Dialogical nursing ethics: the quality of freedom restrictions.

PubMed

Abma, Tineke A; Widdershoven, Guy A M; Frederiks, Brenda J M; van Hooren, Rob H; van Wijmen, Frans; Curfs, Paul L M G

2008-11-01

This article deals with the question of how ethicists respond to practical moral problems emerging in health care practices. Do they remain distanced, taking on the role of an expert, or do they become engaged with nurses and other participants in practice and jointly develop contextualized insights about good care? A basic assumption of dialogical ethics entails that the definition of good care and what it means to be a good nurse is a collaborative product of ongoing dialogues among various stakeholders engaged in the practice. This article discusses the value of a dialogical approach to ethics by drawing on the work of various nursing scholars. We present a case example concerning the quality of freedom restrictions for intellectually disabled people. Issues for discussion include the role and required competences of the ethicist and dealing with asymmetrical relationships between stakeholders.

Identification, definition and quantification of goods and services provided by marine biodiversity: implications for the ecosystem approach.

PubMed

Beaumont, N J; Austen, M C; Atkins, J P; Burdon, D; Degraer, S; Dentinho, T P; Derous, S; Holm, P; Horton, T; van Ierland, E; Marboe, A H; Starkey, D J; Townsend, M; Zarzycki, T

2007-03-01

This paper identifies and defines ecosystem goods and services provided by marine biodiversity. Case studies have been used to provide an insight into the practical issues associated with the assessment of marine ecosystem goods and services at specific locations. The aim of this research was to validate the definitions of goods and services, and to identify knowledge gaps and likely difficulties of quantifying the goods and services. A validated theoretical framework for the assessment of goods and services is detailed, and examples of the goods and services at a variety of case study areas are documented. These results will enable future assessments of marine ecosystem goods and services. It is concluded that the utilisation of this goods and services approach has the capacity to play a fundamental role in the Ecosystem Approach, by enabling the pressures and demands of society, the economy and the environment to be integrated into environmental management.

Sanitation & Safety for Child Feeding Programs.

ERIC Educational Resources Information Center

Florida State Dept. of Health and Rehabilitative Services, Tallahassee.

In the interest of promoting good health, sanitation, and safety practices in the operation of child feeding programs, this bulletin discusses practices in personal grooming and wearing apparel; the purchasing, storage, handling, and serving of food; sanitizing equipment and utensils; procedures to follow in case of a food poisoning outbreak; some…

[The clinical application of zirconium-dioxide-ceramics. Case report].

PubMed

Somfai, Dóra; Zsigmond, Ágnes; Károlyházy, Katalin; Kispély, Barbara; Hermann, Péter

2015-12-01

Due to its outstanding physical, mechanical and esthetic properties, zirconium-dioxide is one of the most popular non-metal denture, capable of surpassing PFM in most cases. The recent advances of CAD/CAM technology makes it a good alternitve. Here we show the usefulness of zirconium-dioxide in everyday dental practice through three case reports.

Adaptive governance good practice: Show me the evidence!

PubMed

Sharma-Wallace, Lisa; Velarde, Sandra J; Wreford, Anita

2018-09-15

Adaptive governance has emerged in the last decade as an intriguing avenue of theory and practice for the holistic management of complex environmental problems. Research on adaptive governance has flourished since the field's inception, probing the process and mechanisms underpinning the new approach while offering various justifications and prescriptions for empirical use. Nevertheless, recent reviews of adaptive governance reveal some important conceptual and practical gaps in the field, particularly concerning challenges in its application to real-world cases. In this paper, we respond directly to the empirical challenge of adaptive governance, specifically asking: which methods contribute to the implementation of successful adaptive governance process and outcomes in practice and across cases and contexts? We adopt a systematic literature review methodology which considers the current body of empirical literature on adaptive governance of social-ecological systems in order to assess and analyse the methods affecting successful adaptive governance practice across the range of existing cases. We find that methods contributing to adaptive governance in practice resemble the design recommendations outlined in previous adaptive governance scholarship, including meaningful collaboration across actors and scales; effective coordination between stakeholders and levels; building social capital; community empowerment and engagement; capacity development; linking knowledge and decision-making through data collection and monitoring; promoting leadership capacity; and exploiting or creating governance opportunities. However, we critically contextualise these methods by analysing and summarising their patterns-in-use, drawing examples from the cases to explore the specific ways they were successfully or unsuccessfully applied to governance issues on-the-ground. Our results indicate some important underlying shared patterns, trajectories, and lessons learned for evidence-based adaptive governance good practice within and across diverse sectors, issues, and contexts. Copyright © 2018. Published by Elsevier Ltd.

Integration of QR codes into an anesthesia information management system for resident case log management.

PubMed

Avidan, Alexander; Weissman, Charles; Levin, Phillip D

2015-04-01

Quick response (QR) codes containing anesthesia syllabus data were introduced into an anesthesia information management system. The code was generated automatically at the conclusion of each case and available for resident case logging using a smartphone or tablet. The goal of this study was to evaluate the use and usability/user-friendliness of such system. Resident case logging practices were assessed prior to introducing the QR codes. QR code use and satisfactions amongst residents was reassessed at three and six months. Before QR code introduction only 12/23 (52.2%) residents maintained a case log. Most of the remaining residents (9/23, 39.1%) expected to receive a case list from the anesthesia information management system database at the end of their residency. At three months and six months 17/26 (65.4%) and 15/25 (60.0%) residents, respectively, were using the QR codes. Satisfaction was rated as very good or good. QR codes for residents' case logging with smartphones or tablets were successfully introduced in an anesthesia information management system and used by most residents. QR codes can be successfully implemented into medical practice to support data transfer. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Knowledge, attitude, and practice regarding dengue virus infection among inhabitants of Aceh, Indonesia: a cross-sectional study.

PubMed

Harapan, Harapan; Rajamoorthy, Yogambigai; Anwar, Samsul; Bustamam, Aslam; Radiansyah, Arsil; Angraini, Pradiba; Fasli, Riny; Salwiyadi, Salwiyadi; Bastian, Reza Akbar; Oktiviyari, Ade; Akmal, Imaduddin; Iqbalamin, Muhammad; Adil, Jamalul; Henrizal, Fenni; Darmayanti, Darmayanti; Pratama, Rovy; Setiawan, Abdul Malik; Mudatsir, Mudatsir; Hadisoemarto, Panji Fortuna; Dhimal, Mandira Lamichhane; Kuch, Ulrich; Groneberg, David Alexander; Imrie, Allison; Dhimal, Meghnath; Müller, Ruth

2018-02-27

The Indonesian region of Aceh was the area most severely affected by the earthquake and tsunami of 26 December 2004. Department of Health data reveal an upward trend of dengue cases in Aceh since the events of the tsunami. Despite the increasing incidence of dengue in the region, there is limited understanding of dengue among the general population of Aceh. The aim of this study was to assess the knowledge, attitude, and practice (KAP) regarding dengue among the people of Aceh, Indonesia in order to design intervention strategies for an effective dengue prevention program. A community-based cross-sectional study was conducted in Aceh between November 2014 and March 2015 with a total of 609 participants living in seven regencies and two municipalities. Information on the socio-demographic characteristics of participants and their KAP regarding dengue was collected using a pre-tested structured questionnaire. The KAP status (good vs. poor) of participants with different socio-demographic characteristics was compared using Chi Square-test, ANOVA or Fisher's exact test as appropriate. Logistic regression analysis was used to determine the predictors of each KAP domain. We found that 45% of participants had good knowledge regarding dengue and only 32% had good attitudes and good dengue preventive practices. There was a significant positive correlation between knowledge and attitudes, knowledge and practice, and attitudes and practice. In addition, people who had good knowledge were 2.7 times more likely to have good attitudes, and people who had good attitudes were 2.2 times more likely to have good practices regarding dengue. The level of education, occupation, marital status, monthly income, socioeconomic status (SES) and living in the city were associated with the knowledge level. Occupation, SES, and having experienced dengue fever were associated with attitudes. Education, occupation, SES and type of residence were associated with preventive practices. Our study suggests that dengue prevention programs are required to increase KAP levels regarding dengue in the communities of Aceh.

GUIDING PRINCIPLES FOR GOOD PRACTICES IN HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT UNITS.

PubMed

Sampietro-Colom, Laura; Lach, Krzysztof; Pasternack, Iris; Wasserfallen, Jean-Blaise; Cicchetti, Americo; Marchetti, Marco; Kidholm, Kristian; Arentz-Hansen, Helene; Rosenmöller, Magdalene; Wild, Claudia; Kahveci, Rabia; Ulst, Margus

2015-01-01

Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA units. A framework for good practice criteria was built inspired by the EFQM excellence business model and information from six literature reviews, 107 face-to-face interviews, forty case studies, large-scale survey, focus group, Delphi survey, as well as local and international validation. In total, 385 people from twenty countries have participated in defining the principles for good practices in HB-HTA units. Fifteen guiding principles for good practices in HB-HTA units are grouped in four dimensions. Dimension 1 deals with principles of the assessment process aimed at providing contextualized information for hospital decision makers. Dimension 2 describes leadership, strategy and partnerships of HB-HTA units which govern and facilitate the assessment process. Dimension 3 focuses on adequate resources that ensure the operation of HB-HTA units. Dimension 4 deals with measuring the short- and long-term impact of the overall performance of HB-HTA units. Finally, nine core guiding principles were selected as essential requirements for HB-HTA units based on the expertise of the HB-HTA units participating in the project. Guiding principles for good practices set up a benchmark for HB-HTA because they represent the ideal performance of HB-HTA units; nevertheless, when performing HTA at hospital level, context also matters; therefore, they should be adapted to ensure their applicability in the local context.

Knowledge and practice of tuberculosis infection control among health professionals in Northwest Ethiopia; 2011.

PubMed

Temesgen, Chanie; Demissie, Meaza

2014-11-19

Tuberculosis (TB) is highly prevalent in sub-Saharan Africa, making the risk of infection transmission high in these countries. Despite high prevalence of TB and expected high probability of nosocomial transmission in Ethiopia, a rapid assessment done in 2008 revealed that most health facilities in Ethiopia do not use tuberculosis infection control (TBIC) practices. Patients and providers are therefore at risk of exposure to TB, especially at high case load facilities. The purpose of this study was to assess TBIC knowledge and practices among health professionals working in hospitals in the Amhara region of Northwest Ethiopia. An institution-based hybrid study was implemented form August 2010 to January 2011. The subjects were health professionals who were proportionally selected from each hospital. Subjects self-administered a questionnaire that contained sections on socio-demographics and on TBIC knowledge and practice. Those answering ≥60% of knowledge questions correctly and ≥50% of practice questions correctly were considered to have good knowledge and practice, respectively. A total of 313 healthcare professionals were enrolled from four healthcare facilities. The response rate was 96%. Only 18.8% received in-service training. Among those who were trained, 74.4%, 95% CI (69.6, 79.3%) were found to have good knowledge and 63.2%, 95% CI (57.9, 68.6%) good practice on TBIC. Training was found to be a predictor of TBIC knowledge, AOR* 3.386 and 95% CI (1.377, 8.330) while knowledge of TBIC was a strong predictor of good TBIC practice, AOR* 10.667 and 95% CI (5.769, 19.721). Though the majority of the respondents had good TBIC knowledge and practice, a considerable proportion of healthcare professionals were not trained on TBIC. Respondents trained on TBIC were found to be more knowledgeable than those not trained. Similarly, respondents with good TBIC knowledge were 10 times more likely to have good TBIC practice compared to those with poor TBIC knowledge. Training was not found to have an effect on TBIC practice. *Adjusted Odds Ratio.

Issues in practice based learning in nursing in the United Kingdom and the Republic of Ireland: Results from a multi professional scoping exercise.

PubMed

Mallik, Maggie; McGowan, Brian

2007-01-01

The first year (2003-2004) of a three year nationally funded project focused on completing a scoping exercise on the nature of practice education in five selected health care professions: Dietetics, Nursing, Occupational Therapy, Physiotherapy and Radiography (). A survey questionnaire, focus groups and secondary sources were used to collect data. Profession specific contributors completed the analysis of results. Resulting case studies were combined to produce a cross-professional overview of current issues in practice-based learning. The nursing case study identified areas of good practice such as; the mentorship model; the development of new support roles; and joint responsibility between Higher Education Institutes (HEIs) and Health Service areas for practice assessment. However, there were variations in the application of these areas of good practice throughout the United Kingdom (UK). Issues included; an inadequate supply of qualified mentors; formal recognition of the mentor role; and lack of knowledge of the relative impact of the differing mentor preparation programmes. In comparing the five professions, all had statutory requirements regarding the nature of practice learning but each profession differed in how this was managed and organised. The need for formal preparation, recognition and reward for the mentor/practice educator role was recognised with collaborative working across the professions a recommendation in order to achieve national improvement in the quality of practice learning support for health care professions.

Why do certain primary health care teams respond better to intimate partner violence than others? A multiple case study.

PubMed

Goicolea, Isabel; Marchal, Bruno; Hurtig, Anna-Karin; Vives-Cases, Carmen; Briones-Vozmediano, Erica; San Sebastián, Miguel

2017-12-09

To analyse how team level conditions influenced health care professionals' responses to intimate partner violence. We used a multiple embedded case study. The cases were four primary health care teams located in a southern region of Spain; two of them considered "good" and two s "average". The two teams considered good had scored highest in practice issues for intimate partner violence, measured via a questionnaire (PREMIS - Physicians Readiness to Respond to Intimate Partner Violence Survey) applied to professionals working in the four primary health care teams. In each case quantitative and qualitative data were collected using a social network questionnaire, interviews and observations. The two "good" cases showed dynamics and structures that promoted team working and team learning on intimate partner violence, had committed social workers and an enabling environment for their work, and had put into practice explicit strategies to implement a women-centred approach. Better individual responses to intimate partner violence were implemented in the teams which: 1) had social workers who were knowledgeable and motivated to engage with others; 2) sustained a structure of regular meetings during which issues of violence were discussed; 3) encouraged a friendly team climate; and 4) implemented concrete actions towards women-centred care. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Medical negligence--prevention and management.

PubMed

Chao, T C

1987-04-01

The rising spate of malpractice cases against doctors appearing in the press and annual reports of medical insurance companies causes concern. Are our doctors more careless or is the public more conscious of litigation? A well publicized malpractice case can ruin the doctor's career and practice. It is well worth a doctor's while to know the pitfalls and learn how to prevent them, and if a mistake happens, how to manage it. Not all mistakes amount to negligence. How will the court view these cases? Some local cases are cited to illustrate the difference between misadventure and negligence. They will serve as guidelines for good medical practice.

Innovative Case Studies of Good Practice in England.

ERIC Educational Resources Information Center

Gifted Education International, 2003

2003-01-01

Four case studies of gifted education programs in England are described, including the development of a teacher handbook based on the principles behind accelerated learning, the identification of students with musical ability and the provision of musical instrument lessons, and the development of a portable information communication technology…

Beliefs and Practices of Expert Respiratory Care Faculty on Critical-Thinking Learning: A Case Study

ERIC Educational Resources Information Center

Hulse, James Leland

2009-01-01

Problem. The development of critical-thinking skills during the professional training of respiratory therapists is imperative for good practice. Research evidence suggests that interactive instructional strategies are far more effective than traditional lectures. Missing from the literature are thick descriptions of how faculty organize the…

Information Technology for Good (IT4G): Merging Information Technology with Social Responsibility

ERIC Educational Resources Information Center

Saulnier, Bruce

2013-01-01

A case is made for a new approach to higher education in the 21st century, an approach in which the traditional majors are extended beyond their usual boundaries by applying one's education to address the public good. The LEAP initiative and the Learning Paradigm College are advanced as exemplars of effective 21st century educational practices,…

Cuban Voices: A Case Study of English Language Teacher Education

ERIC Educational Resources Information Center

Smith, Steven John

2016-01-01

This case study uses qualitative research methods and a postcolonial paradigm to listen to the voices of Cuban teacher educators describing how they educate and prepare English language teachers in Cuba. English language teacher education in Cuba includes features that are considered innovative, contemporary and good practice in the Western world.…

40 CFR 268.5 - Procedures for case-by-case extensions to an effective date.

Code of Federal Regulations, 2011 CFR

2011-07-01

...: (1) He has made a good-faith effort to locate and contract with treatment, recovery, or disposal... specified, such treatment, recovery, or disposal capacity is protective of human health and the environment... technical and practical difficulties associated with providing the alternative capacity will result in the...

40 CFR 268.5 - Procedures for case-by-case extensions to an effective date.

Code of Federal Regulations, 2010 CFR

2010-07-01

...: (1) He has made a good-faith effort to locate and contract with treatment, recovery, or disposal... specified, such treatment, recovery, or disposal capacity is protective of human health and the environment... technical and practical difficulties associated with providing the alternative capacity will result in the...

Dancing Sexual Pleasures: Exploring Teenage Women's Experiences of Sexuality and Pleasure beyond "Sex"

ERIC Educational Resources Information Center

Austin, Josie I.

2016-01-01

This paper focuses on the affective and sensual dimensions of sexuality, especially on what feels good in and on the body. Drawing on a longitudinal participatory case study of a young Christian woman's dancing practices, it illustrates how for young women sexual feelings and sexual pleasure are not only pertinent to those practices normatively…

Collaborativeness as the Core of Professional Learning Communities beyond Culture and Context: Evidence from Canada, Finland, and Israel

ERIC Educational Resources Information Center

Jäppinen, Aini-Kristiina; Leclerc, Martine; Tubin, Dorit

2016-01-01

Professional learning communities (PLC) have been widely accepted as effective with respect to good atmosphere, adequate leadership practices, and functional working practices. However, the outcomes for school improvement depend on case-specific issues. To identify less culturally and contextually bound issues in 3 PLC settings in Canada, Finland,…

Youth Sexual Offending: Context, Good-Enough Lives, and Engaging with a Wider Prevention Agenda

ERIC Educational Resources Information Center

Smallbone, Stephen; Rayment-Mchugh, Susan; Smith, Dimity

2013-01-01

In this article we reflect on developments in our thinking and practice concerning youth sexual offending. We put the case that context is critical to understanding and responding to the problem, and accordingly that a social ecological model provides the most suitable conceptual and practice framework for clinical efforts with this population. We…

The Practice of School Reform: Lessons from Two Centuries

ERIC Educational Resources Information Center

Nehring, James

2009-01-01

Former high school teacher, school leader, activist, consultant, and now professor of education James Nehring combines vivid case studies with practical suggestions to describe how the system works to thwart good schools and what educators can do to improve them. In this book he paints the big picture of school reform in the United States, deftly…

Good life good death according to Christiaan Barnard.

PubMed

Toledo-Pereyra, Luis H

2010-06-01

Christiaan Barnard (1922-2002), pioneering heart transplant surgeon, introduced his ideas on euthanasia in a well-written and researched book, Good Life Good Death. A Doctor's Case for Euthanasia and Suicide, published in 1980. His courage in analyzing this topic in a forthright and clear manner is worth reviewing today. In essence, Barnard supported and practiced passive euthanasia (the ending of life by indirect methods, such as stopping of life support) and discussed, but never practiced, active euthanasia (the ending of life by direct means). Barnard believed that "the primary goal of medicine was to alleviate suffering-not merely to prolong life-he argued that advances in modern medical technology demanded that we evaluate our view of death and the handling of terminal illness." Some in the surgical community took issue with Barnard when he publicized his personal views on euthanasia. We discuss Barnard's beliefs and attempt to clarify some misunderstandings regarding this particular controversial area of medicine.

46 CFR 160.056-2 - Construction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... construction shall be such as is accepted as good engineering practice in the case of the specific material... protected from mechanical damage. It shall be distributed uniformly in the boat and such that at least one...

