Robert A.; Kravitz, Richard L.

2016-01-01

Objective. To describe the development and initial application of the Chronic Pain Coding System. Design. Secondary analysis of data from a randomized clinical trial. Setting. Six primary care clinics in northern California. Subjects. Forty-five primary care visits involving 33 clinicians and 45 patients on opioids for chronic noncancer pain. Methods. The authors developed a structured coding system to accurately and objectively characterize discussions about pain and opioids. Two coders applied the final system to visit transcripts. Intercoder agreement for major coding categories was moderate to substantial (kappa = 0.5–0.7). Mixed effects regression was used to test six hypotheses to assess preliminary construct validity. Results. Greater baseline pain interference was associated with longer pain discussions (P = 0.007) and more patient requests for clinician action (P = 0.02) but not more frequent negative patient evaluations of pain (P = 0.15). Greater clinician-reported visit difficulty was associated with more frequent disagreements with clinician recommendations (P = 0.003) and longer discussions of opioid risks (P = 0.049) but not more frequent requests for clinician action (P = 0.11). Rates of agreement versus disagreement with patient requests and clinician recommendations were similar for opioid-related and non-opioid–related utterances. Conclusions. This coding system appears to be a reliable and valid tool for characterizing patient-clinician communication about opioids and chronic pain during clinic visits. Objective data on how patients and clinicians discuss chronic pain and opioids are necessary to identify communication patterns and strategies for improving the quality and productivity of discussions about chronic pain that may lead to more effective pain management and reduce inappropriate opioid prescribing. PMID:26936453

Development of the Chronic Pain Coding System (CPCS) for Characterizing Patient-Clinician Discussions About Chronic Pain and Opioids.

PubMed

Henry, Stephen G; Chen, Meng; Matthias, Marianne S; Bell, Robert A; Kravitz, Richard L

2016-10-01

To describe the development and initial application of the Chronic Pain Coding System. Secondary analysis of data from a randomized clinical trial. Six primary care clinics in northern California. Forty-five primary care visits involving 33 clinicians and 45 patients on opioids for chronic noncancer pain. The authors developed a structured coding system to accurately and objectively characterize discussions about pain and opioids. Two coders applied the final system to visit transcripts. Intercoder agreement for major coding categories was moderate to substantial (kappa = 0.5-0.7). Mixed effects regression was used to test six hypotheses to assess preliminary construct validity. Greater baseline pain interference was associated with longer pain discussions (P = 0.007) and more patient requests for clinician action (P = 0.02) but not more frequent negative patient evaluations of pain (P = 0.15). Greater clinician-reported visit difficulty was associated with more frequent disagreements with clinician recommendations (P = 0.003) and longer discussions of opioid risks (P = 0.049) but not more frequent requests for clinician action (P = 0.11). Rates of agreement versus disagreement with patient requests and clinician recommendations were similar for opioid-related and non-opioid-related utterances. This coding system appears to be a reliable and valid tool for characterizing patient-clinician communication about opioids and chronic pain during clinic visits. Objective data on how patients and clinicians discuss chronic pain and opioids are necessary to identify communication patterns and strategies for improving the quality and productivity of discussions about chronic pain that may lead to more effective pain management and reduce inappropriate opioid prescribing. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Antenatal testing-a reevaluation: executive summary of a Eunice Kennedy Shriver National Institute of Child Health and Human Development workshop.

PubMed

Signore, Caroline; Freeman, Roger K; Spong, Catherine Y

2009-03-01

In August 2007, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institutes of Health Office of Rare Diseases, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics cosponsored a 2-day workshop to reassess the body of evidence supporting antepartum assessment of fetal well-being, identify key gaps in the evidence, and formulate recommendations for further research. Participants included experts in obstetrics and fetal physiology and representatives from relevant stakeholder groups and organizations. This article is a summary of the discussions at the workshop, including synopses of oral presentations on the epidemiology of stillbirth and fetal neurological injury, fetal physiology, techniques for antenatal monitoring, and maternal and fetal indications for monitoring. Finally, a synthesis of recommendations for further research compiled from three breakout workgroups is presented.

From evidence to action

PubMed Central

Verheyen, Cees CPM; Kerkhoffs, Gino M; Bhandari, Mohit; Schünemann, Holger J

2009-01-01

ABSTRACT Good guidelines will help us to take evidence into practice. In a survey among Dutch orthopedic surgeons, development and use of evidence-based guidelines was perceived as one of the best ways of moving from opinion-based to evidence-based orthopedic practice. The increasing number of guidelines means that knowing how to make a critical appraisal of guidelines is now a key part of every surgeon’s life. This is particularly true because guidelines use varying systems to judge the quality of evidence and the strength of recommendations. In this manuscript we discuss what a guideline is, where we can find guidelines, how to evaluate the quality of guidelines, and finally provide an example on the different steps of guideline development. Thus, we show that good guidelines are a summary of the best available evidence and that they provide a graded recommendation to help surgeons in evidence-based practice. PMID:19234892

Preference Mining Using Neighborhood Rough Set Model on Two Universes.

PubMed

Zeng, Kai

2016-01-01

Preference mining plays an important role in e-commerce and video websites for enhancing user satisfaction and loyalty. Some classical methods are not available for the cold-start problem when the user or the item is new. In this paper, we propose a new model, called parametric neighborhood rough set on two universes (NRSTU), to describe the user and item data structures. Furthermore, the neighborhood lower approximation operator is used for defining the preference rules. Then, we provide the means for recommending items to users by using these rules. Finally, we give an experimental example to show the details of NRSTU-based preference mining for cold-start problem. The parameters of the model are also discussed. The experimental results show that the proposed method presents an effective solution for preference mining. In particular, NRSTU improves the recommendation accuracy by about 19% compared to the traditional method.

The plight of the not-for-profit.

PubMed

Owens, Bramer

2005-01-01

Recent controversies in the hospital sector have questioned whether the levels of charity care, community benefit, and executive compensation provided by not-for-profit hospitals are consistent with mandates of their tax-exempt status and mission statements. This article demonstrates that these recent controversies stem from a combination of historical influences, regulatory inequities, and competitive disadvantages, which are suffocating many not-for-profit hospitals across the nation. Once the current environment is described, the article discusses each threat and offers actionable recommendations to quell current attacks faced by the industry. First, to address the current probe by the Internal Revenue Service, hospitals must begin to link their executive compensation with their organizational mission. Second, to address recent lawsuits, the article presents a standardized definition of community benefit and recommends an alternative model to classify charity care. Finally, to address recent congressional hearings, the article offers a plan for hospitals to gauge their expected benefit to the community they serve.

Sample size in psychological research over the past 30 years.

PubMed

Marszalek, Jacob M; Barber, Carolyn; Kohlhart, Julie; Holmes, Cooper B

2011-04-01

The American Psychological Association (APA) Task Force on Statistical Inference was formed in 1996 in response to a growing body of research demonstrating methodological issues that threatened the credibility of psychological research, and made recommendations to address them. One issue was the small, even dramatically inadequate, size of samples used in studies published by leading journals. The present study assessed the progress made since the Task Force's final report in 1999. Sample sizes reported in four leading APA journals in 1955, 1977, 1995, and 2006 were compared using nonparametric statistics, while data from the last two waves were fit to a hierarchical generalized linear growth model for more in-depth analysis. Overall, results indicate that the recommendations for increasing sample sizes have not been integrated in core psychological research, although results slightly vary by field. This and other implications are discussed in the context of current methodological critique and practice.

Coal liquefaction: A research and development needs assessment: Final report, Volume II

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

Schindler, H.D.; Burke, F.P.; Chao, K.C.

1989-03-01

Volume II of this report on an assessment of research needs for coal liquefaction contains reviews of the five liquefaction technologies---direct, indirect, pyrolysis, coprocessing, and bioconversion. These reviews are not meant to be encyclopedic; several outstanding reviews of liquefaction have appeared in recent years and the reader is referred to these whenever applicable. Instead, these chapters contain reviews of selected topics that serve to support the panel's recommendations or to illustrate recent accomplishments, work in progress, or areas of major research interest. At the beginning of each of these chapters is a brief introduction and a summary of the mostmore » important research recommendations brought out during the panel discussions and supported by the material presented in the review. A review of liquefaction developments outside the US is included. 594 refs., 100 figs., 60 tabs.« less

Precision Fluid Management in Continuous Renal Replacement Therapy.

PubMed

Murugan, Raghavan; Hoste, Eric; Mehta, Ravindra L; Samoni, Sara; Ding, Xiaoqiang; Rosner, Mitchell H; Kellum, John A; Ronco, Claudio

2016-01-01

Fluid management during continuous renal replacement therapy (CRRT) in critically ill patients is a dynamic process that encompasses 3 inter-related goals: maintenance of the patency of the CRRT circuit, maintenance of plasma electrolyte and acid-base homeostasis and regulation of patient fluid balance. In this article, we report the consensus recommendations of the 2016 Acute Disease Quality Initiative XVII conference on 'Precision Fluid Management in CRRT'. We discuss the principles of fluid management, describe various prescription methods to achieve circuit integrity and introduce the concept of integrated fluid balance for tailoring fluid balance to the needs of the individual patient. We suggest that these recommendations could serve to develop the best clinical practice and standards of care for fluid management in patients undergoing CRRT. Finally, we identify and highlight areas of uncertainty in fluid management and set an agenda for future research. © 2016 S. Karger AG, Basel.

Regression Analysis and Calibration Recommendations for the Characterization of Balance Temperature Effects

NASA Technical Reports Server (NTRS)

Ulbrich, N.; Volden, T.

2018-01-01

Analysis and use of temperature-dependent wind tunnel strain-gage balance calibration data are discussed in the paper. First, three different methods are presented and compared that may be used to process temperature-dependent strain-gage balance data. The first method uses an extended set of independent variables in order to process the data and predict balance loads. The second method applies an extended load iteration equation during the analysis of balance calibration data. The third method uses temperature-dependent sensitivities for the data analysis. Physical interpretations of the most important temperature-dependent regression model terms are provided that relate temperature compensation imperfections and the temperature-dependent nature of the gage factor to sets of regression model terms. Finally, balance calibration recommendations are listed so that temperature-dependent calibration data can be obtained and successfully processed using the reviewed analysis methods.

Moral distress reexamined: a feminist interpretation of nurses' identities, relationships, and responsibilites.

PubMed

Peter, Elizabeth; Liaschenko, Joan

2013-10-01

Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and responsibilities in situations of moral distress. We also discuss the importance of nurses creating "counterstories" of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life.

OEXP exploration studies technical report. Volume 3: Special reports, studies, and indepth systems assessments

NASA Technical Reports Server (NTRS)

Roberts, Barney B.; Bland, Dan

1988-01-01

The Office of Exploration (OEXP) at NASA has been tasked with defining and recommending alternatives for an early 1990's national decision on a focused program of manned exploration of the Solar System. The Mission analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report, produced by the MASE, describes the process used to conduct exploration studies and discusses the mission developed in a case study approach. The four case studies developed in FY88 include: (1) a manned expedition to PHOBOS; (2) a manned expedition to MARS; (3) a lunar surface observatory; and a lunar outpost to early Mars evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work.

Recommendations for the Use of Online Social Support for African American Men

PubMed Central

Watkins, Daphne C.; Jefferson, S. Olivia

2014-01-01

African American men face greater psychosocial stressors than African American women and men of other racial and ethnic groups, which place them at higher risk for psychological distress. Yet, research suggests that African Americans are less likely to utilize professional mental health services because of their mistrust of the health care system and their need for more specialized and innovative services. Supplemental resources aimed at positive coping and social support for African American men may reduce the likelihood that they experience psychological distress, which could lead to more severe mental disorders. This article proposes the use of online social support for African American men who are in early, nonsevere stages of psychological distress. We examine the unique experiences of African American men, discuss distress among this underserved group, and finally, offer recommendations for achieving an online community for African American men. PMID:22924797

Rational treatment for multiple digit congenital absence: case report of nonvascularized toe phalangeal transfers and distraction lengthening for symbrachydactyly.

PubMed

Netscher, David T; Richards, Winston T

2006-02-01

A case is discussed in which a young male was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits when he was an infant. This initial surgical procedure was later followed by webspace deepening and ultimately by distraction lengthening of the digits. At 8 years of age, he has a very functional hand with mobile metacarpophalangeal joints in all reconstructed fingers. In fact, he uses this reconstructed right hand as his dominant extremity. The case is discussed in context of phalangeal growth potential, specific indications for this type of reconstruction, and final long-term outcome. This case also helps to recommend rational treatment protocols for similar congenital hand anomalies.

The promise of advanced technology for future air transports

NASA Technical Reports Server (NTRS)

Bower, R. E.

1978-01-01

Progress in all weather 4-D navigation and wake vortex attenuation research is discussed and the concept of time based metering of aircraft is recommended for increased emphasis. The far term advances in aircraft efficiency were shown to be skin friction reduction and advanced configuration types. The promise of very large aircraft, possibly all wing aircraft is discussed, as is an advanced concept for an aerial relay transportation system. Very significant technological developments were identified that can improve supersonic transport performance and reduce noise. The hypersonic transport was proposed as the ultimate step in air transportation in the atmosphere. Progress in the key technology areas of propulsion and structures was reviewed. Finally, the impact of alternate fuels on future air transports was considered and shown not to be a growth constraint.

Social media and college student risk behaviors: A mini-review.

PubMed

Groth, Gabrielle G; Longo, Laura M; Martin, Jessica L

2017-02-01

Use of social media use is widespread and frequent among college students. Posting photos and text related to risk behaviors (e.g., problematic alcohol use, illicit drug use) on social media websites is common and has been linked to personal substance use and negative outcomes. This mini-review summarizes current findings related to associations between college students' social media use and engagement in risk behaviors. Conducting research on social media poses unique challenges for researchers; these challenges are reviewed and their impact on the state of the current literature discussed. Finally, implications for prevention and intervention efforts are discussed as well as recommendations regarding future research in the area of social media and college student risk behaviors. Copyright © 2016 Elsevier Ltd. All rights reserved.

2016 Consensus statement on prevention of atherosclerotic cardiovascular disease in the Hong Kong population.

PubMed

Cheung, B My; Cheng, C H; Lau, C P; Wong, C Ky; Ma, R Cw; Chu, D Ws; Ho, D Hk; Lee, K Lf; Tse, H F; Wong, A Sp; Yan, B Py; Yan, V Wt

2017-04-01

In Hong Kong, the prevalence of atherosclerotic cardiovascular disease has increased markedly over the past few decades, and further increases are expected. In 2008, the Hong Kong Cardiovascular Task Force released a consensus statement on preventing cardiovascular disease in the Hong Kong population. The present article provides an update on these recommendations. A multidisciplinary group of clinicians comprising the Hong Kong Cardiovascular Task Force-10 cardiologists, an endocrinologist, and a family physician-met in September 2014 and June 2015 in Hong Kong. Guidelines from the American College of Cardiology/American Heart Association, the European Society of Hypertension/European Society of Cardiology, and the Eighth Joint National Committee for the Management of High Blood Pressure were reviewed. Group members reviewed the 2008 Consensus Statement and relevant international guidelines. At the meetings, each topical recommendation of the 2008 Statement was assessed against the pooled recommendations on that topic from the international guidelines. A final recommendation on each topic was generated by consensus after discussion. It is recommended that a formal risk scoring system should be used for risk assessment of all adults aged 40 years or older who have at least one cardiovascular risk factor. Individuals can be classified as having a low, moderate, or high risk of developing atherosclerotic cardiovascular disease, and appropriate interventions selected accordingly. Recommended lifestyle modifications include adopting a healthy eating pattern; maintaining a low body mass index; quitting smoking; and undertaking regular, moderate-intensity physical activity. Pharmacological interventions should be selected as appropriate after lifestyle modification.

Future cancer research priorities in the USA: a Lancet Oncology Commission.

PubMed

Jaffee, Elizabeth M; Dang, Chi Van; Agus, David B; Alexander, Brian M; Anderson, Kenneth C; Ashworth, Alan; Barker, Anna D; Bastani, Roshan; Bhatia, Sangeeta; Bluestone, Jeffrey A; Brawley, Otis; Butte, Atul J; Coit, Daniel G; Davidson, Nancy E; Davis, Mark; DePinho, Ronald A; Diasio, Robert B; Draetta, Giulio; Frazier, A Lindsay; Futreal, Andrew; Gambhir, Sam S; Ganz, Patricia A; Garraway, Levi; Gerson, Stanton; Gupta, Sumit; Heath, James; Hoffman, Ruth I; Hudis, Cliff; Hughes-Halbert, Chanita; Ibrahim, Ramy; Jadvar, Hossein; Kavanagh, Brian; Kittles, Rick; Le, Quynh-Thu; Lippman, Scott M; Mankoff, David; Mardis, Elaine R; Mayer, Deborah K; McMasters, Kelly; Meropol, Neal J; Mitchell, Beverly; Naredi, Peter; Ornish, Dean; Pawlik, Timothy M; Peppercorn, Jeffrey; Pomper, Martin G; Raghavan, Derek; Ritchie, Christine; Schwarz, Sally W; Sullivan, Richard; Wahl, Richard; Wolchok, Jedd D; Wong, Sandra L; Yung, Alfred

2017-11-01

We are in the midst of a technological revolution that is providing new insights into human biology and cancer. In this era of big data, we are amassing large amounts of information that is transforming how we approach cancer treatment and prevention. Enactment of the Cancer Moonshot within the 21st Century Cures Act in the USA arrived at a propitious moment in the advancement of knowledge, providing nearly US$2 billion of funding for cancer research and precision medicine. In 2016, the Blue Ribbon Panel (BRP) set out a roadmap of recommendations designed to exploit new advances in cancer diagnosis, prevention, and treatment. Those recommendations provided a high-level view of how to accelerate the conversion of new scientific discoveries into effective treatments and prevention for cancer. The US National Cancer Institute is already implementing some of those recommendations. As experts in the priority areas identified by the BRP, we bolster those recommendations to implement this important scientific roadmap. In this Commission, we examine the BRP recommendations in greater detail and expand the discussion to include additional priority areas, including surgical oncology, radiation oncology, imaging, health systems and health disparities, regulation and financing, population science, and oncopolicy. We prioritise areas of research in the USA that we believe would accelerate efforts to benefit patients with cancer. Finally, we hope the recommendations in this report will facilitate new international collaborations to further enhance global efforts in cancer control. Copyright © 2017 Elsevier Ltd. All rights reserved.

EAES recommendations on methodology of innovation management in endoscopic surgery.

PubMed

Neugebauer, Edmund A M; Becker, Monika; Buess, Gerhard F; Cuschieri, Alfred; Dauben, Hans-Peter; Fingerhut, Abe; Fuchs, Karl H; Habermalz, Brigitte; Lantsberg, Leonid; Morino, Mario; Reiter-Theil, Stella; Soskuty, Gabriela; Wayand, Wolfgang; Welsch, Thilo

2010-07-01

Under the mandate of the European Association for Endoscopic Surgery (EAES) a guideline on methodology of innovation management in endoscopic surgery has been developed. The primary focus of this guideline is patient safety, efficacy, and effectiveness. An international expert panel was invited to develop recommendations for the assessment and introduction of surgical innovations. A consensus development conference (CDC) took place in May 2009 using the method of a nominal group process (NGP). The recommendations were presented at the annual EAES congress in Prague, Czech Republic, on June 18th, 2009 for discussion and further input. After further Delphi processes between the experts, the final recommendations were agreed upon. The development and implementation of innovations in surgery are addressed in five sections: (1) definition of an innovation, (2) preclinical and (3) clinical scientific development, (4) scientific approval, and (5) implementation along with monitoring. Within the present guideline each of the sections and several steps are defined, and several recommendations based on available evidence have been agreed within each category. A comprehensive workflow of the different steps is given in an algorithm. In addition, issues of health technology assessment (HTA) serving to estimate efficiency followed by ethical directives are given. Innovations into clinical practice should be introduced with the highest possible grade of safety for the patient (nil nocere: do no harm). The recommendations can contribute to the attainment of this objective without preventing future promising diagnostic and therapeutic innovations in the field of surgery and allied techniques.

Cultivation, Genetic, Ethnopharmacology, Phytochemistry and Pharmacology of Moringa oleifera Leaves: An Overview.

PubMed

Leone, Alessandro; Spada, Alberto; Battezzati, Alberto; Schiraldi, Alberto; Aristil, Junior; Bertoli, Simona

2015-06-05

Moringa oleifera is an interesting plant for its use in bioactive compounds. In this manuscript, we review studies concerning the cultivation and production of moringa along with genetic diversity among different accessions and populations. Different methods of propagation, establishment and cultivation are discussed. Moringa oleifera shows diversity in many characters and extensive morphological variability, which may provide a resource for its improvement. Great genetic variability is present in the natural and cultivated accessions, but no collection of cultivated and wild accessions currently exists. A germplasm bank encompassing the genetic variability present in Moringa is needed to perform breeding programmes and develop elite varieties adapted to local conditions. Alimentary and medicinal uses of moringa are reviewed, alongside the production of biodiesel. Finally, being that the leaves are the most used part of the plant, their contents in terms of bioactive compounds and their pharmacological properties are discussed. Many studies conducted on cell lines and animals seem concordant in their support for these properties. However, there are still too few studies on humans to recommend Moringa leaves as medication in the prevention or treatment of diseases. Therefore, further studies on humans are recommended.

Cultivation, Genetic, Ethnopharmacology, Phytochemistry and Pharmacology of Moringa oleifera Leaves: An Overview

PubMed Central

Leone, Alessandro; Spada, Alberto; Battezzati, Alberto; Schiraldi, Alberto; Aristil, Junior; Bertoli, Simona

2015-01-01

Moringa oleifera is an interesting plant for its use in bioactive compounds. In this manuscript, we review studies concerning the cultivation and production of moringa along with genetic diversity among different accessions and populations. Different methods of propagation, establishment and cultivation are discussed. Moringa oleifera shows diversity in many characters and extensive morphological variability, which may provide a resource for its improvement. Great genetic variability is present in the natural and cultivated accessions, but no collection of cultivated and wild accessions currently exists. A germplasm bank encompassing the genetic variability present in Moringa is needed to perform breeding programmes and develop elite varieties adapted to local conditions. Alimentary and medicinal uses of moringa are reviewed, alongside the production of biodiesel. Finally, being that the leaves are the most used part of the plant, their contents in terms of bioactive compounds and their pharmacological properties are discussed. Many studies conducted on cell lines and animals seem concordant in their support for these properties. However, there are still too few studies on humans to recommend Moringa leaves as medication in the prevention or treatment of diseases. Therefore, further studies on humans are recommended. PMID:26057747

Development and pretest of key visual imagery in a campaign for the prevention of child maltreatment.

PubMed

Charest, Émilie; Gagné, Marie-Hélène; Goulet, Julie

2017-08-01

This article discusses the development and pretesting of key visual imagery in a promotional campaign developed in Quebec, Canada. This campaign is the media-based component of a broader prevention strategy involving the use of the Triple P program (Sanders, 1999). The purpose was to pretest with parents the preliminary version of a poster that uses the campaign's key visual imagery prior to final production. In total, 26 parents from the regions of Quebec City and Montreal participated in four focus groups. Two general themes emerged from the focus groups: (i) emotions and reactions arising from the key visual imagery; and (ii) comprehension of the message being conveyed. Based on this information, recommendations were made to the marketing agency, which then modified the campaign's key visual imagery and proposed a final layout.

Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension.

PubMed

Leung, Alexander A; Nerenberg, Kara; Daskalopoulou, Stella S; McBrien, Kerry; Zarnke, Kelly B; Dasgupta, Kaberi; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; Tremblay, Guy; McLean, Donna; Tobe, Sheldon W; Ruzicka, Marcel; Burns, Kevin D; Vallée, Michel; Prasad, G V Ramesh; Lebel, Marcel; Feldman, Ross D; Selby, Peter; Pipe, Andrew; Schiffrin, Ernesto L; McFarlane, Philip A; Oh, Paul; Hegele, Robert A; Khara, Milan; Wilson, Thomas W; Penner, S Brian; Burgess, Ellen; Herman, Robert J; Bacon, Simon L; Rabkin, Simon W; Gilbert, Richard E; Campbell, Tavis S; Grover, Steven; Honos, George; Lindsay, Patrice; Hill, Michael D; Coutts, Shelagh B; Gubitz, Gord; Campbell, Norman R C; Moe, Gordon W; Howlett, Jonathan G; Boulanger, Jean-Martin; Prebtani, Ally; Larochelle, Pierre; Leiter, Lawrence A; Jones, Charlotte; Ogilvie, Richard I; Woo, Vincent; Kaczorowski, Janusz; Trudeau, Luc; Petrella, Robert J; Hiremath, Swapnil; Drouin, Denis; Lavoie, Kim L; Hamet, Pavel; Fodor, George; Grégoire, Jean C; Lewanczuk, Richard; Dresser, George K; Sharma, Mukul; Reid, Debra; Lear, Scott A; Moullec, Gregory; Gupta, Milan; Magee, Laura A; Logan, Alexander G; Harris, Kevin C; Dionne, Janis; Fournier, Anne; Benoit, Geneviève; Feber, Janusz; Poirier, Luc; Padwal, Raj S; Rabi, Doreen M

2016-05-01

Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force provides annually updated, evidence-based recommendations to guide the diagnosis, assessment, prevention, and treatment of hypertension. This year, we present 4 new recommendations, as well as revisions to 2 previous recommendations. In the diagnosis and assessment of hypertension, automated office blood pressure, taken without patient-health provider interaction, is now recommended as the preferred method of measuring in-office blood pressure. Also, although a serum lipid panel remains part of the routine laboratory testing for patients with hypertension, fasting and nonfasting collections are now considered acceptable. For individuals with secondary hypertension arising from primary hyperaldosteronism, adrenal vein sampling is recommended for those who are candidates for potential adrenalectomy. With respect to the treatment of hypertension, a new recommendation that has been added is for increasing dietary potassium to reduce blood pressure in those who are not at high risk for hyperkalemia. Furthermore, in selected high-risk patients, intensive blood pressure reduction to a target systolic blood pressure ≤ 120 mm Hg should be considered to decrease the risk of cardiovascular events. Finally, in hypertensive individuals with uncomplicated, stable angina pectoris, either a β-blocker or calcium channel blocker may be considered for initial therapy. The specific evidence and rationale underlying each of these recommendations are discussed. Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force will continue to provide annual updates. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

ESPGHAN-NASPGHAN Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Esophageal Atresia-Tracheoesophageal Fistula.

PubMed

Krishnan, Usha; Mousa, Hayat; Dall'Oglio, Luigi; Homaira, Nusrat; Rosen, Rachel; Faure, Christophe; Gottrand, Frédéric

2016-11-01

Esophageal atresia (EA) is one of the most common congenital digestive anomalies. With improvements in surgical techniques and intensive care treatments, the focus of care of these patients has shifted from mortality to morbidity and quality-of-life issues. These children face gastrointestinal (GI) problems not only in early childhood but also through adolescence and adulthood. There is, however, currently a lack of a systematic approach to the care of these patients. The GI working group of International Network on Esophageal Atresia comprises members from ESPGHAN/NASPGHAN and was charged with the task of developing uniform evidence-based guidelines for the management of GI complications in children with EA. Thirty-six clinical questions addressing the diagnosis, treatment, and prognosis of the common GI complications in patients with EA were formulated. Questions on the diagnosis, and treatment of gastroesophageal reflux, management of "cyanotic spells," etiology, investigation and management of dysphagia, feeding difficulties, anastomotic strictures, congenital esophageal stenosis in EA patients were addressed. The importance of excluding eosinophilic esophagitis and associated GI anomalies in symptomatic patients with EA is discussed as is the quality of life of these patients and the importance of a systematic transition of care to adulthood. A systematic literature search was performed from inception to March 2014 using Embase, MEDLINE, the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Clinical Trials, and PsychInfo databases. The approach of the Grading of Recommendations Assessment, Development and Evaluation was applied to evaluate outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation, using the nominal voting technique. Expert opinion was used where no randomized controlled trials were available to support the recommendation.

A procedure for accurate calibration of the orientation of the three sensors in a vector magnetometer. [at the Goddard Space Flight Center

NASA Technical Reports Server (NTRS)

Mcpherron, R. L.

1977-01-01

Procedures are described for the calibration of a vector magnetometer of high absolute accuracy. It is assumed that the calibration will be performed in the magnetic test facility of Goddard Space Flight Center (GSFC). The first main section of the report describes the test equipment and facility calibrations required. The second presents procedures for calibrating individual sensors. The third discusses the calibration of the sensor assembly. In a final section recommendations are made to GSFC for modification of the test facility required to carry out the calibration procedures.

Technical analysis of US Army Weapons Systems and related advanced technologies of military interest. Final report

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

NONE

1991-06-14

This report summarizes the activities and accomplishments of an US Army technology security project designed to identify and develop effective policy guidelines for militarily critical technologies in specific Army systems and in broad generic technology areas of military interest, Individual systems analyses are documented in separate Weapons Systems Technical Assessments (WSTAs) and the general generic technology areas are evaluated in the Advanced Technology Assessment Reports (ATARs), However, specific details of these assessments are not addressed here, only recommendations regarding aspects of the defined approach, methodology, and format are provided and discussed.

Navier-Stokes computations useful in aircraft design

NASA Technical Reports Server (NTRS)

Holst, Terry L.

1990-01-01

Large scale Navier-Stokes computations about aircraft components as well as reasonably complete aircraft configurations are presented and discussed. Speed and memory requirements are described for various general problem classes, which in some cases are already being used in the industrial design environment. Recent computed results, with experimental comparisons when available, are included to highlight the presentation. Finally, prospects for the future are described and recommendations for areas of concentrated research are indicated. The future of Navier-Stokes computations is seen to be rapidly expanding across a broad front of applications, which includes the entire subsonic-to-hypersonic speed regime.

MJMS at the Dawn of Its Electronic Era

PubMed Central

Dewiputri, Wan Ilma; Mohamad, Irfan

2011-01-01

This special editorial assessed the recent developments in Malaysian Journal of Medical Sciences (MJMS) and examined the characteristics of the submission, peer review, and publication processes for MJMS. This retrospective analysis used information about the manuscripts submitted to MJMS during the one-year period (from 1 June 2010 to 31 May 2010) since the start of current online submission and review system (ScholarOne™ Manuscripts, Thomson Reuters). In addition, we also discussed the future directions of MJMS. Finally, we would like to recommend an annual internal audit for MJMS, which is very useful to monitor the growth of this journal progressively. PMID:22135566

Fourier Transform Methods. Chapter 4

NASA Technical Reports Server (NTRS)

Kaplan, Simon G.; Quijada, Manuel A.

2015-01-01

This chapter describes the use of Fourier transform spectrometers (FTS) for accurate spectrophotometry over a wide spectral range. After a brief exposition of the basic concepts of FTS operation, we discuss instrument designs and their advantages and disadvantages relative to dispersive spectrometers. We then examine how common sources of error in spectrophotometry manifest themselves when using an FTS and ways to reduce the magnitude of these errors. Examples are given of applications to both basic and derived spectrophotometric quantities. Finally, we give recommendations for choosing the right instrument for a specific application, and how to ensure the accuracy of the measurement results..

Materials for high-density electronic packaging and interconnection

NASA Technical Reports Server (NTRS)

1990-01-01

Electronic packaging and interconnections are the elements that today limit the ultimate performance of advanced electronic systems. Materials in use today and those becoming available are critically examined to ascertain what actions are needed for U.S. industry to compete favorably in the world market for advanced electronics. Materials and processes are discussed in terms of the final properties achievable and systems design compatibility. Weak points in the domestic industrial capability, including technical, industrial philosophy, and political, are identified. Recommendations are presented for actions that could help U.S. industry regain its former leadership position in advanced semiconductor systems production.