46 CFR 160.056-2 - Construction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... construction shall be such as is accepted as good engineering practice in the case of the specific material... protected from mechanical damage. It shall be distributed uniformly in the boat and such that at least one...

46 CFR 160.056-2 - Construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... construction shall be such as is accepted as good engineering practice in the case of the specific material... protected from mechanical damage. It shall be distributed uniformly in the boat and such that at least one...

46 CFR 160.056-2 - Construction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... construction shall be such as is accepted as good engineering practice in the case of the specific material... protected from mechanical damage. It shall be distributed uniformly in the boat and such that at least one...

46 CFR 160.056-2 - Construction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... construction shall be such as is accepted as good engineering practice in the case of the specific material... protected from mechanical damage. It shall be distributed uniformly in the boat and such that at least one...

Patterned Evasion Among College Students: Selected Cases

ERIC Educational Resources Information Center

Freedman, Alex S.

1974-01-01

Article focused on student attitudes and practices concerning higher education and presented statements by students in reaction to questions such as, "How do you make good grades without putting in too much time?" (Author/RK)

Communicating with scientific graphics: A descriptive inquiry into non-ideal normativity.

PubMed

Sheredos, Benjamin

2017-06-01

Scientists' graphical practices have recently become a target of inquiry in the philosophy of science, and in the cognitive sciences. Here I supplement our understanding of graphical practices via a case study of how researchers crafted the graphics for scientific publication in the field of circadian biology. The case highlights social aspects of graphical production which have gone understudied - especially concerning the negotiation of publication. I argue that it also supports a challenge to the claim that empirically-informed "cognitive design principles" offer an apt understanding of the norms of success which govern good scientific graphic design to communicate data and hypotheses to other experts. In this respect, the case-study also illustrates how "descriptive" studies of scientific practice can connect with normative issues in philosophy of science, thereby addressing a central concern in recent discussions of practice-oriented philosophy of science. Copyright © 2017 Elsevier Ltd. All rights reserved.

Engaging Sustainability Good Practice within the Curriculum Design and Property Portfolio in the Australian Higher Education Sector

ERIC Educational Resources Information Center

Poon, Joanna

2017-01-01

Purpose: The purpose of this paper is to evaluate the extent to which universities' strategic plans affect the level of incorporation of sustainability within the curriculum design and property portfolio. Design/Methodology/Approach: This research adopted a case study approach. The case study institution was Deakin University in Australia. This…

Still Thinking: The Case for Meditation with Children

ERIC Educational Resources Information Center

Fisher, Robert

2006-01-01

This paper argues the case for meditation with children. It seeks to define what meditation is, why it is important and how it can be practised with children. Meditation provides a good starting point for learning and creativity. It builds upon a long tradition of meditative practice in religious and humanistic settings and research gives evidence…

7 CFR 760.814 - Calculation of acreage for crop losses other than prevented planted.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of the crop, as applicable, or actual acreage of the crop planted for harvest. (b) In cases where... good farming practices; and (4) Could reach maturity if each planting was harvested or would have been harvested. (c) In cases where there is multiple-cropped acreage, each crop may be eligible for disaster...

7 CFR 760.814 - Calculation of acreage for crop losses other than prevented planted.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of the crop, as applicable, or actual acreage of the crop planted for harvest. (b) In cases where... good farming practices; and (4) Could reach maturity if each planting was harvested or would have been harvested. (c) In cases where there is multiple-cropped acreage, each crop may be eligible for disaster...

High-Quality Traineeships: Identifying What Works. A National Vocational Education and Training Research and Evaluation Program Report

ERIC Educational Resources Information Center

Smith, Erica; Comyn, Paul; Kemmis, Roslin Brennan; Smith, Andy

2009-01-01

This study explores the common features of high-quality traineeships using case studies from the cleaning, child care, construction, retail, finance and insurance, and meat processing areas. The research identifies a range of policy measures that could improve both the practice and image of traineeships. A good practice guide has also been…

Good practices in free-energy calculations.

PubMed

Pohorille, Andrew; Jarzynski, Christopher; Chipot, Christophe

2010-08-19

As access to computational resources continues to increase, free-energy calculations have emerged as a powerful tool that can play a predictive role in a wide range of research areas. Yet, the reliability of these calculations can often be improved significantly if a number of precepts, or good practices, are followed. Although the theory upon which these good practices rely has largely been known for many years, it is often overlooked or simply ignored. In other cases, the theoretical developments are too recent for their potential to be fully grasped and merged into popular platforms for the computation of free-energy differences. In this contribution, the current best practices for carrying out free-energy calculations using free energy perturbation and nonequilibrium work methods are discussed, demonstrating that at little to no additional cost, free-energy estimates could be markedly improved and bounded by meaningful error estimates. Monitoring the probability distributions that underlie the transformation between the states of interest, performing the calculation bidirectionally, stratifying the reaction pathway, and choosing the most appropriate paradigms and algorithms for transforming between states offer significant gains in both accuracy and precision.

Electronic business model for small- and medium-sized manufacturing enterprises (SME): a case study

NASA Astrophysics Data System (ADS)

Yuen, Karina; Chung, Walter W.

2001-10-01

This paper identifies three essential factors (information infrastructure, executive information system and a new manufacturing paradigm) that are used to support the development of a new business model for competitiveness. They facilitate changes in organization structure in support of business transformation. A SME can source a good manufacturing practice using a model of academic-university collaboration to gain competitive advantage in the e-business world. The collaboration facilitates the change agents to use information systems development as a vehicle to increase the capability of executives in using information and knowledge management to gain higher responsiveness and customer satisfaction. The case company is used to illustrate the application of a web-based executive information system to interface internal communications with external operation. It explains where a good manufacturing practice may be re-applied by other SMEs to acquire skills as a learning organization grows in an extended enterprise setting.

Applying object-oriented software engineering at the BaBar collaboration

NASA Astrophysics Data System (ADS)

Jacobsen, Bob; BaBar Collaboration Reconstruction Software Group

1997-02-01

The BaBar experiment at SLAC will start taking data in 1999. We are attempting to build its reconstruction software using good software engineering practices, including the use of object-oriented technology. We summarize our experience to date with analysis and design activities, training, CASE and documentation tools, C++ programming practice and similar topics. The emphasis is on the practical issues of simultaneously introducing new techniques to a large collaboration while under a deadline for system delivery.

The ARIA guidelines in specialist practice: a nationwide survey.

PubMed

Van Hoecke, H; Van Cauwenberge, P; Thas, O; Watelet, J B

2010-03-01

In 2001, the ARIA guidelines were published to assist healthcare practitioners in managing allergic rhinitis (AR) according to the best evidence. Very limited information, however, is avail-able on the impact of these guidelines on clinical practice. All Belgian Otorhinolaryngologists were invited to complete a questionnaire, covering demographic and professional characteristics, knowledge, use and perception of the ARIA guidelines and 4 clinical case scenarios of AR. Of the 258 (44%) Belgian Otorhinolaryngologists who participated, almost 90% had ever heard about ARIA and 64% had followed a lecture specifically dedicated to the ARIA guidelines. Furthermore, 62% stated to always or mostly follow the ARIA treatment algorithms in the daily management of AR patients. In the clinical case section, adherence to the ARIA guidelines raised with increased self-reported knowledge and use of the ARIA guidelines and among participants that considered the guidelines more userfriendly. Of the respondents, 51% were considered as good com-pliers. Younger age was a significant predictor for good compliance. More efforts are required to improve the translation of scientific knowledge into clinical practice and to further identify which factors may influence guideline compliance.

Reflexion on linear regression trip production modelling method for ensuring good model quality

NASA Astrophysics Data System (ADS)

Suprayitno, Hitapriya; Ratnasari, Vita

2017-11-01

Transport Modelling is important. For certain cases, the conventional model still has to be used, in which having a good trip production model is capital. A good model can only be obtained from a good sample. Two of the basic principles of a good sampling is having a sample capable to represent the population characteristics and capable to produce an acceptable error at a certain confidence level. It seems that this principle is not yet quite understood and used in trip production modeling. Therefore, investigating the Trip Production Modelling practice in Indonesia and try to formulate a better modeling method for ensuring the Model Quality is necessary. This research result is presented as follows. Statistics knows a method to calculate span of prediction value at a certain confidence level for linear regression, which is called Confidence Interval of Predicted Value. The common modeling practice uses R2 as the principal quality measure, the sampling practice varies and not always conform to the sampling principles. An experiment indicates that small sample is already capable to give excellent R2 value and sample composition can significantly change the model. Hence, good R2 value, in fact, does not always mean good model quality. These lead to three basic ideas for ensuring good model quality, i.e. reformulating quality measure, calculation procedure, and sampling method. A quality measure is defined as having a good R2 value and a good Confidence Interval of Predicted Value. Calculation procedure must incorporate statistical calculation method and appropriate statistical tests needed. A good sampling method must incorporate random well distributed stratified sampling with a certain minimum number of samples. These three ideas need to be more developed and tested.

Analysis of Variance in Vocabulary Learning Strategies Theory and Practice: A Case Study in Libya

ERIC Educational Resources Information Center

Khalifa, Salma H. M.; Shabdin, Ahmad Affendi

2016-01-01

The present study is an outcome of a concern for the teaching of English as a foreign language (EFL) in Libyan schools. Learning of a foreign language is invariably linked to learners building a good repertoire of vocabulary of the target language, which takes us to the theory and practice of imparting training in vocabulary learning strategies…

Raising Roma Educational Participation and Achievement: Collaborative Relationships, Transformative Change, and a Social Europe

ERIC Educational Resources Information Center

Ryder, Andrew Richard

2015-01-01

The paper gives an overview of Roma, Gypsy and Traveller (RGT) educational exclusion in the European Union and seeks to provide insights into good practice through case studies focusing on Bulgaria and the UK. The paper makes a case for the promotion of collaborative relationships, where RGT communities are active partners in developing curricula…

Case four. Synergistic strategy development.

PubMed

Taylor, J D

1990-01-01

Mercy Medical Center is a 467 bed, not-for-profit teaching hospital affiliated with a multispecialty group practice and health maintenance organization through contractual arrangements. Historically, strategy development was not helping the hospital remain viable while accomplishing its mission. Strategic planning was fragmented, not focused toward concern for balance of the overall product line, total growth of the organization or the best use of resources. The hospital did not involve the affiliated group practice or HMO in its planning. This last case in Chapter One describes the pursuit of synergy through strategy formulation. The case provides a good example of what Kanter describes as a post-entrepreneurial organization, striving for advantage through collaboration and linkage with "PALs."

Good Effective School Improvement Practices in Spain.

ERIC Educational Resources Information Center

Murillo, F. Javier

2002-01-01

Presents case studies of five effective school improvement (ESI) programs developed in Spain. Identified characteristics of the Spanish education system that affect the way ESI programs are carried out and developed descriptions of the five programs and lessons learned from them. (SLD)

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

MedlinePlus

... Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health ... Tools Diabetes Education Lesson Plan Outlines Integrating Case Management Into Your Practice [PDF – 290 KB] Integrating DSMES ...

Health information technology and health care activists: Where is the place of Iranians?

PubMed

Ghoochani, Mobina; Kahouei, Mehdi; Hemmat, Morteza; Majdabadi, Hesamedin Askari; Valinejadi, Ali

2017-10-01

The level of knowledge and using health information technology by clinicians, students and staff has always been one of the essential issues in the field of health. The objective of the present study was to evaluate HIT knowledge, attitude, and practice habits among health care professionals and students in educational hospitals in Iran. This case study was carried out in 2016 on 539 personnel of 65 educational hospitals in Iran entailing three subgroups of physicians (n=128), medical students (n=97), and health record staff (n=314). A pretested self-administered questionnaire was designed to evaluate the knowledge, attitude and practice of health information technology. It was comprised of three parts of "baseline general characteristics", "knowledge categories", and "attitude and practice". In total, 28.8% of participants had a good level of knowledge about computer science, whereas 37.7% had a poor level of knowledge. A total of 40% showed good attitude and practice, while 25.6% had poor attitude and practice. Furthermore, 16.4% of physicians, 32% of students and 33.1% of health record staff had good knowledge, while poor knowledge was reported in 45.3% of physicians, 25.8% of students, and 37.6% of staff (p=0.304). The trend of good attitude and practice habits were respectively 28.9%, 50.5%, and 40.8% in physicians, students, and staff, whereas these trends were respectively 30.5%, 4.1%, and 29.9% for poor attitude and practice (p=0.163). Generally, the knowledge level of participants was positively related to the rate of attitude and practice (r=0.847, p<0.001), so the higher knowledge level brought about the higher score in attitude and practice. The level of knowledge and practice of HIT was low among the physicians, students, and staff. Our university can provide a plenary program to promote the level of knowledge and information on practice of HIT.

Drainpipe network management information system design based on GIS and SCADA technique

NASA Astrophysics Data System (ADS)

Gu, Ze-Yu; Zhao, De-An

2011-02-01

Achieving urban drainpipe network integration of geographical information system (GIS) and supervisory control and data acquisition (SCADA) technology is described in this paper. The system design's plans are put forward, which have realized GIS and SCADA system supplementary in the technology and strengthened the model visible analysis ability. It is verified by practical cases that the system has more practical values and a good prospect.

Diagnostic proficiency and reporting of Lassa fever by physicians in Osun State of Nigeria.

PubMed

Olowookere, Samuel Anu; Fatiregun, Akinola Ayoola; Gbolahan, Olalere Omoyosola; Adepoju, Ebenezer Gbenga

2014-06-20

Lassa fever is highly contagious and commonly results in death. It is therefore necessary to diagnose and report any suspected case of Lassa fever to facilitate preventive strategies. This study assessed the preparedness of physicians in the diagnosis and reporting of Lassa fever. The study design was descriptive cross-sectional. The consenting medical doctors completed a self-administered questionnaire on the diagnosis and reporting of Lassa fever. Descriptive and inferential statistics were used in data analyses. One hundred seventy-five physicians participated in the study. The mean age was 41.5 ± 10.9 years (range, 24-75 years). Most of the physicians were male (78.9%) and had practiced medicine ≥ 20 years (51.5%). Most of the physicians had a good knowledge regarding the diagnosis and reporting of Lassa fever; however, none of the physicians had ever diagnosed or reported a suspected case. Predictors of good knowledge include male sex, not practicing at a secondary health care level and post graduation year more than 20 years. There is disparity in knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever. Thus, it is necessary to improve the knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever.

[Support devices for the prevention and treatment of pressure sores].

PubMed

Perrouin-Verbe, Brigite

2014-12-01

There is a strategy to be followed in the treatment of patients with specific pathologies placing them at high risk of pressure sores. In some cases, sophisticated support devices are used.These techniques must be combined with basic good practices.

Liver transplantation after severe hepatic trauma: a sustainable practice. A single-center experience and review of the literature.

PubMed

Patrono, Damiano; Brunati, Andrea; Romagnoli, Renato; Salizzoni, Mauro

2013-01-01

Severe hepatic trauma is a rare indication for liver transplantation (LT). We report our single-center experience of LT for hepatic trauma. Four new cases are discussed in light of a literature review in order to depict the pathways leading from hepatic trauma to LT and to assess the outcomes of this practice. LT is generally indicated in case of uncontrollable hemorrhage, acute liver failure, or post-traumatic late sequelae. Hepatic vessels thrombosis, sepsis, major hepatic resections, and a late referral are factors associated with the progression toward irreversible liver failure. Considering all reported cases, early patient and graft survival reached 68% and 62%, respectively, but in the last decade both have improved to 84%. LT after severe hepatic trauma is a sustainable practice considering the current good outcomes and the ineluctable death of these patients without LT. © 2013 John Wiley & Sons A/S.

Principled Leadership and Business Diplomacy. A Practical, Values-Based Direction for Management Development.

ERIC Educational Resources Information Center

London, Manuel

1999-01-01

Describes business diplomacy based on the Japanese concept of kyosei (working for the common good). Gives case examples of application of principled diplomacy to ethical dilemmas and suggests ways to establish an organizational culture to support principled business leadership. (SK)

The Significance of Leadership Style.

ERIC Educational Resources Information Center

Goldman, Elise

1998-01-01

In a learning environment, leadership style reflects a leader's deeply held educational beliefs, which are mirrored in the school's culture. Case studies illustrate how the leadership styles of three principals affect school ambience. Good leadership practice means acknowledging each person's differing gifts, strengths, and concerns, and utilizing…

Defining principles for good practice: using case studies to inform health systems action on health inequalities.

PubMed

Simpson, Sarah; Kelly, Michael P; Morgan, Antony

2013-02-01

This paper presents work using case studies as a source of data to see if we could extrapolate from the specific to the general particularly with regard to understanding what constitutes effective practice in taking action on SDHI and as a way of enabling policy makers to make better use of knowledge within the case studies and as a way of better understanding what works, in what context and why. Case studies are important to evaluators in that they are relatively straightforward to undertake and because those involved in implementing an intervention are usually keen to profile the intervention. A checklist described in this paper will enable policy advisers and evaluators to quickly review a case study and right away see if it contains enough information to assist in the development of policy options for reducing socially determined health inequalities. Copyright © 2012 Elsevier Ltd. All rights reserved.

Promoting and Disseminating Good Practice in the Planning and Management of Educational Facilities: Capital Investment Strategic Planning - A Case Study, Gold Coast Institute of TAFE, Queensland, Australia.

ERIC Educational Resources Information Center

Crump, Kelvin

This paper presents a case study of the process of capital investment strategic planning at the Gold Coast Institute of Technical and Further Education (TAFE), Queensland, Australia. Capital investment strategic planning is a means of contributing to success by providing strategies to ensure that assets are managed efficiently, effectively, and…

Cash streams: five powerful income streams to increase your net income.

PubMed

Means, G B

1998-01-01

You can dramatically increase your profits by: Cash stream #1--extending credit and earning interest on the unpaid balance; Cash stream #2--doing all of the undone treatment in your practice; Cash stream #3--providing financing for everyone who deserves it; Cash stream #4--treating bigger cases; Cash stream #5--avoid treating deadbeats. There isn't anything I know of, which will jump start your practice as much as these five cash streams--more new patients, better case acceptance as well as increased cash flow. But you must get good at financing. You must have in place an organized, proven, financing system--just like the finance companies do.

Team Science Approach to Developing Consensus on Research Good Practices for Practice-Based Research Networks: A Case Study.

PubMed

Campbell-Voytal, Kimberly; Daly, Jeanette M; Nagykaldi, Zsolt J; Aspy, Cheryl B; Dolor, Rowena J; Fagnan, Lyle J; Levy, Barcey T; Palac, Hannah L; Michaels, LeAnn; Patterson, V Beth; Kano, Miria; Smith, Paul D; Sussman, Andrew L; Williams, Robert; Sterling, Pamela; O'Beirne, Maeve; Neale, Anne Victoria

2015-12-01

Using peer learning strategies, seven experienced PBRNs working in collaborative teams articulated procedures for PBRN Research Good Practices (PRGPs). The PRGPs is a PBRN-specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings. This paper describes the team science processes which culminated in the PRGPs. Skilled facilitators used team science strategies and methods from the Technology of Participation (ToP®), and the Consensus Workshop Method to support teams to codify diverse research expertise in practice-based research. The participatory nature of "sense-making" moved through identifiable stages. Lessons learned include (1) team input into the scope of the final outcome proved vital to project relevance; (2) PBRNs with diverse domains of research expertise contributed broad knowledge on each topic; and (3) ToP® structured facilitation techniques were critical for establishing trust and clarifying the "sense-making" process. © 2015 Wiley Periodicals, Inc.