A Discussion of Aerodynamic Control Effectors (ACEs) for Unmanned Air Vehicles (UAVs)

NASA Technical Reports Server (NTRS)

Wood, Richard M.

2002-01-01

A Reynolds number based, unmanned air vehicle classification structure has been developed which identifies four classes of unmanned air vehicle concepts. The four unmanned air vehicle (UAV) classes are; Micro UAV, Meso UAV, Macro UAV, and Mega UAV. In a similar fashion a labeling scheme for aerodynamic control effectors (ACE) was developed and eleven types of ACE concepts were identified. These eleven types of ACEs were laid out in a five (5) layer scheme. The final section of the paper correlated the various ACE concepts to the four UAV classes and ACE recommendations are offered for future design activities.

Electrical actuation technology bridging, volume 1

NASA Astrophysics Data System (ADS)

Hammond, Monica S.; Doane, George B., III

1993-01-01

This document contains the proceedings from the conference. The workshop addressed key technologies bridging the entire field of electrical actuation including systems methodology, control electronics, power source systems, reliability, maintainability, and vehicle health management with special emphasis on thrust vector control (TVC) applications on NASA launch vehicles. Speakers were drawn primarily from industry with participation from universities and government. In addition, prototype hardware demonstrations were held at the MSFC Propulsion Laboratory each afternoon. Splinter sessions held on the final day afforded the opportunity to discuss key issues and to provide overall recommendations. Presentations are included in this document.

Authorship issues in multi-centre clinical trials: the importance of making an authorship contract.

PubMed

Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian; Vinther, Siri

2015-02-01

Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for them to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference to the original source.

Rural poverty reduction through centrally sponsored schemes.

PubMed

Saxena, N C

2007-10-01

This paper discusses the evolving profile of poverty in India and reviews the national performance of selected anti-poverty programmes between 1997-1998 and 2005. For each programme, it outlines the budgetary allocation principle used for the States and districts and analyzes budgetary performance over the period. The main objective is to explore the extent to which the anti-poverty programmes are reaching their target groups effectively. Finally, it identifies the specific factors responsible for under-performance and provides a set of recommendations for policy makers and programme implementers which could help improve the outcomes of the schemes.

Apollo experience report: Command and service module communications subsystem

NASA Technical Reports Server (NTRS)

Lattier, E. E., Jr.

1974-01-01

The development of spacecraft communications hardware from design to operation is described. Programs, requirements, specifications, and design approaches for a variety of functions (such as voice, telemetry, television, and antennas) are reviewed. Equipment environmental problems such as vibration, extreme temperature variation, and zero gravity are discussed. A review of the development of managerial techniques used in refining the roles of prime and subcontractors is included. The hardware test program is described in detail as it progressed from breadboard design to manned flight system evaluations. Finally, a series of actions is recommended to managers of similar projects to facilitate administration.

ALSEP termination report

NASA Technical Reports Server (NTRS)

Bates, J. R.; Lauderdale, W. W.; Kernaghan, H.

1979-01-01

The Apollo Lunar Surface Experiments Package (ALSEP) final report was prepared when support operations were terminated September 30, 1977, and NASA discontinued the receiving and processing of scientific data transmitted from equipment deployed on the lunar surface. The ALSEP experiments (Apollo 11 to Apollo 17) are described and pertinent operational history is given for each experiment. The ALSEP data processing and distribution are described together with an extensive discussion on archiving. Engineering closeout tests and results are given, and the status and configuration of the experiments at termination are documented. Significant science findings are summarized by selected investigators. Significant operational data and recommendations are also included.

Treatment of onychomycosis caused by dermatophytes--an opinion proposed by Committee for Standardization of the Japanese Society for Medical Mycology 2007.

PubMed

Mohri, Shinobu; Watanabe, Shinichi; Toshio, Kusunoki; Shibuya, Kazutoshi; Nishiyama, Yayoi; Abe, Michiko; Uno, Jun; Oguri, Toyoko; Maeasaki, Shigefumi; Ikeda, Reiko; Abe, Shigeru

2008-01-01

After the rapid progress in therapeutic pharmaceutics against onychomycosis caused by dermatophytes in the 1990s, an optimal therapeutic strategy for individual patients with the onychomycosis has become possible for clinical dermatologists. In this review, we discuss on clinical problems concerning this disease and propose recommendable treatments for each patient with topical and/or systemic use of antifungal agents. Finally, with consideration of already published therapeutic guidelines, we stress the necessity of "order-made" therapy for each patient with his/her medical status and wishes taking into account.

Management of the Space Station Freedom onboard local area network

NASA Technical Reports Server (NTRS)

Miller, Frank W.; Mitchell, Randy C.

1991-01-01

An operational approach is proposed to managing the Data Management System Local Area Network (LAN) on Space Station Freedom. An overview of the onboard LAN elements is presented first, followed by a proposal of the operational guidelines by which management of the onboard network may be effected. To implement the guidelines, a recommendation is then presented on a set of network management parameters which should be made available in the onboard Network Operating System Computer Software Configuration Item and Fiber Distributed Data Interface firmware. Finally, some implications for the implementation of the various network management elements are discussed.

Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening.

PubMed

Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

2018-01-01

Primary-care providers may contribute to the use of low-value cancer screening. We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers' attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Providers reported they would discuss cancer screening more often than they would recommend it ( P <0.001). More providers would discuss and recommend screening for CRC than prostate cancer ( P <0.001), for younger than older patients ( P <0.001), and when the patient requested it than when not ( P <0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). While most providers' reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. More work appears to be needed to help providers to discuss and recommend screening that aligns with value.

ADAAG Review Federal Advisory Committee Recommendations for a New ADAAG. Final Report.

ERIC Educational Resources Information Center

Architectural and Transportation Barriers Compliance Board, Washington, DC.

This report presents the final recommendations, in the form of a new set of guidelines, of a federal advisory committee concerning revisions to the Americans with Disabilities Act Accessibility Guidelines (ADAAG). The guidelines provide scoping and technical requirements for the design, construction, and alteration of sites, facilities, buildings,…

Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update.

PubMed

Rodrigues, A M; Canhão, H; Marques, A; Ambrósio, C; Borges, J; Coelho, P; Costa, L; Fernandes, S; Gonçalves, I; Gonçalves, M; Guerra, M; Marques, M L; Pimenta, S; Pinto, P; Sequeira, G; Simões, E; Teixeira, L; Vaz, C; Vieira-Sousa, E; Vieira, R; Alvarenga, F; Araújo, F; Barcelos, A; Barcelos, F; Barros, R; Bernardes, M; Canas da Silva, J; Cordeiro, A; Costa, M; Cunha-Miranda, L; Cruz, M; Duarte, A C; Duarte, C; Faustino, A; Figueiredo, G; Fonseca, J E; Furtado, C; Gomes, J; Lopes, C; Mourão, A F; Oliveira, M; Pimentel-Santos, F M; Ribeiro, A; Sampaio da Nóvoa, T; Santiago, M; Silva, C; Silva-Dinis, A; Sousa, S; Tavares-Costa, J; Terroso, G; Vilar, A; Branco, J C; Tavares, V; Romeu, J C; da Silva, Jap

2018-01-01

Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007. SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey. The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.

Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative

PubMed Central

Visser, K; Katchamart, W; Loza, E; Martinez-Lopez, J A; Salliot, C; Trudeau, J; Bombardier, C; Carmona, L; van der Heijde, D; Bijlsma, J W J; Boumpas, D T; Canhao, H; Edwards, C J; Hamuryudan, V; Kvien, T K; Leeb, B F; Martín-Mola, E M; Mielants, H; Müller-Ladner, U; Murphy, G; Østergaard, M; Pereira, I A; Ramos-Remus, C; Valentini, G; Zochling, J; Dougados, M

2009-01-01

Objectives: To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders. Methods: 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007–8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in rheumatic disorders were formulated. A systematic literature search in Medline, Embase, Cochrane Library and 2005–7 American College of Rheumatology/European League Against Rheumatism meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford levels of evidence. Each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. Results: A total of 16 979 references was identified, of which 304 articles were included in the systematic reviews. Ten multinational key recommendations on the use of methotrexate were formulated. Nine recommendations were specific for rheumatoid arthritis (RA), including the work-up before initiating methotrexate, optimal dosage and route, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy and management in the perioperative period and before/during pregnancy. One recommendation concerned methotrexate as a steroid-sparing agent in other rheumatic diseases. Conclusions: Ten recommendations for the use of methotrexate in daily clinical practice focussed on RA were developed, which are evidence based and supported by a large panel of rheumatologists, enhancing their validity and practical use. PMID:19033291

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway.

PubMed

Wischmeyer, Paul E; Carli, Franco; Evans, David C; Guilbert, Sarah; Kozar, Rosemary; Pryor, Aurora; Thiele, Robert H; Everett, Sotiria; Grocott, Mike; Gan, Tong J; Shaw, Andrew D; Thacker, Julie K M; Miller, Timothy E; Hedrick, Traci L; McEvoy, Matthew D; Mythen, Michael G; Bergamaschi, Roberto; Gupta, Ruchir; Holubar, Stefan D; Senagore, Anthony J; Abola, Ramon E; Bennett-Guerrero, Elliott; Kent, Michael L; Feldman, Liane S; Fiore, Julio F

2018-06-01

Perioperative malnutrition has proven to be challenging to define, diagnose, and treat. Despite these challenges, it is well known that suboptimal nutritional status is a strong independent predictor of poor postoperative outcomes. Although perioperative caregivers consistently express recognition of the importance of nutrition screening and optimization in the perioperative period, implementation of evidence-based perioperative nutrition guidelines and pathways in the United States has been quite limited and needs to be addressed in surgery-focused recommendations. The second Perioperative Quality Initiative brought together a group of international experts with the objective of providing consensus recommendations on this important topic with the goal of (1) developing guidelines for screening of nutritional status to identify patients at risk for adverse outcomes due to malnutrition; (2) address optimal methods of providing nutritional support and optimizing nutrition status preoperatively; and (3) identifying when and how to optimize nutrition delivery in the postoperative period. Discussion led to strong recommendations for implementation of routine preoperative nutrition screening to identify patients in need of preoperative nutrition optimization. Postoperatively, nutrition delivery should be restarted immediately after surgery. The key role of oral nutrition supplements, enteral nutrition, and parenteral nutrition (implemented in that order) in most perioperative patients was advocated for with protein delivery being more important than total calorie delivery. Finally, the role of often-inadequate nutrition intake in the posthospital setting was discussed, and the role of postdischarge oral nutrition supplements was emphasized.

Human germline gene editing: Recommendations of ESHG and ESHRE.

PubMed

de Wert, Guido; Pennings, Guido; Clarke, Angus; Eichenlaub-Ritter, Ursula; van El, Carla G; Forzano, Francesca; Goddijn, Mariëtte; Heindryckx, Björn; Howard, Heidi C; Radojkovic, Dragica; Rial-Sebbag, Emmanuelle; Tarlatzis, Basil C; Cornel, Martina C

2018-04-01

Technological developments in gene editing raise high expectations for clinical applications, first of all for somatic gene editing but in theory also for germline gene editing (GLGE). GLGE is currently not allowed in many countries. This makes clinical applications in these countries impossible now, even if GLGE would become safe and effective. What were the arguments behind this legislation, and are they still convincing? If a technique can help to avoid serious genetic disorders, in a safe and effective way, would this be a reason to reconsider earlier standpoints? The European Society of Human Reproduction and Embryology (ESHRE) and the European Society of Human Genetics (ESHG) together developed a Background document and Recommendations to inform and stimulate ongoing societal debates. After consulting its membership and experts, this final version of the Recommendations was endorsed by the Executive Committee and the Board of the respective Societies in May 2017. Taking account of ethical arguments, we argue that both basic and pre-clinical research regarding GLGE can be justified, with conditions. Furthermore, while clinical GLGE would be totally premature, it might become a responsible intervention in the future, but only after adequate pre-clinical research. Safety of the child and future generations is a major concern. Future discussions must also address priorities among reproductive and potential non-reproductive alternatives, such as PGD and somatic editing, if that would be safe and successful. The prohibition of human germline modification, however, needs renewed discussion among relevant stakeholders, including the general public and legislators.

Screening for and Management of Obesity in Adults

MedlinePlus

... Task Force Recommendations Screening for and Management of Obesity in Adults The U.S. Preventive Services Task Force ( ... final recommendation on Screening for and Management of Obesity in Adults . This recommendation is for adults ages ...

Comment on 'Shang S. 2012. Calculating actual crop evapotranspiration under soil water stress conditions with appropriate numerical methods and time step. Hydrological Processes 26: 3338-3343. DOI: 10.1002/hyp.8405'

NASA Technical Reports Server (NTRS)

Yatheendradas, Soni; Narapusetty, Balachandrudu; Peters-Lidard, Christa; Funk, Christopher; Verdin, James

2014-01-01

A previous study analyzed errors in the numerical calculation of actual crop evapotranspiration (ET(sub a)) under soil water stress. Assuming no irrigation or precipitation, it constructed equations for ET(sub a) over limited soil-water ranges in a root zone drying out due to evapotranspiration. It then used a single crop-soil composite to provide recommendations about the appropriate usage of numerical methods under different values of the time step and the maximum crop evapotranspiration (ET(sub c)). This comment reformulates those ET(sub a) equations for applicability over the full range of soil water values, revealing a dependence of the relative error in numerical ET(sub a) on the initial soil water that was not seen in the previous study. It is shown that the recommendations based on a single crop-soil composite can be invalid for other crop-soil composites. Finally, a consideration of the numerical error in the time-cumulative value of ET(sub a) is discussed besides the existing consideration of that error over individual time steps as done in the previous study. This cumulative ET(sub a) is more relevant to the final crop yield.

The Application of LiDAR to Assessment of Rooftop Solar Photovoltaic Deployment Potential in a Municipal District Unit

PubMed Central

Nguyen, Ha T.; Pearce, Joshua M.; Harrap, Rob; Barber, Gerald

2012-01-01

A methodology is provided for the application of Light Detection and Ranging (LiDAR) to automated solar photovoltaic (PV) deployment analysis on the regional scale. Challenges in urban information extraction and management for solar PV deployment assessment are determined and quantitative solutions are offered. This paper provides the following contributions: (i) a methodology that is consistent with recommendations from existing literature advocating the integration of cross-disciplinary competences in remote sensing (RS), GIS, computer vision and urban environmental studies; (ii) a robust methodology that can work with low-resolution, incomprehensive data and reconstruct vegetation and building separately, but concurrently; (iii) recommendations for future generation of software. A case study is presented as an example of the methodology. Experience from the case study such as the trade-off between time consumption and data quality are discussed to highlight a need for connectivity between demographic information, electrical engineering schemes and GIS and a typical factor of solar useful roofs extracted per method. Finally, conclusions are developed to provide a final methodology to extract the most useful information from the lowest resolution and least comprehensive data to provide solar electric assessments over large areas, which can be adapted anywhere in the world. PMID:22666044

Brazilian recommendations of mechanical ventilation 2013. Part 2

PubMed Central

2014-01-01

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document. PMID:25410835

Brazilian recommendations of mechanical ventilation 2013. Part I

PubMed Central

Barbas, Carmen Sílvia Valente; Ísola, Alexandre Marini; Farias, Augusto Manoel de Carvalho; Cavalcanti, Alexandre Biasi; Gama, Ana Maria Casati; Duarte, Antonio Carlos Magalhães; Vianna, Arthur; Serpa, Ary; Bravim, Bruno de Arruda; Pinheiro, Bruno do Valle; Mazza, Bruno Franco; de Carvalho, Carlos Roberto Ribeiro; Toufen, Carlos; David, Cid Marcos Nascimento; Taniguchi, Corine; Mazza, Débora Dutra da Silveira; Dragosavac, Desanka; Toledo, Diogo Oliveira; Costa, Eduardo Leite; Caser, Eliana Bernardete; Silva, Eliezer; Amorim, Fabio Ferreira; Saddy, Felipe; Galas, Filomena Regina Barbosa Gomes; Silva, Gisele Sampaio; de Matos, Gustavo Faissol Janot; Emmerich, João Claudio; Valiatti, Jorge Luis dos Santos; Teles, José Mario Meira; Victorino, Josué Almeida; Ferreira, Juliana Carvalho; Prodomo, Luciana Passuello do Vale; Hajjar, Ludhmila Abrahão; Martins, Luiz Cláudio; Malbouisson, Luiz Marcelo Sá; Vargas, Mara Ambrosina de Oliveira; Reis, Marco Antonio Soares; Amato, Marcelo Brito Passos; Holanda, Marcelo Alcântara; Park, Marcelo; Jacomelli, Marcia; Tavares, Marcos; Damasceno, Marta Cristina Paulette; Assunção, Murillo Santucci César; Damasceno, Moyzes Pinto Coelho Duarte; Youssef, Nazah Cherif Mohamad; Teixeira, Paulo José Zimmermann; Caruso, Pedro; Duarte, Péricles Almeida Delfino; Messeder, Octavio; Eid, Raquel Caserta; Rodrigues, Ricardo Goulart; de Jesus, Rodrigo Francisco; Kairalla, Ronaldo Adib; Justino, Sandra; Nemer, Sérgio Nogueira; Romero, Simone Barbosa; Amado, Verônica Moreira

2014-01-01

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document. PMID:25028944

Brazilian recommendations of mechanical ventilation 2013. Part 2

PubMed Central

Barbas, Carmen Sílvia Valente; Ísola, Alexandre Marini; Farias, Augusto Manoel de Carvalho; Cavalcanti, Alexandre Biasi; Gama, Ana Maria Casati; Duarte, Antonio Carlos Magalhães; Vianna, Arthur; Serpa Neto, Ary; Bravim, Bruno de Arruda; Pinheiro, Bruno do Valle; Mazza, Bruno Franco; de Carvalho, Carlos Roberto Ribeiro; Toufen Júnior, Carlos; David, Cid Marcos Nascimento; Taniguchi, Corine; Mazza, Débora Dutra da Silveira; Dragosavac, Desanka; Toledo, Diogo Oliveira; Costa, Eduardo Leite; Caser, Eliana Bernadete; Silva, Eliezer; Amorim, Fabio Ferreira; Saddy, Felipe; Galas, Filomena Regina Barbosa Gomes; Silva, Gisele Sampaio; de Matos, Gustavo Faissol Janot; Emmerich, João Claudio; Valiatti, Jorge Luis dos Santos; Teles, José Mario Meira; Victorino, Josué Almeida; Ferreira, Juliana Carvalho; Prodomo, Luciana Passuello do Vale; Hajjar, Ludhmila Abrahão; Martins, Luiz Claudio; Malbouisson, Luis Marcelo Sá; Vargas, Mara Ambrosina de Oliveira; Reis, Marco Antonio Soares; Amato, Marcelo Brito Passos; Holanda, Marcelo Alcântara; Park, Marcelo; Jacomelli, Marcia; Tavares, Marcos; Damasceno, Marta Cristina Paulette; Assunção, Murillo Santucci César; Damasceno, Moyzes Pinto Coelho Duarte; Youssef, Nazah Cherif Mohamed; Teixeira, Paulo José Zimmermann; Caruso, Pedro; Duarte, Péricles Almeida Delfino; Messeder, Octavio; Eid, Raquel Caserta; Rodrigues, Ricardo Goulart; de Jesus, Rodrigo Francisco; Kairalla, Ronaldo Adib; Justino, Sandra; Nemer, Sergio Nogueira; Romero, Simone Barbosa; Amado, Verônica Moreira

2014-01-01

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document. PMID:25295817

Brazilian recommendations of mechanical ventilation 2013. Part I

PubMed Central

2014-01-01

Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in São Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document. PMID:25210957

The international WAO/EAACI guideline for the management of hereditary angioedema-The 2017 revision and update.

PubMed

Maurer, M; Magerl, M; Ansotegui, I; Aygören-Pürsün, E; Betschel, S; Bork, K; Bowen, T; Balle Boysen, H; Farkas, H; Grumach, A S; Hide, M; Katelaris, C; Lockey, R; Longhurst, H; Lumry, W R; Martinez-Saguer, I; Moldovan, D; Nast, A; Pawankar, R; Potter, P; Riedl, M; Ritchie, B; Rosenwasser, L; Sánchez-Borges, M; Zhi, Y; Zuraw, B; Craig, T

2018-01-10

Hereditary Angioedema (HAE) is a rare and disabling disease. Early diagnosis and appropriate therapy are essential. This update and revision of the global guideline for HAE provides up-to-date consensus recommendations for the management of HAE. In the development of this update and revision of the guideline, an international expert panel reviewed the existing evidence and developed 20 recommendations that were discussed, finalized and consented during the guideline consensus conference in June 2016 in Vienna. The final version of this update and revision of the guideline incorporates the contributions of a board of expert reviewers and the endorsing societies. The goal of this guideline update and revision is to provide clinicians and their patients with guidance that will assist them in making rational decisions in the management of HAE with deficient C1-inhibitor (type 1) and HAE with dysfunctional C1-inhibitor (type 2). The key clinical questions covered by these recommendations are: (1) How should HAE-1/2 be defined and classified?, (2) How should HAE-1/2 be diagnosed?, (3) Should HAE-1/2 patients receive prophylactic and/or on-demand treatment and what treatment options should be used?, (4) Should HAE-1/2 management be different for special HAE-1/2 patient groups such as pregnant/lactating women or children?, and (5) Should HAE-1/2 management incorporate self-administration of therapies and patient support measures? © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

14 CFR 77.65 - Recommendations by parties.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Recommendations by parties. 77.65 Section... Recommendations by parties. Within 20 days after the mailing of the record of hearing by the official reporter, or... copies of his recommendations for a final decision to be made by the Administrator. ...

The oxidative stress theory of disease: levels of evidence and epistemological aspects.

PubMed

Ghezzi, Pietro; Jaquet, Vincent; Marcucci, Fabrizio; Schmidt, Harald H H W

2017-06-01

The theory that oxidative stress (OS) is at the root of several diseases is extremely popular. However, so far, no antioxidant has been recommended or offered by healthcare systems neither has any been approved as therapy by regulatory agencies that base their decisions on evidence-based medicine. This is simply because, so far, despite many preclinical and clinical studies indicating a beneficial effect of antioxidants in many disease conditions, randomised clinical trials have failed to provide the evidence of efficacy required for drug approval. In this review, we discuss the levels of evidence required to claim causality in preclinical research on OS, the weakness of the oversimplification associated with OS theory of disease and the importance of the narrative in its popularity. Finally, from a more translational perspective, we discuss the reasons why antioxidants acting by scavenging ROS might not only prevent their detrimental effects but also interfere with essential signalling roles. We propose that ROS have a complex metabolism and are generated by different enzymes at diverse sites and at different times. Aggregating this plurality of systems into a single theory of disease may not be the best way to develop new drugs, and future research may need to focus on specific oxygen-toxifying pathways rather than on non-specific ROS scavengers. Finally, similarly to what is nowadays required for clinical trials, we recommend making unpublished data available in repositories (open data), as this will allow big data approaches or meta-analyses, without the drawbacks of publication bias. This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc. © 2016 The British Pharmacological Society.

Balancing radiation benefits and risks: The needs of an informed public

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

Not Available

1994-04-01

The American public`s perceptions regarding ionizing radiation do not always conform to or correlate with scientific evidence. The ultimate purpose of this coordinated Federal effort and report is to increase the public`s knowledge of the benefits and risks associated with ionizing radiation. This report is divided into five sections. The first section, Introduction, discusses the public`s knowledge of radiation, their perceptions of benefits versus risks, and the Federal government`s role in public education. The section also outlines the charge to the Subpanel. Radiation Issues and Public Reactions discusses several radiation issues important to Federal agencies for which public education programsmore » need to be established or enhanced. Federal Programs describes Federal agencies with public education programs on radiation and the nature of the programs they support. Education Issues and Federal Strategies explores the elements identified by the Subpanel as critical to the development and implementation of an effective Federal program in the area of public education on radiation issues and nuclear technologies. An important issue repeatedly brought up during the public sector presentations to the Subpanel was the perceived lack of Federal credibility on radiation issues in the eyes of the public. To some degree, this concern was factored into all of the recommendations developed by the subpanel. The issues discussed in this section include the fragmented nature of Federal radiation programs and the need to improve credibility, promote agency responsiveness, and support the enhancement of scientific literacy. Finally, under Recommendations, the Subpanel discusses its overall findings and conclusions.« less

Chemical warfare agent detection: a review of current trends and future perspective.

PubMed

Pacsial-Ong, Eden Joy; Aguilar, Zoraida P

2013-01-01

The World Health Organization recommends countries to create a public health system that can respond to the deliberate release of chemical warfare agents (CWAs). Procedures for preparedness, response, decontamination protocols and medical countermeasures against CWA attacks are described. Known CWAs, including their properties and pharmacological consequences upon exposure, are tabulated and discussed. Requirements imposed on detection systems by various applications and environmental needs are presented in order to assess the devices for detection and identification of specific CWAs. The review surveys current and near-term detection technologies and equipments, as well as devices that are currently available to the military and civilian first responders. Brief technical discussions of several detection technologies are presented, with emphasis placed in the principles of detection. Finally, enabling technologies that form the basis for advanced sensing systems and devices are described.

Final environmental impact statement. Waste Isolation Pilot Plant

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

Not Available

1980-10-01

This volume contains the appendices for the Final Environmental Impact Statement for the Waste Isolation Pilot Plant (WIPP). Alternative geologic environs are considered. Salt, crystalline rock, argillaceous rock, and tuff are discussed. Studies on alternate geologic regions for the siting of WIPP are reviewed. President Carter's message to Congress on the management of radioactive wastes and the findings and recommendations of the interagency review group on nuclear waste management are included. Selection criteria for the WIPP site including geologic, hydrologic, tectonic, physicochemical compatability, and socio-economic factors are presented. A description of the waste types and the waste processing procedures aremore » given. Methods used to calculate radiation doses from radionuclide releases during operation are presented. A complete description of the Los Medanos site, including archaeological and historic aspects is included. Environmental monitoring programs and long-term safety analysis program are described. (DMC)« less

Evaluation of radiographic interpretation competence of veterinary students in Finland.

PubMed

Koskinen, Heli I; Snellman, Marjatta

2009-01-01

In the evaluation of the clinical competence of veterinary students, many different definitions and methods are approved. Due to the increasing discussion of the quality of outcomes produced by newly graduated veterinarians, methods for the evaluation of clinical competencies should also be evaluated. In this study, this was done by comparing two qualitative evaluation schemes: the well-known structure of observed learning outcome (SOLO) taxonomy and a modification of this taxonomy. A case-based final radiologic examination was selected and the investigation was performed by classifying students' outcomes. These classes were finally put next to original (quantitative) scores and the statistical calculations were initiated. Significant correlations between taxonomies (0.53) and the modified taxonomy and original scores (0.66) were found and some qualitative similarities between evaluation methods were observed. In addition, some supplements were recommended for the structure of evaluation schemes, especially for the structure of the modified SOLO taxonomy.

Presence of pro-tobacco messages on the Web.

PubMed

Hong, Traci; Cody, Michael J

2002-01-01

Ignored in the finalized Master Settlement Agreement (National Association of Attorneys General, 1998), the unmonitored, unregulated World Wide Web (Web) can operate as a major vehicle for delivering pro-tobacco messages, images, and products to millions of young consumers. A content analysis of 318 randomly sampled pro-tobacco Web sites revealed that tobacco has a pervasive presence on the Web, especially on e-commerce sites and sites featuring hobbies, recreation, and "fetishes." Products can be ordered online on nearly 50% of the sites, but only 23% of the sites included underage verification. Further, only 11% of these sites contain health warnings. Instead, pro-tobacco sites frequently associate smoking with "glamorous" and "alternative" lifestyles, and with images of young males and young (thin, attractive) females. Finally, many of the Web sites offered interactive site features that are potentially appealing to young Web users. Recommendations for future research and counterstrategies are discussed.

Frugal Construction Standards. Final [Report].

ERIC Educational Resources Information Center

SMART Schools Clearinghouse, Tallahassee, FL.

This booklet provides best practice recommendations for building functional and frugal schools in Florida. Seventeen best practice construction recommendations are addressed, including recommendations for sitework, concrete, masonry, metals, wood and plastics, thermal and moisture protection, doors and windows, finishes, equipment, furnishings,…

[Vaccination schedule of the Spanish Association of Pediatrics: recommendations 2006].

PubMed

2006-01-01

Based on the evidence available, the Vaccines Advisory Committee (VAC) of the Spanish Association of Pediatrics reports and comments on the new developments in vaccines that have taken place in 2005 and recommends some modifications to the vaccination schedule for 2006. In agreement with changes in the product monographs for the meningococcal C vaccine, the VAC recommends two doses for the three commercially available preparations with a booster dose in the second year of life. The European Medicines Evaluation Agency (EMEA) has temporarily suspended the sale of the Hexavac vaccine due to doubts about its long-term protection against hepatitis B. The VAC continues to support the use of these combined vaccines. Currently only Infranrix Hexa is available in Spain. The recommendation of vaccinating adolescents with a booster dose of pertussis vaccine via the administration of an acellular preparation of low antigenic load together with the adult diphtheria and tetanus vaccine remains valid. Vaccination against chickenpox in susceptible children aged more than 12 months old continues to be recommended. There is wide coverage for the 7-valent pneumococcal conjugate vaccine in many areas of Spain. In view of the studies published, the VAC reiterates the need for universal immunization by introducing this vaccine in the official vaccination schedule. Finally, other vaccines not included in this schedule are discussed, with special mention of the advisability of influenza vaccination in children, according to the recommendations of the VAC available at the beginning of each season on the web site of the Spanish Association of Pediatrics www.aeped.es; www. vacunasaep.org.

[Recommendations for the use of methotrexate in patients with juvenile idiopathic arthritis].

PubMed

Calvo, I; Antón, J; López Robledillo, J C; de Inocencio, J; Gamir, M L; Merino, R; Lacruz, L; Camacho, M; Rua, M J; Bustabad, S; Díaz Cordovés-Rego, G

2016-03-01

To develop a consensus document of recommendations for the use of methotrexate (MTX) in patients with juvenile idiopathic arthritis (JIA). A group of eleven experts proposed several clinical questions on the use of MTX in patients with JIA. A systematic review was conducted and the evidence and recommendations for each question were extracted. The results were discussed and validated by the experts in a work session to establish the final recommendations. MTX is recommended as the first drug for inducing remission in JIA, and its indication should be made according to the clinical category of the patient. Prior to treatment, it is recommended to perform a complete blood count, including white cells, levels of liver enzymes, serum creatinine, and other analytical parameters according to specific risk factors. Treatment should be initiated with a dose of 10-15 mg/m(2)/week. In cases of uveitis or polyarthritis, an initial dose of 15 mg/m(2)/week should be considered. For a better bioavailability and tolerability, it is preferable to administer MTX parenterally if the dose is ≥15 mg/m(2)/week. It is necessary to periodically perform an analytical monitoring of the patient and to assess possible alterations in liver enzymes to make changes if necessary. Combinations with biological agents may be necessary, as well as the concomitant addition of folic or folinic acid. This document describes the main recommendations for the appropriate use of MTX in JIA patients, according to scientific evidence and clinical experience. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

The Strategic Study Group on the Status of Women: Report to the President and the Commission for Women--Final Report.

ERIC Educational Resources Information Center

Pennsylvania State Univ., University Park.

The final report of the Pennsylvania State University Strategic Study Group on the Status of Women describes activities and presents recommendations concerned with the broad areas of leadership share, structure and quality of University worklife, and structure and quality of the academic environment. Recommendations address the following specific…

Review of External Examining Arrangements in Universities and Colleges in the UK: Final Report and Recommendations

ERIC Educational Resources Information Center

Universities UK, 2011

2011-01-01

This report outlines the final recommendations of the review of external examining arrangements undertaken by UUK and GuildHE and chaired by Professor Dame Janet Finch, former Vice-Chancellor of Keele University. The review found that, on the whole, external examining arrangements in the UK are working well, but the report offers recommendations…

14 CFR 77.65 - Recommendations by parties.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Recommendations by parties. 77.65 Section... Subpart D § 77.65 Recommendations by parties. Within 20 days after the mailing of the record of hearing by... presiding officer five copies of his recommendations for a final decision to be made by the Administrator. ...

NASA aviation safety reporting system

NASA Technical Reports Server (NTRS)

1978-01-01

A sample of reports relating to operations during winter weather is presented. Several reports involving problems of judgment and decisionmaking have been selected from the numerous reports representative of this area. Problems related to aeronautical charts are discussed in a number of reports. An analytic study of reports involving potential conflicts in the immediate vicinity of uncontrolled airports was performed; the results are discussed in this report. It was found that in three-fourths of 127 such conflicts, neither pilot, or only one of the pilots, was communicating position and intentions on the appropriate frequency. The importance of providing aural transfer of information, as a backup to the visual see and avoid mode of information transfer is discussed. It was also found that a large fraction of pilots involved in potential conflicts on final approach had executed straight-in approaches, rather than the recommended traffic pattern entries, prior to the conflicts. A selection of alert bulletins and responses to them by various segments of the aviation community is presented.

Design Concept for a Minimal Volume Spacecraft Cabin to Serve as a Mars Ascent Vehicle Cabin and Other Alternative Pressurized Vehicle Cabins

NASA Technical Reports Server (NTRS)

Howard, Robert L., Jr.

2016-01-01

The Evolvable Mars Campaign is developing concepts for human missions to the surface of Mars. These missions are round-trip expeditions, thereby requiring crew launch via a Mars Ascent Vehicle (MAV). A study to identify the smallest possible pressurized cabin for this mission has developed a conceptual vehicle referred to as the minimal MAV cabin. The origin of this concept will be discussed as well as its initial concept definition. This will lead to a description of possible configurations to integrate the minimal MAV cabin with ascent vehicle engines and propellant tanks. Limitations of this concept will be discussed, in particular those that argue against the use of the minimal MAV cabin to perform the MAV mission. However, several potential alternative uses for the cabin are identified. Finally, recommended forward work will be discussed, including current work in progress to develop a full scale mockup and conduct usability evaluations.

[Dementia-friendly hospital wards : Expert recommendations for planning and design].

PubMed

Büter, K; Motzek, T; Dietz, B; Hofrichter, L; Junge, M; Kopf, D; von Lützau-Hohlbein, H; Traxler, S; Zieschang, T; Marquardt, G

2017-01-01

Hospitals face great challenges in the necessity of providing care for the rising number of elderly patients with dementia. The adaptation of the spatial environment represents an important component to improve the care situation of patients with dementia. For more than 30 years research results from long-term care have provided evidence on the therapeutic effect of numerous architectural features on people with dementia. Due to specific medical and organizational requirements in hospitals, the transferability of these findings is, however, limited. An interdisciplinary workshop with experts from the fields of medicine, nursing, gerontology, self-help and architecture was conducted in July 2015. Based on existing research findings and experiences from pilot projects, the spatial requirements for dementia-friendly hospital wards were collated, suggested solutions were discussed from different perspectives and finally design recommendations were derived. The article gives a first comprehensive overview of architectural measures that are required for the design of dementia-friendly hospital wards. The recommendations provided range from architectural criteria, such as the size and spatial structure of hospital wards, to interior design elements, including orientation and navigation aids and the use of light and colors. Furthermore, information about the planning process are given.

[Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome].

PubMed

López-Jaramillo, Patricio; Sánchez, Ramiro A; Díaz, Margarita; Cobos, Leonardo; Bryce, Alfonso; Parra-Carrillo, José Z; Lizcano, Fernando; Lanas, Fernando; Sinay, Isaac; Sierra, Iván D; Peñaherrera, Ernesto; Benderky, Mario; Schmid, Helena; Botero, Rodrigo; Urina, Manuel; Lara, Joffre; Foos, Milton C; Márquez, Gustavo; Harrap, Stephen; Ramírez, Agustín J; Zanchetti, Alberto

2014-01-01

The present document has been prepared by a group of experts, members of Cardiology, Endocrinology, Internal Medicine, Nephrology and Diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high- risk population, usually underestimated and undertreated. These recommendations results from presentation and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming both physicians and patients from effectively adhering to guideline recommendations. Copyright © 2013 Elsevier España, S.L. y SEA. All rights reserved.

Panel Discussion : Report of the APS Ad-Hoc Committee on LGBT Issues

NASA Astrophysics Data System (ADS)

Atherton, Tim; Barthelemy, Ramon; Garmon, Savannah; Reeves, Kyle; APS Ad-Hoc Committee on LGBT Issues Team

Following the presentation of the findings and recommendations of the APS Ad-Hoc Committee on LGBT Issues (C-LGBT) by Committee Chair Michael Falk, a panel discussion will be held featuring several members of the committee. The discussion will focus on how APS can best ensure the recommendations of the committee are carried out in a timely fashion and other ideas on future APS efforts toward LGBT inclusion in physics. Discussion topics will also include the research and other input that shaped the committee's findings and recommendations.

Activity versus outcome maximization in time management.

PubMed

Malkoc, Selin A; Tonietto, Gabriela N

2018-04-30

Feeling time-pressed has become ubiquitous. Time management strategies have emerged to help individuals fit in more of their desired and necessary activities. We provide a review of these strategies. In doing so, we distinguish between two, often competing, motives people have in managing their time: activity maximization and outcome maximization. The emerging literature points to an important dilemma: a given strategy that maximizes the number of activities might be detrimental to outcome maximization. We discuss such factors that might hinder performance in work tasks and enjoyment in leisure tasks. Finally, we provide theoretically grounded recommendations that can help balance these two important goals in time management. Published by Elsevier Ltd.

Short-sheeting the psychiatric bed: state-level strategies to curtail the unnecessary hospitalization of adolescents in for-profit mental health facilities.

PubMed

Sperber, M N

1992-01-01

Over the past decade, there has been an increase in the hospitalization of minors in private, for-profit, psychiatric facilities. This increase suggests a tension between what is medically necessary and what is financially desirable. This Note discusses the hospitalization of minors in private, for-profit, mental health facilities and its attendant implications. This Note then examines various state efforts aimed at protecting minors from inappropriate psychiatric hospitalization. Finally, while there is no catch-all solution to the problem, this Note offers specific recommendations for reforming the for-profit psychiatric industry.

Galileo spacecraft integration - International cooperation on a planetary mission in the Shuttle era

NASA Technical Reports Server (NTRS)

Spehalski, R. J.

1983-01-01

The Galileo mission is designed to greatly expand scientific knowledge of Jupiter and its system. The retropropulsion module (RPM) as a major functional element of the Galileo spacecraft is described. The major mission and spacecraft requirements on the RPM are presented. Complexities of the integration process due to the international interface are identified. Challenges associated with integration with new launch vehicles, the Shuttle and upper stage, and their relationships to the RPM are discussed. The results of the integration process involving mission and propulsion performance, reliability, mechanical and thermal interfaces, and safety are described. Finally, considerations and recommendations for future missions involving international cooperation are given.

Unraveling Diagnostic Uncertainty Surrounding Lyme Disease in Children with Neuropsychiatric Illness.

PubMed

Koster, Michael P; Garro, Aris

2018-01-01

Lyme disease is endemic in parts of the United States, including New England, the Atlantic seaboard, and Great Lakes region. The presentation has various manifestations, many of which can mimic psychiatric diseases in children. Distinguishing manifestations of Lyme disease from those of psychiatric illnesses is complicated by inexact diagnostic tests and misuse of these tests when they are not clinically indicated. This article aims to describe manifestations of Lyme disease in children with an emphasis on Lyme neuroborreliosis. Clinical scenarios will be presented and discussed. Finally, recommendations for clinical psychiatrists who encounter children with possible Lyme disease are presented. Copyright © 2017 Elsevier Inc. All rights reserved.

Medico-legal issues in cardiology.

PubMed

Abbott, Ryan; Cohen, Michael

2013-01-01

The aim of this article is to educate physicians about the current litigation climate in cardiology and cardiac surgery, with a focus on the most frequently litigated areas of practice, including failure to diagnose and treat myocardial infarction, coronary artery bypass graft surgery, percutaneous coronary intervention, and the use of tissue plasminogen activator. Empirical research on cardiology malpractice is presented, along with a sampling of up-to-date cases designed to illustrate common issues and important themes. The principles for reducing legal liability are also discussed, including the informed consent process, spoliation of records, and the role of documentation. Finally, practical recommendations are provided for cardiologists and cardiac surgeons to limit their legal liability.

The NASA L3 Study

NASA Technical Reports Server (NTRS)

Stebbins, Robin

2016-01-01

The Astrophysics Implementation Plan calls for a minority role in L3, planned for launch in 2034. L3 The third large mission in ESAs Cosmic Visions 2015-2025 Programme NASA and ESA have been discussing a collaboration for 2 years Gravitational Observatory Advisory Team (GOAT) ESA study evaluating and recommend scientific performance tradeoffs, detection technologies, technology development activities, data analysis capabilities, schedule and cost US representatives: Guido Mueller, Mark Kasevich, Bill Klipstein, RTS Started in October 2014, concluding with a final report in late Marchor early April 2016. ESA solicited interest from ESA Member States in November 2015 NASA is continuing technology development support. ESA is restarting technology development activities.

Enhancing emergency care in low-income countries using mobile technology-based training tools.

PubMed

Edgcombe, Hilary; Paton, Chris; English, Mike

2016-12-01

In this paper, we discuss the role of mobile technology in developing training tools for health workers, with particular reference to low-income countries (LICs). The global and technological context is outlined, followed by a summary of approaches to using and evaluating mobile technology for learning in healthcare. Finally, recommendations are made for those developing and using such tools, based on current literature and the authors' involvement in the field. 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/.

Physics through the 1990s: Gravitation, cosmology and cosmic-ray physics

NASA Technical Reports Server (NTRS)

1986-01-01

The volume contains recommendations for space-and ground-based programs in gravitational physics, cosmology, and cosmic-ray physics. The section on gravitation examines current and planned experimental tests of general relativity; the theory behind, and search for, gravitational waves, including sensitive laser-interferometric tests and other observations; and advances in gravitation theory (for example, incorporating quantum effects). The section on cosmology deals with the big-bang model, the standard model from elementary-particle theory, the inflationary model of the Universe. Computational needs are presented for both gravitation and cosmology. Finally, cosmic-ray physics theory (nucleosynthesis, acceleration models, high-energy physics) and experiment (ground and spaceborne detectors) are discussed.

Integrity and security in an Ada runtime environment

NASA Technical Reports Server (NTRS)

Bown, Rodney L.

1991-01-01

A review is provided of the Formal Methods group discussions. It was stated that integrity is not a pure mathematical dual of security. The input data is part of the integrity domain. The group provided a roadmap for research. One item of the roadmap and the final position statement are closely related to the space shuttle and space station. The group's position is to use a safe subset of Ada. Examples of safe sets include the Army Secure Operating System and the Penelope Ada verification tool. It is recommended that a conservative attitude is required when writing Ada code for life and property critical systems.

Long life valve design concepts

NASA Technical Reports Server (NTRS)

Jones, J. R.; Hall, A. H., Jr.

1975-01-01

Valve concept evaluation, final candidate selection, design, manufacture, and demonstration testing of a pneumatically actuated 10-inch hybrid poppet butterfly shutoff valve are presented. Conclusions and recommendations regarding those valve characteristics and features which would serve to guide in the formulation of future valve procurements are discussed. The pertinent design goals were temperature range of plus 200 to minus 423 F, valve inlet pressure 35 psia, actuation pressure 750 psia, main seal leakage 3 x 0.00001 sccs at 35 psia valve inlet pressure, and a storage and operating life of 10 years. The valve was designed to be compatible with RP-1, propane, LH2, LO2, He, and N2.

Studies and analyses of the Space Shuttle Main Engine: SSME failure data review, diagnostic survey and SSME diagnostic evaluation

NASA Technical Reports Server (NTRS)

Glover, R. C.; Kelley, B. A.; Tischer, A. E.

1986-01-01

The results of a review of the Space Shuttle Main Engine (SSME) failure data for the period 1980 through 1983 are presented. The data was collected, evaluated, and ranked according to procedures established during this study. A number of conclusions and recommendations are made based upon this failure data review. The results of a state-of-the-art diagnostic survey are also presented. This survey covered a broad range of diagnostic sensors and techniques and the findings were evaluated for application to the SSME. Finally, a discussion of the initial activities for the on-going SSME diagnostic evaluation is included.

Molecular Diagnosis of Cystic Fibrosis.

PubMed

Deignan, Joshua L; Grody, Wayne W

2016-01-01

This unit describes a recommended approach to identifying causal genetic variants in an individual suspected of having cystic fibrosis. An introduction to the genetics and clinical presentation of cystic fibrosis is initially presented, followed by a description of the two main strategies used in the molecular diagnosis of cystic fibrosis: (1) an initial targeted variant panel used to detect only the most common cystic fibrosis-causing variants in the CFTR gene, and (2) sequencing of the entire coding region of the CFTR gene to detect additional rare causal CFTR variants. Finally, the unit concludes with a discussion regarding the analytic and clinical validity of these approaches. Copyright © 2016 John Wiley & Sons, Inc.

Security implications of the proliferation of weapons of mass destruction in the Middle East. Final report

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

Hajjar, S.G.

1998-12-17

The author argues that the Arab-Israeli conflict, the Iran-Iraq rivalry, and the lack of progress in the peace process are strong incentives for nations in the region to acquire weapons of mass destruction (WMD). He documents Israeli, Iranian, and Arab WMD programs and capabilities, referencing use of WMD in the region. He discusses the reasons why the major regional powers seek WMD capabilities and examines the nature of the proliferation dynamic as well as nonproliferation and counterproliferation approaches applicable to the region. The author offers several recommendations designed to strengthen these efforts and deal more effectively with causes of proliferation.

Getting Planetary Data into the Hands of Educators: Recommendations from a Community Discussion

NASA Astrophysics Data System (ADS)

Shipp, S.; Lowes, L.; Hammon, A.; Higbie, M.; Klug, S.; Lindstrom, M.; Stockman, S.; Wise, J.

2004-12-01

In March 2004 a community of approximately 60 researchers, formal and informal education specialists, classroom educators, data archivists, and educational product developers came together for a day-long conference to discuss the challenges in bringing planetary data into the classroom. The conference was hosted by the Solar System Exploration Education Forum and the South Central Organization of Researchers and Educators of NASA's Office of Space Science Support Network. The workshop was intended to: initiate a dialog among those interested in identifying paths for bringing planetary data to educators; better understand key challenges facing educators who are working with planetary data and issues with gaining access to data; identify common aspects of success of programs and products developed to make data accessible in educational venues; and finally, identify the remaining challenges and make recommendations for how the community should move forward to bring these data into the classroom. Presentations by researchers and educational specialists encompassed the facilitation of accessing data, effective use of data in the classroom, availability of data for use by the educational community, and paths for accessing and using mission data. Panel discussions explored the experiences of researchers, educators, and product developers in creating and implementing programs and products and the challenges remaining for integrating planetary data into educational environments. Discussion among participants resulted in a series of recommendations for the development and implementation of successful programs, including: 1) the intended audience should play an active role in the design and development process; 2) program and product implementation should incorporate adequate training and support for intended users; 3) data access needs to be made easier, perhaps requiring the filtering of raw data and new user interfaces; 4) product developers should present data within the context of a lesson or an exploration that is appropriate for the age level, with ties to standards, assessments, and connections to other disciplines such as language arts and math to ease the time burden on the classroom educator; 5) data need to be accessible within a broad context of important scientific questions and understanding; and 6) the potential community involved in the educational use of planetary data is large -- resources such as master-teachers, museums, pre-service faculty, minority organizations, amateur astronomers and others should be involved and leveraged. The complete list of recommendations, presentations, and participants can be found at (http://www.lpi.usra.edu/score). This conference was intended to initiate community dialog on the use of planetary data in the classroom. Future conferences and workshops are planned to continue the discussion of issues and challenges.

Employer Policies and Practices to Manage and Prevent Disability: Foreword to the Special Issue.

PubMed

Shaw, William S; Main, Chris J; Pransky, Glenn; Nicholas, Michael K; Anema, Johannes R; Linton, Steven J

2016-12-01

Purpose Employer policies and practices have been shown to impact workplace disability, but research in this area has waned in recent years despite an aging workforce, a growing prevalence of chronic health conditions, and a larger proportion of working-age adults on permanent work disability in many jurisdictions. The purpose of this article is to describe the background rationale and methodology for an invited conference designed to improve research of employer strategies to curtail work disability. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The overall goal was to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. Working groups were organized and draft manuscripts were prepared in advance. Conference activities included working group presentations and critiques, discussions with a panel of industry consultants and advisors, group interaction and debate, generation of final recommendations, and manuscript revision. Results/Conclusion Six principal domains were established with respect to future research: (a) further elucidation of the key workplace factors that buffer the disabling effects of injury and illness; (b) more innovative and feasible options for workplace intervention; (c) measurement of workplace-relevant disability outcomes; (d) a stronger theoretical framework for understanding the factors behind employer uptake and implementation; (e) a focus on special clinical populations and occupations where disability risk is most troubling; and (f) better representation of workers and employers that reflect the diverse and changing nature of work. Final comments and recommendations of the working groups are presented in the following six articles in this special issue of the Journal of Occupational Rehabilitation. Conference attendees recommended changes in methodology, collaboration strategies, and theoretical perspectives to improve the practical and scientific impact of future research of employer practices.

Evidence-informed recommendations for constructing and disseminating messages supplementing the new Canadian Physical Activity Guidelines

PubMed Central

2013-01-01

Background Few validated guidelines exist for developing messages in health promotion practice. In clinical practice, the Appraisal of Guidelines, Research, and Evaluation II (AGREE II) Instrument is the international gold standard for guideline assessment, development, and reporting. In a case study format, this paper describes the application of the AGREE II principles to guide the development of health promotion guidelines for constructing messages to supplement the new Canadian Physical Activity Guidelines (CPAG) released in 2011. Methods The AGREE II items were modified to suit the objectives of developing messages that (1) clarify key components of the new CPAG and (2) motivate Canadians to meet the CPAG. The adapted AGREE II Instrument was used as a systematic guide for the recommendation development process. Over a two-day meeting, five workgroups (one for each CPAG – child, youth, adult, older adult – and one overarching group) of five to six experts (including behavior change, messaging, and exercise physiology researchers, key stakeholders, and end users) reviewed and discussed evidence for creating and targeting messages to supplement the new CPAG. Recommendations were summarized and reviewed by workgroup experts. The recommendations were pilot tested among end users and then finalized by the workgroup. Results The AGREE II was a useful tool in guiding the development of evidence-based specific recommendations for constructing and disseminating messages that supplement and increase awareness of the new CPAG (child, youth, adults, and older adults). The process also led to the development of sample messages and provision of a rationale alongside the recommendations. Conclusions To our knowledge, these are the first set of evidence-informed recommendations for constructing and disseminating messages supplementing physical activity guidelines. This project also represents the first application of international standards for guideline development (i.e., AGREE II) to the creation of practical recommendations specifically aimed to inform health promotion and public health practice. The messaging recommendations have the potential to increase the public health impact of evidence-based guidelines. PMID:23634998

CAEP 2015 Academic Symposium: Recommendations for University Governance and Administration for Emergency Medicine.

PubMed

Petrie, David; Chopra, Anil; Chochinov, Alecs; Artz, Jennifer D; Schull, Michael; Tallon, John; Jones, Gordon; MacPhee, Shannon; Ackerman, Margaret; Stiell, Ian G; Christenson, Jim

2016-04-05

1) To identify the strengths and challenges of governance structures in academic emergency medicine (EM), and 2) to make recommendations on principles and approaches that may guide improvements. Over the course of 9 months, eight established EM leaders met by teleconference, reviewed the literature, and discussed their findings and experiences to arrive at recommendations on governance in academic units of EM. The results and recommendations were presented at the annual Canadian Association of Emergency Physicians (CAEP) Academic Symposium, where attendees provided feedback. The updated recommendations were subsequently distributed to the CAEP Academic Section for further input, and the final recommendations were decided by consensus. The panel identified four governance areas of interest: 1) the elements of governance; 2) the relationships between emergency physicians and academic units of EM, and between the academic units of EM and faculty of medicine; 3) current status of governance in Canadian academic units of EM; and 4) essential elements of good governance. Six recommendations were developed around three themes, including 1) the importance of good governance; 2) the purposes of an academic unit of EM; and 3) essential elements for better governance for academic units of EM. Recommendations included identifying the importance of good governance, recognizing the need to adapt to the different models depending on the local environment; seeking full departmental status, provided it is mutually beneficial to EM and the faculty of medicine (and health authority); using a consultation service to learn from the experience of other academic units of EM; and establishing an annual forum for EM leaders. Although governance of academic EM is complex, there are ways to iteratively improve the mission of academic units of EM: providing exceptional patient care through research and education. Although there is no one-size-fits-all guide, there are practical recommended steps for academic units of EM to consider.

Workshop Report: The Medaka Model for Comparative Assessment of Human Disease Mechanisms

PubMed Central

Obara, Tomoko

2015-01-01

Results of recent studies showing the utility of medaka as a model of various human disease states were presented at the 7th Aquatic Models of Human Disease Conference (December 13–18, 2014, Austin, TX). This conference brought together many of the most highly regarded national and international scientists that employ the medaka model in their investigations. To take advantage of this opportunity, a cohort of established medaka researchers were asked to stay an extra day and represent the medaka scientific community in a workshop entitled “The Medaka Model for Comparative Assessment of Human Disease Mechanisms”. The central purpose of this medaka workshop was to assess current use and project the future resource needs of the American medaka research community. The workshop sought to spur discussions of issues that would promote more informative comparative disease model studies. Finally, workshop attendees met together to propose, discuss, and agree on recommendations regarding the most effective research resources needed to enable US scientists to perform experiments leading to impacting experimental results that directly translate to human disease. Consistent with this central purpose, the workshop was divided into two sessions of invited speakers having expertise and experience in the session topics. The workshop hosted 20 scientific participants (Appendices 1 and 2) and of these, nine scientists presented formal talks. Here, we present a summary report stemming from workshop presentations and subsequent round table discussions, and forward recommendations from this group that we believe represent views of the overall medaka research community. PMID:26099189

Region-to-area screening methodology for the Crystalline Repository Project

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

None

1985-04-01

The purpose of this document is to describe the Crystalline Repository Project's (CRP) process for region-to-area screening of exposed and near-surface crystalline rock bodies in the three regions of the conterminous United States where crystalline rock is being evaluated as a potential host for the second nuclear waste repository (i.e., in the North Central, Northeastern, and Southeastern Regions). This document indicates how the US Department of Energy's (DOE) General Guidelines for the Recommendation of Sites for Nuclear Waste Repositories (10 CFR 960) were used to select and apply factors and variables for the region-to-area screening, explains how these factors andmore » variable are to be applied in the region-to-area screening, and indicates how this methodology relates to the decision process leading to the selection of candidate areas. A brief general discussion of the screening process from the national survey through area screening and site recommendation is presented. This discussion sets the scene for detailed discussions which follow concerning the region-to-area screening process, the guidance provided by the DOE Siting Guidelines for establishing disqualifying factors and variables for screening, and application of the disqualifying factors and variables in the screening process. This document is complementary to the regional geologic and environmental characterization reports to be issued in the summer of 1985 as final documents. These reports will contain the geologic and environmental data base that will be used in conjunction with the methodology to conduct region-to-area screening.« less

Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology.

PubMed

Räber, Lorenz; Mintz, Gary S; Koskinas, Konstantinos C; Johnson, Thomas W; Holm, Niels R; Onuma, Yoshinubo; Radu, Maria D; Joner, Michael; Yu, Bo; Jia, Haibo; Menevau, Nicolas; de la Torre Hernandez, Jose M; Escaned, Javier; Hill, Jonathan; Prati, Francesco; Colombo, Antonio; di Mario, Carlo; Regar, Evelyn; Capodanno, Davide; Wijns, William; Byrne, Robert A; Guagliumi, Giulio

2018-05-22

This Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior to PCI for optimizing stent sizing (stent length and diameter) and planning the procedural strategy is discussed. Regarding post-implantation imaging, the consensus group recommends key parameters that characterize an optimal PCI result and provides cut-offs to guide corrective measures and optimize the stenting result. Moreover, routine performance of intracoronary imaging in patients with stent failure (restenosis or stent thrombosis) is recommended. Finally, strengths and limitations of IVUS and OCT for guiding PCI and assessing stent failures and areas that warrant further research are critically discussed.

Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan.

PubMed

Gutenbrunner, Christoph; Nugraha, Boya

2018-04-18

A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP) for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

DNA Commission of the International Society for Forensic Genetics: revised and extended guidelines for mitochondrial DNA typing.

PubMed

Parson, W; Gusmão, L; Hares, D R; Irwin, J A; Mayr, W R; Morling, N; Pokorak, E; Prinz, M; Salas, A; Schneider, P M; Parsons, T J

2014-11-01

The DNA Commission of the International Society of Forensic Genetics (ISFG) regularly publishes guidelines and recommendations concerning the application of DNA polymorphisms to the question of human identification. Previous recommendations published in 2000 addressed the analysis and interpretation of mitochondrial DNA (mtDNA) in forensic casework. While the foundations set forth in the earlier recommendations still apply, new approaches to the quality control, alignment and nomenclature of mitochondrial sequences, as well as the establishment of mtDNA reference population databases, have been developed. Here, we describe these developments and discuss their application to both mtDNA casework and mtDNA reference population databasing applications. While the generation of mtDNA for forensic casework has always been guided by specific standards, it is now well-established that data of the same quality are required for the mtDNA reference population data used to assess the statistical weight of the evidence. As a result, we introduce guidelines regarding sequence generation, as well as quality control measures based on the known worldwide mtDNA phylogeny, that can be applied to ensure the highest quality population data possible. For both casework and reference population databasing applications, the alignment and nomenclature of haplotypes is revised here and the phylogenetic alignment proffered as acceptable standard. In addition, the interpretation of heteroplasmy in the forensic context is updated, and the utility of alignment-free database searches for unbiased probability estimates is highlighted. Finally, we discuss statistical issues and define minimal standards for mtDNA database searches. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Advanced subsonic long-haul transport terminal area compatibility study. Volume 2: Research and technology recommendations

NASA Technical Reports Server (NTRS)

1974-01-01

The Terminal Area Compatibility (TAC) study is briefly summarized for background information. The most important research items for the areas of noise congestion, and emissions are identified. Other key research areas are also discussed. The 50 recommended research items are categorized by flight phase, technology, and compatibility benefits. The relationship of the TAC recommendations to the previous ATT recommendations is discussed. The bulk of the document contains the 50 recommended research items. For each item, the potential payoff, state of readiness, recommended action and estimated cost and schedule are given.

78 FR 69658 - Ultra-Deepwater Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

... architecture and technology to the Secretary of Energy and provide comments and recommendations and priorities... & Introductions, Opening Remarks, Discussion of History of UDAC Recommendations, Discussion of Subcommittee...

[Advanced Prostate Cancer Consensus Conference 2017 : Discussion of the recommendations for diagnosis and treatment of metastatic prostate cancer by a German panel of experts].

PubMed

Schostak, M; König, F; Bögemann, M; Goebell, P; Hammerer, P; Machtens, S; Schwentner, C; Thomas, C; von Amsberg, G; von Rundstedt, F-C; Heidenreich, A

2018-05-28

In March 2017 the 'Advanced Prostate Cancer Consensus Conference' (APCCC) took place in St. Gallen (Switzerland). The APCCC-panelists are internationally well known experts. With the actual data in mind they discussed treatment options for patients with advanced prostate cancer in order to update the international APCCC-recommendations from the previous meeting in 2015. Recently these consensus recommendations have been published in "European Urology".A group of German experts discussed this year APCCC-votes during the meeting and the recommendations that were concluded from the votes from the German perspective. Reasons for an additional German discussion are country-specific variations that may have influenced the APCCC-votes und recommendations. Due to the concept of the APCCC-meeting the wording of the questions could not always be as necessary.One focus of this year consensus discussion was the treatment of metastatic castration-naive prostate cancer (mCNPC). There are new data which may also influence the therapeutic situation of patients with metastatic castration-resistant prostate cancer (mCRPC). Further points of discussion were the impact of new imaging procedures in the clinical setting as well as the treatment of oligometastatic prostate cancer.

The development of marine renewable energy in China: prospects, challenges and recommendations

NASA Astrophysics Data System (ADS)

Wang, Ji; Wang, Haifeng; Liu, Yuxin; Chen, Libo; Tang, Jiuting

2018-02-01

In this paper, resources distribution and technology status of tidal energy, wave energy, tidal current energy, ocean thermal energy and salinity gradient energy in China is reviewed, and assessment and advices are given for each category. By analysis, we believe that marine renewable energy is a necessary addition to existent renewable energy to meet the energy demand of the areas and islands where traditional forms of energy are not applicable and it is of great importance in adjusting energy structure of China. This paper describes the potential of marine renewable energy in China, and explores the possible role in future energy systems. As the paper discusses, building on these initiatives, and “realizing” the accelerated development of marine energy, presents a number of challenges. This paper describes a scenario for the accelerated development of marine renewable energy in China from now to 2030. Finally, this paper provides recommendations for future development of marine renewable energy in China.

WHO Expert Committee on Specifications for Pharmaceutical Preparations.

PubMed

2003-01-01

This report presents the recommendations of an international group of experts convened by the World Health Organization to consider matters concerning the quality assurance of pharmaceuticals and specifications for drug substances and dosage forms. Of particular relevance to drug regulatory authorities and pharmaceutical manufacturers, the report discusses activities related to the development of The International Pharmacopoeia and basic tests for pharmaceutical substances and dosage forms, as well as quality control of reference materials, good manufacturing practices (GMP), stability studies, inspection, hazard analysis, procurement, storage and other aspects of quality assurance of pharmaceuticals, and regulatory issues. The report is complemented by a number of annexes, including recommendations on the risk of transmitting animal spongiform encephalopathy agents via medicinal products, guidelines on GMP for pharmaceutical products, a model certificate for GMP and guidance on a GMP inspection report. The final annexes provide guidance on the application of Hazard Analysis and Critical Control Point (HACCP) method to pharmaceuticals, good storage practices and a procedure for assessing acceptability of pharmaceutical products for purchase by United Nations agencies.

Pharmacogenetics of anti-cancer drugs: State of the art and implementation - recommendations of the French National Network of Pharmacogenetics.