The Quadruple Helix-Based Innovation Model of Reference Sites for Active and Healthy Ageing in Europe: The Ageing@Coimbra Case Study

PubMed Central

Malva, João O.; Amado, Alda; Rodrigues, Alexandra; Mota-Pinto, Anabela; Cardoso, Ana F.; Teixeira, Ana M.; Todo-Bom, Ana; Devesa, António; Ambrósio, António F.; Cunha, António L.; Gomes, Bárbara; Dantas, Carina; Abreu, Cidalina; Santana, Isabel; Bousquet, Jean; Apóstolo, João; Santos, Lúcia; Meneses de Almeida, Lúcio; Illario, Maddalena; Veríssimo, Rafaela; Rodrigues, Vitor; Veríssimo, Manuel T.

2018-01-01

Challenges posed by demographic changes and population aging are key priorities for the Horizon 2020 Program of the European Commission. Aligned with the vision of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA), the development, exchange, and large-scale adoption of innovative good practices is a key element of the responses required to ensure all European citizens remain as active and healthy as possible as they age. Urged by the need of developing scalable disruptive innovation across Europe, the European Commission and the EIP on AHA created the Reference Sites; local coalition of partners that develop good practices to support AHA. Ageing@Coimbra is an example of how this can be achieved at a regional level. The consortium comprises over 70 institutions that develop innovative practices to support AHA in Portugal. Ageing@Coimbra partners support a regional network of stakeholders that build a holistic ecosystem in health and social care, taking into consideration the specificities of the territories, living environments and cultural resources (2,243,934 inhabitants, 530,423 aged 65 or plus live in the Centre Region of Portugal). Good practices in reducing the burden of brain diseases that affect cognition and memory impairment in older people and tackling social isolation in urban and rural areas are among the top priorities of Ageing@Coimbra. Profiting from the collaborative work of academia, business companies, civil society, and authorities, the quadruple helix of Ageing@Coimbra supports: early diagnosis of frailty and disease; care and cure; and active, assisted, and independent living. This paper describes, as a Community Case Study, the creation of a Reference Site of the EIP on AHA, Ageing@Coimbra, and its impact in Portugal. This Reference Site can motivate other regions to develop innovative formulas to federate stakeholders and networks, building consortia at regional level. This growing movement, across Europe, is inspired by the quadruple helix concept and by the replication of innovative good practices; creating new Reference Sites for the benefit of Citizens. PMID:29868588

The Quadruple Helix-Based Innovation Model of Reference Sites for Active and Healthy Ageing in Europe: The Ageing@Coimbra Case Study.

PubMed

Malva, João O; Amado, Alda; Rodrigues, Alexandra; Mota-Pinto, Anabela; Cardoso, Ana F; Teixeira, Ana M; Todo-Bom, Ana; Devesa, António; Ambrósio, António F; Cunha, António L; Gomes, Bárbara; Dantas, Carina; Abreu, Cidalina; Santana, Isabel; Bousquet, Jean; Apóstolo, João; Santos, Lúcia; Meneses de Almeida, Lúcio; Illario, Maddalena; Veríssimo, Rafaela; Rodrigues, Vitor; Veríssimo, Manuel T

2018-01-01

Challenges posed by demographic changes and population aging are key priorities for the Horizon 2020 Program of the European Commission. Aligned with the vision of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA), the development, exchange, and large-scale adoption of innovative good practices is a key element of the responses required to ensure all European citizens remain as active and healthy as possible as they age. Urged by the need of developing scalable disruptive innovation across Europe, the European Commission and the EIP on AHA created the Reference Sites; local coalition of partners that develop good practices to support AHA. Ageing@Coimbra is an example of how this can be achieved at a regional level. The consortium comprises over 70 institutions that develop innovative practices to support AHA in Portugal. Ageing@Coimbra partners support a regional network of stakeholders that build a holistic ecosystem in health and social care, taking into consideration the specificities of the territories, living environments and cultural resources (2,243,934 inhabitants, 530,423 aged 65 or plus live in the Centre Region of Portugal). Good practices in reducing the burden of brain diseases that affect cognition and memory impairment in older people and tackling social isolation in urban and rural areas are among the top priorities of Ageing@Coimbra. Profiting from the collaborative work of academia, business companies, civil society, and authorities, the quadruple helix of Ageing@Coimbra supports: early diagnosis of frailty and disease; care and cure; and active, assisted, and independent living. This paper describes, as a Community Case Study, the creation of a Reference Site of the EIP on AHA, Ageing@Coimbra, and its impact in Portugal. This Reference Site can motivate other regions to develop innovative formulas to federate stakeholders and networks, building consortia at regional level. This growing movement, across Europe, is inspired by the quadruple helix concept and by the replication of innovative good practices; creating new Reference Sites for the benefit of Citizens.

[How to promote the respect of good infusion practices by meeting health care professionals?].

PubMed

Le Reste, C; Fiedler, A; Dubois, S; Dewailly, A; Le Du, I; Cogulet, V

2016-05-01

Health care professionals often forget that there are risks associated with infusion therapy even if it is a common care. In order to assess this practice and to draw potential improvement actions, an audit of local gravity-flow intravenous infusion practices was conducted. The audit, based on a grid including 66 items from the medical prescription to the end of the infusion therapy administration, was conducted in the 6 units which use the most gravity-flow intravenous infusion devices. A multidisciplinary working group was created to decide and organize priority corrective measures in order to improve infusion practices and quality of healthcare. The audit enabled to observe 90hours of nurse's practices (96 infusions) and highlighted heterogeneity in infusion, in some cases inappropriate infusion practices and misuse of infusion devices. We found 4 main issues: labelling infusion therapy, training of health care professionals on good practices, support the purchase of infusion pumps and standardize perfusion line. An interactive educational program for nurses (workshops) was organized to enhance the respect of good practices: infusion identification at any time, respect of hygiene rules, flow rate regulation by counting drops, appropriate use of pumps and flow rate regulators. The audit drew up work priorities. The workshops made easier exchanges between professionals and had a warm welcome that's why it is essential to carry on such training. This collaborative approach between pharmacists, nurses, hygienists and biomedical technicians contribute to drug management improvement and promote optimal patient care. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Dispensing doctor practices and community pharmacies: exploring the quality of pharmaceutical services.

PubMed

Weiss, Marjorie C; Grey, Elisabeth; Harris, Michael; Rodham, Karen

2016-01-01

This research sought (a) to investigate the similarities and differences in how pharmaceutical services are provided by community pharmacies (CPs) and dispensing doctor practices (DPs) and (b) to identify the issues relevant to determining the quality of pharmaceutical services in these settings. UK pharmaceutical services, including dispensing prescriptions and public health advice, can be provided from both (CP) and, in rural areas, (DP). While there is much similarity between CPs and DPs in the types of services provided, there is also the potential for variation in service quality across settings. A postal questionnaire of DPs and CPs in South West England was conducted to provide a descriptive overview of pharmaceutical services across the settings. A subsection of questionnaire respondent sites were selected to take part in case studies, which involved documentary analyses, observation and staff interviews. Survey response was 39% for CPs (52/134) and 48% (31/64) for DPs. There were three CP and four DP case study sites, with 17 staff interviews. More pharmacies than practices were open at the weekend and they had more staff trained above NVQ level 2. Both doctors and pharmacists saw themselves as medicines experts, as being accessible and having good relationships with patients. Workplace practices and organisational ethos varied both within and across settings, with good practice observed in both. Overall, CPs and DPs have much in common. Workplace culture and an evidence-based approach to checking prescriptions and error reporting need to be considered in future assessments of service quality.

Attitudes of US neurologists concerning the ethical dimensions of managed care.

PubMed

Bernat, J L; Ringel, S P; Vickrey, B G; Keran, C

1997-07-01

We surveyed attitudes of US neurologists about the ethical dimensions of managed care by administering a written instrument containing paradigmatic cases portraying conflicts of physicians, patients, and managed care organizations (MCOs). After each case, we assessed neurologists' attitudes by asking them their degree of agreement with a series of statements. We found that neurologists (1) generally were willing to follow clinical practice guidelines if they were created by medical societies; (2) experienced frequent conflicts of interest or conflicts of obligation in the care of their MCO patients; (3) feared legal ramifications of their clinical decisions on MCO patients; (4) were unwilling to employ deception or gaming to achieve what they perceived to be good patient care; (5) believed that their professional prerogatives and autonomy were under attack by MCOs; and (6) felt that the good of their patients should not be sacrificed for the good of society.

The Standard of Care: Legal History and Definitions: the Bad and Good News

PubMed Central

Moffett, Peter; Moore, Gregory

2011-01-01

The true meaning of the term “the standard of care” is a frequent topic of discussion among emergency physicians as they evaluate and perform care on patients. This article, using legal cases and dictums, reviews the legal history and definitions of the standard of care. The goal is to provide the working physician with a practical and useful model of the standard of care to help guide daily practice. PMID:21691483

Diagnostic proficiency and reporting of Lassa fever by physicians in Osun State of Nigeria

PubMed Central

2014-01-01

Background Lassa fever is highly contagious and commonly results in death. It is therefore necessary to diagnose and report any suspected case of Lassa fever to facilitate preventive strategies. This study assessed the preparedness of physicians in the diagnosis and reporting of Lassa fever. Methods The study design was descriptive cross-sectional. The consenting medical doctors completed a self-administered questionnaire on the diagnosis and reporting of Lassa fever. Descriptive and inferential statistics were used in data analyses. Results One hundred seventy-five physicians participated in the study. The mean age was 41.5 ± 10.9 years (range, 24–75 years). Most of the physicians were male (78.9%) and had practiced medicine ≥ 20 years (51.5%). Most of the physicians had a good knowledge regarding the diagnosis and reporting of Lassa fever; however, none of the physicians had ever diagnosed or reported a suspected case. Predictors of good knowledge include male sex, not practicing at a secondary health care level and post graduation year more than 20 years. Conclusion There is disparity in knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever. Thus, it is necessary to improve the knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever. PMID:24950705

Education Governance in Action: Lessons from Case Studies

ERIC Educational Resources Information Center

Burns, Tracey; Köster, Florian; Fuster, Marc

2016-01-01

Governing multi-level education systems requires governance models that balance responsiveness to local diversity with the ability to ensure national objectives. This delicate equilibrium is difficult to achieve given the complexity of many education systems. Countries are therefore increasingly looking for examples of good practice and models of…

Sales Simulation Games: Student and Instructor Perceptions

ERIC Educational Resources Information Center

Beuk, Frederik

2016-01-01

This study combines the perspective of students (n = 137) and sales instructors (n = 248). It compares how well selling and sales management simulation games, case discussions, and traditional lectures are perceived to conform to the seven principles for good practice in undergraduate education. The study further compares each method's performance…

Keep These Guidelines in Mind when Reviewing Your Religious Leave Policy.

ERIC Educational Resources Information Center

Sharp, Ralph

1986-01-01

Provides five guidelines to follow in developing alternative policy for accommodating employees' religious practices. Discusses two court cases where school systems lost to teachers because the schools did not make good-faith attempts to accommodate the teachers' religious needs. Includes outline of a board's comprehensive policy for religious…

A Gestalt Approach to Group Supervision

ERIC Educational Resources Information Center

Melnick, Joseph; Fall, Marijane

2008-01-01

The authors define and then describe the practice of group supervision. The role of creative experiment in assisting supervisees who perceive themselves as confused, moving in circles, or immobilized is described. Fictional case examples illustrate these issues in supervision. The authors posit the "good fit" of Gestalt theory and techniques with…

Content Analysis of Chemistry Curricula in Germany Case Study: Chemical Reactions

ERIC Educational Resources Information Center

Timofte, Roxana S.

2015-01-01

Curriculum-assessment alignment is a well known foundation for good practice in educational assessment, for items' curricular validity purposes. Nowadays instruments are designed to measure pupils' competencies in one or more areas of competence. Sub-competence areas could be defined theoretically and statistical analysis of empirical data by…

Achieving Quality Learning in Higher Education.

ERIC Educational Resources Information Center

Nightingale, Peggy; O'Neil, Mike

This volume on quality learning in higher education discusses issues of good practice particularly action learning and Total Quality Management (TQM)-type strategies and illustrates them with seven case studies in Australia and the United Kingdom. Chapter 1 discusses issues and problems in defining quality in higher education. Chapter 2 looks at…

Case Report: Emergence of bovine viral diarrhea virus persistently infected calves in a closed herd

USDA-ARS?s Scientific Manuscript database

Bovine viral diarrhea virus (BVDV) continues to have significant economic impact on the cattle industry worldwide. The virus is primarily maintained in the cattle population due to persistently infected animals. Herd surveillance along with good vaccination programs and biosecurity practices are the...

Using E-Learning to Improve Prescribing Practice in Emerging Prescribers

ERIC Educational Resources Information Center

Baskett, Karen

2011-01-01

This paper reports on "The National Prescribing Curriculum" (NPC), a series of online, case-based modules designed to improve prescribing performance and confidence in emerging Australian prescribers. The modules mirror the decision-making process outlined in the "WHO Guide to Good Prescribing" (de Vries "et al.",…

Promotion, prevention and protection: interventions at the population- and community-levels for mental, neurological and substance use disorders in low- and middle-income countries.

PubMed

Petersen, Inge; Evans-Lacko, Sara; Semrau, Maya; Barry, Margaret M; Chisholm, Dan; Gronholm, Petra; Egbe, Catherine O; Thornicroft, Graham

2016-01-01

In addition to services within the health system, interventions at the population and community levels are also important for the promotion of mental health, primary prevention of mental, neurological and substance use (MNS) disorders, identification and case detection of MNS disorders; and to a lesser degree treatment, care and rehabilitation. This study aims to identify "best practice" and "good practice" interventions that can feasibly be delivered at these population- and community-levels in low- and middle-income countries (LMICs), to aid the identification of resource efficiencies and allocation in LMICs. A narrative review was conducted given the wide range of relevant interventions. Expert consensus was used to identify "best practice" at the population-level on the basis of existing quasi-experimental natural experiments and cost effectiveness, with small scale emerging and promising evidence comprising "good practice". At the community-level, using expert consensus, the ACE (Assessing Cost-Effectiveness in Prevention Project) grading system was used to differentiate "best practice" interventions with sufficient evidence from "good practice" interventions with limited but promising evidence. At the population-level, laws and regulations to control alcohol demand and restrict access to lethal means of suicide were considered "best practice". Child protection laws, improved control of neurocysticercosis and mass awareness campaigns were identified as "good practice". At the community level, socio-emotional learning programmes in schools and parenting programmes during infancy were identified as "best practice". The following were all identified as "good practice": Integrating mental health promotion strategies into workplace occupational health and safety policies; mental health information and awareness programmes as well as detection of MNS disorders in schools; early child enrichment/preschool educational programs and parenting programs for children aged 2-14 years; gender equity and/or economic empowerment programs for vulnerable groups; training of gatekeepers to identify people with MNS disorders in the community; and training non-specialist community members at a neighbourhood level to assist with community-based support and rehabilitation of people with mental disorders. Interventions provided at the population- and community-levels have an important role to play in promoting mental health, preventing the onset, and protecting those with MNS disorders. The importance of inter-sectoral engagement and the need for further research on interventions at these levels in LMICs is highlighted.

Applying TOGAF for e-government implementation based on service oriented architecture methodology towards good government governance

NASA Astrophysics Data System (ADS)

Hodijah, A.; Sundari, S.; Nugraha, A. C.

2018-05-01

As a Local Government Agencies who perform public services, General Government Office already has utilized Reporting Information System of Local Government Implementation (E-LPPD). However, E-LPPD has upgrade limitation for the integration processes that cannot accommodate General Government Offices’ needs in order to achieve Good Government Governance (GGG), while success stories of the ultimate goal of e-government implementation requires good governance practices. Currently, citizen demand public services as private sector do, which needs service innovation by utilizing the legacy system as a service based e-government implementation, while Service Oriented Architecture (SOA) to redefine a business processes as a set of IT enabled services and Enterprise Architecture from the Open Group Architecture Framework (TOGAF) as a comprehensive approach in redefining business processes as service innovation towards GGG. This paper takes a case study on Performance Evaluation of Local Government Implementation (EKPPD) system on General Government Office. The results show that TOGAF will guide the development of integrated business processes of EKPPD system that fits good governance practices to attain GGG with SOA methodology as technical approach.

[Cases of suspected poisoning in small animal practice - a retrospective and prospective survey].

PubMed

Allkämper, Svenja; Kösters, Sarah; Campe, Amely; Kietzmann, Manfred; Kreienbrock, Lothar

2018-06-01

Systematic survey of data from cases of suspected poisoning in small animal practices. In 11 exemplary selected small animal practices, patient files from cases of suspected poisoning over 2006/2007, data entry forms of poisonings 2009-2010 and the contact group, which are all patients with at least one visit in 2007, were analysed. In 2007, approximately 1 in 200 dog and 1 in 500 cat patients were presented with poisoning. More than 70 % of cases concerned dogs. Some breeds of hunting dogs were more frequently affected than expected from their percentage in the practice population. Suspicion of poisoning was retrospective mainly founded in neutered dogs. In addition to numerous unspecific symptoms, bleeding was frequently observed. With central nervous system symptoms or a critical general condition a founded suspicion was observed more frequently. In cases of unfounded suspicion, inflammation of the gastrointestinal tract was mostly present. Other frequently seen diseases were infections, tumours and autoimmune diseases. The main toxins in the retrospective evaluation were coumarin derivatives (37 %), drugs (10 %) and chocolate (7 %). The prospective survey yielded a higher percentage of poisoning with drugs and plants. The diagnosis was mainly based on case history and clinical signs. Therapy was predominantly symptomatic. Poisoning with coumarin derivatives is the most frequent intoxication in dogs, but also cats. The risk from permethrin for cats remains current. In daily practice, therapy is mostly symptomatic without any specific toxicological evidence. Consequently, the causative toxin is frequently unknown. Therefore, additional methods for elimination (stomach/rectal lavage, medical coal, lipid therapy) should be included as therapeutical options. For a successful systematic prospective survey in daily practice a good collaboration between practice and investigator is necessary. Schattauer GmbH.

What do consistently high-performing in vitro fertilization programs in the U.S. do?

PubMed

Van Voorhis, Bradley J; Thomas, Mika; Surrey, Eric S; Sparks, Amy

2010-09-01

To identify common clinical and laboratory practices among consistently high-performing IVF programs. Questionnaire study of selected IVF programs. Academic and private practice IVF programs. Ten of 12 programs identified as having consistently high singleton delivery rates per cycle. None. Common clinical practices. Common clinical practices identified among these programs included testing all patients for ovarian reserve, endometrial defects, and hydrosalpinges; use of a mixed LH and FSH stimulation protocol with step-down dosing; and use of ultrasound guidance for ET. Common laboratory practices included selective use of intracytoplasmic sperm injection, group culture of embryos in microdrops, and use of blastocyst ET in selected cases. Common laboratory features included good air quality using filtration and heated stages for oocyte and embryo work. Although a number of factors were identified in this best-practices questionnaire, programs often differed in many aspects of care. However, high-performing programs cited experience of physicians, embryologists, and staff members as well as consistency of approach, attention to detail, and good communication as being vital to excellent outcomes. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Blended E-learning in a Web-based virtual hospital: a useful tool for undergraduate education in urology.

PubMed

Horstmann, M; Renninger, M; Hennenlotter, J; Horstmann, C C; Stenzl, A

2009-08-01

E-learning is a teaching tool used successfully in many medical subspecialties. Experience with its use in urology, however, is scarce. We present our teaching experience with the INMEDEA simulator to teach urological care to medical students. The INMEDEA simulator is an interactive e-learning system built around a virtual hospital which includes a department of urology. It allows students to solve virtual patient cases online. In this study, students were asked to prepare two urological cases prior to discussion of the cases in small groups. This blended teaching approach was evaluated by students through anonymous questionnaires. Of 70 4th year medical students 76% judged this teaching method as good or very good. Eighty-seven percent felt that it offered a good way to understand urological diseases better and 72% felt that learning with this method was fun. Nevertheless, 30 out of 70 free text statements revealed that further improvements of the program, including an easier and more comfortable navigation and a faster supply of information are necessary. Virtual patient cases offer a practicable solution for teaching based on problem solving in urology with a high acceptance rate by students.