PubMed

Quaranta, Sylvie; Thomas, Fabienne

2017-04-01

Individualized treatment is of special importance in oncology because the drugs used for chemotherapy have a very narrow therapeutic index. Pharmacogenetics may contribute substantially to clinical routine for optimizing cancer treatment to limit toxic effects while maintaining efficacy. This review presents the usefulness of pharmacogenetic tests for some key applications: dihydropyrimidine dehydrogenase (DPYD) genotyping for fluoropyrimidine (5-fluorouracil, capecitabine), UDP glucuronosylstransferase (UGT1A1) for irinotecan and thiopurine S-methyltransferase (TPMT) for thiopurine drugs. Depending on the level of evidence, the French National Network of Pharmacogenetics (RNPGx) has issued three levels of recommendations for these pharmacogenetic tests: essential, advisable, and potentially useful. Other applications, for which the level of evidence is still discussed, will be evoked in the final section of this review. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Patient-Physician Discussions of Colorectal Cancer Screening: Delivery of the 5 ‘As’ in Practice

PubMed Central

Lafata, Jennifer Elston; Cooper, Gregory S.; Divine, George; Flocke, Susan A.; Oja-Tebbe, Nancy; Stange, Kurt C.; Wunderlich, Tracy

2015-01-01

Background The US Preventive Services Task Force advocates for shared decision-making and 5As framework (assess, advise, agree, assist and arrange) for preventive health recommendations. Purpose To describe patient-physician colorectal cancer (CRC) screening discussions, evaluate concordance with 5As framework, and test whether discussion content varies by patient adherence to prior recommendation. Methods Direct observation of periodic health examinations in 2007-2009 among primary care patients aged 50-80 due for CRC screening. Qualitative content analyses used to code office visit audio-recordings for occurrence of 5As and other discussion content. Results 97% of visits contained CRC screening discussion; 31% of these contained evidence of patient non-adherence to prior physician recommendation for CRC screening. While 59% of visits provided some assistance (i.e., help scheduling a colonoscopy or delivery of stool cards), the first three steps of 5As (assess, advise, and agree) were rarely comprehensively provided (1-21%). Only 3% included the recommended last step, arrange follow up. Patients non-adherent to a prior recommendation were significantly (P<0.05) less likely to have the reason(s) for screening discussed (37% vs, 65%) or be told endoscopy clinic would call to schedule colonoscopy (19% vs. 27%), and significantly more likely to have fecal occult blood testing (FOBT) (34% vs. 25%) or FOBT and colonoscopy recommended (24% vs. 14%) and a screening plan negotiated (21% vs. 14%). Conclusions Most patients due for CRC screening discuss screening with their physician, but with limited application of 5As approach. Opportunities to improve CRC screening decision-making are great, particularly among those non-adherent with prior recommendations. PMID:16905030

Patient-Physician Discussions of Colorectal Cancer Screening: Delivery of the 5 ‘As’ in Practice

PubMed Central

Lafata, Jennifer Elston; Cooper, Gregory S.; Divine, George; Flocke, Susan A.; Oja-Tebbe, Nancy; Stange, Kurt C.; Wunderlich, Tracy

2015-01-01

Background The US Preventive Services Task Force advocates for shared decision-making and 5As framework (assess, advise, agree, assist and arrange) for preventive health recommendations. Purpose To describe patient-physician colorectal cancer (CRC) screening discussions, evaluate concordance with 5As framework, and test whether discussion content varies by patient adherence to prior recommendation. Methods Direct observation of periodic health examinations in 2007-2009 among primary care patients aged 50-80 due for CRC screening. Qualitative content analyses used to code office visit audio-recordings for occurrence of 5As and other discussion content. Results 97% of visits contained CRC screening discussion; 31% of these contained evidence of patient non-adherence to prior physician recommendation for CRC screening. While 59% of visits provided some assistance (i.e., help scheduling a colonoscopy or delivery of stool cards), the first three steps of 5As (assess, advise, and agree) were rarely comprehensively provided (1-21%). Only 3% included the recommended last step, arrange follow up. Patients non-adherent to a prior recommendation were significantly (P<0.05) less likely to have the reason(s) for screening discussed (37% vs, 65%) or be told endoscopy clinic would call to schedule colonoscopy (19% vs. 27%), and significantly more likely to have fecal occult blood testing (FOBT) (34% vs. 25%) or FOBT and colonoscopy recommended (24% vs. 14%) and a screening plan negotiated (21% vs. 14%). Conclusions Most patients due for CRC screening discuss screening with their physician, but with limited application of 5As approach. Opportunities to improve CRC screening decision-making are great, particularly among those non-adherent with prior recommendations. PMID:22011418

Do patients discussed at a lung cancer multidisciplinary team meeting receive guideline-recommended treatment?

PubMed

Boxer, Miriam M; Duggan, Kirsten J; Descallar, Joseph; Vinod, Shalini K

2016-03-01

Clinical guidelines provide evidence-based management recommendations to guide practice. This study aimed to evaluate whether patients discussed at a lung cancer multidisciplinary team meeting received guideline-recommended treatment and determine reasons for not receiving guideline-recommended treatment. All new lung cancer patients discussed at the Liverpool/Macarthur lung cancer multidisciplinary team meeting between 1 December 2005 and 31 December 2010 were included. Guideline-recommended treatment was assigned according to pathology, stage and ECOG (Eastern Co-operative Oncology Group) performance status as per the 2004 Australian Lung Cancer Guidelines. This was compared with actual treatment received to determine adherence to guidelines. For those patients who did not receive guideline-recommended treatment, the medical record was reviewed to determine the reason(s) for this. Survival was compared between those who did and did not receive guideline-recommended treatment. 808 new patients were discussed at the multidisciplinary team meeting. Guideline-recommended treatment could not be assigned in 2% of patients due to missing data. 435 patients (54%) received guideline-recommended treatment, and 356 (44%) did not. The most common reasons for not receiving guideline-recommended treatment were a decline in ECOG performance status (24%), large tumor volume precluding radical radiotherapy (17%), comorbidities (15%) and patient preference (13%). Patients less than 70 years who received guideline-recommended treatment had improved survival compared with those who did not. A significant proportion of lung cancer patients did not receive guideline-recommended treatment due to legitimate reasons. Alternative guidelines are needed for patients not suitable for current best practice. Treatment according to guidelines was a predictor for survival. © 2015 Wiley Publishing Asia Pty Ltd.

The missing link in preconceptional care: the role of comparative effectiveness research.

PubMed

Salihu, Hamisu M; Salinas, Abraham; Mogos, Mulubrhan

2013-07-01

This paper discusses an important element that is missing from the existing algorithm of preconception care, namely, comparative effectiveness research (CER). To our knowledge, there has been limited assessment of the comparative effectiveness of diverse interventions that promote preconception health, conditions under which these are most effective, for which particular populations, and their comparative costs. CER can improve the decision making process for the funding, development, implementation, and evaluation of comprehensive preconception care programs, specifically by identifying the most effective interventions with acceptable costs to society. This paper will examine the framework behind preconception care and how the inclusion of comparative effectiveness research and evaluation into the existing algorithm of preconception care could foster improvement in maternal and child health. We discuss challenges and opportunities regarding the utilization of CER in the decision making process in preconception health, and finally, we provide recommendations for future directions.

Female sex trafficking: conceptual issues, current debates, and future directions.

PubMed

Meshkovska, Biljana; Siegel, Melissa; Stutterheim, Sarah E; Bos, Arjan E R

2015-01-01

Female sex trafficking is a pressing concern. In this article, we provide a comprehensive overview of relevant issues regarding the concept of female sex trafficking and research in the field of human trafficking, drawing on a variety of disciplines, including economics, gender and sexuality studies, psychology, sociology, law, and social work. We discuss the debates surrounding the definition of human trafficking, compare and contrast it with human smuggling, and outline connections between female sex trafficking and the issue of sex work and prostitution. We further discuss the history and current estimations of female sex trafficking. We then outline the main actors in female sex trafficking, including trafficked persons, traffickers, clients, and service providers, and we overview the trafficking process from recruitment to identification, recovery, and (re)integration. Finally, we conclude with recommendations for future research that tie together the concepts of vulnerability, exploitation, and long-term recovery and (re)integration.

The Missing Link in Preconceptional Care: The Role of Comparative Effectiveness Research

PubMed Central

Salihu, Hamisu M.; Salinas, Abraham; Mogos, Mulubrhan

2012-01-01

This paper discusses an important element that is missing from the existing algorithm of preconception care, namely, comparative effectiveness research (CER). To our knowledge, there has been limited assessment of the comparative effectiveness of diverse interventions that promote preconception health, conditions under which these are most effective, for which particular populations, and their comparative costs. CER can improve the decision making process for the funding, development, implementation, and evaluation of comprehensive preconception care programs, specifically by identifying the most effective interventions with acceptable costs to society. This paper will examine the framework behind preconception care and how the inclusion of comparative effectiveness research and evaluation into the existing algorithm of preconception care could foster improvement in maternal and child health. We discuss challenges and opportunities regarding the utilization of CER in the decision making process in preconception health, and finally, we provide recommendations for future directions. PMID:22718466

Single- and dual-carrier microwave noise abatement in the deep space network. [microwave antennas

NASA Technical Reports Server (NTRS)

Bathker, D. A.; Brown, D. W.; Petty, S. M.

1975-01-01

The NASA/JPL Deep Space Network (DSN) microwave ground antenna systems are presented which simultaneously uplink very high power S-band signals while receiving very low level S- and X-band downlinks. Tertiary mechanisms associated with elements give rise to self-interference in the forms of broadband noise burst and coherent intermodulation products. A long-term program to reduce or eliminate both forms of interference is described in detail. Two DSN antennas were subjected to extensive interference testing and practical cleanup program; the initial performance, modification details, and final performance achieved at several planned stages are discussed. Test equipment and field procedures found useful in locating interference sources are discussed. Practices deemed necessary for interference-free operations in the DSN are described. Much of the specific information given is expected to be easily generalized for application in a variety of similar installations. Recommendations for future investigations and individual element design are given.

Environmental review of the Panda-Brandywine cogeneration project. Final report

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

Walters, G.; Keating, R.; Huggins, A.

1997-02-01

The Maryland Public Service Commission (PSC) granted a Certificate of Public Convenience and Necessity (CPCN) to Panda-Brandywine, L.P., to construct and operate a 248-megawatt (electric) generating station near Brandywine, Prince George`s County, Maryland. This report describes PPRP`s evaluation of the environmental and socioeconomic impacts of the Panda-Brandywine facility, summarizes the results of that evaluation, and presents recommendations for license conditions which have been incorporated into Panda`s CPCN. The document includes description of the proposed facility, host facility, and associated linear facilities (transmission line, pipelines); discussion of existing environmental and socioeconomic conditions at the site and in the vicinity; analysis ofmore » the potential air quality, surface water, biological, ground water, socioeconomic, cultural, and noise impacts from the proposed facility; and discussion of critical engineering issues associated with operation of the facility, including water supply, water discharge, and fuel handling.« less

Consumer managed care appeals: are the available procedural protections fundamentally fair?

PubMed

Nevers, A H

2000-01-01

Managed care incentives to reduce costs have also resulted in incentives to deny care. Anecdotes concerning managed care denials of care have led to a consumer outcry for protection either through the use of procedural due process or by the establishment of patient rights that would include appeal and grievance protections. This Article reviews the procedural protections of constitutional due process, the Consumer Due Process Protocol, and the Patient Bill of Rights. The Article then extensively discusses the availability of these procedural protections in various public and private forums. The discussion of public forums includes proposals contained in recent national legislative initiatives. The author then reviews relevant federal and state law, as well as Uniform Law proposals. Next, the Article analyzes the protections provided by accreditation agencies, dispute resolution organizations, professional organizations, and health insurers. Finally, the author recommends criteria to be used to determine whether a procedure is fundamentally fair.

[Role of vitamin D in allergic diseases: Current research status].

PubMed

Sperl, A; Klimek, L

2015-05-01

Recent research has focused on the relationship between vitamin D and allergy development. Results show that on the one hand a vitamin D deficiency can be responsible for the emergence of allergies, however, on the other hand a vitamin-D (over-) substitution was also seen in context with an increased allergy development. This article provides an overview on the current state of research and points at the problematic aspects that accompany the assessment of these studies. The paradoxic effect of vitamin D is currently being explained by epigenetic programming in pregnancy, by too low vitamin-D levels or excessive supplementation in newborns. Very recently, a gender-specific impact of vitamin D is also being discussed. For a final assessment of vitamin-D effects on the emergence of allergies, further research is necessary. Due to a high level of heterogeneity among current observational studies regarding central aspects of the discussion, randomised clinical trials are recommended.

Effects of extreme heat and drought on trees: what do we know and what do we need to know?

NASA Astrophysics Data System (ADS)

Teskey, R. O.

2017-12-01

It is almost certain that trees will experience heat waves and droughts during their lifetime. In response, they have acquired many adaptations to survive these periods of intense stress. For example, recently we have investigated the surprising role that stomata play in maintaining leaf function at very high temperatures by opening widely to cool the leaf even when photosynthesis is zero. This process and its trade-offs, as well as many other physiological and morphological responses to high temperatures, will be discussed. The current state of knowledge of the mechanisms trees use to cope with extreme drought, including leaf shedding, hydraulic architecture, carbohydrate storage, and changes in wood anatomy will be discussed. Examples of how the interactions between drought and heat affect trees also will be provided. Finally, an assessment of knowledge gaps and recommendations for future research will be provided.

Soil and leaf litter metaproteomics—a brief guideline from sampling to understanding

PubMed Central

Keiblinger, Katharina M.; Fuchs, Stephan; Zechmeister-Boltenstern, Sophie; Riedel, Katharina

2016-01-01

The increasing application of soil metaproteomics is providing unprecedented, in-depth characterization of the composition and functionality of in situ microbial communities. Despite recent advances in high-resolution mass spectrometry, soil metaproteomics still suffers from a lack of effective and reproducible protein extraction protocols and standardized data analyses. This review discusses the opportunities and limitations of selected techniques in soil-, and leaf litter metaproteomics, and presents a step-by-step guideline on their application, covering sampling, sample preparation, extraction and data evaluation strategies. In addition, we present recent applications of soil metaproteomics and discuss how such approaches, linking phylogenetics and functionality, can help gain deeper insights into terrestrial microbial ecology. Finally, we strongly recommend that to maximize the insights environmental metaproteomics may provide, such methods should be employed within a holistic experimental approach considering relevant aboveground and belowground ecosystem parameters. PMID:27549116

[The gynecologist and the problem of therapeutic abortion].

PubMed

Pundel, J P

1972-01-01

Most of this essay on the abortion problem in French-speaking western Europe concerns the Sermon of Hippocrates forbidding abortion; the discussion ends with an ethical discussion on abortion codes in a pluralist society. 1st, scholars question whether Hippocrates himself actually wrote the text of the Sermon, or whether his Pythagorean followers did. 2nd, probably abortion in Hippocrates' time was relegated to midwives and lithotomists. The meaning of the quotation "I do not give any abortive remedy" is obscure since in other contexts Hippocrates distinguished between abortive and contraceptive drugs and also abortive instruments. Finally, Hipoocrates specifically recommended abortion, e.g., to avoid pregnancy for prostitutes. Persons in authority, then, should not invoke Hippocrates or any other moral code to deprive a woman of medical abortion, especially in cases of rape, age, and failure of contraception. Divorce, for example, has been legalized in most countries, without forcing anyone to take advantage of it.

Exploding head syndrome.

PubMed

Sharpless, Brian A

2014-12-01

Exploding head syndrome is characterized by the perception of abrupt, loud noises when going to sleep or waking up. They are usually painless, but associated with fear and distress. In spite of the fact that its characteristic symptomatology was first described approximately 150 y ago, exploding head syndrome has received relatively little empirical and clinical attention. Therefore, a comprehensive review of the scientific literature using Medline, PsycINFO, Google Scholar, and PubMed was undertaken. After first discussing the history, prevalence, and associated features, the available polysomnography data and five main etiological theories for exploding head syndrome are summarized. None of these theories has yet reached dominance in the field. Next, the various methods used to assess and treat exploding head syndrome are discussed, as well as the limited outcome data. Finally, recommendations for future measure construction, treatment options, and differential diagnosis are provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

Small or big in the eyes of the other: on the developmental psychopathology of self-conscious emotions as shame, guilt, and pride.

PubMed

Muris, Peter; Meesters, Cor

2014-03-01

The self-conscious emotions of guilt, shame, and pride typically occur when people evaluate their own self through the eyes of another person. This article will first of all discuss the nature and function of self-conscious emotions, and describe their developmental course in children and adolescents. Then, a number of variables are discussed that are thought to increase young people's proneness to experience self-conscious emotions. Following this, the empirical evidence on the relationships between guilt, shame, and pride and various types of psychopathology in children and adolescents will be summarized. A model is presented to explain why these self-conscious emotions are associated with a diversity of psychopathological outcomes. Finally, recommendations for clinical practice are made in terms of assessment and interventions targeting the origins and sequelae of self-conscious emotions.

Space-brain: The negative effects of space exposure on the central nervous system.

PubMed

Jandial, Rahul; Hoshide, Reid; Waters, J Dawn; Limoli, Charles L

2018-01-01

Journey to Mars will be a large milestone for all humankind. Throughout history, we have learned lessons about the health dangers associated with exploratory voyages to expand our frontiers. Travelling through deep space, the final frontier, is planned for the 2030s by NASA. The lessons learned from the adverse health effects of space exposure have been encountered from previous, less-lengthy missions. Prolonged multiyear deep space travel to Mars could be encumbered by significant adverse health effects, which could critically affect the safety of the mission and its voyagers. In this review, we discuss the health effects of the central nervous system by space exposure. The negative effects from space radiation and microgravity have been detailed. Future aims and recommendations for the safety of the voyagers have been discussed. With proper planning and anticipation, the mission to Mars can be done safely and securely.

Strawman II. Recommendations for a regulatory program for mining waste and materials under Subtitle D of the Resource Conservation and Recovery Act. Final report

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

Not Available

1990-05-21

The package, referred to as 'Strawman II', is a working document that represents EPA's latest staff position on an effective program to regulate wastes and other materials uniquely associated with noncoal mining. Strawman II does not represent a proposed rule. The package consists of two parts: (1) the Foreward, which describes the pre-rulemaking Strawman process, a background and overview of the mining waste program as envisioned in the package, and discussions of major issues concerning the program and its scope; and (2) the Regulatory Approach, presented as '40 CFR XXX, XXY, and XXZ' to reflect how the program might appearmore » in regulatory language. Discussions and amplifications of specific points are also interspersed throughout the Regulatory Approach. EPA encourages all interested parties to convey their views on any and all aspects of the program concept.« less

Recommendations of the Commission on Government Procurement: A Final Assessment

DTIC Science & Technology

1979-05-31

Assessment TECHNICAi; LIBRARY Important structural changes are now in place on procurement reforms first proposed in 1972, but the program is far...COMPTROLLER GENERAL’S REPORT TO THE CONGRESS RECOMMENDATIONS OF THE COMMISSION ON GOVERNMENT PROCUREMENT: A FINAL ASSESSMENT DIGEST As Federal...legislation and —the Office of Federal Procurement Policy (OFPP) to lead in making needed changes. OVERALL ASSESSMENT Success of the reform program is still

U.S. Immigration Policy and the National Interest. The Final Report and Recommendations of the Select Commission on Immigration and Refugee Policy with Supplemental Views by Commissioners.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Select Commission on Immigration and Refugee Policy.

This final report (March, 1981) of the Select Commission on Immigration and Refugee Policy reviews the provisions and effects of the Immigration and Nationality Act and makes recommendations related to the following areas of study: international issues, undocumented/illegal aliens, the admission of immigrants, phasing in new programs, refugee and…

75 FR 41891 - Certain Footwear: Recommendations for Modifying the Harmonized Tariff Schedule of the United States

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

... INTERNATIONAL TRADE COMMISSION [Investigation No. 1205-8] Certain Footwear: Recommendations for Modifying the Harmonized Tariff Schedule of the United States AGENCY: United States International Trade Commission. ACTION: Change in date for transmitting final recommendations to the President. SUMMARY: The...

What's next for dyslipidemia management? The 2013 ACC/AHA Guidelines, the NLA recommendations, and beyond.

PubMed

Waite, Laura H; Phan, Yvonne L; Spinler, Sarah A

2016-01-01

To compare and contrast the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines and the 2014/2015 National Lipid Association (NLA) Recommendations for Management of Dyslipidemia in the context of evolving evidence. Guidelines from the National Cholesterol Education Program (NCEP), ACC/AHA, and NLA; recent clinical trials involving non-statin therapies. Not applicable. At the authors' discretion, preference was given to references focusing on guidelines and recent clinical trials involving dyslipidemia management. In late 2013, the ACC/AHA released guidelines on the treatment of blood cholesterol to reduce risk for atherosclerotic cardiovascular disease (ASCVD) in adults. Reflecting contemporary evidence-based literature, low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) numeric treatment goals were eliminated, and a new method of risk assessment (the Pooled Cohort Equations) was recommended. The guidelines emphasized lipid lowering in 4 patient populations proven to benefit from statin therapy, recommending moderate to high-intensity statin dosing, with no additional drug therapies and limited ongoing monitoring. Clinical controversies ignited by these guidelines led to the publication of recommendations by the NLA in 2014 and 2015. Part 1 of the NLA recommendations incorporated parts of both the ATP III guidelines and the 2013 ACC/AHA guidelines along with updated original recommendations. These recommendations provided numeric LDL-C, non-HDL-C, and apolipoprotein B treatment goals and potential additional ASCVD risk factors, with stepwise risk assessment based on traditional cardiac risk factors and multiple assessment tools. In addition to statins, the 2014 NLA recommendations highlighted the benefit of additional or alternative lipid-lowering therapies. Part 2 of the NLA recommendations expanded the guidance for treatment of special populations and prioritized ezetimibe as a non-statin agent based on recent evidence. Finally, the US Food and Drug Administration recently approved 2 medications from a new class, the PCSK9 inhibitors, although their role in therapy remains unclear pending outcomes data. We aim to highlight the core recommendations of recent guideline publications and to discuss similarities and differences in the context of the future management of dyslipidemia. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Municipal solid waste in Brazil: A review.

PubMed

Alfaia, Raquel Greice de Souza Marotta; Costa, Alyne Moraes; Campos, Juacyara Carbonelli

2017-12-01

The production of municipal solid waste (MSW) represents one of the greatest challenges currently faced by waste managers all around the world. In Brazil, the situation with regard to solid waste management is still deficient in many aspects. In 2015, only 58.7% of the MSW collected in Brazilian cities received appropriate final disposal. It was only as late as 2010 that Brazil established the National Policy on Solid Waste (NPSW) based on the legislation and programmes established in the 1970s in more developed countries. However, the situation with regard to MSW management has changed little since the implementation of the NPSW. Recent data show that, in Brazil, disposal in sanitary landfills is practically the only management approach to MSW. Contrary to expectations, despite the economic recession in 2015 the total annual amount of MSW generated nationwide increased by 1.7%, while in the same period the Brazilian population grew by 0.8% and economic activity decreased by 3.8%. The article describes the panorama with regard to MSW in Brazil from generation to final disposal and discusses the issues related to the delay in implementing the NPSW. The collection of recyclable material, the recycling process, the application of reverse logistics and the determination of the gravimetric composition of MSW in Brazil are also addressed in this article. Finally, a brief comparison is made between MSW management in Brazil and in other countries, the barriers to developing effective waste disposal systems are discussed and some recommendations for future MSW management development in Brazil are given.

Proceedings of the November 2011 Traceability Research Summit: this report is the third in a series on Traceability Summits sponsored by IFT beginning in July 2011.

PubMed

Hickey, Caitlin; Bhatt, Tejas

2013-12-01

Fifty thought leaders in the area of food traceability met for a 3rd time to discuss methodologies and finalize the principles that define their vision for traceability. Participants in the summit included representatives from industry, trade associations, government, academia, consumer groups, and more. One main focus of this summit included a discussion on the current regulations and voluntary initiatives in place regarding traceability. Overall, it was recognized that the recommendations from this summit group would be more specific and stringent in comparison to these current regulations and initiatives. The participants sought to be leaders in the traceability arena, with their recommendations leading the industry to optimal traceability systems and methods. Participants agreed on many principles for their vision of traceability, emphasizing the importance of access to traceability data. They discussed having industry be asked for "basic" tracing data prior to the need for a large-scale investigation, having standards for sharing data, and having the data in electronic form. Participants foresaw the importance of capturing data electronically in the future, although they recognized that many firms do not currently do this. The group also saw a need for a transition period to implement changes, and to provide implementation training and resource aid to small businesses. Summit participants discussed specific definitions and examples for key data elements and critical tracking events that could be used by industry to capture tracing data at specific points within the supply chain. Overall, participants refined the goals of the summit group and started to identify specific ways to achieve those goals. © 2013 Institute of Food Technologists®

Irritable bowel syndrome--the main recommendations.

PubMed

Andresen, Viola; Keller, Jutta; Pehl, Christian; Schemann, Michael; Preiss, Jan; Layer, Peter

2011-11-01

Irritable bowel syndrome is characterized by chronic abdominal symptoms and irregular bowel movements without any cause than can be revealed by routine diagnostic assessment. In recent years, its pathophysiology has come to be much better understood, and new therapeutic approaches have been developed. These advances were taken into consideration and assessed for their relevance to clinical practice in the framework of a new interdisciplinary S3 guideline. A systematic search of the literature retrieved a total 5573 articles, from which 243 were selected on the basis of criteria relating to their form and content, individually assessed, and summarized in evidence tables. The recommendations formulated in this way were discussed in a Delphi procedure and a consensus conference, then accordingly modified and finalized. Variable symptom constellations are caused by disturbances of gastrointestinal regulation at multiple levels. The diagnosis of irritable bowel syndrome requires both chronic bowel symptoms that interfere with everyday life and the exclusion of relevant differential diagnoses. Its treatment is based on general therapeutic principles, dietary recommendations, psychological components, and symptomatic medication. Bulking agents, laxatives, spasmolytics, loperamide, and probiotic agents are recommended (with variable recommendation strengths), as are--for selected patients--antidepressants, 5-HT4 agonists, 5-HT3 antagonists, and topical antibiotics. The first German S3 guideline on irritable bowel syndrome translates up-to-date scientific knowledge as represented in current publications into concrete recommendations for diagnosis and treatment in clinical practice. In the future, it is likely that further causative pathophysiological mechanisms will be discovered; this should lead, in turn, to the development of new, causally directed treatments, which will supplement or replace the traditional, purely symptomatic treatments that are still in use today.

Workshop to discuss NRC 2014 Recommendations for IRIS

EPA Pesticide Factsheets

EPA is holding a public workshop to discuss some specific recommendations from the National Academies' National Research Council's May 2014 report on further improving the scientific quality of IRIS assessments.

78 FR 46965 - Draft Guidance for Industry on Bioequivalence Recommendations for Mesalamine Rectal Suppositories...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... Recommendations for Mesalamine.'' The recommendations provide specific guidance on the design of bioequivalence... suppositories: A fasting BE study with pharmacokinetic endpoints and comparative in vitro studies (melting point...). The draft guidance, when finalized, will represent the Agency's current thinking on the design of BE...

10 CFR 709.17 - Final disposition of CI evaluation findings and recommendations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... and recommendations. (a) Following completion of a CI evaluation, the Director of the Office of Intelligence and Counterintelligence must recommend, in writing, to the appropriate Program Manager that the covered person's access be approved or retained, or denied or revoked. (b) If the Program Manager agrees...

10 CFR 709.17 - Final disposition of CI evaluation findings and recommendations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... recommendations. 709.17 Section 709.17 Energy DEPARTMENT OF ENERGY COUNTERINTELLIGENCE EVALUATION PROGRAM CI... Intelligence and Counterintelligence must recommend, in writing, to the appropriate Program Manager that the covered person's access be approved or retained, or denied or revoked. (b) If the Program Manager agrees...

Recommending blood glucose monitors, a pharmacy perspective.

PubMed

Carter, Alan

2007-03-01

Selection of what blood glucose monitoring system to utilize has become an issue for physicians, diabetes educators, pharmacists, and patients. The field of competing makes and models of blood glucose monitoring systems has become crowded, with manufacturers touting improvements in accuracy, ease of use/alternate site options, stored results capacity, software evaluation tools, and/or price point. Personal interviews of 12 pharmacists from community and academic practice settings about monitor preference, as well as results from a national survey of pharmacist recommendations, were compared to actual wholesale sales data to estimate the impact of such recommendations on final monitor selection by the patient. Accu-Chek monitors were recommended 34.65% of the time and represented 28.58% of sales, with a success rate of 82.48% of being the monitor selected. OneTouch monitors had 27.72% of recommendations but represented 31.43% of sales, indicating possible patient brand loyalty or formulary preference for that product. FreeStyle(R) monitors came in third for pharmacist recommendations and were selected by the patient 61.68% of the time when recommended. The category of "other monitor" choices was selected 60.89% of the time by patients given those suggestions. Included in the "other monitor" category was the new disposable monitor marketed as the Sidekick. Based on sales data provided, the Sidekick made up 2.87% of "other monitor" category sales, representing 68% of the "other monitor" segment. While patients frequently follow pharmacist monitoring system suggestions, the ultimate deciding factor is most often the final out-of-pocket cost to the patient. As a result, cost of supplies often becomes the most important determining factor in final monitor selection at the patient level. If the patient cannot afford to perform the recommended daily testing intervals, all other determining factors and suggestions become moot.

WHO Working Group on revision of the Manual of Laboratory Methods for Testing DTP Vaccines-Report of two meetings held on 20-21 July 2006 and 28-30 March 2007, Geneva, Switzerland.

PubMed

Corbel, Michael J; Das, Rose Gaines; Lei, Dianliang; Xing, Dorothy K L; Horiuchi, Yoshinobu; Dobbelaer, Roland

2008-04-07

This report reflects the discussion and conclusions of a WHO group of experts from National Regulatory Authorities (NRAs), National Control Laboratories (NCLs), vaccine industries and other relevant institutions involved in standardization and control of diphtheria, tetanus and pertussis vaccines (DTP), held on 20-21 July 2006 and 28-30 March 2007, in Geneva Switzerland for the revision of WHO Manual for quality control of DTP vaccines. Taking into account recent developments and standardization in quality control methods and the revision of WHO recommendations for D, T, P vaccines, and a need for updating the manual has been recognized. In these two meetings the current situation of quality control methods in terms of potency, safety and identity tests for DTP vaccines and statistical analysis of data were reviewed. Based on the WHO recommendations and recent validation of testing methods, the content of current manual were reviewed and discussed. The group agreed that the principles to be observed in selecting methods included identifying those critical for assuring safety, efficacy and quality and which were consistent with WHO recommendations/requirements. Methods that were well recognized but not yet included in current Recommendations should be taken into account. These would include in vivo and/or in vitro methods for determining potency, safety testing and identity. The statistical analysis of the data should be revised and updated. It was noted that the mouse based assays for toxoid potency were still quite widely used and it was desirable to establish appropriate standards for these to enable the results to be related to the standard guinea pig assays. The working group was met again to review the first drafts and to input further suggestions or amendments to the contributions of the drafting groups. The revised manual was to be finalized and published by WHO.

Future Aeronautical Communication Infrastructure Technology Investigation

NASA Technical Reports Server (NTRS)

Gilbert, Tricia; Jin, Jenny; Bergerm Jason; Henriksen, Steven

2008-01-01

This National Aeronautics and Space Administration (NASA) Contractor Report summarizes and documents the work performed to investigate technologies that could support long-term aeronautical mobile communications operating concepts for air traffic management (ATM) in the timeframe of 2020 and beyond, and includes the associated findings and recommendations made by ITT Corporation and NASA Glenn Research Center to the Federal Aviation Administration (FAA). The work was completed as the final phase of a multiyear NASA contract in support of the Future Communication Study (FCS), a cooperative research and development program of the United States FAA, NASA, and EUROCONTROL. This final report focuses on an assessment of final five candidate technologies, and also provides an overview of the entire technology assessment process, including final recommendations.

Direct and enhanced disclosure of researcher financial conflicts of interest: the role of trust.