The Application of Linear and Nonlinear Water Tanks Case Study in Teaching of Process Control

NASA Astrophysics Data System (ADS)

Li, Xiangshun; Li, Zhiang

2018-02-01

In the traditional process control teaching, the importance of passing knowledge is emphasized while the development of creative and practical abilities of students is ignored. Traditional teaching methods are not very helpful to breed a good engineer. Case teaching is a very useful way to improve students’ innovative and practical abilities. In the traditional case teaching, knowledge points are taught separately based on different examples or no examples, thus it is very hard to setup the whole knowledge structure. Though all the knowledge is learned, how to use the knowledge to solve engineering problems keeps challenging for students. In this paper, the linear and nonlinear tanks are taken as illustrative examples which involves several knowledge points of process control. The application method of each knowledge point is discussed in detail and simulated. I believe the case-based study will be helpful for students.

Oral health knowledge and practices of dentists practicing in a teaching hospital in Nigeria.

PubMed

Jegede, Akinlolu Tolulope; Oyedele, Titus Ayodeji; Sodipo, Babasola Olufemi; Folayan, Morenike Oluwatoyin

2016-01-01

To assess the oral health practices and knowledge of practicing dentists at a tertiary health institution in Nigeria, and the possible association of age and sex with caries prevention practices. A cross-sectional study was conducted. All practicing dentists in the institution were eligible to participate in the study. A questionnaire that assessed oral health practices and knowledge was administered. Respondents were expected to select the most appropriate responses that reflected their knowledge of oral health practices and caries prevention practices. Questions included assessment of knowledge and practice of tooth brushing, flossing, refined carbohydrate intake, and dental service utilization. Participants' responses were scored and dichotomized to poor and good knowledge, and poor and good practices, using the median scores. Bivariate analysis was conducted to identify factors associated with good and poor oral health practices, and good and poor knowledge. Fifty-two eligible study participants were accessible at the time of questionnaire administration. Only 46 respondents returned the filled questionnaire giving a response rate of 88.5%. The age of respondents ranged between 25 and 48 years. The majority of respondents had good oral health practices (65.2%) and good oral health knowledge (85%). However, few respondents had good caries prevention practices: 39.2% brushed at least twice daily, 45.7% took refined carbohydrate less than once daily, 36.9% used dental floss at least once daily, and 60.9% undertook preventive dental care. The correlation between the dentists' oral health knowledge score and oral health practices score was insignificant (0.90; P = 0.55). A large number of dentists practicing in the tertiary hospital had good oral health practices and good oral health knowledge. However, the proportion of dentists with good caries prevention practices was low.

Introducing New Peer Worker Roles into Mental Health Services in England: Comparative Case Study Research Across a Range of Organisational Contexts.

PubMed

Gillard, Steve; Holley, Jess; Gibson, Sarah; Larsen, John; Lucock, Mike; Oborn, Eivor; Rinaldi, Miles; Stamou, Elina

2015-11-01

A wide variety of peer worker roles is being introduced into mental health services internationally. Empirical insight into whether conditions supporting role introduction are common across organisational contexts is lacking. A qualitative, comparative case study compared the introduction of peer workers employed in the statutory sector, voluntary sector and in organisational partnerships. We found good practice across contexts in structural issues including recruitment and training, but differences in expectations of the peer worker role in different organisational cultures. Issues of professionalism and practice boundaries were important everywhere but could be understood very differently, sometimes eroding the distinctiveness of the role.

'A good shepherd, but with obstructive sleep apnoea syndrome': traditional uvulectomy case series and literature review.

PubMed

Ravesloot, M J L; de Vries, N

2011-09-01

In the West, removal of the uvula is predominantly undertaken as part of palatal surgery, in cases of obstructive sleep apnoea. In the developing world, such as the Middle East and Africa, uvulectomy is a more common practice. The uvula is removed for curative or preventive purposes, or as part of ritual practice. Due to immigration from developing to developed world countries, and to Western doctors working abroad, such doctors are increasingly being confronted with unfamiliar traditional healing practices, within a medical context. The Medline and Embase online databases were systematically searched for literature on traditional uvulectomy. We present a review of this literature. We also present the first report, to our best knowledge, of obstructive sleep apnoea as a late complication of traditional uvulectomy. Traditional uvulectomy may be complicated by post-operative haemorrhage and local infections, among many other problems. We report cases of obstructive sleep apnoea and snoring caused by palatal stenosis resulting from traditional uvulectomy during childhood.

Relational autonomy in the care of the vulnerable: health care professionals' reasoning in Moral Case Deliberation (MCD).

PubMed

Heidenreich, Kaja; Bremer, Anders; Materstvedt, Lars Johan; Tidefelt, Ulf; Svantesson, Mia

2017-12-14

In Moral Case Deliberation (MCD), healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals' moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justifications for influencing the patient, the incapacitated patient's nebulous interests, and coping with the conflict between using coercion to achieve good while protecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals reflected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, defining their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient's autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients' influence and at the same time take responsibility for their needs as vulnerable humans.

Identifying patients with undetected colorectal cancer: an independent validation of QCancer (Colorectal).

PubMed

Collins, G S; Altman, D G

2012-07-10

Early identification of colorectal cancer is an unresolved challenge and the predictive value of single symptoms is limited. We evaluated the performance of QCancer (Colorectal) prediction model for predicting the absolute risk of colorectal cancer in an independent UK cohort of patients from general practice records. A total of 2.1 million patients registered with a general practice surgery between 01 January 2000 and 30 June 2008, aged 30-84 years (3.7 million person-years) with 3712 colorectal cancer cases were included in the analysis. Colorectal cancer was defined as incident diagnosis of colorectal cancer during the 2 years after study entry. The results from this independent and external validation of QCancer (Colorectal) prediction model demonstrated good performance data on a large cohort of general practice patients. QCancer (Colorectal) had very good discrimination with an area under the ROC curve of 0.92 (women) and 0.91 (men), and explained 68% (women) and 66% (men) of the variation. QCancer (Colorectal) was well calibrated across all tenths of risk and over all age ranges with predicted risks closely matching observed risks. QCancer (Colorectal) appears to be a useful tool for identifying undetected cases of undiagnosed colorectal cancer in primary care in the United Kingdom.

A Case Study of the Implementation of Social Models of Teaching in E-Learning: "The Social Networks in Education", Online Course of the Inter-Orthodox Centre of the Church of Greece

ERIC Educational Resources Information Center

Komninou, Ioanna

2018-01-01

The development of e-learning has caused a growing interest in learning models that may have the best results. We believe that it is good practice to implement social learning models in the field of online education. In this case, the implementation of complex instruction in online training courses for teachers, on "Social Networks in…

Genomes in the cloud: balancing privacy rights and the public good.

PubMed

Ohno-Machado, Lucila; Farcas, Claudiu; Kim, Jihoon; Wang, Shuang; Jiang, Xiaoqian

2013-01-01

The NIH-funded iDASH1 National Center for Biomedical Computing was created in 2010 with the goal of developing infrastructure, algorithms, and tools to integrate Data for Analysis, 'anonymization,' and SHaring. iDASH is based on the premise that, while a strong case for not sharing information to preserve individual privacy can be made, an equally compelling case for sharing genome information for the public good (i.e., to support new discoveries that promote health or alleviate the burden of disease) should also be made. In fact, these cases do not need to be mutually exclusive: genome data sharing on a cloud does not necessarily have to compromise individual privacy, although current practices need significant improvement. So far, protection of subject data from re-identification and misuse has been relying primarily on regulations such as HIPAA, the Common Rule, and GINA. However, protection of biometrics such as a genome requires specialized infrastructure and tools.

Disability Rights, Gender, and Development: A Resource Tool for Action. Full Report

ERIC Educational Resources Information Center

de Silva de Alwis, Rangita

2008-01-01

This resource tool builds a normative framework to examine the intersections of disability rights and gender in the human rights based approach to development. Through case studies, good practices and analyses the research tool makes recommendations and illustrates effective tools for the implementation of gender and disability sensitive laws,…

A Framework for Enabling Graduate Outcomes in Undergraduate Programmes

ERIC Educational Resources Information Center

Bond, C. H.; Spronken-Smith, R.; McLean, A.; Smith, N.; Frielick, S.; Jenkins, M.; Marshall, S.

2017-01-01

Our research aim was to determine what enables engagement with graduate outcomes in tertiary institutions in Aotearoa/New Zealand. We used a mixed methods approach comprising a survey sent to all tertiary institutions, follow-up interviews with 10 academic leaders and eight case studies of good practice of programmes engaged with graduate outcomes…

Innovative Pathways from School: The Case Studies. Phase 1 Report 2002.

ERIC Educational Resources Information Center

Boyd, Sally; McDowall, Sue; Cooper, Garrick

This report documents the Innovative Pathways study of nonconventional year 12 and 13 programs at 7 schools, considered successful in assisting "at risk" students in their transition from school to the work force or further education and training. Elements of good practice are documented that contributed to and assisted students'…

13 CFR 134.213 - Discovery.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Discovery. 134.213 Section 134.213... OFFICE OF HEARINGS AND APPEALS Rules of Practice for Most Cases § 134.213 Discovery. (a) Motion. A party may obtain discovery only upon motion, and for good cause shown. (b) Forms. The forms of discovery...

Good and Just Teaching: The Case for Social Justice in Teacher Education

ERIC Educational Resources Information Center

Cochran-Smith, Marilyn; Shakman, Karen; Jong, Cindy; Terrell, Dianna G.; Barnatt, Joan; McQuillan, Patrick

2009-01-01

A particularly controversial aspect of teacher preparation is the increasing number of teacher preparation programs that emphasize "social justice" as part of the curriculum. This article examines how students in a program with a social justice agenda understood the concept and how their understandings played out in practice. Using interviews and…

Raising the Achievement of White Working Class Pupils: Good Practice in Schools

ERIC Educational Resources Information Center

Lewis, Kirstin; Demie, Feyisa

2015-01-01

This research identifies strategies that schools have used to raise achievement among white working class pupils in multiracial schools. The methodological approach comprises case studies of schools and focus group interviews to ascertain the views of teachers, parents and children about strategies that worked to raise achievement. The study…

The Medicalisation of Food Pedagogies in Primary Schools and Popular Culture: A Case for Awakening Subjugated Knowledges

ERIC Educational Resources Information Center

Welch, Rosie; McMahon, Samantha; Wright, Jan

2012-01-01

In this study we interrogate the ways nutrition and health have become increasingly influential to children's everyday life practices and conceptualisations of food. We challenge the orthodoxy of meanings afforded to food that draw a distinct binary between "good"/"bad" or "healthy"/"unhealthy"; ideas widely…

Technology Transfer: A Case Study of Programs and Practices at NASA, DOD, DOC, and Academia

ERIC Educational Resources Information Center

Blood, John R.

2009-01-01

Technology transfer is vital to humanity. It spurs innovation, promotes commerce, and provides technology-based goods and services. Technology transfer is also highly complex and interdependent in nature. This interdependence is exemplified principally by the various technology transfer interactions between government, industry, and academia. …

Ecological Disaster and Rhetorical Response: Exxon's Communications in the Wake of the Valdez Spill.

ERIC Educational Resources Information Center

Tyler, Lisa

1992-01-01

Examines Exxon's communication efforts in the wake of the Exxon Valdez oil spill disaster. Identifies communication practices that damaged the corporation's credibility, antagonized the public, and contributed to the public perception of its corporate arrogance. Notes that the Valdez spill makes a good case for classroom study. (PRA)

Good practice in social care: the views of people with severe and complex needs and those who support them.

PubMed

Gridley, Kate; Brooks, Jenni; Glendinning, Caroline

2014-11-01

This paper reports findings drawn from a study of good practice in English social care for adults with disability and older people with severe and complex needs. People with severe and complex needs are a relatively small proportion of adult social care service users, but they are growing in numbers and have resource-intensive needs. The study involved qualitative research with adults with disability and older people with severe and complex needs, family carers and members of specialist organisations (n = 67), focusing on the features of social care services they considered to be good practice. Data were collected between August 2010 and June 2011. The approach to data collection was flexible, to accommodate participants' communication needs and preferences, including face-to-face and telephone interviews, Talking Mats(©) sessions and a focus group. Data were managed using Framework and analysed thematically. Features of good practice were considered at three levels: (i) everyday support; (ii) service organisation; and (iii) commissioning. Findings relating to the first two of these are presented here. Participants emphasised the importance of person-centred ways of working at all levels. Personalisation, as currently implemented in English social care, aims to shift power from professionals to service users through the allocation of personal budgets. This approach focuses very much on the role of the individual in directing his/her own support arrangements. However, participants in this study also stressed the importance of ongoing professional support, for example, from a specialist key worker or case manager to co-ordinate diverse services and ensure good practice at an organisational level. The paper argues that, despite the recent move to shift power from professionals to service users, people with the most complex needs still value support from professionals and appropriate organisational support. Without these, they risk being excluded from the benefits that personalisation, properly supported, could yield. © 2014 John Wiley & Sons Ltd.

[Hospital fluoroquinolone prescription habits in northern France].

PubMed

Levent, T; Cabaret, P

2010-09-01

The aim of the study was to assess the good use organization and fluoroquinolone prescription habits in cases of bone and joint, urinary, pulmonary, and digestive infections. A declarative survey was made (questionnaire for the hospital and for the prescriber). Thirty percent (44/145) of hospitals participated with 274 prescribers. Eighty percent had prescription protocols, 71 % of clinicians had access to epidemiologic data. A percentage of 30.7 (853/2,771) of prescriptions included a fluoroquinolone, 44.5 % (380/853) among these had not been recommended. The excessive prescription reached 24.4 % (116/474) in case of bone and joint infection, 14.6 % (107/731), and 20 % (157/779) in cases of digestive and respiratory infection respectively. Prescriptions for urinary infection were adequate in 47.6 % (375/787) of cases. Inadequate prescriptions were made because of bad knowledge of bacteria resistance epidemiology and pharmacology (insufficient dose, monotherapy at risk of selection), and non-application of good practice recommendations. This study justifies the rationalization of antibiotic prescription. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Decision-making in palliative care: a reflective case study.

PubMed

Birchall, Melissa

2005-01-01

Critical examination of the processes by which we as nurses judge and reach clinical decisions is important. It facilitates the maintenance and refinement of good standards of nursing care and the pinpointing of areas where improvement is needed. In turn this potentially could support broader validation of nurse expertise and contribute to emancipation of the nursing profession. As pure theory, clinical decision-making may appear abstract and alien to nurses struggling in 'the swampy lowlands' (Schon 1983) of the realities of practice. This paper explores some of the key concepts in decision-making theory by introducing, then integrating, them in a reflective case study. The case study, which examines a 'snapshot' of the patient and practitioner's journey, interwoven with theory surrounding clinical decision-making, may aid understanding and utility of concepts and theories in practice.

21 CFR 110.5 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

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

21 CFR 225.1 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

21 CFR 226.1 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

The Local Turn: an Introductory Essay Revisiting Leadership, Elite Capture and Good Governance in Indonesian Conservation and Development Programs.

PubMed

Warren, Carol; Visser, Leontine

The local turn in good governance theory and practice responded to critiques of the ineffectiveness of state management and the inequity of privatization alternatives in natural resource management. Confounding expectations of greater effectiveness from decentralised governance, including community-based natural resource management, however, critics argue that expanded opportunities for elite capture have become widely associated with program failures. This overview of theoretical controversies on leadership, patronage and elite capture is part of a themed section in this issue that challenges assumptions across a wide range of current policy literature. It introduces a set of Indonesian case studies that examine practices of local leaders and elites and seek to account in structural terms for appropriations both by ('elite capture') and of ('captured elites') these key figures. These studies explore the structural factors and co-governance practices most likely to promote effective participation of the full spectrum of local interests in pursuit of better local natural resource governance.

Indonesian journalistic competitions: tribute or threat for press practice

NASA Astrophysics Data System (ADS)

Dewi, P. A. R.; Aji, G. G.; Sukardani, P. S.

2018-01-01

This research aims to Investigate journalists’ understanding toward glittering generalities practice - positive and good coverage of the caused by the Journalistic contests, the prices are attracting them, Reviews their motives to Participate, and their beliefs about ethics al thing. It is also retrieve how the chief editor, as a decision maker in the mass media taking his responsibility on the glittering news. This research uses a case study method by conducting indepth interviews on journalists, editors, and professional the alliance to collect the data and analyse it based on critical paradigm. The results show that journalist believe that competition is good, and there is no violation as long as the stick to the press code of conduct, but for chief editors and professional alliance, they begin to aware the damage of the contest. The findings of this work will be valuable to develop critical thinking of press workers and promote awareness to the society to control the media practice.

Good Practices in Free-energy Calculations

NASA Technical Reports Server (NTRS)

Pohorille, Andrew; Jarzynski, Christopher; Chipot, Christopher

2013-01-01

As access to computational resources continues to increase, free-energy calculations have emerged as a powerful tool that can play a predictive role in drug design. Yet, in a number of instances, the reliability of these calculations can be improved significantly if a number of precepts, or good practices are followed. For the most part, the theory upon which these good practices rely has been known for many years, but often overlooked, or simply ignored. In other cases, the theoretical developments are too recent for their potential to be fully grasped and merged into popular platforms for the computation of free-energy differences. The current best practices for carrying out free-energy calculations will be reviewed demonstrating that, at little to no additional cost, free-energy estimates could be markedly improved and bounded by meaningful error estimates. In energy perturbation and nonequilibrium work methods, monitoring the probability distributions that underlie the transformation between the states of interest, performing the calculation bidirectionally, stratifying the reaction pathway and choosing the most appropriate paradigms and algorithms for transforming between states offer significant gains in both accuracy and precision. In thermodynamic integration and probability distribution (histogramming) methods, properly designed adaptive techniques yield nearly uniform sampling of the relevant degrees of freedom and, by doing so, could markedly improve efficiency and accuracy of free energy calculations without incurring any additional computational expense.