PubMed

Spece, Roy G

2013-01-01

In earlier writing, I recommended direct disclosure of major researcher financial conflicts of interest in per capita funding arrangements--the practice of providing researchers with a fixed sum for each subject recruited and enrolled in a study. This Article adds a recommendation for enhanced direct disclosure. The enhancement in the disclosure is a summary of why per capita and excess payments are being discussed and further includes whether the sponsors of the research and the researchers have claimed that there are no excess payments. The reason per capita payments are being discussed is because of the risk--with special caution when sponsors and researchers are not willing to claim that there are no excess payments--of introducing bias into researchers' decisions regarding study design, implementation, and interpretation, as well as concerning whom to enroll or keep in studies. Researchers' claims that there are no excess payments do not vitiate the risk of such payments. Nevertheless, a special admonition when sponsors and researchers do not claim the absence of excess payments would hopefully encourage them to eschew excess payments. My recommendations are required by the rights to bodily integrity and autonomy embedded in informed consent. Several arguments have been made against my recommendations, many of which relate to supposed effects on trust. My rights-based recommendations should not be rejected because of objections based on propositions that (1) are conceptually unclear because of a failure to unbundle different kinds and degrees of trust and (2) have not been empirically proven even where concepts are clarified. In some instances, the required strong empirical confirmation cannot be made because of practical or ethical restraints, including the fact that some of the necessary studies would require invasion of the right to informed consent. Finally, I suggest and partially apply an organizational method to generate empirical questions and guidance for future research in this area. Even the few hypothetical scenarios addressed demonstrate how complex--and sometimes practically or ethically impossible--the empirical studies must be to adduce proofs sufficient to overcome the imperative of informed consent.

Using Google Blogs and Discussions to Recommend Biomedical Resources: A Case Study

PubMed Central

Reed, Robyn B.; Chattopadhyay, Ansuman; Iwema, Carrie L.

2013-01-01

This case study investigated whether data gathered from discussions within the social media provide a reliable basis for a biomedical resources recommendation system. Using a search query to mine text from Google Blogs and Discussions, a ranking of biomedical resources was determined based on those most frequently mentioned. To establish quality, these results were compared to rankings by subject experts. An overall agreement between the frequency of social media discussions and subject expert recommendations was observed when identifying key bioinformatics and consumer health resources. Testing the method in more than one biomedical area implies this procedure could be employed across different subjects. PMID:24180648

Screening for Hepatitis C Infections in Adults

MedlinePlus

Understanding Task Force Recommendations Screening for Hepatitis C Virus Infection in Adults The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Hepatitis C ...

78 FR 9054 - Issuance of Final Guidance Publication

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-07

... NIOSH-144] Issuance of Final Guidance Publication AGENCY: National Institute for Occupational Safety and... Services (HHS). ACTION: Notice of issuance of final guidance publication. SUMMARY: The National Institute...), announces the availability of the following publication: ``NIOSH Criteria for a Recommended Standard...

Examination of commercial aviation operational energy conservation strategies

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

None

Forty-seven fuel conservation strategies are identified for commercial aviation and the fuel saving potential, costs, constraints, and current implementation levels of these options are examined. This assessment is based on a comprehensive review of published data and discussions with representatives from industry and government. Analyses were performed to quantify the fuel saving potential of each option, and to assess the fuel savings achieved to date by the airline industry. Those options requiring further government support for option implementation were identified, rated, and ranked in accordance with a rating methodology developed in the study. Finally, recommendations are made for future governmentmore » efforts in the area of fuel conservation in commercial aviation.« less

Women trafficked into prostitution: determinants, human rights and health needs.

PubMed

Gajic-Veljanoski, Olga; Stewart, Donna E

2007-09-01

Human trafficking is an international challenge that increasingly affects industrialized countries. It represents a gross violation of a person's right to liberty and freedom of movement, and is often accompanied by violence and degrading treatment which can have detrimental effects on health. In this article, we review the definition and extent of human trafficking, and focus on the human rights abuses and determinants of trafficking in women. Mental health and other health outcomes are reviewed, and differences between countries in organized activities for victim assistance and protection are assessed. Finally, we discuss the roles of mental health and other healthcare providers in identifying and helping trafficked women, and recommend a tailored multidisciplinary approach for victim assistance.

A comparison of top and middle level women administrators in social work, nursing, and education: career supports and barriers.

PubMed

Collins, S K

1984-01-01

Presented in this article are findings from a descriptive study of a national stratified random sample of 259 women administrators in social work, nursing, and education. Subjects responded to a 54 item, mailed questionnaire about their career experiences. The author explores career support from parents and persons within their work organizations. Barriers of sex discrimination and difficulties balancing career and family responsibilities are included. Finally, the extent to which the women administrators provided career assistance to other women is discussed. Comparisons between the three fields and between top and middle management levels are emphasized. Recommendations are made for increasing women's opportunities for career achievement within the fields studied.

Lower Columbia River Salmon Business Plan for Terminal Fisheries : Final Report.

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

Salmon For All

1996-07-01

Salmon fishing in the Northwest requires a public-private partnership. The public through its decision-makers, agencies, and laws states it will do all that is necessary to protect and preserve the valuable salmon resource. Yet, the public side of the partnership is broken. The Columbia River salmon fishing industry, with over 140 years of documented history, is at a crossroads. This report explores a variety of issues, concerns, and ideas related to terminal fishery development. In some cases recommendations are made. In addition, options are explored with an understanding that those designated as decision-makers must make decisions following considerable discussion andmore » reflection.« less

The other half of the story: effect size analysis in quantitative research.

PubMed

Maher, Jessica Middlemis; Markey, Jonathan C; Ebert-May, Diane

2013-01-01

Statistical significance testing is the cornerstone of quantitative research, but studies that fail to report measures of effect size are potentially missing a robust part of the analysis. We provide a rationale for why effect size measures should be included in quantitative discipline-based education research. Examples from both biological and educational research demonstrate the utility of effect size for evaluating practical significance. We also provide details about some effect size indices that are paired with common statistical significance tests used in educational research and offer general suggestions for interpreting effect size measures. Finally, we discuss some inherent limitations of effect size measures and provide further recommendations about reporting confidence intervals.

Application of geostatistics to coal-resource characterization and mine planning. Final report

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

Kauffman, P.W.; Walton, D.R.; Martuneac, L.

1981-12-01

Geostatistics is a proven method of ore reserve estimation in many non-coal mining areas but little has been published concerning its application to coal resources. This report presents the case for using geostatistics for coal mining applications and describes how a coal mining concern can best utilize geostatistical techniques for coal resource characterization and mine planning. An overview of the theory of geostatistics is also presented. Many of the applications discussed are documented in case studies that are a part of the report. The results of an exhaustive literature search are presented and recommendations are made for needed future researchmore » and demonstration projects.« less

The System Dynamics Research on the Private Cars' Amount in Beijing

NASA Astrophysics Data System (ADS)

Fan, Jie; Yan, Guang-Le

The thesis analyzes the development problem of private cars’ amount in Beijing from the perspective of system dynamics. With the flow chart illustrating the relationships of relevant elements, the SD model is established by VENSIM to simulate the growth trend of private autos’ amount in the future on the background of “Public Transportation First” policy based on the original data in Beijing. Then the article discusses the forecasting impacts of “Single-and-double license plate number limit” on the number of city vehicles and private cars under the assumption that this policy implemented for long after the 2008 Olympic Games. Finally, some recommendations are put forward for proper control over this problem.

Employer involvement in defined contribution investment education.

PubMed

Blau, G; VanDerhei, J L

2000-01-01

In this paper the authors consider the personnel problems that may arise for defined contribution plan sponsors if major market corrections cause older employees to delay retirement beyond previous expectations. We move from that basic premise to argue that, given the continued evolution from defined benefit (DB) to defined contribution (DC) retirement plans, employers need to be more "proactive" in educating their employees about their retirement planning. A human resources perspective is used to support this argument, apart from and in addition to legal considerations such as ERISA Section 404(c). Specifics of employer involvement and its place as a component of an organization's culture are discussed. Finally, recommendations are given for employers to consider.

F100 Multivariable Control Synthesis Program. Computer Implementation of the F100 Multivariable Control Algorithm

NASA Technical Reports Server (NTRS)

Soeder, J. F.

1983-01-01

As turbofan engines become more complex, the development of controls necessitate the use of multivariable control techniques. A control developed for the F100-PW-100(3) turbofan engine by using linear quadratic regulator theory and other modern multivariable control synthesis techniques is described. The assembly language implementation of this control on an SEL 810B minicomputer is described. This implementation was then evaluated by using a real-time hybrid simulation of the engine. The control software was modified to run with a real engine. These modifications, in the form of sensor and actuator failure checks and control executive sequencing, are discussed. Finally recommendations for control software implementations are presented.

Development and application of the maximum entropy method and other spectral estimation techniques

NASA Astrophysics Data System (ADS)

King, W. R.

1980-09-01

This summary report is a collection of four separate progress reports prepared under three contracts, which are all sponsored by the Office of Naval Research in Arlington, Virginia. This report contains the results of investigations into the application of the maximum entropy method (MEM), a high resolution, frequency and wavenumber estimation technique. The report also contains a description of two, new, stable, high resolution spectral estimation techniques that is provided in the final report section. Many examples of wavenumber spectral patterns for all investigated techniques are included throughout the report. The maximum entropy method is also known as the maximum entropy spectral analysis (MESA) technique, and both names are used in the report. Many MEM wavenumber spectral patterns are demonstrated using both simulated and measured radar signal and noise data. Methods for obtaining stable MEM wavenumber spectra are discussed, broadband signal detection using the MEM prediction error transform (PET) is discussed, and Doppler radar narrowband signal detection is demonstrated using the MEM technique. It is also shown that MEM cannot be applied to randomly sampled data. The two new, stable, high resolution, spectral estimation techniques discussed in the final report section, are named the Wiener-King and the Fourier spectral estimation techniques. The two new techniques have a similar derivation based upon the Wiener prediction filter, but the two techniques are otherwise quite different. Further development of the techniques and measurement of the technique spectral characteristics is recommended for subsequent investigation.

New criteria for measuring range management activities.

Treesearch

T.M. Quigley; D.S. Dillard; J.B. [and others] Reese

1989-01-01

The USDA Forest Service national range program is currently evaluating its information needs at the national level A Range Measurement Task Group of Agency personnel was assembled in January 1988 to evaluate the information needs and recommend appropriate measures and reports. This document is the final recommendation of the task group. The recommendation includes...

Total Coliform Rule Distribution System Advisory Committee (TCRDSAC) Document

EPA Pesticide Factsheets

This document provide information about the TCRDSAC, including its charter, processes and recommendations. The Agency used the Advisory Committee recommendations to develop proposed and final rules that revised the Total Coliform Rule.

Which Benefits and Harms of Using Fenugreek as a Galactogogue Need to Be Discussed during Clinical Consultations? A Delphi Study among Breastfeeding Women, Gynecologists, Pediatricians, Family Physicians, Lactation Consultants, and Pharmacists

PubMed Central

Qiblawi, Sara; Ghanayem, Haifa

2018-01-01

Background Breastfeeding women with hypogalactia are commonly recommended to use fenugreek as a galactogogue. This study aimed to achieve formal consensus among breastfeeding women and healthcare providers on which potential harms and benefits of using fenugreek need to be communicated and discussed during clinical consultations. Methods A two-iterative round Delphi technique was used in two separate panels of breastfeeding women (n = 65) and healthcare providers (n = 56) to achieve formal consensus on a list of 24 and 16 items related to potential harms and benefits of fenugreek. Results About 70% of the healthcare providers recommended quite often herbal remedies for breastfeeding women and about 68% of the women had been recommended to use herbal remedies many times by their healthcare providers. Consensus was achieved on 21 potential harms and 14 potential benefits of using fenugreek to enhance human milk supply that need to be discussed with breastfeeding women during consultations. Conclusion Probably, potential harms and benefits of recommending fenugreek as herbal galactogogue for breastfeeding women seeking recommendations to increase their human milk supply need to be discussed during clinical consultations. Further observational studies are needed to assess what is being discussed in daily consultations when herbal remedies are recommended. PMID:29849697

[Preventing dependency in the elderly].

PubMed

Gómez Pavón, J; Martín Lesende, I; Baztán Cortés, J J; Regato Pajares, P; Formiga Pérez, F; Segura Benedito, A; Abizanda Soler, P; de Pedro Cuesta, J

2008-01-01

Dependency, i.e. the need to depend on another person to perform activities of daily living, is the main concern and cause of suffering and poor quality of life in the elderly. The prevalence of dependency increases with age and is related to the presence of prior disease and fragility. Dependency is associated with increased morbidity, mortality and institutionalization, as well as with greater health and social resource utilization, all of which increases health costs. To create a consensus document on the main health recommendations for the prevention of dependency in the elderly, based on the scientific evidence available to date, with the collaboration of scientific societies and public health administrations (the Spanish Ministry of Health, Autonomous Communities and Cities). a) a preliminary consensus document was drafted by an expert group composed of representatives of various scientific societies and health administrations. This document was based on a review of the recommendations and guidelines published by the main organizations involved in health promotion and the prevention of disease, functional deterioration and dependency in the elderly; b) the consensus document was reviewed by the remaining experts assigned by the scientific societies and central and autonomous administrations; c) the final document was approved after a session in which the text was discussed and reviewed by all the experts participating in the working group (including the academic committee); d) the document was presented and discussed in the First National Conference on Prevention and Health Promotion in Clinical Practice in Spain. All participating experts signed a conflicts of interest statement. The document provides recommendations, with their grades of evidence, grouped in the following three categories: a) health promotion and disease prevention, with specific preventive activities for the elderly, including prevention of geriatric syndromes; b) prevention of functional deterioration, with clinical recommendations that can be applied in primary and specialized care; c) prevention of iatrogeny (drug prescription, inappropriate use of diagnostic and therapeutic modalities and healthcare). These recommendations were tailored to the characteristics of the older person (OP), categorized in five groups: healthy OP, OP with chronic disease, fragile or at risk OP, dependent OP, and OP at the end of life. These recommendations should be implemented by public health administrations to improve strategies for the prevention of dependency in the elderly in the xxi century.

Approaches for Establishing Clinically Relevant Dissolution Specifications for Immediate Release Solid Oral Dosage Forms.

PubMed

Hermans, Andre; Abend, Andreas M; Kesisoglou, Filippos; Flanagan, Talia; Cohen, Michael J; Diaz, Dorys A; Mao, Y; Zhang, Limin; Webster, Gregory K; Lin, Yiqing; Hahn, David A; Coutant, Carrie A; Grady, Haiyan

2017-11-01

This manuscript represents the perspective of the Dissolution Analytical Working Group of the IQ Consortium. The intent of this manuscript is to highlight the challenges of, and to provide a recommendation on, the development of clinically relevant dissolution specifications (CRS) for immediate release (IR) solid oral dosage forms. A roadmap toward the development of CRS for IR products containing active ingredients with a non-narrow therapeutic window is discussed, within the context of mechanistic dissolution understanding, supported by in-human pharmacokinetic (PK) data. Two case studies present potential outcomes of following the CRS roadmap and setting dissolution specifications. These cases reveal some benefits and challenges of pursuing CRS with additional PK data, in light of current regulatory positions, including that of the US Food and Drug Administration (FDA), who generally favor this approach, but with the understanding that both industry and regulatory agency perspectives are still evolving in this relatively new field. The CRS roadmap discussed in this manuscript also describes a way to develop clinically relevant dissolution specifications based primarily on dissolution data for batches used in pivotal clinical studies, acknowledging that not all IR product development efforts need to be supported by additional PK studies, albeit with the associated risk of potentially unnecessarily tight manufacturing controls. Recommendations are provided on what stages during the life cycle investment into in vivo studies may be valuable. Finally, the opportunities for CRS within the context of post-approval changes, Modeling and Simulation (M&S), and the application of biowaivers, are briefly discussed.

The Nature of Science and the Next Generation Science Standards: Analysis and Critique

NASA Astrophysics Data System (ADS)

McComas, William F.; Nouri, Noushin

2016-08-01

This paper provides a detailed analysis of the inclusion of aspects of nature of science (NOS) in the Next Generation Science Standards (NGSS). In this new standards document, NOS elements in eight categories are discussed in Appendix H along with illustrative statements (called exemplars). Many, but not all, of these exemplars are linked to the standards by their association with either the "practices of science" or "crosscutting concepts," but curiously not with the recommendations for science content. The study investigated all aspects of NOS in NGSS including the accuracy and inclusion of the supporting exemplar statements and the relationship of NOS in NGSS to other aspects of NOS to support teaching and learning science. We found that while 92 % of these exemplars are acceptable, only 78 % of those written actually appear with the standards. "Science as a way of knowing" is a recommended NOS category in NGSS but is not included with the standards. Also, several other NOS elements fail to be included at all grade levels thus limiting their impact. Finally, NGSS fails to include or insufficiently emphasize several frequently recommended NOS elements such as creativity and subjectivity. The paper concludes with a list of concerns and solutions to the challenges of NOS in NGSS.

Canadian Cardiovascular Society position statement on the management of thoracic aortic disease.

PubMed

Boodhwani, Munir; Andelfinger, Gregor; Leipsic, Jonathon; Lindsay, Thomas; McMurtry, M Sean; Therrien, Judith; Siu, Samuel C

2014-06-01

This Canadian Cardiovascular Society position statement aims to provide succinct perspectives on key issues in the management of thoracic aortic disease (TAD). This document is not a comprehensive overview of TAD and important elements of the epidemiology, presentation, diagnosis, and management of acute aortic syndromes are deliberately not discussed; readers are referred to the 2010 guidelines published by the American Heart Association, American College of Cardiology, American Association for Thoracic Surgery, and other stakeholders. Rather, this document is a practical guide for clinicians managing adult patients with TAD. Topics covered include size thresholds for surgical intervention, emerging therapies, imaging modalities, medical and lifestyle management, and genetics of TAD. The primary panel consisted of experts from a variety of disciplines that are essential for comprehensive management of TAD patients. The methodology involved a focused literature review with an emphasis on updates since 2010 and the use of Grading of Recommendations Assessment, Development, and Evaluation methodology to arrive at specific recommendations. The final document then underwent review by a secondary panel. This document aims to provide recommendations for most patients and situations. However, the ultimate judgement regarding the management of any individual patients should be made by their health care team. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

7 CFR 1940.321 - Use of completed EIS.

Code of Federal Regulations, 2010 CFR

2010-01-01

... final EIS will be a major factor in the Agency's final decision. Agency staff making recommendations on...-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED... subpart and provide them to the approving official prior to a final decision. ...

Recovery in Psychosis: A Delphi Study With Experts by Experience

PubMed Central

Law, Heather; Morrison, Anthony P.

2014-01-01

This study aimed to establish consensus about the meaning of recovery among individuals with experience of psychosis. A Delphi approach was utilized to allow a large sample of service users to be anonymously consulted about their views on recovery. Service users were invited to take part in a 3-stage consultation process. A total of 381 participants gave their views on recovery in the main stage of this study, with 100 of these taking part in the final review stage. The final list of statements about recovery included 94 items, which were rated as essential or important by >80% of respondents. These statements covered items which define recovery, factors which help recovery, factors which hinder recovery, and factors which show that someone is recovering. As far as we are aware, it is the first study to identify areas of consensus in relation to definitions of recovery from a service user perspective, which are typically reported to be an idiosyncratic process. Implications and recommendations for clinical practice and future research are discussed. PMID:24727194

Development of code evaluation criteria for assessing predictive capability and performance

NASA Technical Reports Server (NTRS)

Lin, Shyi-Jang; Barson, S. L.; Sindir, M. M.; Prueger, G. H.

1993-01-01

Computational Fluid Dynamics (CFD), because of its unique ability to predict complex three-dimensional flows, is being applied with increasing frequency in the aerospace industry. Currently, no consistent code validation procedure is applied within the industry. Such a procedure is needed to increase confidence in CFD and reduce risk in the use of these codes as a design and analysis tool. This final contract report defines classifications for three levels of code validation, directly relating the use of CFD codes to the engineering design cycle. Evaluation criteria by which codes are measured and classified are recommended and discussed. Criteria for selecting experimental data against which CFD results can be compared are outlined. A four phase CFD code validation procedure is described in detail. Finally, the code validation procedure is demonstrated through application of the REACT CFD code to a series of cases culminating in a code to data comparison on the Space Shuttle Main Engine High Pressure Fuel Turbopump Impeller.

Student nurses' experiences of using a learning contract as a method of assessment.

PubMed

Bailey, Maria E; Tuohy, Dympna

2009-10-01

The purpose of this study was to describe final year undergraduate nurses' experiences of assessment through the use of a learning contract. Using a qualitative descriptive design, data was collected from a purposive sample of final (fourth) year undergraduate student nurses. Two approaches were taken for data collection, anonymous evaluative questionnaires and interviews. The study was approved by the local university research and ethics committee. Data was thematically analysed. This article presents and discusses the findings from the interviews. Findings suggest that students' approach to the assessment strategy influenced engagement with the learning contract. Three themes were identified: skills, perceptions, and actions. Within these themes three types of learner were identified: happy, pragmatic and fearful. Factors found to influence successful completion of the learning contract were: support, relevant skills, prior experiential learning and required theoretical knowledge. Recommendations include the need for educators to consider module assessments that recognise the learning needs and preferences of the student within a supportive environment.

A Standardized Education Checklist for Parents of Children Newly Diagnosed With Cancer: A Report From the Children's Oncology Group.

PubMed

Rodgers, Cheryl; Bertini, Vanessa; Conway, Mary Ashe; Crosty, Ashley; Filice, Angela; Herring, Ruth Anne; Isbell, Julie; Lown DrPH, E Anne; Miller, Kristina; Perry, Margaret; Sanborn, Paula; Spreen, Nicole; Tena, Nancy; Winkle, Cindi; Darling, Joan; Slaven, Abigail; Sullivan, Jeneane; Tomlinson, Kathryn M; Windt, Kate; Hockenberry, Marilyn; Landier, Wendy

2018-03-01

Parents of children newly diagnosed with cancer must acquire new knowledge and skills in order to safely care for their child at home. Institutional variation exists in the methods and content used by nurses in providing the initial education. The goal of this project was to develop a checklist, standardized across institutions, to guide nursing education provided to parents of children newly diagnosed with cancer. A team of 21 members (19 nurses and 2 parent advocates) used current hospital educational checklists, expert consensus recommendations, and a series of iterative activities and discussions to develop one standardized checklist. The final checklist specifies primary topics that are essential to teach prior to the initial hospital discharge, secondary topics that should be discussed within the first month after the cancer diagnosis, and tertiary topics that should be discussed prior to completion of therapy. This checklist is designed to guide education and will set the stage for future studies to identify effective teaching strategies that optimize the educational process for parents of children newly diagnosed with cancer.

STS pilot user development program

NASA Technical Reports Server (NTRS)

Mcdowell, J. R.

1977-01-01

Full exploitation of the STS capabilities will be not only dependent on the extensive use of the STS for known space applications and research, but also on new, innovative ideas of use originating with both current and new users. In recognition of this, NASA has been engaged in a User Development Program for the STS. The program began with four small studies. Each study addressed a separate sector of potential new users to identify techniques and methodologies for user development. The collective results established that a user development function was not only feasible, but necessary for NASA to realize the full potential of the STS. This final report begins with a description of the overall pilot program plan, which involved five specific tasks defined in the contract Statement of Work. Each task is then discussed separately; but two subjects, the development of principal investigators and space processing users, are discussed separately for improved continuity of thought. These discussions are followed by a summary of the primary results and conclusions of the Pilot User Development Program. Specific recommendations of the study are given.

Office of Exploration: Exploration studies technical report. Volume 2: Studies approach and results

NASA Technical Reports Server (NTRS)

Roberts, Barney B.; Bland, Dan

1988-01-01

The NASA Office of Exploration has been tasked with defining and recommending alternatives for an early 1990's national decision on a focused program of human exploration of the solar system. The Mission Analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report describes the process that has been developed in a case study approach. The four case studies that were developed in FY88 include: (1) human expedition to Phobos; (2) human expeditions to Mars; (3) lunar observatory; and (4) lunar outpost to early Mars evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work. Volume 2 describes the case study process, the technical results of each of the case studies, and opportunities for additional study. Included in the discussion of each case study is a description of the mission key features and profile. Mission definition and manifesting are detailed, followed by a description of the mission architecture and infrastructure. Systems concepts for the required orbital nodes, transportation systems, and planetary surface systems are discussed. Prerequisite implementation plans resulting from the synthesized case studies are described and in-depth assessments are presented.

Documenting legal status: a systematic review of measurement of undocumented status in health research.

PubMed

Young, Maria-Elena De Trinidad; Madrigal, Daniel S

2017-01-01

Undocumented status is rarely measured in health research, yet it influences the lives and well-being of immigrants. The growing body of research on undocumented status and health shows the need to assess the measurement of this legal status. We discuss the definition of undocumented status, conduct a systematic review of the methodological approaches currently taken to measure undocumented status of immigrants in the USA, and discuss recommendations for advancement of measurement methods. We conducted a systematic review of 61 studies indexed in PubMed, conducted in the USA, and published from 2004 to 2014. We categorized each of the studies' data source and type, measurement type, and information for classifying undocumented participants. Studies used self-reported or proxy measures of legal status. Information to classify undocumented participants included self-reported status, possession of a Social Security number, possession of health insurance or institutional resources, concern about deportation, and participant characteristics. Findings show it is feasible to collect self-reported measures of undocumented status. We recommend that researchers collect self-reported measures of undocumented status whenever possible and limit the use of proxy measures. Validated and standardized measures are needed for within and across country measurement. Authors should provide methodological information about measurement in publications. Finally, individuals who are undocumented should be included in the development of these methodologies. This systematic review is not registered.

Blade system design studies volume II : preliminary blade designs and recommended test matrix.

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

Griffin, Dayton A.

2004-06-01

As part of the U.S. Department of Energy's Wind Partnerships for Advanced Component Technologies (WindPACT) program, Global Energy Concepts, LLC is performing a Blade System Design Study (BSDS) concerning innovations in materials, processes and structural configurations for application to wind turbine blades in the multi-megawatt range. The BSDS Volume I project report addresses issues and constraints identified to scaling conventional blade designs to the megawatt size range, and evaluated candidate materials, manufacturing and design innovations for overcoming and improving large blade economics. The current report (Volume II), presents additional discussion of materials and manufacturing issues for large blades, including amore » summary of current trends in commercial blade manufacturing. Specifications are then developed to guide the preliminary design of MW-scale blades. Using preliminary design calculations for a 3.0 MW blade, parametric analyses are performed to quantify the potential benefits in stiffness and decreased gravity loading by replacement of a baseline fiberglass spar with carbon-fiberglass hybrid material. Complete preliminary designs are then presented for 3.0 MW and 5.0 MW blades that incorporate fiberglass-to-carbon transitions at mid-span. Based on analysis of these designs, technical issues are identified and discussed. Finally, recommendations are made for composites testing under Part I1 of the BSDS, and the initial planned test matrix for that program is presented.« less

Evaluation of the Inhalation Carcinogenicity of Ethylene Oxide ...

EPA Pesticide Factsheets

On September 22, 2006, the draft Evaluation of the Carinogenicity of Ethylene Oxide (EPA/635/R-06/003) and the draft charge to external peer reviewers were released for external peer review and public comment. This draft was reviewed by EPA’s Science Advisory Board (SAB) and the expert panel’s final report was made available December 21, 2007. Since that time the Agency implemented the May 2009 IRIS assessment development process in which other federal agencies and the Executive Offices of the President are provided two opportunities to comment on IRIS human health assessments; Interagency Science Consultation (Step 3) prior to public comment/peer review and Interagency Science Discussion (Step 6b) following peer review. In July, 2011, the draft assessment incorporating the SAB recommendations (December 2007) was sent to other federal agencies and Executive Offices of the President as part of Step 6 of the IRIS process. Following the May 2009 process, all written comments submitted by other agencies will be made publicly available. Accordingly, the interagency comments for ethylene oxide and the interagency science discussion materials provided to the other agencies are posted on this site. Note: After further consideration EPA has decided to undertake an additional peer review of the revised draft assessment on how the Agency responded to the SAB panel recommendations (December 2007), the exposure-response modeling of epidemiologic data, including n

Physician communication about adolescent vaccination: How is human papillomavirus vaccine different?

PubMed

Gilkey, Melissa B; Moss, Jennifer L; Coyne-Beasley, Tamera; Hall, Megan E; Shah, Parth D; Brewer, Noel T

2015-08-01

Low human papillomavirus (HPV) vaccination coverage stands in stark contrast to our success in delivering other adolescent vaccines. To identify opportunities for improving physicians' recommendations for HPV vaccination, we sought to understand how the communication context surrounding adolescent vaccination varies by vaccine type. A national sample of 776 U.S. physicians (53% pediatricians, 47% family medicine physicians) completed our online survey in 2014. We assessed physicians' perceptions and communication practices related to recommending adolescent vaccines for 11- and 12-year-old patients. About three-quarters of physicians (73%) reported recommending HPV vaccine as highly important for patients, ages 11-12. More physicians recommended tetanus, diphtheria, and acellular pertussis (Tdap) (95%) and meningococcal vaccines (87%, both p<0.001) as highly important for this age group. Only 13% of physicians perceived HPV vaccine as being highly important to parents, which was far fewer than perceived parental support for Tdap (74%) and meningococcal vaccines (62%, both p<0.001). Physicians reported that discussing HPV vaccine took almost twice as long as discussing Tdap. Among physicians with a preferred order for discussing adolescent vaccines, most (70%) discussed HPV vaccine last. Our findings suggest that primary care physicians perceived HPV vaccine discussions to be burdensome, requiring more time and engendering less parental support than other adolescent vaccines. Perhaps for this reason, physicians in our national study recommended HPV vaccine less strongly than other adolescent vaccines, and often chose to discuss it last. Communication strategies are needed to support physicians in recommending HPV vaccine with greater confidence and efficiency. Copyright © 2015 Elsevier Inc. All rights reserved.

Do physicians’ recommendations pull patients away from their preferred treatment options?

PubMed Central

Mendel, Rosmarie; Traut‐Mattausch, Eva; Frey, Dieter; Bühner, Markus; Berthele, Achim; Kissling, Werner; Hamann, Johannes

2011-01-01

Abstract Context and objective  Shared decision making is especially advocated for preference‐sensitive decisions. We investigated whether physicians’ recommendations pull patients away from their preferred treatment option when making a preference‐sensitive decision. Design, participants and methods  Inpatients (N = 102 with schizophrenia, N = 101 with multiple sclerosis) were presented with a hypothetical scenario (the choice between two drugs). They were first asked about their preferences concerning the two drugs and then they received a (fictitious) clinician’s recommendation that was contrary to their preferences. Subsequently they made a final choice between the two drugs. Main outcome measures  The main outcome measure was whether the patient followed the physician’s advice in the hypothetical scenario. Thereby patient’s (pre‐recommendation) preferences served as a baseline. Results  In the decision scenario, about 48% of the patients with schizophrenia and 26% of the patients with multiple sclerosis followed the advice of their physician and thus chose the treatment option that went against their initial preferences. Patients who followed their physician’s advice were less satisfied with their decision than patients not following their physician’s advice (schizophrenia: t = 2.61, P = 0.01; multiple sclerosis: t = 2.67, P = 0.009). Discussion and conclusions  When sharing decisions with patients, physicians should be aware that their advice might influence patients’ decisions away from their preferred treatment option. They should encourage their patients to identify their own preferences and help to find the treatment option most consistent with them. PMID:21323824

[Preoperative evaluation of adult patients before elective, noncardiothoracic surgery : Joint recommendation of the German Society of Anesthesiology and Intensive Care Medicine, the German Society of Surgery, and the German Society of Internal Medicine].