An inquiry into good hospital governance: A New Zealand-Czech comparison

PubMed Central

Ditzel, Elizabeth; Štrach, Pavel; Pirozek, Petr

2006-01-01

Background This paper contributes to research in health systems literature by examining the role of health boards in hospital governance. Health care ranks among the largest public sectors in OECD countries. Efficient governance of hospitals requires the responsible and effective use of funds, professional management and competent governing structures. In this study hospital governance practice in two health care systems – Czech Republic and New Zealand – is compared and contrasted. These countries were chosen as both, even though they are geographically distant, have a universal right to 'free' health care provided by the state and each has experienced periods of political change and ensuing economic restructuring. Ongoing change has provided the impetus for policy reform in their public hospital governance systems. Methods Two comparative case studies are presented. They define key similarities and differences between the two countries' health care systems. Each public hospital governance system is critically analysed and discussed in light of D W Taylor's nine principles of 'good governance'. Results While some similarities were found to exist, the key difference between the two countries is that while many forms of 'ad hoc' hospital governance exist in Czech hospitals, public hospitals in New Zealand are governed in a 'collegiate' way by elected District Health Boards. These findings are discussed in relation to each of the suggested nine principles utilized by Taylor. Conclusion This comparative case analysis demonstrates that although the New Zealand and Czech Republic health systems appear to show a large degree of convergence, their approaches to public hospital governance differ on several counts. Some of the principles of 'good governance' existed in the Czech hospitals and many were practiced in New Zealand. It would appear that the governance styles have evolved from particular historical circumstances to meet each country's specific requirements. Whether or not current practice could be improved by paying closer attention to theoretical models of 'good governance' is debatable. PMID:16460571

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

21 CFR 1271.150 - Current good tissue practice requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency.

PubMed

von der Lippe, Anna Louise; Oddli, Hanne Weie; Halvorsen, Margrethe Seeger

2017-09-10

Within a mixed methods program of research the present study aimed at expanding knowledge about interactions in the initial therapeutic collaboration by combining focus on client interpersonal style and therapist contribution. The study involves in-depth analyses of therapist-client interactions in the initial two sessions of good and poor outcome therapies. Based on interpersonal theory and previous research, the Inventory of Interpersonal Problems (IIP-64-C) was used to define poor outcome cases, that is, low proactive agency cases. To compare good and poor outcome cases matched on this interpersonal pattern, cases were drawn from two different samples; nine poor outcome cases from a large multi-site outpatient clinic study and nine good outcome cases from a process-outcome study of highly experienced therapists. Qualitative analysis of therapist behaviors resulted in 2 main categories, fostering client's proactive agentic involvement in change work and discouraging client's proactive agentic involvement in change work, 8 categories and 22 sub-categories. The findings revealed distinct and cohesive differences in therapist behaviors between the two outcome groups, and point to the particular therapist role of fostering client agency through engagement in a shared work on change when clients display strong unassertiveness and low readiness for change. Clinical or Methodological Significance Summary: The present analysis combines focus on client interpersonal style, therapist strategies/process and outcome. The categories generated from the present grounded theory analysis may serve as a foundation for identifying interactions that are associated with agentic involvement in future process research and practice, and hence we have formulated principles/strategies that were identified by the analysis.

Good Pharma? How Business Communication Research Can Help Bridge the Gap between Students and Practitioners

ERIC Educational Resources Information Center

Bruyer, Tom; Jacobs, Geert; Vandendaele, Astrid

2016-01-01

This article presents a case-based exploration of the complex interactions between learning, research, and practice in the field of business and professional communication. It focuses on a student research project in the area of corporate social responsibility in the biopharmaceutical industry. Adopting an autoethnographic approach, we aim to…

Multiple-Choice Question Tests: A Convenient, Flexible and Effective Learning Tool? A Case Study

ERIC Educational Resources Information Center

Douglas, Mercedes; Wilson, Juliette; Ennis, Sean

2012-01-01

The research presented in this paper is part of a project investigating assessment practices, funded by the Scottish Funding Council. Using established principles of good assessment and feedback, the use of online formative and summative multiple choice tests (MCT's) was piloted to support independent and self-directed learning and improve…

Transforming the Preparation of Educational Leaders: A Case for Ethical District-University Partnerships

ERIC Educational Resources Information Center

Sherman, Whitney H.

2006-01-01

A good number of scholars have recently addressed concerns about the disconnect between higher education and K-12 practice. According to Goldring and Sims (2005), those involved with leadership preparation must connect thought to action. Although many have taken the position that collaboration is essential, it has been much more difficult to…

Ethical Issues in Internet Research: International Good Practice and Irish Research Ethics Documents

ERIC Educational Resources Information Center

Felzmann, Heike

2013-01-01

This chapter discusses the main research ethical concerns that arise in internet research and reviews existing research ethical guidance in the Irish context in relation to its application to internet research. The chapter begins with a brief outline of high profile cases in the early history of the internet that highlighted specific emerging…

Integrating Teaching Practice with Developmental Norms: The Case of Phonological Teaching in L2

ERIC Educational Resources Information Center

Wong, Richard Kwok-Shing; MacWhinney, Brian

2009-01-01

This paper highlights the crucial role of phonological instruction in early second language English learning. Although older learners can acquire grammar and vocabulary efficiently, younger learners appear to have a greater facility with the learning of sounds. Thus, it makes good sense to focus on articulatory skills for these early learners. By…

High Education as a Common Good in China: A Case Study for Ideas and Practice

ERIC Educational Resources Information Center

Zhu, Jiangang

2016-01-01

China began its modern system of higher education with the establishment of the former Peking University in Beijing in 1898. The traditional Confucian philosophy of education has been replaced dramatically by modern western philosophy. However, since the communist party came to power in 1949, the philosophy of higher education has experienced many…

'It'll Look Good on Your Personal Statement': Self-Marketing amongst University Applicants in the United Kingdom

ERIC Educational Resources Information Center

Shuker, Lucie

2014-01-01

"Selling yourself" through personal statements and interviews is now a standard practice for university applicants. This article draws on a multi-case-study research project to report on the self-marketing orientations of students within three 16-19 institutions in England. These orientations (active/passive; internal/external;…

Developing Oral Case Presentation Skills: Peer and Self-Evaluations as Instructional Tools.

PubMed

Williams, Dustyn E; Surakanti, Shravani

2016-01-01

Oral case presentation is an essential skill in clinical practice that is decidedly varied and understudied in teaching curricula. We developed a curriculum to improve oral case presentation skills in medical students. As part of an internal medicine clerkship, students receive instruction in the elements of a good oral case presentation and then present a real-world case in front of a video camera. Each student self-evaluates his/her presentation and receives evaluations from his/her peers. We expect peer and self-evaluation to be meaningful tools for developing skills in oral presentation. We hope to not only improve the quality of oral case presentations by students but also to reduce the time burden on faculty.

Approaches for building community participation: A qualitative case study of Canadian food security programs.

PubMed

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2017-10-01

There is increasing opportunity and support for occupational therapists to expand their scope of practice in community settings. However, evidence is needed to increase occupational therapists' knowledge, confidence, and capacity with building community participation and adopting community-centered practice roles. The purpose of this study is to improve occupational therapists' understanding of an approach to building community participation, through case study of a network of Canadian food security programs. Qualitative case study was utilized. Data were semistructured interviews, field observations, documents, and online social media. Thematic analysis was used to identify and describe four themes that relate to processes used to build community participation. The four themes were use of multiple methods, good leaders are fundamental, growing participation via social media, and leveraging outcomes. Occupational therapists can utilize an approach for building community participation that incorporates resource mobilization. Challenges of sustainability and social exclusion must be addressed.

Development of a virtual lab for practical eLearning in eHealth.

PubMed

Herzog, Juliane; Forjan, Mathias; Sauermann, Stefan; Mense, Alexander; Urbauer, Philipp

2015-01-01

In recent years an ongoing development in educational offers for professionals working in the field of eHealth has been observed. This education is increasingly offered in the form of eLearning courses. Furthermore, it can be seen that simulations are a valuable part to support the knowledge transfer. Based on the knowledge profiles defined for eHealth courses a virtual lab should be developed. For this purpose, a subset of skills and a use case is determined. After searching and evaluating appropriate simulating and testing tools six tools were chosen to implement the use case practically. Within an UML use case diagram the interaction between the tools and the user is represented. Initially tests have shown good results of the tools' feasibility. After an extensive testing phase the tools should be integrated in the eHealth eLearning courses.

Avoiding plagiarism: guidance for nursing students.

PubMed

Price, Bob

The pressures of study, diversity of source materials, past assumptions relating to good writing practice, ambiguous writing guidance on best practice and students' insecurity about their reasoning ability, can lead to plagiarism. With the use of source checking software, there is an increased chance that plagiarised work will be identified and investigated, and penalties given. In extreme cases, plagiarised work may be reported to the Nursing and Midwifery Council and professional as well as academic penalties may apply. This article provides information on how students can avoid plagiarism when preparing their coursework for submission.

Emerging Good Practices for Transforming Value Assessment: Patients' Voices, Patients' Values.

PubMed

Perfetto, Eleanor M; Harris, Jason; Mullins, C Daniel; dosReis, Susan

2018-04-01

Patient engagement is a transformative strategy for improving value assessment. US value framework developers have increased engagement activities, but more needs to be learned about how to best achieve meaningful patient engagement in value assessment. The objective was to glean good practices in patient engagement emerging from patient community experiences, to be used in value assessment. The National Health Council Value Workgroup conducted a survey and held a focus group with its member advocacy organizations to gather experiences with value framework developers and views on emerging good practices. Ten of 13 organizations completed the survey; reporting 13 interactions with four framework developers. Most rated experiences as "good" to "very good." Emerging good practices included (1) engage early; (2) engage a range of patients; (3) leverage patient-provided information, data resources, and outreach mechanisms; (4) be transparent; and (5) appreciate and accommodate resource constraints. Twelve of 13 organizations participated in the focus group, and this produced 30 emerging good practices in four areas: (1) timing; (2) methodology and data; (3) partnering; and (4) characterizing engagement. Patient engagement was limited in early development of value frameworks but has increased in the past few years. Patient groups report positive experiences that can serve as emerging good practices. These groups also reported experienced challenges in their interactions and recommended good practices to mitigate those challenges. The growing pool of patient engagement experiences can be translated into good practices to advance a patient-centered, value-driven health care ecosystem. Lessons learned from these early experiences can help establish recommend emerging good practices that can eventually result in best practices and standards in the field. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Clinical audit of leg ulceration prevalence in a community area: a case study of good practice.

PubMed

Hindley, Jenny

2014-09-01

This article presents the findings of an audit on venous leg ulceration prevalence in a community area as a framework for discussing the concept and importance of audit as a tool to inform practice and as a means to benchmark care against national or international standards. It is hoped that the discussed audit will practically demonstrate how such procedures can be implemented in practice for those who have not yet undertaken it, as well as highlighting the unexpected extra benefits of this type of qualitative data collection that can often unexpectedly inform practice and influence change. Audit can be used to measure, monitor and disseminate evidence-based practice across community localities, facilitating the identification of learning needs and the instigation of clinical change, thereby prioritising patient needs by ensuring safety through the benchmarking of clinical practice.

Good practices in Local Government - A first overview of Portuguese reality

NASA Astrophysics Data System (ADS)

Carvalhosa, P.; Portela, F.; Machado, J.; Santos, M. F.; Abelha, A.

2017-03-01

Good practices in eGov are being increasingly used by Local Governments being that it is considered by them as an advantage. The main goal is providing to the town hall a differentiation point and approximate their services to the citizens. For this, it is necessary to define and apply innovative strategies in order to increase the use of services by the citizens. This paper is framed in a research work and it presents a first overview of the existing good practices in eGov, taking in consideration the Portuguese’s reality. The good practices identified were distinguished with many awards and with a positive response from the target audience. The use of digital marketing strategies aims to increase their membership and coming closer the municipalities of its citizens through the dissemination of the good practices. At this moment the data collected are almost exclusively of good practice in Portugal, however some international practices were also identified. As a result of this study the community has a list of good practices that can be applied in their municipalities.

Knowledge, attitudes and practices of traceability among livestock traders in south-western Nigeria: implications for sustainable livestock industry.

PubMed

Adesokan, Hezekiah K; Ocheja, Samuel E

2014-01-01

Livestock diseases and other animal health events are a threat to achieving sustainable livestock industry. The knowledge of trace-back and the practice of providing feedback on diseases encountered in slaughtered animals from the abattoir to the farm can help limit the spread as well as manage potential future incidents of such diseases. We assessed the knowledge, attitudes and practices of 200 willing livestock traders on traceability in Bodija Municipal Abattoir, south-western Nigeria. The results reveal that the majority of these traders had poor knowledge (79.5 %) and practices (74.0 %) of traceability, though 89.5 % demonstrated good attitudes. While 22.9 % knew that traceability could be an effective means to control diseases, only a lower proportion (9.0 %) knew the health status of the animals being purchased. Though 29.0 % reported the diseases encountered in their animals during slaughter to the farm, only 9.5 % followed up to ensure the farmers take steps at preventing further occurrence of the reported diseases. While age (p = 0.000; 0.014) and education (p = 0.000; 0.000) were both significant for good knowledge and attitudes, frequency of condemned cases (p = 0.000) and length of years in the trade (p = 0.004) were, respectively, significant for good knowledge and attitudes with none associated with practice. These poor levels of knowledge and practices of traceability are a threat to sustainable livestock industry, food security and human health; hence, there is an urgent need to institute national feedback mechanism on slaughtered animals in order to strengthen interventions against diseases at farm levels.

Good practices in health care "management experimentation models": insights from an international public-private partnership on transplantation and advanced specialized therapies.

PubMed

Longo, Maria Cristina

2015-01-01

The research analyzes good practices in health care "management experimentation models," which fall within the broader range of the integrative public-private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the "management experimentation models" are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations. In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC - Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies. The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable. The recognition of ISMETT's good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

The post-Ebola virus disease scourge in Nigeria: Individual levels of preparedness among physicians in the Federal Capital Territory Abuja.

PubMed

Alli, Adewale L; Nwegbu, Maxwell M; Ibekwe, Perpetua U; Ibekwe, Titus S

2016-01-01

Ebola virus disease (EVD) is a viral hemorrhagic illness with great propensity for spread across international borders. The latest outbreak in the West African region, which involved Nigeria, was the worst among previously documented 25 outbreaks since discovery in 1976. The Nigerian response toward attaining Ebola free status was phenomenal and a case study for most nations. However, the persistence of EVD in West Africa is still a risk to recurrence, hence, the need to assess the level of consciousness of Nigerian physicians towards this. A cross-sectional study utilizing the instrument of a pretested semi-structured questionnaire was conducted among physicians practicing within the federal capital city of Nigeria. General knowledge, treatment, prevention, and reporting of EVD were assessed and appropriate statistical analyses done using SPSS 20. Of the 101 respondents, 45% and 87% showed excellent level (>80% score) of "general knowledge" and "reporting" on EVD, respectively. However, only 51% respondents had good (60-80%) knowledge on EVD treatment. Three percent correctly identified the "EVD helpline" phone-numbers for reporting suspected cases. Furthermore, 43.6% admitted the availability of personal protective equipment (PPE) in their hospitals while 35.6% had witnessed a demonstration of the use. The distribution of the PPEs appeared skewed - 74.4% (teaching-hospitals), 16% (private-hospitals), and the primary health care centers (9.6%). A majority of the physicians showed good level of preparedness as it relates to general knowledge on EVD, knowledge on good clinical practice, use of protocols and standard precautions and PPE. The identification of deficits in knowledge on treatment of EVD and flow path for the notification of suspected cases requires urgent redress given the risk of re-occurrence in the country.

Securing the Adoption of Good Practice in Scotland's Colleges. A Report by HM Inspectors of Education for the Scottish Funding Council

ERIC Educational Resources Information Center

Her Majesty's Inspectorate of Education, 2006

2006-01-01

The purpose of this report is to describe the main mechanisms currently in use in Scotland's colleges to ensure that the adoption of good practice actually happens. It investigates how colleges identify and promote good practice in their own institutions; how they develop strategies and processes to ensure good practice is shared, adopted and…

Second-Order Factor Analysis as a Validity Assessment Tool: A Case Study Example Involving Perceptions of Stereotypic Love.

ERIC Educational Resources Information Center

Borrello, Gloria M.; Thompson, Bruce

The calculation of second-order results in the validity assessment of measures and some useful interpretation aids are presented. First-order and second-order results give different and informative pictures of data dynamics. Several aspects of good practice in interpretation of second-order results are presented using data from 487 subjects…

Implementing Primary Social and Emotional Aspects of Learning (SEAL) Small Group Interventions: Recommendations for Practitioners

ERIC Educational Resources Information Center

Lendrum, Ann; Humphrey, Neil; Kalambouka, Afroditi; Wigelsworth, Michael

2009-01-01

This article presents an extended vignette describing a good practice model for implementing SEAL small group work at "Mellington Primary", a fictional school. The vignette/model was developed from in-depth case studies at five primary schools in the north-west of England during a national evaluation of primary SEAL by the authors. The…

What Lies at the Heart of Good Undergraduate Teaching? A Case Study in Organic Chemistry

ERIC Educational Resources Information Center

Davidowitz, Bette; Rollnick, Marissa

2011-01-01

Teaching organic chemistry at the undergraduate level has long been regarded as challenging and students are often alienated by the mass of detail which seems to characterise the subject. In this paper we investigate the practice of an accomplished lecturer by trying to capture and portray his pedagogical content knowledge, PCK, in order to reveal…

Measuring and Maximising Research Impact in Applied Social Science Research Settings. Good Practice Guide

ERIC Educational Resources Information Center

Stanwick, John; Hargreaves, Jo

2012-01-01

This guide describes the National Centre for Vocational Education Research (NCVER) approach to measuring impact using examples from its own case studies, as well as showing how to maximise the impact of applied social science research. Applied social science research needs to demonstrate that it is relevant and useful both to public policy and…

The Role of Reflection in Developing Eupraxis in Learning to Teach English

ERIC Educational Resources Information Center

Smagorinsky, Peter; Shelton, Stephanie Anne; Moore, Cynthia

2015-01-01

This case study focuses on one beginning English teacher's work toward eupraxia, i.e., good practice informed by reflection in a setting in which a degree of free choice is available. The study uses a Vygotskian framework for studying concept development that focuses on the settings of human activity and how ambiguous social concepts are developed…

Practicing a Good Life: Three Case Studies from the Programs for the Theological Exploration of Vocation

ERIC Educational Resources Information Center

Sutphen, Molly

2014-01-01

The Lilly Endowment's Programs for the Theological Exploration of Vocation offered a range of educational activities and opportunities for students, faculty, and staff to reflect on and discern their values, beliefs, and goals across a wide spectrum of collegiate life. Tim Clydesdale has found that these opportunities were of much value to those…

Strategic Planning in Higher Education: A Guide for Heads of Institutions, Senior Managers and Members of Governing Bodies.

ERIC Educational Resources Information Center

Higher Education Funding Council for England, Bristol.

This guide provides examples of good practice in strategic planning within higher education, particularly as it applies to Northern Ireland. Examples are drawn from the experiences of 13 case study universities and colleges. Sections of the report include a summary; an introduction and overview of the strategic planning process; and a discussion…

Clinical Competencies and the Basic Sciences: An Online Case Tutorial Paradigm for Delivery of Integrated Clinical and Basic Science Content

ERIC Educational Resources Information Center

DiLullo, Camille; Morris, Harry J.; Kriebel, Richard M.

2009-01-01

Understanding the relevance of basic science knowledge in the determination of patient assessment, diagnosis, and treatment is critical to good medical practice. One method often used to direct students in the fundamental process of integrating basic science and clinical information is problem-based learning (PBL). The faculty facilitated small…

Designing a good life: a matrix for the technological mediation of morality.

PubMed

Swierstra, Tsjalling; Waelbers, Katinka

2012-03-01

Technologies fulfill a social role in the sense that they influence the moral actions of people, often in unintended and unforeseen ways. Scientists and engineers are already accepting much responsibility for the technological, economical and environmental aspects of their work. This article asks them to take an extra step, and now also consider the social role of their products. The aim is to enable engineers to take a prospective responsibility for the future social roles of their technologies by providing them with a matrix that helps to explore in advance how emerging technologies might plausibly affect the reasons behind people's (moral) actions. On the horizontal axis of the matrix, we distinguished the three basic types of reasons that play a role in practical judgment: what is the case, what can be done and what should be done. On the vertical axis we distinguished the morally relevant classes of issues: stakeholders, consequences and the good life. To illustrate how this matrix may work in practice, the final section applies the matrix to the case of the Google PowerMeter. © The Author(s) 2010. This article is published with open access at Springerlink.com

Updates on Knowledge, Attitude and Preventive Practices on Tuberculosis among Healthcare Workers.