PubMed

Zwissler, B

2017-06-01

Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e. g. blood chemistry, ECG, spirometry, chest x‑ray) can contribute to a reduction of perioperative risk is often not very well known or is controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication. Therefore, the German Scientific Societies of Anesthesiology and Intensive Care Medicine (DGAI), Internal Medicine (DGIM) and Surgery (DGCH) have joined to elaborate recommendations on the preoperative evaluation of adult patients prior to elective, noncardiothoracic surgery, which were initially published in 2010. These recommendations have now been updated based on the current literature and existing international guidelines. In the first part the general principles of preoperative evaluation are described (part A). The current concepts for extended evaluation of patients with known or suspected major cardiovascular disease are presented in part B. Finally, the perioperative management of patients' long-term medication is discussed (part C). The concepts proposed in these interdisciplinary recommendations endorsed by the DGAI, DGIM and DGCH provide a common basis for a structured preoperative risk assessment and management. These recommendations aim to ensure that surgical patients undergo a rational preoperative assessment and at the same time to avoid unnecessary, costly and potentially dangerous testing. The joint recommendations reflect the current state-of-the-art knowledge as well as expert opinions because scientific-based evidence is not always available. These recommendations will be subject to regular re-evaluation and updating when new validated evidence becomes available.

Surrogate outcomes: experiences at the Common Drug Review

PubMed Central

2013-01-01

Background Surrogate outcomes are a significant challenge in drug evaluation for health technology assessment (HTA) agencies. The research objectives were to: identify factors associated with surrogate use and acceptability in Canada’s Common Drug Review (CDR) recommendations, and compare the CDR with other HTA or regulatory agencies regarding surrogate concerns. Methods Final recommendations were identified from CDR inception (September 2003) to December 31, 2010. Recommendations were classified by type of outcome (surrogate, final, other) and acceptability of surrogates (determined by the presence/absence of statements of concern regarding surrogates). Descriptive and statistical analyses examined factors related to surrogate use and acceptability. For thirteen surrogate-based submissions, recommendations from international HTA and regulatory agencies were reviewed for statements about surrogate acceptability. Results Of 156 final recommendations, 68 (44%) involved surrogates. The overall ‘do not list’ (DNL) rate was 48%; the DNL rate for surrogates was 41% (p = 0.175). The DNL rate was 64% for non-accepted surrogates (n = 28) versus 25% for accepted surrogates (odds ratio 5.4, p = 0.002). Clinical uncertainty, use of economic evidence over price alone, and a premium price were significantly associated with non-accepted surrogates. Surrogates were used most commonly for HIV, diabetes, rare diseases, cardiovascular disease and cancer. For the subset of drugs studied, other HTA agencies did not express concerns for most recommendations, while regulatory agencies frequently stated surrogate acceptance. Conclusions The majority of surrogates were accepted at the CDR. Non-accepted surrogates were significantly associated with clinical uncertainty and a DNL recommendation. There was inconsistency of surrogate acceptability across several international agencies. Stakeholders should consider collaboratively establishing guidelines on the use, validation, and acceptability of surrogates. PMID:24341379

75 FR 66184 - The Future of Aviation Advisory Committee (FAAC) Subcommittee on Financing; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

..., and sufficient level of funding for our aviation system and make recommendations to the Secretary for... recommendations to the Secretary of Transportation to ensure the competitiveness of the U.S. aviation industry and... recommendations for presentation at the final meeting of the FAAC on December 15, 2010. Registration The meeting...

20 CFR 30.316 - How does the FAB issue a final decision on a claim?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How does the FAB issue a final decision on a... Adjudicatory Process Hearings and Final Decisions on Claims § 30.316 How does the FAB issue a final decision on... waives any objections to all or part of the recommended decision, the FAB may issue a final decision...

78 FR 69440 - Certain Electronic Imaging Devices; Notice of Request for Statements on the Public Interest

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

... Final Initial Determination and Recommended Determination on Remedy and Bonding in the above-captioned... Recommended Determination on Remedy and Bonding issued in this investigation on September 30, 2013. Comments...

Recycled plastics in highway construction and maintenance : final report.

DOT National Transportation Integrated Search

1997-07-01

Installation and serviceability were examined for several products manufactured, in part, from recycled products. The following recommendations were reached: : The type of recycled plastic snow pole employed in this study is not recommended for gener...

Patterns of Care Among Patients Receiving Radiation Therapy for Bone Metastases at a Large Academic Institution

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

Ellsworth, Susannah G.; Alcorn, Sara R., E-mail: salcorn2@jhmi.edu; Hales, Russell K.

Purpose: This study evaluates outcomes and patterns of care among patients receiving radiation therapy (RT) for bone metastases at a high-volume academic institution. Methods and Materials: Records of all patients whose final RT course was for bone metastases from April 2007 to July 2012 were identified from electronic medical records. Chart review yielded demographic and clinical data. Rates of complicated versus uncomplicated bone metastases were not analyzed. Results: We identified 339 patients whose final RT course was for bone metastases. Of these, 52.2% were male; median age was 65 years old. The most common primary was non-small-cell lung cancer (29%). Most patientsmore » (83%) were prescribed ≤10 fractions; 8% received single-fraction RT. Most patients (52%) had a documented goals of care (GOC) discussion with their radiation oncologist; hospice referral rates were higher when patients had such discussions (66% with vs 50% without GOC discussion, P=.004). Median life expectancy after RT was 96 days. Median survival after RT was shorter based on inpatient as opposed to outpatient status at the time of consultation (35 vs 136 days, respectively, P<.001). Hospice referrals occurred for 56% of patients, with a median interval between completion of RT and hospice referral of 29 days and a median hospice stay of 22 days. Conclusions: These data document excellent adherence to American Society for Radiation Oncolology Choosing Wisely recommendation to avoid routinely using >10 fractions of palliative RT for bone metastasis. Nonetheless, single-fraction RT remains relatively uncommon. Participating in GOC discussions with a radiation oncologist is associated with higher rates of hospice referral. Inpatient status at consultation is associated with short survival.« less

[Implementation of a Clinical Practice Guidelines for the Management of Adults With Schizophrenia in Colombia].

PubMed

Sánchez Díaz, Natalia; Duarte Osorio, Andrés; Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia

2016-01-01

To present overall strategies and activities for the implementation process of the recommendations contained in the clinical practice guideline for the management of adults with schizophrenia (GPC_E) published by the Colombian Ministry of Health and Welfare (MSPS). Prioritize the proposed recommendations, identify barriers and solving strategies to implement the GPC_E, and develop a monitoring and evaluation system for the key recommendations. The Guideline Developer Group (GDG) included professionals with primary dedication to implementation issues that accompanied the entire process. During the GDG meetings implementation topics were identified and discussed, and later complemented by literature reviews concerning the experience of mental health guidelines implementation at national and international level. Additionally, feedback from the discussions raised during the socialization meetings, and joint meetings with the MSPS and the Institute of Technology Assessment in Health (IETS) were included. The prioritization of recommendations was made in conjunction with the GDG, following the proposed steps in the methodological guide for the development of Clinical Practice Guidelines with Economic Evaluation in the General System of Social Security in Colombian Health (GMEGPC) using the tools 13 and 14. the conclusions and final adjustments were discussed with the GPC_E leaders. The implementation chapter includes a description of the potential barriers, solution strategies, facilitators and monitoring indicators. The identified barriers were categorized in the following 3 groups: Cultural context, health system and proposed interventions. The issues related to solving strategies and facilitating education programs include community mental health, mental health training for health workers in primary care, decentralization and integration of mental health services at the primary care level, use of technologies information and communication and telemedicine. To monitor and evaluate o the implementation process, five (5) indicators were designed one (1) structure, two (2) process and two (2)outcome indicators. The GPC_E implementation within the Colombian General health System of Social Security (SGSSSC) poses multiple challenges. Potential barriers, enabling strategies and indicators for monitoring and evaluation described in this article, can provide efficient support to ensure the success of this process in the institutions that will adopt the guideline. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

The application of mixed recommendation algorithm with user clustering in the microblog advertisements promotion

NASA Astrophysics Data System (ADS)

Gong, Lina; Xu, Tao; Zhang, Wei; Li, Xuhong; Wang, Xia; Pan, Wenwen

2017-03-01

The traditional microblog recommendation algorithm has the problems of low efficiency and modest effect in the era of big data. In the aim of solving these issues, this paper proposed a mixed recommendation algorithm with user clustering. This paper first introduced the situation of microblog marketing industry. Then, this paper elaborates the user interest modeling process and detailed advertisement recommendation methods. Finally, this paper compared the mixed recommendation algorithm with the traditional classification algorithm and mixed recommendation algorithm without user clustering. The results show that the mixed recommendation algorithm with user clustering has good accuracy and recall rate in the microblog advertisements promotion.

48 CFR 1852.235-73 - Final Scientific and Technical Reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Final Scientific and Technical Reports. 1852.235-73 Section 1852.235-73 Federal Acquisition Regulations System NATIONAL..., including recommendations and conclusions based on the experience and results obtained. The final report...

Frailty Markers and Treatment Decisions in Patients Seen in Oncogeriatric Clinics: Results from the ASRO Pilot Study.

PubMed

Farcet, Anaïs; de Decker, Laure; Pauly, Vanessa; Rousseau, Frédérique; Bergman, Howard; Molines, Catherine; Retornaz, Frédérique

2016-01-01

Comprehensive Geriatric Assessment (CGA) is the gold standard to help oncologists select the best cancer treatment for their older patients. Some authors have suggested that the concept of frailty could be a more useful approach in this population. We investigated whether frailty markers are associated with treatment recommendations in an oncogeriatric clinic. This prospective study included 70 years and older patients with solid tumors and referred for an oncogeriatric assessment. The CGA included nine domains: autonomy, comorbidities, medication, cognition, nutrition, mood, neurosensory deficits, falls, and social status. Five frailty markers were assessed (nutrition, physical activity, energy, mobility, and strength). Patients were categorized as Frail (three or more frailty markers), pre-frail (one or two frailty markers), or not-frail (no frailty marker). Treatment recommendations were classified into two categories: standard treatment with and without any changes and supportive/palliative care. Multiple logistic regression models were used to analyze factors associated with treatment recommendations. 217 patients, mean age 83 years (± Standard deviation (SD) 5.3), were included. In the univariate analysis, number of frailty markers, grip strength, physical activity, mobility, nutrition, energy, autonomy, depression, Eastern Cooperative Oncology Group Scale of Performance Status (ECOG-PS), and falls were significantly associated with final treatment recommendations. In the multivariate analysis, the number of frailty markers and basic Activities of Daily Living (ADL) were significantly associated with final treatment recommendations (p<0.001 and p = 0.010, respectively). Frailty markers are associated with final treatment recommendations in older cancer patients. Longitudinal studies are warranted to better determine their use in a geriatric oncology setting.

Feminist self-defense and resistance training for college students: a critical review and recommendations for the future.

PubMed

Gidycz, Christine A; Dardis, Christina M

2014-10-01

There remains resistance to feminist self-defense and resistance training programming for women, despite (a) documented effectiveness of rape resistance strategies in avoiding rape, (b) consistently high rates of sexual victimization on college campuses, and (c) limited evidence of lasting change in sexual assault perpetration reduction within existing men's prevention programs. The current article seeks to discuss (1) the rationale for feminist self-defense and resistance training for women, (2) key components of feminist self-defense and resistance training, (3) barriers to its implementation, (4) outcomes of self-defense and resistance training programming, and (5) recommendations for future work. Such suggestions include increasing funding for large-scale self-defense and rape resistance outcome research to examine program effectiveness. Specifically, outcome research that examines the role of contextual factors (e.g., alcohol use) and women's victimization histories is needed. Finally, self-defense training and resistance training should be combined with bystander intervention and men's programs with the goal of providing synergistic effects on rape reduction. © The Author(s) 2014.

The physical environment and child development: An international review

PubMed Central

Ferguson, Kim T.; Cassells, Rochelle C.; MacAllister, Jack W.; Evans, Gary W.

2014-01-01

A growing body of research in the United States and Western Europe documents significant effects of the physical environment (toxins, pollutants, noise, crowding, chaos, housing, school and neighborhood quality) on children and adolescents’ cognitive and socioemotional development. Much less is known about these relations in other contexts, particularly the global South. We thus briefly review the evidence for relations between child development and the physical environment in Western contexts, and discuss some of the known mechanisms behind these relations. We then provide a more extensive review of the research to date outside of Western contexts, with a specific emphasis on research in the global South. Where the research is limited, we highlight relevant data documenting the physical environment conditions experienced by children, and make recommendations for future work. In these recommendations, we highlight the limitations of employing research methodologies developed in Western contexts (Ferguson & Lee, 2013). Finally, we propose a holistic, multidisciplinary and multilevel approach based on Bronfenbrenner’s (1979) bioecological model to better understand and reduce the aversive effects of multiple environmental risk factors on the cognitive and socioemotional development of children across the globe. PMID:23808797

Fear appeals and attitude change: effects of a threat's noxiousness, probability of occurrence, and the efficacy of coping responses.

PubMed

Rogers, R W; Mewborn, C R

1976-07-01

Three factorial experiments examined the persuasive effects of the noxiousness of threatened event, its probability of occurrence, and the efficacy of recommended protective measures. A total of 176 students participated in separate studies on the topics of cigarette smoking, driving safety, and venereal disease. The results disclosed that increments in the efficacy variable increased intentions to adopt the efficacy variable increased intentions to adopt the recommended practices. Interaction effects revealed that when the preventive practices were effective, increments in the noxiousness and probability variables facilitated attitude change; however, when the coping responses were the preventive practices were effective, increments in the noxiousness and probability either had no effect or a deleterious effect, respectively. These interaction effects were discussed in terms of a defensive avoidance hypothesis, the crucial component of which was an inability to ward off the danger. Furthermore, the effect of the emotion of fear upon intentions was found to be mediated by the cognitive appraisal of severity of the threat. Finally, similarities with and extensions of previous studies were reviewed.

Curriculum Alignment with Vision and Change Improves Student Scientific Literacy

PubMed Central

Auerbach, Anna Jo; Schussler, Elisabeth E.

2017-01-01

The Vision and Change in Undergraduate Biology Education final report challenged institutions to reform their biology courses to focus on process skills and student active learning, among other recommendations. A large southeastern university implemented curricular changes to its majors’ introductory biology sequence in alignment with these recommendations. Discussion sections focused on developing student process skills were added to both lectures and a lab, and one semester of lab was removed. This curriculum was implemented using active-learning techniques paired with student collaboration. This study determined whether these changes resulted in a higher gain of student scientific literacy by conducting pre/posttesting of scientific literacy for two cohorts: students experiencing the unreformed curriculum and students experiencing the reformed curriculum. Retention of student scientific literacy for each cohort was also assessed 4 months later. At the end of the academic year, scientific literacy gains were significantly higher for students in the reformed curriculum (p = 0.005), with those students having double the scientific literacy gains of the cohort in the unreformed curriculum. Retention of scientific literacy did not differ between the cohorts. PMID:28495933

The imperative for new approaches for managing and leading in healthcare for the 21st century--observations from the Canadian Nurses Association's National Expert Commission Experience and Report.

PubMed

McTeer, Maureen

2014-12-01

The Canadian healthcare system must change to meet current and future realities, particularly to respond effectively to changing age and cultural demographics and new medical/scientific technologies. To meet its ongoing policy role, the Canadian Nurses Association established a National Expert Commission in 2011, mandated to prepare a report on healthcare reform and transformation, with a clear focus on the role individual nurses and the nursing profession generally could play in ensuring better health, better care and better value for Canadians. In this paper, Commission co-chair, health law specialist Maureen McTeer, outlines the key findings and recommendations of their final report, titled A Nursing Call to Action: The Health of our Nation, the Future of our Health System which she and co-chair Dr. Marlene Smadu presented originally at the CNA's biennial meeting in Vancouver, in June, 2012. The discussion focuses on the rationale behind the commission's recommendation for a new registered nursing education curriculum and approach to training.

Durability of polymer matrix composites for automotive structural applications: A state-of-the-art review

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

Corum, J.M.; Simpson, W.A. Jr.; Sun, C.T.

1995-07-01

A key unanswered question that must be addressed before polymeric composites will be widely used in automotive structural components is their known durability. Major durability issues are the effects that cyclic loadings, creep, automotive fluid environments, and low-energy impacts have on dimensional stability, strength, and stiffness throughout the required life of a composite component. This report reviews the current state of understanding in each of these areas. It also discusses the limited information that exists on one of the prime candidate materials for automotive structural applications--an isocyanurate reinforced with a continuous strand, swirl mat. Because of the key role thatmore » nondestructive evaluations must play in understanding damage development and progression, a chapter is included on ultrasonic techniques. A final chapter then gives conclusions and recommendations for research needed to resolve the various durability issues. These recommendations will help provide a sound basis for program planning for the Durability of Lightweight Composite Structures Project sponsored by the US Department of Energy in cooperation with the Automotive Composites Consortium of Chrysler, Ford, and General Motors.« less

The report of my death was an exaggeration: A review for researchers using microsatellites in the 21st century1

PubMed Central

Hodel, Richard G. J.; Segovia-Salcedo, M. Claudia; Landis, Jacob B.; Crowl, Andrew A.; Sun, Miao; Liu, Xiaoxian; Gitzendanner, Matthew A.; Douglas, Norman A.; Germain-Aubrey, Charlotte C.; Chen, Shichao; Soltis, Douglas E.; Soltis, Pamela S.

2016-01-01

Microsatellites, or simple sequence repeats (SSRs), have long played a major role in genetic studies due to their typically high polymorphism. They have diverse applications, including genome mapping, forensics, ascertaining parentage, population and conservation genetics, identification of the parentage of polyploids, and phylogeography. We compare SSRs and newer methods, such as genotyping by sequencing (GBS) and restriction site associated DNA sequencing (RAD-Seq), and offer recommendations for researchers considering which genetic markers to use. We also review the variety of techniques currently used for identifying microsatellite loci and developing primers, with a particular focus on those that make use of next-generation sequencing (NGS). Additionally, we review software for microsatellite development and report on an experiment to assess the utility of currently available software for SSR development. Finally, we discuss the future of microsatellites and make recommendations for researchers preparing to use microsatellites. We argue that microsatellites still have an important place in the genomic age as they remain effective and cost-efficient markers. PMID:27347456

Current nutritional recommendations and novel dietary strategies to manage sarcopenia

PubMed Central

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

2015-01-01

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

Probiotic products in Canada with clinical evidence: What can gastroenterologists recommend?

PubMed Central

Reid, Gregor; Anukam, Kingsley; Koyama, Tara

2008-01-01

Probiotics, defined as ‘live microorganisms, which when administered in adequate amounts, confer a health benefit on the host’, are finally becoming an option for gastroenterologists in Canada, after being available for many years in Japan, Europe and the United States of America. Unfortunately, Health Canada and the US Food and Drug Administration have not controlled the use of the term ‘probiotic’ or put into place United Nations and World Health Organization guidelines. The net result is that a host of products called ‘probiotics’ are available but are not truly probiotic. The aim of the present review was to discuss the rationale for probiotics in gastroenterology, and specifically examine which products are options for physicians in Canada, and which ones patients might be using. It is hoped that by clarifying what probiotics are, and the strengths and limitations of their use, specialists will be better placed to make recommendations on the role of these products in patient care. In due course, more clinically documented probiotics will emerge, some with therapeutic effects based on a better understanding of disease processes. PMID:18299736

Depression and Cardiac Disease: Epidemiology, Mechanisms, and Diagnosis

PubMed Central

Huffman, Jeff C.; Celano, Christopher M.; Beach, Scott R.; Motiwala, Shweta R.; Januzzi, James L.

2013-01-01

In patients with cardiovascular disease (CVD), depression is common, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. Both physiological and behavioral factors—including endothelial dysfunction, platelet abnormalities, inflammation, autonomic nervous system dysfunction, and reduced engagement in health-promoting activities—may link depression with adverse cardiac outcomes. Because of the potential impact of depression on quality of life and cardiac outcomes, the American Heart Association has recommended routine depression screening of all cardiac patients with the 2- and 9-item Patient Health Questionnaires. However, despite the availability of these easy-to-use screening tools and effective treatments, depression is underrecognized and undertreated in patients with CVD. In this paper, we review the literature on epidemiology, phenomenology, comorbid conditions, and risk factors for depression in cardiac disease. We outline the associations between depression and cardiac outcomes, as well as the mechanisms that may mediate these links. Finally, we discuss the evidence for and against routine depression screening in patients with CVD and make specific recommendations for when and how to assess for depression in this high-risk population. PMID:23653854

The DECIDE evidence to recommendation framework adapted to the public health field in Sweden.

PubMed

Guldbrandsson, Karin; Stenström, Nils; Winzer, Regina

2016-12-01

Organizations worldwide compile results from scientific studies, and grade the evidence of interventions, in order to assist policy makers. However, quality of evidence alone is seldom sufficient to make a recommendation. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) framework aims to facilitate decision making and to improve dissemination and implementation of recommendations in the healthcare and public health sector. The aim of this study was to investigate whether the DECIDE framework is applicable in the public health field in Sweden. The DECIDE framework was presented and discussed in interviews with stakeholders and governmental organizations and tested in panels. Content analyses were performed. In general, the informants were positive to the DECIDE framework. However, two questions, the first regarding individual autonomy and the second regarding method sustainability, were by the stakeholders felt to be missing in the framework. The importance of the composition of the DECIDE stakeholder panel was lifted by the informants, as was the significant role of the chair. Further, the informants raised concerns about the general lack of research evidence based on RCT design regarding universal methods in the public health sector. Finally, the local, regional and national levels' responsibility for dissemination and implementation of recommendations were lifted by the informants. The DECIDE framework might be useful as a tool for dissemination and implementation of recommendations in the public health field in Sweden. Important questions for further research are whether these findings are suitable for other public health topics and in other public health settings. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Recommender systems

NASA Astrophysics Data System (ADS)

Lü, Linyuan; Medo, Matúš; Yeung, Chi Ho; Zhang, Yi-Cheng; Zhang, Zi-Ke; Zhou, Tao

2012-10-01

The ongoing rapid expansion of the Internet greatly increases the necessity of effective recommender systems for filtering the abundant information. Extensive research for recommender systems is conducted by a broad range of communities including social and computer scientists, physicists, and interdisciplinary researchers. Despite substantial theoretical and practical achievements, unification and comparison of different approaches are lacking, which impedes further advances. In this article, we review recent developments in recommender systems and discuss the major challenges. We compare and evaluate available algorithms and examine their roles in the future developments. In addition to algorithms, physical aspects are described to illustrate macroscopic behavior of recommender systems. Potential impacts and future directions are discussed. We emphasize that recommendation has great scientific depth and combines diverse research fields which makes it interesting for physicists as well as interdisciplinary researchers.

Assessment and Recommendations of Compounding Education in AACP Member Institutions

PubMed Central

Augustine, Sam; Birnie, Christine; Nagel, Karen; Ray, Dipan; Ruble, James; Scolaro, Kelly; Athay Adams, Jennifer

2012-01-01

In August 2009, the American Association of Colleges of Pharmacy (AACP) Council of Sections established a Task Force to assess the current status of compounding education at its member institutions and to provide recommendations for future direction. The Task Force conducted a survey in late June 2010 of faculty members enrolled in the AACP Pharmaceutics and Pharmacy Practice sections to gain qualitative information of the current state of compounding education. The survey results were then organized around eight curricular topics for which the Task Force members provided interpretations and recommendations. A final report was sent to the AACP Council of Sections on February 15, 2011. This publication provides the information contained in that final report to the professional community. PMID:23049115

A Process Evaluation of Project Developmental Continuity. Interim Report II, Part B: Recommendations for Measuring Program Impact.

ERIC Educational Resources Information Center

Love, John M.; And Others

This report presents recommendations for measures to be used in assessing the impact of Project Developmental Continuity (PDC). Chapter I reviews the purpose of the impact study and presents the basic considerations guiding the selection of measures. Chapter II describes the review process that led to the final recommendations. Chapter III…

Development of Performance Standards for Employment Service. Volume 2: Part B. Findings and Recommendations. Final Report.

ERIC Educational Resources Information Center

Fairchild, Charles K.

The objective of the project was to develop methods for establishing output and input performance standards for the placement and placement support functions of the United States Employment Service (ES). This part of Volume 2 reports substantive findings and recommendations developed during the course of the project. A key recommendation is that…

77 FR 40891 - Towing Safety Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-11

... ``Recommendations for Safety Standards of Portable Facility Vapor Control Systems.'' (4) Period for public comment... teleconference to review and discuss a new Task Statement titled ``Recommendations for Safety Standards of Portable Facility Vapor Control Systems'' and to discuss the progress of open Task Statements. This meeting...

Factors Associated with Medicaid Providers Recommendation of the HPV Vaccine to Low-Income Adolescent Girls

PubMed Central

Bynum, Shalanda A.; Staras, Stephanie A. S.; Malo, Teri L.; Giuliano, Anna R.; Shenkman, Elizabeth; Vadaparampil, Susan T.

2013-01-01

Background HPV vaccination in the US remains a public health challenge with vaccine rates of 50%. Although health care providers can facilitate HPV vaccination, several factors may impede their ability to universally recommend the vaccine. To maximize the potential of HPV vaccines, it is important to understand challenges providers face in the clinical environment. Purpose The study sought to identify factors associated with recommendation of the HPV vaccine for low-income adolescents in the early (9–10), target (11–12), early adolescent catch-up (13–14), and late adolescent catch-up (15–17) vaccination groups. Methods Surveys were mailed from October 2009-April 2010 to a random sample of Florida-based physicians serving Medicaid-enrolled adolescents. Data were analyzed in 2013. Results Among early adolescents, discomfort discussing sexually transmitted infections (STIs) with teens (odds ratio [OR]=1.75), difficulty ensuring vaccine completion (OR=0.73), and discomfort discussing STIs with parents (OR=0.44) were associated with recommendation. For target adolescents, discomfort discussing STIs with teens (OR=2.45), time constraints (OR=0.70), vaccine efficacy concerns (OR=0.65), discomfort discussing STIs with parents (OR=0.33), obstetrics/gynecology (OR=0.25) and family medicine (OR=0.24) specialty, and non-Hispanic Black patient (OR=0.15) were associated with recommendation. In early catch-up adolescents, concerns that teens will practice riskier behaviors (OR=0.57), discomfort discussing STIs with parents (OR=0.47), and family medicine specialty (OR=0.20) were associated with recommendation. For late catch-up adolescents, family medicine specialty (OR=0.13) was associated with recommendation. Conclusion Modifiable factors that impede or influence provider recommendations of HPV vaccines can be addressed through intervention. Overall, findings suggest that efforts should focus on sexuality communication and family medicine specialty. PMID:24064282

An evaluation of teaching methods in the introductory physics classroom

NASA Astrophysics Data System (ADS)

Savage, Lauren Michelle Williams

The introductory physics mechanics course at the University of North Carolina at Charlotte has a history of relatively high DFW rates. In 2011, the course was redesigned from the traditional lecture format to the inverted classroom format (flipped). This format inverts the classroom by introducing material in a video assigned as homework while the instructor conducts problem solving activities and guides discussions during the regular meetings. This format focuses on student-centered learning and is more interactive and engaging. To evaluate the effectiveness of the new method, final exam data over the past 10 years was mined and the pass rates examined. A normalization condition was developed to evaluate semesters equally. The two teaching methods were compared using a grade distribution across multiple semesters. Students in the inverted class outperformed those in the traditional class: "A"s increased by 22% and "B"s increased by 38%. The final exam pass rate increased by 12% under the inverted classroom approach. The same analysis was used to compare the written and online final exam formats. Surprisingly, no students scored "A"s on the online final. However, the percent of "B"s increased by 136%. Combining documented best practices from a literature review with personal observations of student performance and attitudes from first hand classroom experience as a teaching assistant in both teaching methods, reasons are given to support the continued use of the inverted classroom approach as well as the online final. Finally, specific recommendations are given to improve the course structure where weaknesses have been identified.

How well do final year undergraduate medical students master practical clinical skills?

PubMed Central

Störmann, Sylvère; Stankiewicz, Melanie; Raes, Patricia; Berchtold, Christina; Kosanke, Yvonne; Illes, Gabrielle; Loose, Peter; Angstwurm, Matthias W.

2016-01-01

Introduction: The clinical examination and other practical clinical skills are fundamental to guide diagnosis and therapy. The teaching of such practical skills has gained significance through legislative changes and adjustments of the curricula of medical schools in Germany. We sought to find out how well final year undergraduate medical students master practical clinical skills. Methods: We conducted a formative 4-station objective structured clinical examination (OSCE) focused on practical clinical skills during the final year of undergraduate medical education. Participation was voluntary. Besides the examination of heart, lungs, abdomen, vascular system, lymphatic system as well as the neurological, endocrinological or orthopaedic examination we assessed other basic clinical skills (e.g. interpretation of an ECG, reading a chest X-ray). Participants filled-out a questionnaire prior to the exam, inter alia to give an estimate of their performance. Results: 214 final year students participated in our study and achieved a mean score of 72.8% of the total score obtainable. 9.3% of participants (n=20) scored insufficiently (<60%). We found no influence of sex, prior training in healthcare or place of study on performance. Only one third of the students correctly estimated their performance (35.3%), whereas 30.0% and 18.8% over-estimated their performance by 10% and 20% respectively. Discussion: Final year undergraduate medical students demonstrate considerable deficits performing practical clinical skills in the context of a formative assessment. Half of the students over-estimate their own performance. We recommend an institutionalised and frequent assessment of practical clinical skills during undergraduate medical education, especially in the final year. PMID:27579358

Lecture recording system in anatomy: possible benefit to auditory learners.

PubMed

Bacro, Thierry R H; Gebregziabher, Mulugeta; Ariail, Jennie

2013-01-01

The literature reports that using Learning Recording Systems (LRS) is usually well received by students but that the pedagogical value of LRS in academic settings remains somewhat unclear. The primary aim of the current study is to document students' perceptions, actual pattern of usage, and impact of use of LRS on students' grade in a dental gross and neuroanatomy course. Other aims are to determine if students' learning preference correlated with final grades and to see if other factors like gender, age, overall academic score on the Dental Aptitude Test (DAT), lecture levels of difficulty, type of lecture, category of lecture, or teaching faculty could explain the impact, if any, of the use of LRS on the course final grade. No significant correlation was detected between the final grades and the variables studied except for a significant but modest correlation between final grades and the number of times the students accessed the lecture recordings (r=0.33 with P=0.01). Also, after adjusting for gender, age, learning style, and academic DAT, a significant interaction between auditory and average usage time was found for final grade (P=0.03). Students who classified themselves as auditory and who used the LRS on average for fewer than 10 minutes per access, scored an average final grade of 16.43 % higher than the nonauditory students using the LRS for the same amount of time per access. Based on these findings, implications for teaching are discussed and recommendations for use of LRS are proposed. Copyright © 2013 American Association of Anatomists.

Provider Recommendations in the Face of Scientific Uncertainty: An Analysis of Audio-Recorded Discussions about Vitamin D.