PubMed

Wahab, Farhanah Abd; Abdullah, Sarimah; Abdullah, Jafri Malin; Jaafar, Hasnan; Noor, Siti Suraiya Md; Mohammad, Wan Mohd Zahiruddin Wan; Yusoff, Abdul Aziz Mohamed; Tharakan, John; Bhaskar, Shalini; Sangu, Muthuraju; Mahmood, Mohd Shah; Kassim, Fauziah; Rafia, Md Hanip; Haspani, Mohammed Safari Mohammed; Alias, Azmi; Pando, Rogelio Hernández

2016-11-01

Ranking as the most communicable disease killer worldwide, tuberculosis, has accounted with a total of 9.6 million new tuberculosis cases with 1.5 million tuberculosis-related deaths reported globally in 2014. Tuberculosis has remain as an occupational hazard for healthcare workers since 1920s and due to several tuberculosis outbreaks in healthcare settings in the early 1990s, the concern about the transmission to both patients and healthcare workers has been raised. Healthcare workers have two to three folds greater the risk of active tuberculosis than the general population. Several studies on knowledge, attitude and practices on tuberculosis among healthcare workers worldwide have revealed that majority of the participated healthcare workers had good knowledge on tuberculosis. Most of the healthcare workers from South India and South Africa also reported to have positive attitude whereas a study in Thailand reported that most of the healthcare providers have negative attitude towards tuberculosis patients. Nevertheless, majority of the healthcare workers have low level of practice on tuberculosis prevention. An improved communication between healthcare workers and the patients as well as their families is the key to better therapeutic outcomes with good knowledge, attitude and preventive practice towards tuberculosis.

[Manipulative reduction and small splint fixation combined with micromovement exercise for treatment of humeral shaft fractures].

PubMed

Tang, Hao-chen; Xiang, Ming; Chen, Hang; Hu, Xiao-chuan; Yang, Guo-yong

2016-01-01

To investigate the therapeutic efficacy of bone-setting manipulative reduction and small splint fixation combined with micro-movement theory exercise for treatment of humeral shaft fractures. From March 2011 to February 2014, 64 cases of humeral shaft fractures were treated by bone-setting manipulative reduction and small splint fixation including 28 males and 36 females with an average age of 38.1 years old ranging from 22 to 67 years old. According to the classification of AO/OTA, there were 10 cases of type A1, 12 cases of type A2,11 cases of type A3,10 cases of type B1,12 cases of type B2, 7 cases of type B3, 2 cases of type C1, 1 case of type C2, 1 case of type C3. After close reduction early functional exercise performed according to micro-movement theory. All patients had no other parts of the fractures, neurovascular injury, and serious medical problems. Patients were followed up for fracture healing, shoulder and elbow joint function recovery, and curative effect. All patients were followed up from 10 to 12 months with an average of 10.3 months. Of them, 2 cases had a small amount of callus growth at 3 months after close reduction, so instead of operation; 2 cases appeared radial nerve symptoms after close reduction ,so instead of operation. Other patients were osseous healing, the time was 8 to 12 weeks with an average of 10.2 weeks. After osseous healing, according to Constant-Murley score system ,the average score was (93.5 ± 3.2) points, the result was excellent in 29 cases, good in 29 cases, fair in 6 cases, excellent and good rate was 90.3%; according to the Mayo score system, the average score was (93.7 ± 4.2) points, the result was excellent in 35 cases, good in 23 cases, fair in 6 cases, excellent and good rate was 91.9%. Bone-setting manipulative reduction and small splint fixation combined with micromovement theory exercise for treatment of humeral shaft fractures has advantage of positive effect, easy and inexpensive method, the treatment has relevant scientific basis and practical value, it can effectively reduce complications, promote patients early recovery.

21 CFR 184.1452 - Manganese gluconate.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

The virtuous pathologist. An ethical basis for laboratory medicine.

PubMed

Stempsey, W E

1989-06-01

The profession of pathology is a practice in the technical sense used by many philosophers. Such practices have internal goods, which, it is hoped, lead to the attainment of a certain end. The ultimate end of the practice of pathology must be the good of the patient in terms of restoring health. Key internal goods in pathology are technical competence, the proper pathologist-patient relationship, and the proper pathologist-clinician relationship. Virtues are predispositions to act so as to attain the end of the practice and further the internal goods. Technical growth in the practice of pathology must be accompanied by continued attempts to articulate the goals and internal goods of the practice. Only if pathologists are predisposed to act in accordance with proper goals will an ethical practice be assured.

[Good drug distribution practice and its implementation in drug distribution companies].

PubMed

Draksiene, Gailute

2002-01-01

Good Distribution Practice is based on the Directive of the Board of the European Community 92/25/EEC regarding the wholesale distribution of drugs for human consumption. It is stated in the Directive that the whole drug distribution channel is to be controlled from the point of drug production or import down to the supplies to the end user. In order to reach the goal, the drug distribution company must create the quality assurance system and facilitate its correct functioning. This aim requires development of the rules of the Good Distribution Practice. Those rules set the general requirements of the Good Distribution Practice for distribution companies that they must conduct. The article explains main requirements postulated in the rules of the Good Distribution Practice and implementation of the Good Distribution Practice requirements in drug distribution companies.

[A guide to good practice for information security in the handling of personal health data by health personnel in ambulatory care facilities].

PubMed

Sánchez-Henarejos, Ana; Fernández-Alemán, José Luis; Toval, Ambrosio; Hernández-Hernández, Isabel; Sánchez-García, Ana Belén; Carrillo de Gea, Juan Manuel

2014-04-01

The appearance of electronic health records has led to the need to strengthen the security of personal health data in order to ensure privacy. Despite the large number of technical security measures and recommendations that exist to protect the security of health data, there is an increase in violations of the privacy of patients' personal data in healthcare organizations, which is in many cases caused by the mistakes or oversights of healthcare professionals. In this paper, we present a guide to good practice for information security in the handling of personal health data by health personnel, drawn from recommendations, regulations and national and international standards. The material presented in this paper can be used in the security audit of health professionals, or as a part of continuing education programs in ambulatory care facilities. Copyright © 2013 Elsevier España, S.L. All rights reserved.

[Identification of Good-Practice Projects in Promoting Physical Activity - Methods, Pitfalls and Sampled Outcomes].

PubMed

Henn, Annette; Karger, Claudia; Wöhlken, Katrin; Meier, Diana; Ungerer-Röhrich, Ulrike; Graf, Christine; Woll, Alexander

2017-03-01

The aim of this paper is to identify and show examples of good practice of public health promotion. For this, uniform quality criteria were worked out under consideration of national and international scientific literature.For the identification of examples of good practice, a comparison of different quality criteria was carried out and combined with each other in a first step. In the following step, examples of good practice were identified after a comprehensive search. The choice of the "good-practice" projects is exemplary and lays no claim to completeness.6 main quality criteria (QC) of programs promoting physical activity could be identified in the national and international context. The analysis showed altogether 10 projects which can exemplarily be classified as examples of good practice of the target groups of children and teenagers, adults, older people and people with pre-existing illnesses. These projects, however, show major differences in their (methodological) quality.The analysis reports a lack of "Good-Practice" examples. Deficits lie mainly in documentation and sustainability. Because of incomplete documentation, an assessment as a "Good-Practice" example is only possible to a limited extent; a lot of information, particularly in the evaluation, is missing. © Georg Thieme Verlag KG Stuttgart · New York.

It Doesn't Have to End in Disaster: A Case for Employment Compliance.

PubMed

Twigg, Tim

2016-01-01

It only takes one unhappy or disgruntled person to create a legal nightmare for you. There's no need to take this gamble. All it takes is awareness, commitment and action on your part. Once you have your HR house in order and have implemented a sound HR program in your practice, you also can feel good about knowing you are giving your staff every protection due to them under the law and every opportunity to be happy and successful in your practice. For yourself, you will be minimizing your risks and protecting your most valuable asset--your practice. You also will have given yourself the gift of peace of mind.

Unusual increase in reported cases of paratyphoid A fever among travellers returning from Cambodia, January to September 2013.

PubMed

Tourdjman, M; Le Hello, S; Gossner, C; Delmas, G; Tubiana, S; Fabre, L; Kerléguer, A; Tarantola, A; Fruth, A; Friesema, I; Thorstensen Brandal, L; Lawrence, J; Fisher, I; Dufour, M; Weill, F X; de Valk, H

2013-09-26

From January to September 2013, a marked increase in notifications of Salmonella Paratyphi A infections among travellers returning from Cambodia occurred in France. An investigation revealed 35 cases without a common source: 21 in France, five in Germany, three in the Netherlands, one in Norway, one in the United Kingdom, four in New-Zealand. Data suggest an ongoing event that should trigger further investigation. Travellers to Cambodia should observe preventive measures including good personal hygiene and food handling practices.

[The Application of Bryophyllum pinnatum Preparations in Obstetrics and Gynaecology – a Multicenter, Prospective Observational Study].

PubMed

Fürer, Karin; Simões-Wüst, Ana Paula; Winkler, Alice; Amsler, Nadine; Schnelle, Martin; von Mandach, Ursula

2015-01-01

Bryophyllum pinnatum has been introduced in anthroposophic medicine in Europe and is nowadays also widely used in conventional medicine. The aim of this study was to assess the prescriptions in the field of gynaecology and obstetrics in Switzerland and to document potential effects and possible adverse events of B. pinnatum. Private practices and clinics for obstetrics and gynaecology were asked to document each prescription of B. pinnatum for their female patients during 31 months with an online questionnaire. At the University Hospital Zurich, at the Cantonal Hospital Winterthur as well as at 2 private practices, a total of 174 women and 208 prescriptions of B. pinnatum were recorded (several prescriptions per patient were possible). Most of the patients were pregnant (87%). B. pinnatum was prescribed as a tocolytic agent to 83% of all patients and to 95% of all pregnant patients and showed a good or a very good effectiveness. Further, 14% of the patients received B. pinnatum for sedation against their restlessness during the day and 5% for sedation against sleep problems. A decrease of the restlessness was achieved for these 2 indications. 13% of the patients suffered from a hyperactive bladder and in two-thirds of them the effectiveness of the treatment with B. pinnatum was classified as very good. In 92% of the cases, Bryophyllum 50% chewable tablets were prescribed. In conventional gynaecology and obstetrics, B. pinnatum is predominantly prescribed for pregnant women in case of prematurel abour, against restlessness and for hyperactive bladder. B. pinnatum showed a good effectiveness with a high benefit in the treatment of hyperactivity-associated health problems. © 2015 S. Karger GmbH, Freiburg.

21 CFR 129.1 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the..., methods, practices, and controls used in the processing, bottling, holding, and shipping of bottled...

Teleworking: Guidelines for Good Practice. IES Report 329.

ERIC Educational Resources Information Center

Huws, Ursula; And Others

Because teleworking presents major new challenges to human resource managers, trade unions, and others involved in the development of good employment practices, this book provides practical guidelines for good practice in regard to teleworkers that recognize that teleworking is not a single category, but covers at least five distinct groups with…

Urban Environment Development based on Universal Design Principles

NASA Astrophysics Data System (ADS)

Harsritanto, Bangun Ir

2018-02-01

Universal Design is a design which facilitated full range of human diversity. By applying Universal design principles, urban environment can be more functional and more user-friendly for everyone. This study examined five urban streets of South Korea as a country experienced on developing various urban street designs based on universal design. This study aimed to examine and compare the South Korea cases using seven principles of universal design. The research methods of this study are literature study, case study, and site observation. The results of this study are: South Korea cases are good practices, urgency of implementing the direction into local regulations; and change of urban development paradigm.

21 CFR 184.1101 - Diacetyl tartaric acid esters of mono- and diglycerides.

Code of Federal Regulations, 2010 CFR

2010-04-01

... used in food with no limitation other than current good manufacturing practice. The affirmation of this... following current good manufacturing practice conditions of use: (1) The ingredient is used in food as an... levels not to exceed current good manufacturing practice: baked goods and baking mixes as defined in...

21 CFR 184.1101 - Diacetyl tartaric acid esters of mono- and diglycerides.

Code of Federal Regulations, 2011 CFR

2011-04-01

... used in food with no limitation other than current good manufacturing practice. The affirmation of this... following current good manufacturing practice conditions of use: (1) The ingredient is used in food as an... levels not to exceed current good manufacturing practice: baked goods and baking mixes as defined in...

Protection of people and environment from radiation risk through good regulatory practice

NASA Astrophysics Data System (ADS)

Jais, Azlina Mohammad; Hassan, Najwa

2017-01-01

The term "good regulatory practice" has seen growing frequency of usage worldwide, especially since the 2011 Fukushima nuclear incident. However, the term appears quite ambiguous as it may mean differently to different people. This leads us to the first important question: what does "good regulatory practice" actually mean? When used in conjunction with the Fukushima incident, do we imply that there is an absence of "good regulatory practice" in the Japanese' Nuclear and Industry Safety Agency (NISA)? This is quite troubling. It is clear that the term should be defined formally so that our understanding of "good regulatory practice" can be standardized. There is still another important question beyond agreeing on what "good regulatory practice" is: is "good regulatory practice" specific to a region, or is it global? And is it applicable only to nuclear regulators, or to all types of regulators per se? This paper aims to deliberate on the above mentioned questions. Specifically, we hope to discuss the "good regulatory practice" for atomic energy activities in order to protect the people and the environment from radiation risk of such activities. By understanding what "good regulatory practice" truly means, a newcomer country such as Malaysia can quickly learn and adopt these practices so as to assure a competent national nuclear regulatory authority who will be responsible in ensuring the safety, security and safeguards of peaceful atomic energy activities in the country including nuclear liability. In understanding this concept, a holistic approach will be taken by looking into example of advanced and newcomer countries of various nuclear regulatory authorities all around the world. Then the paper will focus on the challenges that the current nuclear regulatory authority in Malaysia which is Atomic Energy Licensing Board has, its challenges to follow the concept of "good regulatory practice" and its ways to overcome it. This study explore the initiatives could be considered by nuclear regulatory authority and the necessary criteria of an "ideal" how nuclear regulatory authority should implement the "good regulatory practice" approach.

Physicians’ influence on breast cancer patient compliance

PubMed Central

Kostev, Karel; Waehlert, Lilia; Jockwig, Achim; Jockwig, Barbara; Hadji, Peyman

2014-01-01

In recent years there have been major advances in the treatment of breast cancer. However, taking the prescribed medication for a sufficient period of time is crucial to the success of any therapy. Thus far, no database-based studies have been published in German-speaking countries empirically examining the influence of the physician on the compliance of patients. The aim of this study is to investigate, quantify, and critically discuss the effect treating physicians have on the compliance of their breast cancer patients. Patients with a confirmed breast cancer diagnosis who started therapy (tamoxifen or aromatase inhibitors) between January 2001 and December 2011 were selected from the representative IMS Disease Analyzer database and analyzed with regard to their compliance. Practices were grouped into two categories concerning the compliance of all treated patients. A regression model showed that a breast cancer patient who is treated in a practice with a trend toward poor compliance has a nearly 60% higher risk for treatment discontinuation than would be the case in a practice with good compliance. It shows how important it is to motivate physicians to strive toward good compliance rates. PMID:24454275

Assessment of Clinical Practices for Crushing Medication in Geriatric Units.

PubMed

Fodil, M; Nghiem, D; Colas, M; Bourry, S; Poisson-Salomon, A-S; Rezigue, H; Trivalle, C

2017-01-01

To assess the modification of the form of medication and evaluate staff observance of good clinical practices. One-day assessment of clinical practices. 17 geriatrics units in the 3 Teaching Hospitals of Paris-Sud (APHP), France. Elderly in-patients with difficulties swallowing capsules and tablets. Assessment of target-patient prescriptions and direct observation of nurses' medical rounds. 155/526 in-patients (29.5%) were unable to swallow tablets or capsules: 98 (40.3%) in long-term care, 46 patients (23.8%) in the rehabilitation unit and 11 (12.2%) in the acute care unit (p = .005). In thirty-nine (27.3%) of the 143 prescriptions studied all tablets were safe to crush and all capsules were safe to open. In 104 cases, at least one medication could not be safely modified, including 26 cases (18.2%) in which none of the prescribed drugs were safe to crush or open. In 48.2% of the 110 medications that were crushed, crushing was forbidden, and presented a potential threat in 12.7% of cases or a reduced efficacy in 8.2% of cases. Crushing methods were rarely appropriate: no specific protective equipment was used (81.8%), crushing equipment was shared between patients without cleaning (95.1%), medications were spilled or lost (69.9%). The method of administration was appropriate (water, jellified water) in 25% of the cases, questionable (soup, coffee, compote, juice, cream) in 55% of the cases and unacceptable (laxative) in 21% of the cases. Management of drug prescriptions in patients with swallowing difficulties is not optimal, and may even have iatrogenic effects. In this study, 12.7% of the modifications of the drug form could have been harmful. Doctors, pharmacists and nurses need to reevaluate their practices.

21 CFR 113.5 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 113.5 Section... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10, 113.40..., methods, practices, and controls used by the commercial processor in the manufacture, processing, or...

Top 10 metrics for life science software good practices.

PubMed

Artaza, Haydee; Chue Hong, Neil; Corpas, Manuel; Corpuz, Angel; Hooft, Rob; Jimenez, Rafael C; Leskošek, Brane; Olivier, Brett G; Stourac, Jan; Svobodová Vařeková, Radka; Van Parys, Thomas; Vaughan, Daniel

2016-01-01

Metrics for assessing adoption of good development practices are a useful way to ensure that software is sustainable, reusable and functional. Sustainability means that the software used today will be available - and continue to be improved and supported - in the future. We report here an initial set of metrics that measure good practices in software development. This initiative differs from previously developed efforts in being a community-driven grassroots approach where experts from different organisations propose good software practices that have reasonable potential to be adopted by the communities they represent. We not only focus our efforts on understanding and prioritising good practices, we assess their feasibility for implementation and publish them here.

Top 10 metrics for life science software good practices

PubMed Central

2016-01-01

Metrics for assessing adoption of good development practices are a useful way to ensure that software is sustainable, reusable and functional. Sustainability means that the software used today will be available - and continue to be improved and supported - in the future. We report here an initial set of metrics that measure good practices in software development. This initiative differs from previously developed efforts in being a community-driven grassroots approach where experts from different organisations propose good software practices that have reasonable potential to be adopted by the communities they represent. We not only focus our efforts on understanding and prioritising good practices, we assess their feasibility for implementation and publish them here. PMID:27635232

Philosophical methodology and strikes.

PubMed

Thomasma, David C

1991-01-01

...how do we train residents to employ ethical reasoning? This is a good question, not only for the problem of strikes, but also for all medical training. The best method is inductive, since that most closely parallels the clinical reasoning processes that define the reality of medical practice. The strengths of inductive reasoning are that it most closely matches the realities of practice, it arises from the particular circumstances of the case, and it leads to a casuistic conclusion that applies more directly than abstract reasoning models to the problem at hand. The weaknesses, though, require that inductive models include a check and balance.

The microbial quality of drinking water in Manonyane community: Maseru District (Lesotho).

PubMed

Gwimbi, P

2011-09-01

Provision of good quality household drinking water is an important means of improving public health in rural communities especially in Africa; and is the rationale behind protecting drinking water sources and promoting healthy practices at and around such sources. To examine the microbial content of drinking water from different types of drinking water sources in Manonyane community of Lesotho. The community's hygienic practices around the water sources are also assessed to establish their contribution to water quality. Water samples from thirty five water sources comprising 22 springs, 6 open wells, 6 boreholes and 1 open reservoir were assessed. Total coliform and Escherichia coli bacteria were analyzed in water sampled. Results of the tests were compared with the prescribed World Health Organization desirable limits. A household survey and field observations were conducted to assess the hygienic conditions and practices at and around the water sources. Total coliform were detected in 97% and Escherichia coli in 71% of the water samples. The concentration levels of Total coliform and Escherichia coli were above the permissible limits of the World Health Organization drinking water quality guidelines in each case. Protected sources had significantly less number of colony forming units (cfu) per 100 ml of water sample compared to unprotected sources (56% versus 95%, p < 0.05). Similarly in terms of Escherichia coli, protected sources had less counts (7% versus 40%, p < 0.05) compared with those from unprotected sources. Hygiene conditions and practices that seemed to potentially contribute increased total coliform and Escherichia coli counts included non protection of water sources from livestock faeces, laundry practices, and water sources being down slope of pit latrines in some cases. These findings suggest source water protection and good hygiene practices can improve the quality of household drinking water where disinfection is not available. The results also suggest important lines of inquiry and provide support and input for environmental and public health programmes, particularly those related to water and sanitation.