PubMed

Tarn, Derjung M; Paterniti, Debora A; Wenger, Neil S

2016-08-01

Little is known about how providers communicate recommendations when scientific uncertainty exists. To compare provider recommendations to those in the scientific literature, with a focus on whether uncertainty was communicated. Qualitative (inductive systematic content analysis) and quantitative analysis of previously collected audio-recorded provider-patient office visits. Sixty-one providers and a socio-economically diverse convenience sample of 603 of their patients from outpatient community- and academic-based primary care, integrative medicine, and complementary and alternative medicine provider offices in Southern California. Comparison of provider information-giving about vitamin D to professional guidelines and scientific information for which conflicting recommendations or insufficient scientific evidence exists; certainty with which information was conveyed. Ninety-two (15.3 %) of 603 visit discussions touched upon issues related to vitamin D testing, management and benefits. Vitamin D deficiency screening was discussed with 23 (25 %) patients, the definition of vitamin D deficiency with 21 (22.8 %), the optimal range for vitamin D levels with 26 (28.3 %), vitamin D supplementation dosing with 50 (54.3 %), and benefits of supplementation with 46 (50 %). For each of the professional guidelines/scientific information examined, providers conveyed information that deviated from professional guidelines and the existing scientific evidence. Of 166 statements made about vitamin D in this study, providers conveyed 160 (96.4 %) with certainty, without mention of any equivocal or contradictory evidence in the scientific literature. No uncertainty was mentioned when vitamin D dosing was discussed, even when recommended dosing was higher than guideline recommendations. Providers convey the vast majority of information and recommendations about vitamin D with certainty, even though the scientific literature contains inconsistent recommendations and declarations of inadequate evidence. Not communicating uncertainty blurs the contrast between evidence-based recommendations and those without evidence. Providers should explore best practices for involving patients in decision-making by acknowledging the uncertainty behind their recommendations.

Selecting cockpit functions for speech I/O technology

NASA Technical Reports Server (NTRS)

Simpson, C. A.

1985-01-01

A general methodology for the initial selection of functions for speech generation and speech recognition technology is discussed. The SCR (Stimulus/Central-Processing/Response) compatibility model of Wickens et al. (1983) is examined, and its application is demonstrated for a particular cockpit display problem. Some limits of the applicability of that model are illustrated in the context of predicting overall pilot-aircraft system performance. A program of system performance measurement is recommended for the evaluation of candidate systems. It is suggested that no one measure of system performance can necessarily be depended upon to the exclusion of others. Systems response time, system accuracy, and pilot ratings are all important measures. Finally, these measures must be collected in the context of the total flight task environment.

Problems related to the use of animals for therapeutic and care purposes. The Document of the National Committee for Bioethics.

PubMed

Santori, Pasqualino

2011-01-01

The Italian Ministry of Health, in 2002, instructed the National Committee for Bioethics to carefully review and ultimately provide evidence for future legislative bills in various aspects. One such matter was that of the subject of "Pet Therapy", generically viewed as a "man-animal" relationship, with the purpose of proving beneficiary to both human health and welfare. The necessity of a bioethical approach was deemed important in establishing the concrete benefits for mankind (and the research required to demonstrate this) whilst also considering any possible malaise inflicted on those animals participating. The final recommendations decided upon, took into consideration effectiveness, cost, suitable alternatives, discussion of the intervention with the patient.

Brief communication: On direct impact probability of landslides on vehicles

NASA Astrophysics Data System (ADS)

Nicolet, Pierrick; Jaboyedoff, Michel; Cloutier, Catherine; Crosta, Giovanni B.; Lévy, Sébastien

2016-04-01

When calculating the risk of railway or road users of being killed by a natural hazard, one has to calculate a temporal spatial probability, i.e. the probability of a vehicle being in the path of the falling mass when the mass falls, or the expected number of affected vehicles in case such of an event. To calculate this, different methods are used in the literature, and, most of the time, they consider only the dimensions of the falling mass or the dimensions of the vehicles. Some authors do however consider both dimensions at the same time, and the use of their approach is recommended. Finally, a method considering an impact on the front of the vehicle is discussed.

Brief Communication: On direct impact probability of landslides on vehicles

NASA Astrophysics Data System (ADS)

Nicolet, P.; Jaboyedoff, M.; Cloutier, C.; Crosta, G. B.; Lévy, S.

2015-12-01

When calculating the risk of railway or road users to be killed by a natural hazard, one has to calculate a "spatio-temporal probability", i.e. the probability for a vehicle to be in the path of the falling mass when the mass falls, or the expected number of affected vehicles in case of an event. To calculate this, different methods are used in the literature, and, most of the time, they consider only the dimensions of the falling mass or the dimensions of the vehicles. Some authors do however consider both dimensions at the same time, and the use of their approach is recommended. Finally, a method considering an impact on the front of the vehicle in addition is discussed.

Multiplexer/demultiplexer flexibility enhancement program

NASA Technical Reports Server (NTRS)

1978-01-01

This final report summarizes the accomplishments of the NASA/JSC MDM Flexibility Enhancement Program, Contract NAS9-15359 as carried out by Sperry Flight Systems from April through December 1977. Included are discussions of major statement of work tasks and the results, conclusions and recommended actions. All tasks called out in the amended SOW were carried out. Significant development tasks which were completed included the following: (1) Development, breadboard and test of a Pulse Output 28-volt Module. (2) Development and test of a 32-channel DC Analog Input (DCIN) Differential Module. (3) Development and test of a sequence memory module using an M2708 EPROM which can be programmed in the unit. (4) Development and test of a radiator top cover for a radiation-cooled Flexible MDM.

Evaluation of laminar flow control system concepts for subsonic commercial transport aircraft

NASA Technical Reports Server (NTRS)

1978-01-01

A two-year study conducted to establish a basis for industry decisions on the application of laminar flow control (LFC) to future commercial transports was presented. Areas of investigation included: (1) mission definition and baseline selection; (2) concepts evaluations; and (3) LFC transport configuration selection and component design. The development and evaluation of competing design concepts was conducted in the areas of aerodynamics, structures and materials, and systems. The results of supporting wind tunnel and laboratory testing on a full-scale LFC wing panel, suction surface opening concepts and structural samples were included. A final LFC transport was configured in incorporating the results of concept evaluation studies and potential performance improvements were assessed. Remaining problems together with recommendations for future research are discussed.

Analysis and interpretation of the 1985 Sequoia transport experiment. Final report

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

Myrup, L.; Flocchini, R.

1987-10-01

An analysis and interpretation is presented of the 1985 Aerosol Transport and Characterization Program at Sequoia National Park, sponsored by the California Air Resources Board. Overall, it was found that the Program produced unique data sets and interesting new results relating particulate air quality and meteorology in the context of complex terrain. The major conclusion is that the meso-scale wind field, as modulated by synoptic-scale fluctuations, is the chief factor acting to cause variation in particulate concentrations in the Park. Areas for future work are discussed. In addition, it was recommended that in future measurement programs, greater effort be mademore » to locate sites completely unaffected by local sources of pollutants.« less

Current status of computational methods for transonic unsteady aerodynamics and aeroelastic applications

NASA Technical Reports Server (NTRS)

Edwards, John W.; Malone, John B.

1992-01-01

The current status of computational methods for unsteady aerodynamics and aeroelasticity is reviewed. The key features of challenging aeroelastic applications are discussed in terms of the flowfield state: low-angle high speed flows and high-angle vortex-dominated flows. The critical role played by viscous effects in determining aeroelastic stability for conditions of incipient flow separation is stressed. The need for a variety of flow modeling tools, from linear formulations to implementations of the Navier-Stokes equations, is emphasized. Estimates of computer run times for flutter calculations using several computational methods are given. Applications of these methods for unsteady aerodynamic and transonic flutter calculations for airfoils, wings, and configurations are summarized. Finally, recommendations are made concerning future research directions.

Business game using information technologies for the students of final courses to direction of telecommunication

NASA Astrophysics Data System (ADS)

Khmelevskaya, A. V.; Klyuchnikova, O. E.; Golovin, P. V.; Yakushev, A. S.

2017-01-01

This article discusses the use of business games in the field of Infocommunications and information security. The authors consider the developed business game "Interview - rules of successful employment," "The tender to design Local Area Network," "Emergency situation in telecommunications company." This business games allows students to develop many skills and abilities. This games gives students the opportunity to take advantage of their theoretical knowledge and already in student years to begin them practically to realize and apply, producing own preparation the same for a further successful professional growth. The games is recommended for use as a new integrated form of organization-semester independent students work with a public defense of result and demonstration all professional competencies.

Effect of commercial and military performance requirements for transport category aircraft on space shuttle booster design and operation

NASA Technical Reports Server (NTRS)

Bithell, R. A.; Pence, W. A., Jr.

1972-01-01

The effect of two sets of performance requirements, commercial and military, on the design and operation of the space shuttle booster is evaluated. Critical thrust levels are established according to both sets of operating rules for the takeoff, cruise, and go-around flight modes, and the effect on engine requirements determined. Both flyback and ferry operations are considered. The impact of landing rules on potential shuttle flyback and ferry bases is evaluated. Factors affecting reserves are discussed, including winds, temperature, and nonstandard flight operations. Finally, a recommended set of operating rules is proposed for both flyback and ferry operations that allows adequate performance capability and safety margins without compromising design requirements for either flight phase.

Advances in Instrumental Analysis of Brominated Flame Retardants: Current Status and Future Perspectives

PubMed Central

2014-01-01

This review aims to highlight the recent advances and methodological improvements in instrumental techniques applied for the analysis of different brominated flame retardants (BFRs). The literature search strategy was based on the recent analytical reviews published on BFRs. The main selection criteria involved the successful development and application of analytical methods for determination of the target compounds in various environmental matrices. Different factors affecting chromatographic separation and mass spectrometric detection of brominated analytes were evaluated and discussed. Techniques using advanced instrumentation to achieve outstanding results in quantification of different BFRs and their metabolites/degradation products were highlighted. Finally, research gaps in the field of BFR analysis were identified and recommendations for future research were proposed. PMID:27433482

International Launch Vehicle Selection for Interplanetary Travel

NASA Technical Reports Server (NTRS)

Ferrone, Kristine; Nguyen, Lori T.

2010-01-01

In developing a mission strategy for interplanetary travel, the first step is to consider launch capabilities which provide the basis for fundamental parameters of the mission. This investigation focuses on the numerous launch vehicles of various characteristics available and in development internationally with respect to upmass, launch site, payload shroud size, fuel type, cost, and launch frequency. This presentation will describe launch vehicles available and in development worldwide, then carefully detail a selection process for choosing appropriate vehicles for interplanetary missions focusing on international collaboration, risk management, and minimization of cost. The vehicles that fit the established criteria will be discussed in detail with emphasis on the specifications and limitations related to interplanetary travel. The final menu of options will include recommendations for overall mission design and strategy.

Latin-American guidelines for opioid use in chronic nononcologic pain.

PubMed

Lara-Solares, Argelia; Aguayo Zamora, Carlos; Amescua García, César; Garcia, João Batista Santos; Berenguel Cook, María Del Rosario; Bonilla Sierra, Patricia; Campos Kraychete, Durval; Flores Cantisani, José Alberto; Guerrero, Carlos; Guillén Núñez, María Del Rocío; Hernández Castro, John Jairo; Hernández Ortíz, Andrés; Jreige Iskandar, Aziza; Lech, Osvandré; Macías Guerra, Jacqueline; Ramírez Samayoa, Gerardo; Rangel Morillo, Edwin; Rico Pazos, María Antonieta; Sempértegui Gallegos, Manuel

2017-05-01

Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to current Latin-American reality. Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the literature and shaped the final manuscript. The expert panel developed guidelines taking into consideration the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction. Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients' quality of life by increasing access to these effective agents.

Trajectory optimization for the National Aerospace Plane

NASA Technical Reports Server (NTRS)

Lu, Ping

1992-01-01

The primary objective of this research is to develop an efficient and robust trajectory optimization tool for the optimal ascent problem of the National Aerospace Plane (NASP). This report is organized in the following order to summarize the complete work: Section two states the formulation and models of the trajectory optimization problem. An inverse dynamics approach to the problem is introduced in Section three. Optimal trajectories corresponding to various conditions and performance parameters are presented in Section four. A midcourse nonlinear feedback controller is developed in Section five. Section six demonstrates the performance of the inverse dynamics approach and midcourse controller during disturbances. Section seven discusses rocket assisted ascent which may be beneficial when orbital altitude is high. Finally, Section eight recommends areas of future research.

The Role of Positive Traits and Pain Catastrophizing in Pain Perception

PubMed Central

Hood, Anna

2013-01-01

A variety of biological, psychological, and social factors interact to influence pain. This article focuses on two distinct, but connected, psychological factors—positive personality traits and pain catastrophizing—and their link with pain perception in healthy and clinical populations. First, we review the protective link between positive personality traits, such as optimism, hope, and self-efficacy, and pain perception. Second, we provide evidence of the well-established relationship between pain catastrophizing and pain perception and other related outcomes. Third, we outline the inverse relationship between positive traits and pain catastrophizing, and offer a model that explains the inverse link between positive traits and pain perception through lower pain catastrophizing. Finally, we discuss clinical practice recommendations based on the aforementioned relationships. PMID:23512722

An Independent Scientific Assessment of Well Stimulation in California Volume II

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

Jane C.S. Long; Laura C. Feinstein; Corinne E. Bachmann

This study is issued in three volumes. Volume I, issued in January 2015, describes how well stimulation technologies work, how and where operators deploy these technologies for oil and gas production in California, and where they might enable production in the future. Volume II, the present volume, discusses how well stimulation could affect water, atmosphere, seismic activity, wildlife and vegetation, and human health. Volume II reviews available data, and identifies knowledge gaps and alternative practices that could avoid or mitigate these possible impacts. Volume III, also issued in July 2015, presents case studies that assess environmental issues and qualitative risksmore » for specific geographic regions. A final Summary Report summarizes key findings, conclusions and recommendations of all three volumes.« less

Humanistic psychotherapy research 1990-2015: from methodological innovation to evidence-supported treatment outcomes and beyond.

PubMed

Angus, Lynne; Watson, Jeanne Cherry; Elliott, Robert; Schneider, Kirk; Timulak, Ladislav

2015-01-01

Over the past 25 years, humanistic psychotherapy (HP) researchers have actively contributed to the development and implementation of innovative practice-informed research measures and coding systems. Qualitative and quantitative research findings, including meta-analyses, support the identification of HP approaches as evidence-based treatments for a variety of psychological conditions. Implications for future psychotherapy research, training, and practice are discussed in terms of addressing the persistent disjunction between significant HP research productivity and relatively low support for HP approaches in university-based clinical training programs, funding agencies, and government-supported clinical guidelines. Finally, specific recommendations are provided to further enhance and expand the impact of HP research for clinical training programs and the development of treatment guidelines.

Data dictionaries in information systems - Standards, usage , and application

NASA Technical Reports Server (NTRS)

Johnson, Margaret

1990-01-01

An overview of data dictionary systems and the role of standardization in the interchange of data dictionaries is presented. The development of the data dictionary for the Planetary Data System is cited as an example. The data element dictionary (DED), which is the repository of the definitions of the vocabulary utilized in an information system, is an important part of this service. A DED provides the definitions of the fields of the data set as well as the data elements of the catalog system. Finally, international efforts such as the Consultative Committee on Space Data Systems and other committees set up to provide standard recommendations on the usage and structure of data dictionaries in the international space science community are discussed.

A new evidence-based risk stratification system for cutaneous squamous cell carcinoma into low, intermediate, and high risk groups with implications for management.

PubMed

Baum, Christian L; Wright, Adam C; Martinez, Juan-Carlos; Arpey, Christopher J; Brewer, Jerry D; Roenigk, Randall K; Otley, Clark C

2018-01-01

Most primary cutaneous squamous cell carcinomas are cured with surgery. A subset, however, may develop local and nodal metastasis that may eventuate in disease-specific; death. This subset has been variably termed high risk. Herein, we review; an emerging body of data on the risks of these outcomes and propose an evidence-based; risk stratification for low-, intermediate-, and high-risk tumors that takes into; account both tumor and patient characteristics. Finally, we discuss a framework for; management of these tumors on the basis of data, when available, and our; recommendations when data are sparse. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Cutting power costs starts with basic analyses

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

Paik, M.

1996-10-07

Oil and gas production departments should already be reducing their power costs. Regardless of how US deregulation of electricity finally shakes out, power costs are a large portion of total operating expense. Much has been written in recent months about the rosy days, ahead, when electric utilities will be fully deregulated. But this will only be an extension of the opportunities available today; although, after deregulation, many new options will add both opportunities along with complexities. There is no magic to reducing power costs. It is simply a matter of working at it. Recommended steps for lowering power costs ismore » shown. The paper discusses electricity basics, power bills, managing power cost, field equipment changes, electrical equipment changes and deregulation.« less

78 FR 44156 - Certain Rubber Resins and Processes for Manufacturing Same; Notice of Request for Statements on...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

... administrative law judge has issued a Final Initial Determination and Recommended Determination on Remedy and... Recommended Determination on Remedy and Bonding issued in this investigation on June 17, 2013. Comments should...

Promoting fruit and vegetable consumption in different lifestyle groups: recommendations for program development based on behavioral research and consumer media data.

PubMed

Della, Lindsay J; DeJoy, David M; Lance, Charles E

2008-01-01

Fruit and vegetable consumption affects the etiology of cardiovascular disease as well as many different types of cancers. Still, Americans' consumption of fruit and vegetables is low. This article builds on initial research that assessed the validity of using a consumer-based psychographic audience segmentation in tandem with the theory of planned behavior to explain differences among individuals' consumption of fruit and vegetables. In this article, we integrate the findings from our initial analyses with media and purchase data from each audience segment. We then propose distinct, tailored program suggestions for reinventing social marketing programs focused on increasing fruit and vegetable consumption in each segment. Finally, we discuss the implications of utilizing a consumer-based psychographic audience segmentation versus a more traditional readiness-to-change social marketing segmentation. Differences between these two segmentation strategies, such as the ability to access media usage and purchase data, are highlighted and discussed.

Significances of Multimedia Technologies Training

NASA Astrophysics Data System (ADS)

Zhang, Fulei

The use of multimedia technologies in education has enabled teachers to simulate final outcomes and assist s-tudents in applying knowledge learned from textbooks, thereby compensating for the deficiency of traditional teach- ing methods. It is important to examine how effective these technologies are in practical use. This study developed online learning-teaching resource platforms using Flash multimedia, providing interactive and integrated features in an easy-to-use user interface, in order to discuss Computer-Aided Drawing (CAD). The study utilized a teaching experiment with a non-equivalent pretest-posttest control group design to test and discuss students' professional cognition, operating skill cognition, and level of learning satisfaction during the learning process. No significant differences emerged between the groups in regards to professional cognition or operation skills cognition. However, a significant difference in learning satisfaction was noted, indicating that the coursework with multimedia Flash produced greater satisfaction than with traditional learning methods. Results are explained in detail and recommendations for further research provided.

Needs assessment final report

NASA Technical Reports Server (NTRS)

Sepulveda, Jose A.

1992-01-01

The stated purposes of the Management Science Faculty Fellowship Project were to: (1) provide a comprehensive analysis of KSC management training for engineers and other management professionals from project/program lead through executive levels; and (2) development of evaluation methodologies which can be used to perform ongoing program-wide course-to-course assessments. This report will focus primarily in the first stated purpose for the project. Ideally, the analysis of KSC management training will build in the current system and efficiently propose improvements to achieve existing goals and objectives while helping to identify new visions and new outcomes for the Center's Management Training Mission. Section 2 describes the objectives, approach, and specific tasks used to analyze KSC's Management training System. Section 3 discusses the main conclusions derived from an analysis of the available training data. Section 4 discusses the characteristics and benefits envisioned for a Management Training System. Section 5 proposes a Training System as identified by the results of a Needs Assessment exercise conducted at KSC this summer. Section 6 presents a number of recommendations for future work.

A pathologist's road map to benign, precancerous, and malignant intraepithelial proliferations in the fallopian tube.

PubMed

Mehrad, Mitra; Ning, Gang; Chen, Eleanor Y; Mehra, Karishma K; Crum, Christopher Paul

2010-09-01

The fallopian tube has recently emerged as an important site of origin for not only early serous cancer in women with inherited mutations in BRCA1/BRCA2 but as a source of many pelvic serous carcinomas. With this increased attention has come the inevitable need to sort out what epithelial abnormalities are clinically important and how they should be reported by the practicing pathologist. This review addresses 4 categories of tubal epithelial change: (1) metaplasias; (2) nonmalignant atypias; (3) potential precursors, including secretory cell outgrowths and p53 signatures; and (4) tubal intraepithelial carcinomas. A modified protocol for sectioning the fallopian tube (SEE-FIM) is discussed and each of the above topics is covered in the context of its differential diagnosis and recommendations for reporting are included. Finally, the rationale for close inspection of the tube, both in presumed benign and malignant disease, is discussed, with reference to an ongoing multi-institutional web-based project (Pelvic-ovarian Cancer Interception project).

Promoting fruit and vegetable consumption in different lifestyle groups: Recommendations for program development based on behavioral research and consumer media data

PubMed Central

DeJoy, David M.; Lance, Charles E.

2014-01-01

Fruit and vegetable consumption impacts the etiology of cardiovascular disease as well as many different types of cancers. Still, Americans' consumption of fruit and vegetables is low. This article builds on initial research that assessed the validity of using a consumer-based psychographic audience segmentation in tandem with the theory of planned behavior to explain differences among individuals' consumption of fruit and vegetables. In this article, we integrate the findings from our initial analyses with media and purchase data from each audience segment. We then propose distinct, tailored program suggestions for reinventing social marketing programs focused on increasing fruit and vegetable consumption in each segment. Finally, we discuss the implications of utilizing a consumer-based psychographic audience segmentation versus more traditional readiness-to-change social marketing segmentation. Differences between these two segmentation strategies, such as the ability to access media usage and purchase data, are highlighted and discussed. PMID:18935880

Image-guided intervention in the coagulopathic patient.

PubMed

Kohli, Marc; Mayo-Smith, William; Zagoria, Ronald; Sandrasegaran, Kumar

2016-04-01

Determining practice parameters for interventional procedures is challenging due to many factors including unreliable laboratory tests to measure bleeding risk, variable usage of standardized terminology for adverse events, poorly defined standards for administration of blood products, and the growing numbers of anticoagulant and antiplatelet medications. We aim to address these and other issues faced by radiologists performing invasive procedures through a review of available literature, and experiential guidance from three academic medical centers. We discuss the significant limitations with respect to using prothrombin-time and international normalized ratio to measure bleeding risk, especially in patients with synthetic defects due to liver function. Factors affecting platelet function including the impact of uremia; recent advances in laboratory testing, including platelet function testing; and thromboelastography are also discussed. A review of the existing literature of fresh-frozen plasma replacement therapy is included. The literature regarding comorbidities affecting coagulation including malignancy, liver failure, and uremia are also reviewed. Finally, the authors present a set of recommendations for laboratory thresholds, corrective transfusions, as well as withholding and restarting medications.

Satellite Power System (SPS) student participation

NASA Technical Reports Server (NTRS)

Ladwig, A.; David, L.

1978-01-01

A assessment of methods which are appropriate to initiate student participation in the discussion of a satellite power system (SPS) is presented. Methods which are incorporated into the campus environment and the on-going learning experience are reported. The discussion of individual methods for student participation includes a description of the technique, followed by comments on its enhancing and limiting factors, references to situations where the method has been demonstrated, and a brief consideration of cost factors. The two categories of recommendations presented are: an outline of fourteen recommendations addressing specific activities related to student participation in the discussion of SPS, and three recommendations pertaining to student participation activities in general.

Extracorporeal Treatment for Lithium Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup

PubMed Central

Decker, Brian S.; Goldfarb, David S.; Dargan, Paul I.; Friesen, Marjorie; Gosselin, Sophie; Hoffman, Robert S.; Lavergne, Valéry; Nolin, Thomas D.

2015-01-01

The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical and toxicokinetic data were extracted and summarized following a predetermined format. The entire workgroup voted through a two-round modified Delphi method to reach a consensus on voting statements. A RAND/UCLA Appropriateness Method was used to quantify disagreement, and anonymous votes were compiled and discussed in person. A second vote was conducted to determine the final workgroup recommendations. In total, 166 articles met inclusion criteria, which were mostly case reports, yielding a very low quality of evidence for all recommendations. A total of 418 patients were reviewed, 228 of which allowed extraction of patient-level data. The workgroup concluded that lithium is dialyzable (Level of evidence=A) and made the following recommendations: Extracorporeal treatment is recommended in severe lithium poisoning (1D). Extracorporeal treatment is recommended if kidney function is impaired and the [Li+] is >4.0 mEq/L, or in the presence of a decreased level of consciousness, seizures, or life-threatening dysrhythmias irrespective of the [Li+] (1D). Extracorporeal treatment is suggested if the [Li+] is >5.0 mEq/L, significant confusion is present, or the expected time to reduce the [Li+] to <1.0 mEq/L is >36 hours (2D). Extracorporeal treatment should be continued until clinical improvement is apparent or [Li+] is <1.0 mEq/L (1D). Extracorporeal treatments should be continued for a minimum of 6 hours if the [Li+] is not readily measurable (1D). Hemodialysis is the preferred extracorporeal treatment (1D), but continuous RRT is an acceptable alternative (1D). The workgroup supported the use of extracorporeal treatment in severe lithium poisoning. Clinical decisions on when to use extracorporeal treatment should take into account the [Li+], kidney function, pattern of lithium toxicity, patient’s clinical status, and availability of extracorporeal treatments. PMID:25583292

A proposed configurable approach for recommendation systems via data mining techniques

NASA Astrophysics Data System (ADS)

Khedr, Ayman E.; Idrees, Amira M.; Hegazy, Abd El-Fatah; El-Shewy, Samir

2018-02-01

This study presents a configurable approach for recommendations which determines the suitable recommendation method for each field based on the characteristics of its data, the method includes determining the suitable technique for selecting a representative sample of the provided data. Then selecting the suitable feature weighting measure to provide a correct weight for each feature based on its effect on the recommendations. Finally, selecting the suitable algorithm to provide the required recommendations. The proposed configurable approach could be applied on different domains. The experiments have revealed that the approach is able to provide recommendations with only 0.89 error rate percentage.

Recommended system of application and development

NASA Astrophysics Data System (ADS)

Wang, Wei

2018-04-01

A recommender system is a project that helps users identify their wishes and needs. The recommender system has been successfully applied to many e-commerce environments, such as news, film, music, books and other areas of recommendation. This paper mainly discusses the application of recommendation technology in software engineering, data and knowledge engineering, configurable projects and persuasion technology, and summarizes the development trend of recommendation technology in the future.

Study on AC loss measurements of HTS power cable for standardizing

NASA Astrophysics Data System (ADS)

Mukoyama, Shinichi; Amemiya, Naoyuki; Watanabe, Kazuo; Iijima, Yasuhiro; Mido, Nobuhiro; Masuda, Takao; Morimura, Toshiya; Oya, Masayoshi; Nakano, Tetsutaro; Yamamoto, Kiyoshi

2017-09-01

High-temperature superconducting power cables (HTS cables) have been developed for more than 20 years. In addition of the cable developments, the test methods of the HTS cables have been discussed and proposed in many laboratories and companies. Recently the test methods of the HTS cables is required to standardize and to common in the world. CIGRE made the working group (B1-31) for the discussion of the test methods of the HTS cables as a power cable, and published the recommendation of the test method. Additionally, IEC TC20 submitted the New Work Item Proposal (NP) based on the recommendation of CIGRE this year, IEC TC20 and IEC TC90 started the standardization work on Testing of HTS AC cables. However, the individual test method that used to measure a performance of HTS cables hasn’t been established as world’s common methods. The AC loss is one of the most important properties to disseminate low loss and economical efficient HTS cables in the world. We regard to establish the method of the AC loss measurements in rational and in high accuracy. Japan is at a leading position in the AC loss study, because Japanese researchers have studied on the AC loss technically and scientifically, and also developed the effective technologies for the AC loss reduction. The JP domestic commission of TC90 made a working team to discussion the methods of the AC loss measurements for aiming an international standard finally. This paper reports about the AC loss measurement of two type of the HTS conductors, such as a HTS conductor without a HTS shield and a HTS conductor with a HTS shield. The AC loss measurement method is suggested by the electrical method..

The Education of Indian Children and Youth. National Study of American Indian Education, Series 4, No. 6, Summary Report and Recommendations.

ERIC Educational Resources Information Center

Havighurst, Robert J.

As a part of the Final Report of the National Study of American Indian Education, this document contains the summary report and recommendations regarding education of Indian children and youth. The document summarizes results of field research made in 30 Indian communities and contains recommendations for action to improve the education of…

Reflective Cracking of Flexible Pavements Phase I and II Final Recommendations

DOT National Transportation Integrated Search

2008-02-02

This report summarizes all the findings and recommendations from the Phase I and Phase II of the Nevada Department of Transportation (NDOT) study initiated in 2006 to mitigate reflective cracking in hot mix asphalt (HMA) overlays. Based on the analys...

Curve identification for high friction surface treatment (HFST) installation recommendation : final report.

DOT National Transportation Integrated Search

2016-09-01

The objectives of this study are to develop and deploy a means for cost-effectively extracting curve information using the widely available GPS and GIS data to support high friction surface treatment (HFST) installation recommendations (i.e., start a...

Recommended Guidelines for PKU Programs.

ERIC Educational Resources Information Center

Children's Bureau (DHEW), Washington, DC.

A discussion of screening tests for phenylketonuria recommends and provides some data on two tests, lists five disadvantages of urine tests, and discusses three new tests. Also considered are the role of the central laboratory facility and seven suggestions for screening different types of infants at different times. Treatment or followup programs…

77 FR 43855 - Secretarial Commission on Indian Trust Administration and Reform

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-26

... documents and identify recommendations from previous studies, and consider the nature and scope of necessary... of the Interior, 1849 C Street NW., Room 6119, Washington, DC 20240; or email to [email protected]ios... recommendations; Discussion of Commission Subcommittee progress and products; Review of and discussion of...

Recovery of Navy distillate fuel from reclaimed product. Volume I. Technical discussion

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

Brinkman, D.W.; Whisman, M.L.

1984-11-01

In an effort to assist the Navy to better utilize its waste hydrocarbons, NIPER, with support from the US Department of Energy, is conducting research designed to ultimately develop a practical technique for converting Reclaimed Product (RP) into specification Naval Distillate Fuel (F-76). The first phase of the project was focused on reviewing the literature and available information from equipment manufacturers. The literature survey has been carefully culled for methodology applicable to the conversion of RP into diesel fuel suitable for Navy use. Based upon the results of this study, a second phase has been developed and outlined in whichmore » experiments will be performed to determine the most practical recycling technologies. It is realized that the final selection of one particular technology may be site-specific due to vast differences in RP volume and available facilities. A final phase, if funded, would involve full-scale testing of one of the recommended techniques at a refueling depot. The Phase I investigations are published in two volumes. Volume 1, Technical Discussion, includes the narrative and Appendices I and II. Appendix III, a detailed Literature Review, includes both a narrative portion and an annotated bibliography containing about 800 referenvces and abstracts. This appendix, because of its volume, has been published separately as Volume 2. 18 figures, 4 tables.« less

Final Report of the NASA Technology Readiness Assessment (TRA) Study Team

NASA Technical Reports Server (NTRS)

Hirshorn, Steven; Jefferies, Sharon

2016-01-01

The material in this report covers the results on the NASA-wide TRA team, who are responsible for ascertaining the full extent of issues and ambiguities pertaining to TRATRL and to provide recommendations for mitigation. The team worked for approximately 6 months to become knowledgeable on the current TRATRL process and guidance and to derive recommendations for improvement.The team reviewed the TRA processes of other government agencies (OGA), including international agencies, and found that while the high-level processes are similar, the NASA process has a greater level of detail. Finally, NASA’s HQ OCT continues to monitor the GAO’s efforts to produce a TRA Best Practices Guide, a draft of which was received in February 2016. This Guide could impact the recommendations of this report.