Plasma Discharge Initiation of Explosives in Rock Blasting Application: A Case Study

NASA Astrophysics Data System (ADS)

Jae-Ou, Chae; Young-Jun, Jeong; V, M. Shmelev; A, A. Denicaev; V, M. Poutchkov; V, Ravi

2006-07-01

A plasma discharge initiation system for the explosive volumetric combustion charge was designed, investigated and developed for practical application. Laboratory scale experiments were carried out before conducting the large scale field tests. The resultant explosions gave rise to less noise, insignificant seismic vibrations and good specific explosive consumption for rock blasting. Importantly, the technique was found to be safe and environmentally friendly.

10 Years of the LLAS eLearning Symposium: Case Studies in Good Practice

ERIC Educational Resources Information Center

Borthwick, Kate, Ed.; Corradini, Erika, Ed.; Dickens, Alison, Ed.

2015-01-01

This e-book is a celebration of and reflection on 10 years of the LLAS elearning symposium, an event which is run by the Centre for Languages, Linguistics and Area Studies (LLAS) based at the University of Southampton, UK. Over the past ten years, the symposium has followed the innovations brought about in the digital realm and has offered a…

In search of the good old life: Ontological breakdown and responsive hope at the margins of life.

PubMed

Grøn, Lone; Mattingly, Cheryl

2018-01-01

What might the good life amount to at the margins of life? Taking our point of departure in Jonathan Lear's notions of ontological breakdown and radical hope as well as the phenomenology of lived time, we explore hope within the institutional aging process in Denmark. Drawing on two ethnographic cases, Vagn and Thea, we propose a phenomenological and responsive hope emerging within complex temporalities. This is a relational hope to be included among the living, to be a human being among others. Importantly, it is neither optimistic nor naive but rather hope practiced in the face of devastating life circumstances.

Forecasting the Emergency Department Patients Flow.

PubMed

Afilal, Mohamed; Yalaoui, Farouk; Dugardin, Frédéric; Amodeo, Lionel; Laplanche, David; Blua, Philippe

2016-07-01

Emergency department (ED) have become the patient's main point of entrance in modern hospitals causing it frequent overcrowding, thus hospital managers are increasingly paying attention to the ED in order to provide better quality service for patients. One of the key elements for a good management strategy is demand forecasting. In this case, forecasting patients flow, which will help decision makers to optimize human (doctors, nurses…) and material(beds, boxs…) resources allocation. The main interest of this research is forecasting daily attendance at an emergency department. The study was conducted on the Emergency Department of Troyes city hospital center, France, in which we propose a new practical ED patients classification that consolidate the CCMU and GEMSA categories into one category and innovative time-series based models to forecast long and short term daily attendance. The models we developed for this case study shows very good performances (up to 91,24 % for the annual Total flow forecast) and robustness to epidemic periods.

Promoting Good Psychiatric Management for Patients With Borderline Personality Disorder.

PubMed

Links, Paul S; Ross, James; Gunderson, John G

2015-08-01

General psychiatric management for patients with borderline personality disorder was devised to be an outpatient intervention that could be readily learned and easily delivered by independent community mental health professionals. To disseminate the approach, Drs. Gunderson and Links developed the Handbook of Good Psychiatric Management for Borderline Personality Disorder (Gunderson & Links, ) that presented the basics of the approach, videos to illustrate the appropriate clinical skills, and case examples to practice adherence to the approach. Unfortunately, the inclusion of "psychiatric" in the treatment's name may discourage psychologists and other mental health professionals from using this therapy. In this article, we review the basic principles and approaches related to general psychiatric management. With a case example, we illustrate how psychologists can use all the general psychiatric management principles for their patients with BPD, except medications and, as a result, provide and deliver this approach effectively. © 2015 Wiley Periodicals, Inc.

Good practices in transportation evacuation preparedness and response : results of the FHWA workshop series.

DOT National Transportation Integrated Search

2009-08-01

This document provides an overview of the good practices identified during a series of multi-state workshops on Transportation Evacuation Preparedness and Response in four regions across the United States. Good practices are not presented in priority...

Good practices in transportation evacuation preparedness and response : results of the FHWA Workshop Series

DOT National Transportation Integrated Search

2009-08-01

This document provides an overview of the good practices identified during a series of multi-state workshops on Transportation Evacuation Preparedness and Response in four regions across the United States. Good practices are not presented in priority...

WHO Expert Committee on specifications for pharmaceutical preparations.

PubMed

2010-01-01

The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new guidelines were adopted and recommended for use: good practices for pharmaceutical quality control laboratories; supplementary guidelines for active pharmaceutical ingredients; good manufacturing practices for pharmaceutical products containing hazardous substances; good manufacturing practices for sterile pharmaceutical products; good distribution practices for pharmaceutical products; guidelines on the requalification of prequalified dossiers: and guidelines for the preparation of a contract research organization master file.

The Wall Interference of a Wind Tunnel of Elliptic Cross Section

NASA Technical Reports Server (NTRS)

Tani, Itiro; Sanuki, Matao

1944-01-01

The wall interference is obtained for a wind tunnel of elliptic section for the two cases of closed and open working sections. The approximate and exact methods used gave results in practically good agreement. Corresponding to the result given by Glauert for the case of the closed rectangular section, the interference is found to be a minimum for a ratio of minor to major axis of 1:square root of 6 This, however, is true only for the case where the span of the airfoil is small in comparison with the width of the tunnel. For a longer airfoil the favorable ellipse is flatter. In the case of the open working section the circular shape gives the minimum interference.

Challenges in developing e-government for good governance in North Sumatra

NASA Astrophysics Data System (ADS)

Siahaan, AY

2017-01-01

E-government as one form of public administration reform in Indonesia is increasingly related to the pursuance of good governance. This paper examines the relationship between of e-government and good governance by utilizing the case study design on the implementation of e-procurement in North Sumatra. It reveals centrality of local politics and business culture in understanding resistances of both local government officials and local business which creates loopholes’ for the practice of ‘bad governance’ in all phases of e-procurement in North Sumatra province. Data transparency does not equate and guarantee the realization of good governance. Public knowledge and understanding on government decision making processes and accountability (process and policy transparency) are central to achieve good governance through e-procurement. E-procurement system does not automatically change organizational and working culture of the implementers and suppliers. This paper provides insight to the attitude and the perception of private sector engage in e-procurement towards government in implementing e-government. Resistance, digital divide and local politics interrelatedly obstruct the realization of pursuing good governance through e-procurement.

Case studies of pre-engineered and manufactured sound isolation rooms for music practice and radio broadcast

NASA Astrophysics Data System (ADS)

Probst, Ron N.; Rypka, Dann

2005-09-01

Pre-engineered and manufactured sound isolation rooms were developed to ensure guaranteed sound isolation while offering the unique ability to be disassembled and relocated without loss of acoustic performance. Case studies of pre-engineered sound isolation rooms used for music practice and various radio broadcast purposes are highlighted. Three prominent universities wrestle with the challenges of growth and expansion while responding to the specialized acoustic requirements of these spaces. Reduced state funding for universities requires close examination of all options while ensuring sound isolation requirements are achieved. Changing curriculum, renovation, and new construction make pre-engineered and manufactured rooms with guaranteed acoustical performance good investments now and for the future. An added benefit is the optional integration of active acoustics to provide simulations of other spaces or venues along with the benefit of sound isolation.

Narrative Practice and the Signs of Safety Approach: Engaging Adolescents in Building Rigorous Safety Plans

ERIC Educational Resources Information Center

Gibson, Matthew

2014-01-01

The Signs of Safety approach to child protection has been gaining prominence around the world and this approach has developed through learning from good practice. Generally, examples of good practice are derived from adults who pose a risk to children, while this paper outlines an example of good practice that engages an adolescent in building a…

Spring is a good time to clean up your vendor contracts.

PubMed

Daigrepont, Jeffery

2013-01-01

Whether it's a new purchase or renewal, every year physicians and hospitals obligate themselves financially to vendor contracts without fully understanding the terms and conditions of their commitments. Some of these contracts renew automatically without permission or approval and come with automatic price increases. In some cases, practices may even be paying for services no longer being used or maintenance fees for support services no longer needed. However, discerning what vendor and system to select or renew, based on the unique objectives of the practice or hospital, can be overwhelming. This article provides many helpful strategies for negotiating a rock-solid contract that is a win for the physician practice or hospital and holds the vendor accountable for delivery of promises.

Accountability in action?: the case of a database purchasing decision.

PubMed

Neyland, Daniel; Woolgar, Steve

2002-06-01

The increasing prevalence of audit in university settings has raised concerns about the potentially adverse effects of invasive measures of performance upon the conduct of research and generation of knowledge. What sustains the current commitment to audit? It is argued that in order to address this question we need to understand how and to what extent notions of accountability are played out in practice. This is illustrated through the analysis of materials from an ethnographic study of 'good management practice' in the deployment of technologies in university settings. The paper examines the ways in which ideas of accountability - involving considerations such as 'value for money' - inform the practical processes of deciding about the purchase of a new database technology.

Valuing and selling a practice.

PubMed

Sullivan, Walter

2012-11-01

Surgeons, as they contemplate retirement, wrongly believe that their practices do not have financial value. In fact, a well-organized efficiently functioning office with an emphasis on excellent service in combination with a constant stream of patients make it financially ideal for the new surgeon. Being able to assume such a practice can be a very smart financial decision. The practice's worth can be determined by a careful analysis of the practice financials and an evaluation of the functioning of the office and employees. Purchasing such a practice can be, economically, a very smart move by a new surgeon. Payments are made over time at a rate that allows the surgeon to make a good living, leaving him with real equity once the payments are complete. The departing surgeon, who had spent years building this successful practice, gets some of this value back in the form of an income stream to supplement his retirement. This process should be considered in virtually every case. Do not just "close the door."

Perceptions of Science Teachers on Implementation of Seven Principles for Good Practice in Education by Chickering and Gamson in Courses

ERIC Educational Resources Information Center

Ugras, Mustafa; Asiltürk, Erol

2018-01-01

The present study aimed to determine the perceptions of science teachers on the implementation of the seven principles for good practice in education by Chickering and Gamson in their courses. Seven principles for good science education were used as a data collection tool in the survey. "The seven principles for good practice in science…

Knowledge and prevalence of Human African Trypanosomiasis among residents of Kachia grazing reserve, Kachia local government area, Kaduna state, Nigeria, 2012

PubMed Central

Uba, Belinda Vernyuy; Aliyu, Ahmad; Abubakar, Aisha; Uba, Sabo Ado; Gidado, Saheed; Edukugho, Aboyowa; Anagbogu, Ifeoma; Kalejaiye, John; Nguku, Patrick

2016-01-01

Introduction Human African Trypanosomiasis (HAT) is a vector borne parasitic disease transmitted to humans by infected tse-tse flies cause morbidity including delayed child mental development. Reports of nuisance and bites from tse-tse flies by residents of Kachia grazing led to the study to determine the knowledge, practices and prevalence of HAT among residents of the grazing reserve. Methods We conducted active case search in a cross-sectional study using multi-stage sampling with probability proportionate to size. We administered structured questionnaire on Knowledge, practices relating to HAT prevention and screened for HAT using card agglutination test for Trypanosomiasis (CATT). Knowledge of HAT was scored 0-5 and categorized good (3-5) and poor (0-2) based on score, predisposition to risk of HAT as exposure to ≥two risk factors and, a case of HAT as any respondent that tested positive on CATT. We analysed data using Epi-info and MS-excel. Results Of the 300 respondents, mean age 39(±17years) interviewed, 56.3% were males, 12.0% had good knowledge of HAT and 76.3% were exposed to HAT risk factors. Prevention practices included clearing of overgrown bushes around houses (99%), use of insecticidal treated nets (75.7%) and protective clothing (41.0%). Males {Odds Ratio [OR] 5.0; 95% Confidence Interval (CI) 1.8 - 13.6}, age above 40 years {OR 5.0; 95% CI 1.1 - 24.4} and family history of HAT {OR 8.7; 95% CI 2.4 - 32.1} were significantly associated with HAT knowledge. None tested positive on CATT. Conclusion Despite poor knowledge of HAT, residents practiced HAT preventive measures and zero HAT prevalence was recorded. PMID:27222686

78 FR 12068 - Device Good Manufacturing Practice Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] Device Good Manufacturing Practice Advisory Committee; Notice of Meeting AGENCY: Food and Drug... Committee: Device Good Manufacturing Practice Advisory Committee. General Function of the Committee: To...

Application of case teaching in genetics courses to students majoring in forestry.

PubMed

Wang, Qin-Mei; Cui, Jian-Guo; Yu, Chang-Zhi; Zhang, Zhi; Wu, Yue-Liang; Zhang, Li-Jie; Lin, Mei

2017-10-20

Undergraduate students majoring in forestry generally reflect that genetics is one of the most difficult compul-sory courses, because the traditional teaching method is difficult to satisfy their needs. According to the theoretical charac-teristics of forestry and actual demands of the students, in the light of teaching and research experience in recent years, we adopted a series of typical genetic cases such as 'opening coffin to identify relatives', stem-throne of Lycium ruthenicum Murr, and magic powers in Harry Potter. Our practices revealed that the case teaching in genetics could train good personality traits, learning abilities and creativity of the students, stimulate their interests and initiatives in learning, and increase systematic learning.

Proposed Terminology for Anal Squamous Lesions: Its Application and Interobserver Agreement Among Pathologists in Academic and Community Hospitals.

PubMed

Roma, Andres A; Liu, Xiuli; Patil, Deepa T; Xie, Hao; Allende, Daniela

2017-07-01

To analyze interobserver reproducibility and compare practice patterns between academic and community settings of Lower Anogenital Squamous Terminology (LAST). In total, 132 anal biopsy slides were revised as well as p16 immunostains. LAST was used in 49% of cases (academic center, 68%; satellite hospitals [community practice setting], 32%). After pathology review and consensus interpretation, 23 (17%) case diagnoses were reclassified: eight (34.8%) cases (benign or low-grade squamous intraepithelial lesion [LSIL]) were upgraded to high-grade squamous intraepithelial lesion (HSIL) (p16 confirmed ordered during review); four (17.4%) cases originally classified as HSIL were downgraded to LSIL (p16 originally ordered in one case). There was no significant difference in discrepancies between original and consensus diagnosis in the community vs academic setting or by subspecialty (gynecological vs gastrointestinal). Overall interobserver agreement among reviewers was substantial (κ = 0.63) and improved with the use of p16 immunostain in challenging cases (κ = 0.71; P < .001). This new terminology is not yet uniformly used by pathologists in anal/perianal biopsy specimens; this two-tier system has a good interobserver agreement and is further improved with p16 use in appropriate cases. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

In search of practice performance data? Call the hospital.

PubMed

Bellile, S K

1997-01-01

Comparative performance data is increasingly being used by hospitals and managed care plans to evaluate physician practices. Outcomes data can also be a valuable tool for continuous improvement within a practice. Administrators need to understand the different categories and sources of physician practice data. Hospitals are a particularly good, yet often underutilized, data resource. Descriptive, financial and clinical information available from hospital systems can be used to compare one physician's performance to norms for specific case types (e.g. DRG's), focus internal review efforts and support managed care marketing and negotiation. Administrators need to identify key hospital contacts, make specific data requests and knowledgeably (and cautiously) interpret the data received. Finally, the administrator plays a crucial role turning data into information: identifying and presenting key findings and insuring that the information is used to the group's competitive advantage.

A multimedia case based approach to the study of office ergonomics.

PubMed

August-Dalfen, Sharon; Snider, Laurie

2003-01-01

Multimedia technology has the capacity to provide students with an interactive approach to problem based learning and to bridge the gap between theoretical knowledge and clinical practice. The present paper describes the design and development of the program ErgoROM, a CD which presents a case study to assist occupational therapy students in their studies of office ergonomics. A pilot study showed that overall, 91% of respondents rated the ErgoROM as either "Excellent" or "Very Good". Additionally they reported that ErgoROM had a positive impact on active learning and critical thinking.

A guide to unclassified sensitive information protection

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

Donahue, S.C.

1996-11-14

This document is a reference guide for CIC-Division employees who lead or participate in projects that use and/or produce unclassified sensitive information. It is intended for use on a case by case basis to develop project specific sensitive information handling procedures and standards. It contains criteria for identifying sensitive information and determining levels of sensitivity, and describes cost effective measures for protecting various levels of sensitive information. The goal of this document is to help establish good business practices that benefit both the Laboratory and its customers. Division personnel are encouraged to apply these guidelines.

[ADHD and addiction; application of the Belgian guideline with particular reference to comorbid affective disorders].

PubMed

Matthys, F; Joostens, P; Tremmery, S; Stes, S; Sabbe, B

2013-01-01

Two patients with a multi-substance use disorder and an apparent comorbid ADHD disorder were given psychiatric treatment for both illnesses. Each patient had a comorbid affective disorder. In both cases the approach was based on the Belgian guideline Good clinical practice in the recognition and treatment of young adults with addiction problems& squo. We use the case-reports to demonstrate the usefulness and relevance of the guideline in an outpatient setting compared to an inpatient setting and look particularly at the implications of other kinds of comorbidity encompassed by the guideline.

Educational Method of Engineering Ethics Aiming for Comprehensive Understanding

NASA Astrophysics Data System (ADS)

Yasui, Mitsukuni; Fujiki, Hiroyuki; Aoyagi, Manabu; Sugata, Noriyuki; Hayasaka, Narihito

We have proposed the omnibus style to teach an engineering ethics program. This paper showed the essentials to practice the class. The engineering ethics program is constituted with the factors; grade, subject, objective even if it is operated by some themes and teachers in the style of omnibus. Also, teachers have to select the cases which have dilemma of the engineer and the good effect. And they should teach how to analyze the case. Evaluation of student activity must be made up by versatile style according to objective. And student is recommended to understand the relation of activity and object.

21 CFR 123.5 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 123.5 Section...) FOOD FOR HUMAN CONSUMPTION FISH AND FISHERY PRODUCTS General Provisions § 123.5 Current good manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities, methods...

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

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Applicability of current good manufacturing practice regulations. 210.2 Section 210.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING...

Understanding Graduate School Aspirations: The Effect of Good Teaching Practices

ERIC Educational Resources Information Center

Hanson, Jana M.; Paulsen, Michael B.; Pascarella, Ernest T.

2016-01-01

This study examined the effects of good teaching practices on post-baccalaureate degree aspirations using logistic regression techniques on a multi-institutional, longitudinal sample of students at 4-year colleges and universities in the USA. We examined whether eight good teaching practices (non-classroom interactions with faculty, prompt…

77 FR 71804 - Request for Notification From Industry Organizations Interested in Participating in the Selection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

... Representatives on the Device Good Manufacturing Practice Advisory Committee AGENCY: Food and Drug Administration... Device Good Manufacturing Practice Advisory Committee (DGMPAC) in the Center for Devices and Radiological... regarding good manufacturing practices governing the methods used in, and the facilities and controls used...