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism

PubMed Central

Léger, Juliane; Olivieri, Antonella; Donaldson, Malcolm; Torresani, Toni; Krude, Heiko; van Vliet, Guy; Polak, Michel

2014-01-01

Objective: The aim was to formulate practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). Evidence: A systematic literature search was conducted to identify key articles relating to the screening, diagnosis, and management of CH. The evidence-based guidelines were developed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Consensus Process: Thirty-two participants drawn from the European Society for Paediatric Endocrinology and five other major scientific societies in the field of pediatric endocrinology were allocated to working groups with assigned topics and specific questions. Each group searched the literature, evaluated the evidence, and developed a draft document. These papers were debated and finalized by each group before presentation to the full assembly for further discussion and agreement. Recommendations: The recommendations include: worldwide neonatal screening, approaches to assess the cause (including genotyping) and the severity of the disorder, the immediate initiation of appropriate L-T4 supplementation and frequent monitoring to ensure dose adjustments to keep thyroid hormone levels in the target ranges, a trial of treatment in patients suspected of transient CH, regular assessments of developmental and neurosensory functions, consulting health professionals as appropriate, and education about CH. The harmonization of diagnosis, management, and routine health surveillance would not only optimize patient outcomes, but should also facilitate epidemiological studies of the disorder. Individuals with CH require monitoring throughout their lives, particularly during early childhood and pregnancy. PMID:24446653

Aiming for a holistic integrated service for men diagnosed with prostate cancer - Definitions of standards and skill sets for nurses and allied healthcare professionals.

PubMed

Lamb, Alastair D; Thompson, Sue; Kinsella, Netty; Gerbitz, Ingmar; Chapman, Elaine; Putt, Lisa; Bennett, Sophie; Thankappannair, Vineetha; Geoghegan, Lisa; Wright, Naomi; Stirton-Croft, Alison; Nixon, Penny; Styling, Andrew; Whitney, Diane; Hodgson, Lindsay; Punt, Lisa; Longmore, Jenny; Carter, Mike; Petch, Bill; Rimmer, Yvonne; Russell, Simon; Hughes-Davies, Luke; Mazhar, Danish; Shah, Nimish C; Gnanapragasam, Vincent J; Doble, Andrew; Bratt, Ola; Kastner, Christof

2017-08-01

To establish a comprehensive set of recommendations for the service structure and skill set of nurses and allied healthcare professionals in prostate cancer care. Using components of formal consensus methodology, a 30-member multidisciplinary panel produced 53 items for discussion relating to the provision of care for prostate cancer patients by specialist nurses and allied healthcare professionals. Items were developed by two rounds of email correspondence in which, first, items were generated and, second, items refined to form the basis of a consensus meeting which constituted the third round of review. The fourth and final round was an email review of the consensus output. The panel agreed on 33 items that were appropriate for recommendations to be made. These items were grouped under categories of "Environment" and "Patient Pathway" and included comments on training, leadership, communication and quality assessment as well as specific items related to prostate diagnosis clinics, radical treatment clinics and follow-up survivor groups. Specialist nurses and allied healthcare professionals play a vital role alongside urologists and oncologists to provide care to men with prostate cancer and their families. We present a set of standards and consensus recommendations for the roles and skill-set required for these practitioners to provide gold-standard prostate cancer care. These recommendations could form the basis for development of comprehensive integrated prostate cancer pathways in prostate cancer centres as well as providing guidance for any units treating men with prostate cancer. Copyright © 2017. Published by Elsevier Ltd.

Stakeholder consultation insights on the future of genomics at the clinical-public health interface.

PubMed

Modell, Stephen M; Kardia, Sharon L R; Citrin, Toby

2014-05-01

In summer 2011, the Centers for Disease Control and Prevention Office of Public Health Genomics conducted a stakeholder consultation, administered by the University of Michigan Center for Public Health and Community Genomics, and Genetic Alliance, to recommend priorities for public health genomics from 2012 through 2017. Sixty-two responses from health professionals, administrators, and members of the public were pooled with 2 sets of key informant interviews and 3 discussion groups. NVivo 9 and manual methods were used to organize themes. This review offers an interim analysis of progress with respect to the final recommendations, which demonstrated a strong interest in moving genomic discoveries toward implementation and comparative effectiveness (T3/T4) translational research. A translational research continuum exists with familial breast and ovarian cancer at one end and prostate cancer at the other. Cascade screening for inherited arrhythmia syndromes and hypercholesterolemia lags stakeholder recommendations in the United States but not in Europe; implementation of health service-based screening for Lynch syndrome, and integration into electronic health information systems, is on pace with the recommended timeline. A number of options exist to address deficits in the funding of translational research, particularly for oncogenomic gene expression profiling. The goal of personalized risk assessment necessitates both research progress (eg, in whole genome sequencing, as well as provider education in the differentiation of low- vs high-risk status. The public health approach supports an emphasis on genetic test validation while endorsing clinical translation research inclusion of an environmental and population-based perspective. Copyright © 2014 Mosby, Inc. All rights reserved.

Development of practice guidelines for psychological interventions in the rehabilitation of patients with oncological disease (breast, prostate, or colorectal cancer): Methods and results.

PubMed

Reese, Christina; Weis, Joachim; Schmucker, Dieter; Mittag, Oskar

2017-10-01

The goal of this project was to develop evidence- and consensus-based practice guidelines for psychological interventions in the rehabilitation of patients with oncological disease (breast, prostate, or colorectal cancer). First of all, we conducted a literature search and survey of all oncological rehabilitation centers in Germany (N = 145) to obtain a thorough perspective of the recent evidence, guidelines, the structural framework, and practice of psychological services in oncological rehabilitation. Next, an expert workshop was held with national experts from scientific departments, clinicians from rehabilitation centers, and patients. In this workshop, we drafted and agreed upon an initial version of the practice guidelines. Afterwards, the practice guidelines were sent to all head physicians and senior psychologists at oncological rehabilitation centers in Germany for approval (N = 280 questionnaires). In addition, key recommendations were discussed with a group of rehabilitation patients. Finally, the practice guidelines were revised by the expert panel and made available online to the public. The practice guidelines have been widely accepted by both the expert panel and the surveyed clinicians and patients. They include recommendations for psycho-oncological interventions that should be offered to all rehabilitation patients with breast, prostate, or colorectal cancer. They also comprise recommendations for specific problem areas concerning psychological functions, body functions, and environmental and personal factors. The practice guidelines provide detailed recommendations for high-quality psychosocial care in an oncological rehabilitation context. It is their aim to guide the multidisciplinary team, especially psychologists and physicians, in their daily practice. Copyright © 2016 John Wiley & Sons, Ltd.

Epi-Fluorescence Microscopy

PubMed Central

Webb, Donna J.; Brown, Claire M.

2012-01-01

Epi-fluorescence microscopy is available in most life sciences research laboratories, and when optimized can be a central laboratory tool. In this chapter, the epi-fluorescence light path is introduced and the various components are discussed in detail. Recommendations are made for incident lamp light sources, excitation and emission filters, dichroic mirrors, objective lenses, and charge-coupled device (CCD) cameras in order to obtain the most sensitive epi-fluorescence microscope. The even illumination of metal-halide lamps combined with new “hard” coated filters and mirrors, a high resolution monochrome CCD camera, and a high NA objective lens are all recommended for high resolution and high sensitivity fluorescence imaging. Recommendations are also made for multicolor imaging with the use of monochrome cameras, motorized filter turrets, individual filter cubes, and corresponding dyes that are the best choice for sensitive, high resolution multicolor imaging. Images should be collected using Nyquist sampling and should be corrected for background intensity contributions and nonuniform illumination across the field of view. Photostable fluorescent probes and proteins that absorb a lot of light (i.e., high extinction co-efficients) and generate a lot of fluorescence signal (i.e., high quantum yields) are optimal. A neuronal immune-fluorescence labeling protocol is also presented. Finally, in order to maximize the utility of sensitive wide-field microscopes and generate the highest resolution images with high signal-to-noise, advice for combining wide-field epi-fluorescence imaging with restorative image deconvolution is presented. PMID:23026996

[The relevance of the International Committee of Medical Journal Editors (ICMJE) for medical publishing and research].

PubMed

Reyes, Humberto B

2014-01-01

The International Committee of Medical Journal Editors is a leading independent institution providing guidance for the report of biomedical research and health related topics in medical journals. Established in 1978, it is currently constituted by editors of fourteen general medical journals from different countries, plus one representative for the US National Library of Medicine and one representative for the World Association of Biomedical Journal Editors. Since 1978 the Committee provides a document, originally named "Uniform Requirements…", "to help authors, editors, and others involved in peer review and biomedical publishing create and distribute accurate, clear, unbiased medical journal articles". This document has been updated several times and the last version was released in August 2013, now renamed "Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals", available in www.icmje.org and citable as "ICMJE Recommendations". A vast proportion of medical journals, worldwide, have adopted these recommendations as rules. The ICMJE discusses and provides guidance on several relevant aspects including criteria on authorship, peer review, scientific misconduct, conflicts of interest, clinical trials registration, good editorial practices, the relations between editors and journal owners, the protection of individuals subject to medical research, the solvency of electronic publications, among others. The 2013 ICMJE Annual Meeting took place in Santiago, Chile, in November 4 and 5. The photograph shows attendants to the final session.

Recommendations for improved and coherent acquisition and processing of backscatter data from seafloor-mapping sonars

NASA Astrophysics Data System (ADS)

Lamarche, Geoffroy; Lurton, Xavier

2018-06-01

Multibeam echosounders are becoming widespread for the purposes of seafloor bathymetry mapping, but the acquisition and the use of seafloor backscatter measurements, acquired simultaneously with the bathymetric data, are still insufficiently understood, controlled and standardized. This presents an obstacle to well-accepted, standardized analysis and application by end users. The Marine Geological and Biological Habitat Mapping group (Geohab.org) has long recognized the need for better coherence and common agreement on acquisition, processing and interpretation of seafloor backscatter data, and established the Backscatter Working Group (BSWG) in May 2013. This paper presents an overview of this initiative, the mandate, structure and program of the working group, and a synopsis of the BSWG Guidelines and Recommendations to date. The paper includes (1) an overview of the current status in sensors and techniques available in seafloor backscatter data from multibeam sonars; (2) the presentation of the BSWG structure and results; (3) recommendations to operators, end-users, sonar manufacturers, and software developers using sonar backscatter for seafloor-mapping applications, for best practice methods and approaches for data acquisition and processing; and (4) a discussion on the development needs for future systems and data processing. We propose for the first time a nomenclature of backscatter processing levels that affords a means to accurately and efficiently describe the data processing status, and to facilitate comparisons of final products from various origins.

Analysis of The Planning Education in the Light of the Contemporary Trends in Planning

NASA Astrophysics Data System (ADS)

Husar, Milan; Ceren Varis, Sila; Ondrejicka, Vladimir

2017-12-01

This paper examines the way the planning education is taught and examines the recent trends in the curricula of planning education institutions. The introduction of changing economic systems and planning in the field of education is discussed against these changes. Additionally, the evolution in the planner’s role and how it affects the planning education is discussed. The paper is addressing trends and challenges the countries and their planning changes are facing in 21st century. The trends such as increasing globalization, fuzziness of spatial structures and their borders, complexity and uncertainty and the growing interconnectedness of the world are discussed. Another aim is to prepare a common ground, a platform at the university level for scientific cooperation in the field of planning. This study aims at examining the situation of planning in the contemporary world. The identified challenges include the need for more flexibility in planning and planning education, the emergence of innovations and creativity in planners and planning projects, the necessity of promoting soft skills while keeping the existing technical nature of planning and lastly, the need for more interdisciplinary work. The final part of the paper is discussing the future planning education and recommendations on how the schools of planning should reflect these changes.

Notification: Follow-Up on Significant Information Technology Security Findings and Recommendations

EPA Pesticide Factsheets

Project #OA-FY14-0056, January 17, 2014. The EPA OIG plans to begin preliminary research to follow up on recommendations issued in its final reports between specific fiscal years, and reports associated with the FY 2013 OIG Management Challenges memo.

Area XV Career Education Research & Planning. Final Report.

ERIC Educational Resources Information Center

Indian Hills Community Coll., Ottumwa, IA.

Critical issues in career education are addressed in this report of an advisory committee seeking input and making recommendations for career education implementation in Iowa. Recommendations addressing state, area, and local school district responsibilities are grouped into three main perspectives: planning, implementation, and evaluation. The…

Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report

PubMed Central

Clavien, Pierre-Alain; Lesurtel, Mickael; Bossuyt, Patrick M M; Gores, Gregory J; Langer, Bernard; Perrier, Arnaud

2012-01-01

Although liver transplantation is a widely accepted treatment for hepatocellular carcinoma (HCC), much controversy remains and there is no generally accepted set of guidelines. An international consensus conference was held on Dec 2–4, 2010, in Zurich, Switzerland, with the aim of reviewing current practice regarding liver transplantation in patients with HCC and to develop internationally accepted statements and guidelines. The format of the conference was based on the Danish model. 19 working groups of experts prepared evidence-based reviews according to the Oxford classification, and drafted recommendations answering 19 specific questions. An independent jury of nine members was appointed to review these submissions and make final recommendations, after debates with the experts and audience at the conference. This report presents the final 37 statements and recommendations, covering assessment of candidates for liver transplantation, criteria for listing in cirrhotic and non-cirrhotic patients, role of tumour downstaging, management of patients on the waiting list, role of living donation, and post-transplant management. PMID:22047762

Recommendation in evolving online networks

NASA Astrophysics Data System (ADS)

Hu, Xiao; Zeng, An; Shang, Ming-Sheng

2016-02-01

Recommender system is an effective tool to find the most relevant information for online users. By analyzing the historical selection records of users, recommender system predicts the most likely future links in the user-item network and accordingly constructs a personalized recommendation list for each user. So far, the recommendation process is mostly investigated in static user-item networks. In this paper, we propose a model which allows us to examine the performance of the state-of-the-art recommendation algorithms in evolving networks. We find that the recommendation accuracy in general decreases with time if the evolution of the online network fully depends on the recommendation. Interestingly, some randomness in users' choice can significantly improve the long-term accuracy of the recommendation algorithm. When a hybrid recommendation algorithm is applied, we find that the optimal parameter gradually shifts towards the diversity-favoring recommendation algorithm, indicating that recommendation diversity is essential to keep a high long-term recommendation accuracy. Finally, we confirm our conclusions by studying the recommendation on networks with the real evolution data.

Long-term effects of user preference-oriented recommendation method on the evolution of online system

NASA Astrophysics Data System (ADS)

Shi, Xiaoyu; Shang, Ming-Sheng; Luo, Xin; Khushnood, Abbas; Li, Jian

2017-02-01

As the explosion growth of Internet economy, recommender system has become an important technology to solve the problem of information overload. However, recommenders are not one-size-fits-all, different recommenders have different virtues, making them be suitable for different users. In this paper, we propose a novel personalized recommender based on user preferences, which allows multiple recommenders to exist in E-commerce system simultaneously. We find that output of a recommender to each user is quite different when using different recommenders, the recommendation accuracy can be significantly improved if each user is assigned with his/her optimal personalized recommender. Furthermore, different from previous works focusing on short-term effects on recommender, we also evaluate the long-term effect of the proposed method by modeling the evolution of mutual feedback between user and online system. Finally, compared with single recommender running on the online system, the proposed method can improve the accuracy of recommendation significantly and get better trade-offs between short- and long-term performances of recommendation.

Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

PubMed

Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E

2014-08-01

Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

Mute swans and their Chesapeake Bay habitats: proceedings of a symposium

USGS Publications Warehouse

Perry, M.C.

2004-01-01

The symposium 'Mute Swans and their Chesapeake Bay Habitats,' held on June 7, 2001, provided a forum for biologists and managers to share research findings and management ideas concerning the exotic and invasive mute swan (Cygnus olar). This species has been increasing in population size and is considered by many to be a problem in regard to natural food resources in the Bay that are used by native waterfowl during the winter months. Other persons, however, feel that resource managers are attempting to create a problem to justify more killing of waterfowl by hunters. Some persons also believe that managers should focus on the larger issues causing the decline of native food resources, such as the unabated human population increase in the Bay watershed and in the immediate coastal areas of the Bay. The symposium, sponsored by the Wildfowl Trust of North America and the U.S. Geological Survey, provided the atmosphere for presentation of mute swan data and opinions in a collegial setting where discussion was welcomed and was often informative and enthusiastic. An interesting historic review of the swan in regard to the history of mankind was presented, followed by a discussion on the positive and negative effects of invasive species. Biologists from different parts of the continent discussed the population status of the species in several states in the east and in the Great Lakes area. Data on the food habits of this species were presented in regard to submerged aquatic vegetation, and an interesting discussion on the role that the food habits of Canada geese in regard to native vegetation was presented. Findings and recommendations of the Mute Swan Task Force were presented. Finally, a representative of the Friends of Animals gave a thought-provoking presentation in defense of the mute swan. The presentations, in general, provided the necessary information and recommendations to allow managers to proceed with management of this controversial species with new and valuable perspectives.

Studies on Sporulation Optimization and Chracterization of Bacillus subtilis Spore Quality

DTIC Science & Technology

2011-12-01

in the other two media. Finally, heat and bleach resistance were recommended in place of acid res istance as indicators of spore hardiness. 1S...sporicidal chemicals (e .g., hypochlorite, hydrogen peroxide/per-acetic, and chlorine dioxide gas ), are strongly recommended as spore quality...effected by exposure to one or more sporicidal chemicals (e.g., hypochlorite, hydrogen peroxide/pre-acetic, chlorine dioxide gas ), are strongly recommended

Environmental investigation for property transfer, Fort Holabird Crime Records Center. Environmental investigation and alternatives assessment. Final report

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

Finger, F.J.; Todd, Q.R.

An Environmental Investigation and Alternatives Assessment was conducted for the Crime Records Center at Fort Holabird in Baltimore, Maryland. Groundwater sampling, underground storage tank tightness testing, radon sampling, asbestos sampling, soil observations, and a review of previously collected data were used to develop remedial alternatives and recommendations. Removal and record keeping were recommended for asbestos. The recommendation for groundwater was no action.

Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations

PubMed Central

Sommers, Juultje; Engelbert, Raoul HH; Dettling-Ihnenfeldt, Daniela; Gosselink, Rik; Spronk, Peter E; Nollet, Frans; van der Schaaf, Marike

2015-01-01

Objective: To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units. Methods: We used the EBRO method, as recommended by the ‘Dutch Evidence Based Guideline Development Platform’ to develop an ‘evidence statement for physiotherapy in the intensive care unit’. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts. Results: Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment. Conclusions: These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014. PMID:25681407

Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations.

PubMed

Sommers, Juultje; Engelbert, Raoul H H; Dettling-Ihnenfeldt, Daniela; Gosselink, Rik; Spronk, Peter E; Nollet, Frans; van der Schaaf, Marike

2015-11-01

To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units. We used the EBRO method, as recommended by the 'Dutch Evidence Based Guideline Development Platform' to develop an 'evidence statement for physiotherapy in the intensive care unit'. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts. Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment. These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014. © The Author(s) 2015.

Andrographis paniculata (Burm. f.) Wall. ex Nees: A Review of Ethnobotany, Phytochemistry, and Pharmacology

PubMed Central

Sule, Abubakar; Rahman, K. M. Hafizur

2014-01-01

As aboriginal sources of medications, medicinal plants are used from the ancient times. Andrographis paniculata is one of the highly used potential medicinal plants in the world. This plant is traditionally used for the treatment of common cold, diarrhoea, fever due to several infective cause, jaundice, as a health tonic for the liver and cardiovascular health, and as an antioxidant. It is also used to improve sexual dysfunctions and serve as a contraceptive. All parts of this plant are used to extract the active phytochemicals, but the compositions of phytoconstituents widely differ from one part to another and with place, season, and time of harvest. Our extensive data mining of the phytoconstituents revealed more than 55 ent-labdane diterpenoids, 30 flavonoids, 8 quinic acids, 4 xanthones, and 5 rare noriridoids. In this review, we selected only those compounds that pharmacology has already reported. Finally we focused on around 46 compounds for further discussion. We also discussed ethnobotany of this plant briefly. Recommendations addressing extraction process, tissue culture, and adventitious rooting techniques and propagation under abiotic stress conditions for improvement of phytoconstituents are discussed concisely in this paper. Further study areas on pharmacology are also proposed where needed. PMID:25950015

Shuttle payload bay thermal environments: Summary and conclusion report for STS Flights 1-5

NASA Technical Reports Server (NTRS)

Fu, J. H.; Graves, G. R.

1987-01-01

The thermal data for the payload bay of the first five shuttle flights is summarized and the engineering evaluation of that data is presented. After a general discussion on mission profiles and vehicle configurations, the thermal design and flight instrumentation systems of the payload bay are described. The thermal flight data sources and a categorization of the data are then presented. A thermal flight data summarization section provides temperature data for the five phases of a typical mission profile. These are: prelaunch, ascent, on-orbit, entry and postlanding. The thermal flight data characterization section encompasses this flight data for flight to flight variations, payload effects, temperature ranges, and other variations. Discussion of the thermal environment prediction models in use by industry and various NASA Centers, and the results predicted by these models, is followed by an evaluation of the correlation between the actual flight data and the results predicted by the models. Finally, the available thermal data are evaluated from the viewpoint of the user concerned with establishing the thermal environment in the payload bay. The data deficiencies are discussed and recommendations for their elimination are presented.

Psychometric challenges and proposed solutions when scoring facial emotion expression codes.

PubMed

Olderbak, Sally; Hildebrandt, Andrea; Pinkpank, Thomas; Sommer, Werner; Wilhelm, Oliver

2014-12-01

Coding of facial emotion expressions is increasingly performed by automated emotion expression scoring software; however, there is limited discussion on how best to score the resulting codes. We present a discussion of facial emotion expression theories and a review of contemporary emotion expression coding methodology. We highlight methodological challenges pertinent to scoring software-coded facial emotion expression codes and present important psychometric research questions centered on comparing competing scoring procedures of these codes. Then, on the basis of a time series data set collected to assess individual differences in facial emotion expression ability, we derive, apply, and evaluate several statistical procedures, including four scoring methods and four data treatments, to score software-coded emotion expression data. These scoring procedures are illustrated to inform analysis decisions pertaining to the scoring and data treatment of other emotion expression questions and under different experimental circumstances. Overall, we found applying loess smoothing and controlling for baseline facial emotion expression and facial plasticity are recommended methods of data treatment. When scoring facial emotion expression ability, maximum score is preferred. Finally, we discuss the scoring methods and data treatments in the larger context of emotion expression research.

Blended/Hybrid Courses: A Review of the Literature and Recommendations for Instructional Designers and Educators

ERIC Educational Resources Information Center

Helms, Samuel A.

2014-01-01

This article explores some of the literature on blended/hybrid learning and identifies recommendations for instructional designers and faculty. Terminology and definitions are discussed first including the debate between the words "blended" and "hybrid." A working definition for the article is discussed but the article does not…

Video Games: Research, Ratings, Recommendations. ERIC Digest.

ERIC Educational Resources Information Center

Cesarone, Bernard

This Digest reviews research on the demographics and effects of video game playing, discusses game rating systems, and offers recommendations for parents. The Digest begins by discussing research on the time children spend playing electronic games, which shows that younger children's game playing at home (90% of fourth-graders played at least one…

Norms in Conflict: Statecraft, Preventive Force, and Counter Proliferation

DTIC Science & Technology

2016-12-01

power. Finally, the ethical character of norms offers a framework for the attacking state to justify its actions to the international community ...national identity, sanctions, and ethics play in counter-proliferation strategies. Finally, it concludes by offering policy recommendations for...role that national identity, sanctions, and ethics play in counter-proliferation strategies. Finally, it concludes by offering policy

Task Force on Declining Enrollment. Final Report.

ERIC Educational Resources Information Center

Hamden Public Schools, CT.

This task force in Hamden, Connecticut, discovered an intricate relationship among declining enrollment and finances, buildings, community impact, and educational impact. Their study resulted in nine conclusions and recommendations. (1) We will recommend to the board of education criteria, procedures, and timetables for closing a school. (2)…

UCSD's Automated Merit Processing System.

ERIC Educational Resources Information Center

Merryman, Robert; Johnson, Judy R.; Block, Ron

1998-01-01

The University of California San Diego replaced its manual staff merit-increase-recommendation process with an online computer program to reduce workloads and improve the quality of the final recommendations. The highly successful system has been enthusiastically embraced by the campus community and recognized by the National Association of…

42 CFR 137.434 - If an Indian Tribe objects to the recommended decision, what will the Secretary do?

Code of Federal Regulations, 2010 CFR

2010-10-01

... SELF-GOVERNANCE Appeals Pre-Award Disputes § 137.434 If an Indian Tribe objects to the recommended decision, what will the Secretary do? (a) The Secretary has 45 days from the date it receives the final...

78 FR 32996 - Western Pacific Fisheries; Fishing in the Marianas Trench, Pacific Remote Islands, and Rose Atoll...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-03

... consider the use of modern gear integral to both maintaining traditional indigenous fishing in the... traditional indigenous fishing practices. The Council recommended incorporating the Proclamations' fishery... traditional indigenous fishing practices. This final rule implements the Council's recommendations. Consistent...

The content of diet and physical activity consultations with older adults in primary care.

PubMed

Bardach, Shoshana H; Schoenberg, Nancy E

2014-06-01

Despite numerous benefits of consuming a healthy diet and receiving regular physical activity, engagement in these behaviors is suboptimal. Since primary care visits are influential in promoting healthy behaviors, we sought to describe whether and how diet and physical activity are discussed during older adults' primary care visits. 115 adults aged 65 and older consented to have their routine primary care visits recorded. Audio-recorded visits were transcribed and diet and physical activity content was coded and analyzed. Diet and physical activity were discussed in the majority of visits. When these discussions occurred, they lasted an average of a minute and a half. Encouragement and broad discussion of benefits of improved diet and physical activity levels were the common type of exchange. Discussions rarely involved patient behavioral self-assessments, patient questions, or providers' recommendations. The majority of patient visits include discussion of diet and physical activity, but these discussions are often brief and rarely include recommendations. Providers may want to consider ways to expand their lifestyle behavior discussions to increase patient involvement and provide more detailed, actionable recommendations for behavior change. Additionally, given time constraints, a wider array of approaches to lifestyle counseling may be necessary. Published by Elsevier Ireland Ltd.

Design definition of the Laser Atmospheric Wind Sounder (LAWS), phase 2. Volume 2: Final report

NASA Technical Reports Server (NTRS)

Wilson, D. J.

1992-01-01

Lockheed personnel, along with team member subcontractors and consultants, have performed a preliminary design for the LAWS Instrument. Breadboarding and testing of a LAWS class laser have also been performed. These efforts have demonstrated that LAWS is a feasible Instrument and can be developed with existing state-of-the-art technology. Only a commitment to fund the instrument development and deployment is required to place LAWS in orbit and obtain the anticipated science and operational forecasting benefits. The LAWS Science Team was selected in 1988-89 as were the competing LAWS phase 1/2 contractor teams. The LAWS Science Team developed requirements for the LAWS Instrument, and the NASA/LAWS project office defined launch vehicle and platform design constraints. From these requirements and constraints, the lockheed team developed LAWS Instrument concepts and configurations. A system designed to meet these requirements and constraints is outlined. The LAWS primary subsystem and interfaces - laser, optical, and receiver/processor - required to assemble a lidar are identified. Also identified are the support subsystems required for the lidar to function from space: structures and mechanical, thermal, electrical, and command and data management. The Lockheed team has developed a preliminary design of a LAWS Instrument System consisting of these subsystems and interfaces which will meet the requirements and objectives of the Science Team. This final report provides a summary of the systems engineering analyses and trades of the LAWS. Summaries of the configuration, preliminary designs of the subsystems, testing recommendations, and performance analysis are presented. Environmental considerations associated with deployment of LAWS are discussed. Finally, the successful LAWS laser breadboard effort is discussed along with the requirements and test results.

Research on Long Tail Recommendation Algorithm

NASA Astrophysics Data System (ADS)

Hu, Xuezhi; Zhang, Chuang; Wu, Ming; Zeng, Yang

2017-10-01

Most recommendation systems in the major electronic commerce platforms are influenced by the long tail effect more or less. There are sufficient researches of how to assess recommendation effect while no criteria to evaluate long tail recommendation rate. In this study, we first discussed the existing problems of recommending long tail products through specific experiments. Then we proposed a long tail evaluation criteria and compared the performance in long tail recommendation between different models.

Regression Model Term Selection for the Analysis of Strain-Gage Balance Calibration Data

NASA Technical Reports Server (NTRS)

Ulbrich, Norbert Manfred; Volden, Thomas R.

2010-01-01

The paper discusses the selection of regression model terms for the analysis of wind tunnel strain-gage balance calibration data. Different function class combinations are presented that may be used to analyze calibration data using either a non-iterative or an iterative method. The role of the intercept term in a regression model of calibration data is reviewed. In addition, useful algorithms and metrics originating from linear algebra and statistics are recommended that will help an analyst (i) to identify and avoid both linear and near-linear dependencies between regression model terms and (ii) to make sure that the selected regression model of the calibration data uses only statistically significant terms. Three different tests are suggested that may be used to objectively assess the predictive capability of the final regression model of the calibration data. These tests use both the original data points and regression model independent confirmation points. Finally, data from a simplified manual calibration of the Ames MK40 balance is used to illustrate the application of some of the metrics and tests to a realistic calibration data set.

Orion Pad Abort 1 Crew Module Inertia Test Approach and Results

NASA Technical Reports Server (NTRS)

Herrera, Claudia; Harding, Adam

2010-01-01

The Flight Loads Laboratory at the Dryden Flight Research Center conducted tests to measure the inertia properties of the Orion Pad Abort 1 (PA-1) Crew Module. These measurements were taken to validate analytical predictions of the inertia properties of the vehicle and assist in reducing uncertainty for derived aero performance results calculated post launch. The first test conducted was to determine the Ixx of the Crew Module. This test approach used a modified torsion pendulum test step up that allowed the suspended Crew Module to rotate about the x axis. The second test used a different approach to measure both the Iyy and Izz properties. This test used a Knife Edge fixture that allowed small rotation of the Crew Module about the y and z axes. Discussions of the techniques and equations used to accomplish each test are presented. Comparisons with the predicted values used for the final flight calculations are made. Problem areas, with explanations and recommendations where available, are addressed. Finally, an evaluation of the value and success of these techniques to measure the moments of inertia of the Crew Module is provided.

Evaluation of Subsequent Heat Treatment Routes for Near-β Forged TA15 Ti-Alloy

PubMed Central

Sun, Zhichao; Wu, Huili; Yang, He

2016-01-01

TA15 Ti-alloy is widely used to form key load-bearing components in the aerospace field, where excellent service performance is needed. Near-β forging technology provides an attractive way to form these complicated Ti-alloy components but subsequent heat treatment has a great impact on the final microstructure and mechanical properties. Therefore evaluation and determination of the heat treatment route is of particular significance. In this paper, for the near-β forged TA15 alloy, the formation and evolution of microstructures under different subsequent heat treatment routes (annealing, solution and aging, toughening and strengthening) were studied and the cooling mode after forging was also considered. Then, the type and characteristics of the obtained microstructures were discussed through quantitative metallographic analysis. The corresponding mechanical properties (tensile, impact toughness, and fracture toughness) and effects of microstructural characteristics were investigated. Finally, for a required microstructure and performance a reasonable heat treatment route was recommended. The work is of importance for the application and development of near-β forging technology. PMID:28773994

76 FR 49786 - Notice of Availability of the Final Environmental Impact Statement/Environmental Impact Report...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-11

... of Fish and Game (CDFG), the lead State agency, have prepared a joint Final EIS/EIR for the proposed... decision. The CDFG will advance its recommendations to the California Fish and Game Commission (Commission...

Federal Register notice: Office of Solid Waste Chemicals; Final Test Rule

EPA Pesticide Factsheets

EPA is issuing a final test rule, under section 4 of the Toxic Substances Control Act(TSCA) requiring and/or recommending that manufacturers and processors of 33 chemicals perform testing for human health effects and/or chemical fate.