78 FR 16824 - Tobacco Product Manufacturing Practice; Establishment of a Public Docket

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

... recommendations for regulations on good manufacturing practice for tobacco products that were submitted to FDA by... performance of a tobacco product), packing, and storage of a tobacco product conform to current good... group of 13 tobacco companies submitted to FDA: (1) Recommendations for good manufacturing practice...

Using Quality Management Systems to Improve Test Development and Standards and to Promote Good Practice: A Case Study of Testing Italian as a Foreign Language

ERIC Educational Resources Information Center

Grego Bolli, Giuliana

2014-01-01

This article discusses the problem of quality in the production of language tests in the context of Italian language examinations. The concept of quality is closely related to the application of stated standards and related procedures. These standards, developed over the last thirty years, are mainly related to the concepts of the accountability…

Preoperative Site Marking: Are We Adhering to Good Surgical Practice?

PubMed

Bathla, Sonia; Chadwick, Michael; Nevins, Edward J; Seward, Joanna

2017-06-29

Wrong-site surgery is a never event and a serious, preventable patient safety incident. Within the United Kingdom, national guidance has been issued to minimize the risk of such events. The mandate includes preoperative marking of all surgical patients. This study aimed to quantify regional variation in practice within general surgery and opinions of the surgeons, to help guide the formulation and implementation of a regional general surgery preoperative marking protocol. A SurveyMonkey questionnaire was designed and distributed to 120 surgeons within the Mersey region, United Kingdom. This included all surgical trainees in Mersey (47 registrars, 56 core trainees), 15 consultants, and 2 surgical care practitioners. This sought to ascertain their routine practice and how they would choose to mark for 12 index procedures in general surgery, if mandated to do so. A total of 72 responses (60%) were obtained to the SurveyMonkey questionnaire. Only 26 (36.1%) said that they routinely marked all of their patients preoperatively. The operating surgeon marked the patient in 69% of responses, with the remainder delegating this task. Markings were visible after draping in only 55.6% of marked cases. Based on our findings, surgeons may not be adhering to "Good Surgical Practice"; practice is widely variable and surgeons are largely opposed and resistant to marking patients unless laterality is involved. We suggest that all surgeons need to be actively engaged in the design of local marking protocols to gain support, change practice, and reduce errors.

Dental caries status and oral health practice among 12-15 year old children in Jorpati, Kathmandu.

PubMed

Khanal, S; Acharya, J

2014-09-01

Oral health is an essential component of health throughout life. There has been a decline in dental caries and periodontal disease in developed countries which can be attributed to the implementation of preventive programmes but in developing countries dental diseases are still on the rise. Therefore this cross sectional study was carried out to assess the prevalence of dental caries and oral hygiene practices among 12 to 15 years old children. Self administered close ended questionnaires were used to assess the oral hygiene practice. The overall dental caries prevalence was 58.3% and the mean DMFT score was 1.2 (± 1.79) and the deft score was 0.6 (± 1.24). Majority of the children (84.1%) presented with the practice of brushing their teeth once everyday using tooth brush and toothpaste. Regular dental check up was very poor (5.6%) but 77.4% reported that they visited a dentist in case of pain or presence of stains in the teeth. Females (63.4%) and children studying in higher secondary class (74.2%) showed a "good" level of oral hygiene practice than males and children in secondary class respectively. Children having "good" practice presented with "low" dental caries severity. The utilization of dental services was poor in the children, therefore highlighting the necessity to implement preventive programmes is important which would help in reducing the incidence of the dental caries as well as aiding in prompt treatment of dental caries at its initial stages.

Perceptions of good medical practice in the NHS: a survey of senior health professionals.

PubMed

Hutchinson, A; Williams, M; Meadows, K; Barbour, R S; Jones, R

1999-12-01

To categorize senior health professionals' experience with poor medical practice in hospitals and in general practice, to describe perceptions which senior NHS staff have of good medical practice, and to describe how problems of poor medical practice are currently managed. A postal questionnaire survey. The questionnaire sought perceptions of good medical practice, asked participants to characterise deviations from good practice, and to describe experience with managing poor performance at the time of the introduction of the General Medical Council (GMC) performance procedures. A range of NHS settings in the UK: hospital trusts, health authorities/boards, local medical committees, community health councils. Senior health professionals involved in the management of medical professional performance. Perceptions of what constitutes good medical practice. Most respondents considered that persistent problems related to clinical practice (diagnosis, management, and outcome and prescribing) would require local management and, possibly, referral to the GMC performance procedures. Informal mechanisms, including informal discussion, education, training, and work shifting, were the most usual means of handling a doctor whose performance was poor. Many took a less serious view of deficiencies in performance on manner and attitude and communication, although consultation skills rather than technical skills comprised the greatest number of complaints about doctors. Senior NHS professionals seem reluctant to consider persistently poor consultation skills in the same critical light as they do persistently poor technical practice. These attitudes may need to change with the implementation of clinical governance and updated guidance from the GMC on what constitutes good medical practice.

Investigating School-Wide Antecedents of Good Practice Dissemination from Individual Subject Projects

ERIC Educational Resources Information Center

Christophersen, Knut-Andreas; Elstad, Eyvind; Turmo, Are

2012-01-01

Good practice dissemination is an unsolved problem in education. This article describes how clear and "soft" leadership and perceptions of social and economic exchange operate in the bottom-up processes of school reforms and examines the relative impact of these factors on school-wide good practice dissemination and discusses how…

The Conditional Nature of High Impact/Good Practices on Student Learning Outcomes

ERIC Educational Resources Information Center

Seifert, Tricia A.; Gillig, Benjamin; Hanson, Jana M.; Pascarella, Ernest T.; Blaich, Charles F.

2014-01-01

Using a multi-institutional sample of undergraduate students, this study found that the relationships between engaging in high impact/good practices and liberal arts outcomes differ based on students' precollege and background characteristics. Findings suggest that high impact/good practices are not a panacea and require a greater degree of…

Good Practices for Transforming Education

ERIC Educational Resources Information Center

Benavente, Ana; Panchaud, Christine

2008-01-01

This text is a guide to the reading and interpretation of the "good practices" that are developing in the countries participating in this project and elsewhere. A systematic approach to the factors making up a "good practice" has enabled us to share our analyses in a more structured manner and to reflect on their potential for…

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

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false What is current good manufacturing practice for PET drugs? 212.2 Section 212.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION...

40 CFR 86.098-23 - Required data.

Code of Federal Regulations, 2010 CFR

2010-07-01

... accordance with good engineering practice to assure that the engines covered by a certificate issued under... and conducted in accordance with good engineering practice to assure that the vehicles covered by a... systems are designed, using good engineering practice, to meet the standards of § 86.096-10 or § 86.098-11...

Good Laboratory Practice. Part 3. Implementing Good Laboratory Practice in the Analytical Lab

ERIC Educational Resources Information Center

Wedlich, Richard C.; Pires, Amanda; Fazzino, Lisa; Fransen, Joseph M.

2013-01-01

Laboratories submitting experimental results to the Food and Drug Administration (FDA) or the Environmental Protection Agency (EPA) in support of Good Laboratory Practice (GLP) nonclinical laboratory studies must conduct such work in compliance with the GLP regulations. To consistently meet these requirements, lab managers employ a "divide…

Individualised patient care: a framework for guidelines.

PubMed

Redfern, S

It is assumed that individualised patient care (IPC) benefits both patients and nurses. This study set out to clarify what IPC means to nurses and how they practise it, as well as how it is experienced by patients. With some exceptions, IPC was not practised widely in the seven wards used as case studies. Even in the wards where it was more common, there were some examples of bad practice. Factors that facilitated IPC were: the personal qualities of the nurses; a shared understanding among the ward team of the goals of nursing care and what constitutes good practice; levels of staffing and skill mix; effective leadership and management of nursing work.

Skin whitening among Cameroonian female university students: knowledge, attitudes, practices and motivations.

PubMed

Kouotou, Emmanuel Armand; Nansseu, Jobert Richie N; Adegbidi, Hugues; Zoa Mebara, Theophane Christel Joel; Ndjitoyap Ndam, Elie Claude

2017-04-17

Lack of data on skin whitening (SW) among Cameroonian female university students prompted us to undertake the present study which aimed at assessing the knowledge, attitudes, practices and motivations of female university students vis-a-vis SW. This was a cross-sectional study conducted from January to April 2013 in 4 university campuses of Yaoundé, Cameroon. Any female student regularly registered in one of the study sites, who was present at the campus when the investigator visited and volunteered to participate in the study was enrolled. Overall, we recruited 620 female students, their ages ranging from 16 to 46 years with a mean of 21.3 ± 2.9 years. Only 87 participants (14%) found that SW was a good practice. One hundred and sixty nine respondents (27.3%) were currently practicing SW with no age difference when compared to their counterparts (p = 0.09). The desire to have a uniform body skin color was the prevailing reason motivating the practice of SW (39.1%), followed by the need to have a soft skin (29%). Assessment of levels of knowledge regarding advantages of the black skin and deleterious effects of SW showed excellent scores (≥75% of good answers) only in 6.1 and 0.5% of cases respectively, with no difference between those practicing SW or not (all p values > 0.05). The practice of SW is common among Cameroonian female university students who should therefore be educated on the advantages of the black skin and the harmful effects of SW.

21 CFR 184.1449 - Manganese citrate.

Code of Federal Regulations, 2012 CFR

2012-04-01

... than current good manufacturing practice. The affirmation of this ingredient as generally recognized as safe (GRAS) as a direct human food ingredient is based upon the following current good manufacturing... good manufacturing practice: baked goods as defined in § 170.3(n)(1) of this chapter; nonalcoholic...

21 CFR 184.1449 - Manganese citrate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... than current good manufacturing practice. The affirmation of this ingredient as generally recognized as safe (GRAS) as a direct human food ingredient is based upon the following current good manufacturing... good manufacturing practice: baked goods as defined in § 170.3(n)(1) of this chapter; nonalcoholic...

21 CFR 184.1449 - Manganese citrate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... than current good manufacturing practice. The affirmation of this ingredient as generally recognized as safe (GRAS) as a direct human food ingredient is based upon the following current good manufacturing... good manufacturing practice: baked goods as defined in § 170.3(n)(1) of this chapter; nonalcoholic...

21 CFR 184.1449 - Manganese citrate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... than current good manufacturing practice. The affirmation of this ingredient as generally recognized as safe (GRAS) as a direct human food ingredient is based upon the following current good manufacturing... good manufacturing practice: baked goods as defined in § 170.3(n)(1) of this chapter; nonalcoholic...

Cytomegalovirus (CMV) and Pregnancy

MedlinePlus

... way to prevent infection is to practice good hygiene, particularly proper hand washing. An interventional study in ... a CMV infection found that teaching about good hygiene (and practicing good hygiene) reduced the risk of ...

Managing wetlands for disaster risk reduction: A case study of the eastern Free State, South Africa

PubMed Central

Collins, Nacelle

2018-01-01

This article investigated the knowledge and practice of a nature-based solution to reduce disaster risks of drought, veld fires and floods using wetlands in the eastern Free State, South Africa. A mixed research method approach was used to collect primary data using three data collection tools, namely questionnaires, interviews and field observations. Ninety-five wetlands under communal and private ownership as well as a few in protected areas were sampled, with their users completing questionnaires. The study showed that communal wetlands were more degraded, while wetlands in protected areas and in private commercial farms were in a good ecological state. An extensive literature review reveals that healthy wetlands are effective buffers in reducing disaster risks such as drought, veld fires and floods which are recurrent in the study area. Therefore, through better land-use and management practices, backed by education and awareness, wetlands could be good instruments to mitigate recurrent natural hazards in the agriculturally dominated eastern Free State in South Africa.

Promoting research integrity in the geosciences

NASA Astrophysics Data System (ADS)

Mayer, Tony

2015-04-01

Conducting research in a responsible manner in compliance with codes of research integrity is essential. The geosciences, as with all other areas of research endeavour, has its fair share of misconduct cases and causes celebres. As research becomes more global, more collaborative and more cross-disciplinary, the need for all concerned to work to the same high standards becomes imperative. Modern technology makes it far easier to 'cut and paste', to use Photoshop to manipulate imagery to falsify results at the same time as making research easier and more meaningful. So we need to promote the highest standards of research integrity and the responsible conduct of research. While ultimately, responsibility for misconduct rests with the individual, institutions and the academic research system have to take steps to alleviate the pressure on researchers and promote good practice through training programmes and mentoring. The role of the World Conferences on Research Integrity in promoting the importance of research integrity and statements about good practice will be presented and the need for training and mentoring programmes will be discussed

Team Science Approach to Developing Consensus on Research Good Practices for Practice‐Based Research Networks: A Case Study

PubMed Central

Daly, Jeanette M.; Nagykaldi, Zsolt J.; Aspy, Cheryl B.; Dolor, Rowena J.; Fagnan, Lyle J.; Levy, Barcey T.; Palac, Hannah L.; Michaels, LeAnn; Patterson, V. Beth; Kano, Miria; Smith, Paul D.; Sussman, Andrew L.; Williams, Robert; Sterling, Pamela; O'Beirne, Maeve; Neale, Anne Victoria

2015-01-01

Abstract Using peer learning strategies, seven experienced PBRNs working in collaborative teams articulated procedures for PBRN Research Good Practices (PRGPs). The PRGPs is a PBRN‐specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings. This paper describes the team science processes which culminated in the PRGPs. Skilled facilitators used team science strategies and methods from the Technology of Participation (ToP®), and the Consensus Workshop Method to support teams to codify diverse research expertise in practice‐based research. The participatory nature of “sense‐making” moved through identifiable stages. Lessons learned include (1) team input into the scope of the final outcome proved vital to project relevance; (2) PBRNs with diverse domains of research expertise contributed broad knowledge on each topic; and (3) ToP® structured facilitation techniques were critical for establishing trust and clarifying the “sense‐making” process. PMID:26602516

A case study on modeling and independent practice cycles in teaching beginning science inquiry

NASA Astrophysics Data System (ADS)

Sadeghpour-Kramer, Margaret Ann Plattenberger

With increasing pressure to produce high standardized test scores, school systems will be looking for the surest ways to increase scores. Decision makers uninformed about the value of inquiry science may recommend more direct teaching methods and curricula in the hope that students will more quickly accumulate factual information for high test scores. This researcher and other proponents of inquiry science suggest that the best preparation for any test is the ability to use all available information and problem solving skills to think through to a solution. This study proposes to test the theory that inquiry problem solving skills need to be modeled and practiced in increasingly independent situations to be learned. Students tend to copy what they have been led to believe is correct, and to avoid continued copying, their skills must be applied in new situations requiring independent practice and improvement. This study follows ten sixth grade students, selected for maximum variation, as they participate in a series of five cycles of modeling and practicing inquiry science investigations as part of an ongoing unit on water quality. The cycles were designed to make the students increasingly independent in their use of inquiry. The results showed that all ten students made significant progress from copying teacher modeling in investigation #1 towards independent inquiry, with nine of the ten achieving acceptable to good beginning independent inquiry in investigation #5. Each case was analyzed independently using such case study methodology as pattern matching, case study protocols, and theoretical propositions. Constant comparison and other case study methods were used in a cross-case analysis. Eight cases confirmed a matching set of propositions and the hypothesis, in literal replication, and the other two cases confirmed a set of propositions and the hypothesis through theoretical replication. The study suggests to educators that repeated cycles of modeling and increasingly independent practice serve three purposes; first to develop independent inquiry skills by providing multiple opportunities with intermittent modeling, second to repeat the modeling initially in very similar situations and then encourage transfer to new situations, and third to provide repeated modeling for those students who do not grasp the concepts as quickly as do their classmates.

Preventing congenital syphilis - a regional audit of syphilis in pregnant women seen in Genitourinary Medicine services.

PubMed

Hussey, J; Mitchell, L; Hew, Y; Foster, K; Waldram, A

2014-05-01

Genitourinary case records of 42 pregnant women with syphilis were reviewed as part of a regional audit following the re-emergence of congenital syphilis in the north east of England. National standards, from the British Association of Sexual Health and HIV guidelines on managing syphilis in pregnancy, were met in the majority of cases with 69% being treated according to national guidance and all cases completing treatment. Locally developed standards on multidisciplinary working and communication were met less well, with particular issues regarding the documentation of pregnancy outcomes in GUM records and communication between specialities being highlighted. A regional good practice guide has been developed and implemented to address standards not met, reduce adverse outcomes and prevent future cases of congenital syphilis.

A Completed Cycle Audit of Psychiatric Discharge Summaries.

PubMed

Najim, Hellme; Jaffar, Khalid

2015-09-01

Patients discharge summaries are important as they record a vital miles stone in patients' care. Their accurate record improves patients' care and clarifies communication between different health professionals. 60 Discharge summaries from different consultant psychiatrists' case load were audited. The results were analysed and presented with recommendations to improve them a format was suggested. A reaudit of 62 discharge summaries was carried out by the same team after three years in the same catchment area but the practice has changed to inpatient and community. Improvement in most of the areas audited occur in the reaudit which indicates the usefulness of audit in improving clinical practice which a pivotal part of clinical governance. This completed audit cycle has proven that clinical practice has been reviewed and methods of improving it have been implemented. It has been noted that more items were reviewed and added to the second cycle which should be condoned. Discharge summaries are important clinical documents in secondary and primary care communications. They are helpful for secondary care staff as they good references for people in out of hours services and Accident and Emergency. Good quality discharge summaries improve patients care and make it easy to manage clinical risk.

Environmental aspects in plant protection practices of non-agricultural pesticide users: case study of communes and the ministry of public works and transport (MET) of the Walloon Region (Belgium).

PubMed

Godeaux, D; Schiffers, B; Culot, M

2008-01-01

In order to gain a better understanding of non-agricultural pesticide use and to prepare the legislative and technical dossiers required under the Water Framework Directive, between October 2006 and March 2007, two surveys were conducted of 97 Walloon communes and 65 districts of the Walloon Ministry of Public Works and Transport (MET) (General Directorates for Motorways and Roads and for Waterway Infrastructure). The questionnaire (26 questions on six topics) was sent by e-mail or fax, with a response rate of 60 out of 97 communes and 33 out of 65 districts. This article describes the environmental aspects of the surveys (health-related aspects are the subject of separate article). The surveys have brought to light a number of good practices (including zero pesticides) and a growing awareness of environmental issues among non-agricultural users. However, bad habits, legislation infringements and a failure to follow good plant protection practice are still a problem and pose major environmental risks (in the form of water pollution from pesticides). Information, awareness-raising and training therefore remain a priority for non-agricultural users.

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

75 FR 16345 - Administrative Practices and Procedures; Good Guidance Practices; Technical Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

.... FDA-1999-N-3539] (formerly Docket No. 1999N-4783) Administrative Practices and Procedures; Good Guidance Practices; Technical Amendment AGENCY: Food and Drug Administration, HHS. ACTION: Final rule... Subjects in 21 CFR Part 10 Administrative practice and procedure, News media. 0 Therefore, under the...

Monitoring clinical standards in a chronic peritoneal dialysis program.

PubMed

Leung, Dora K C

2009-02-01

Multiple factors may influence the effectiveness of a chronic peritoneal dialysis program. Continuous monitoring of various aspects of clinical standards with reviews enhances opportunities for bridging the gap between existing practice and good practice, and good practice to best practice.

Concept analysis of good death in long term care residents.

PubMed

Krishnan, Preetha

2017-01-02

The purpose of this concept analysis paper is to delineate the meaning of good death in long term care (LTC) settings and examine its implications for nursing. The Walker and Avant (2011) method was chosen for this analysis. An in depth literature review identifies uses of the concept and determines the defining attributes of the good death. This paper also illustrates case presentations, antecedents, consequences, empirical referents and implications for clinical practice to clarify the concept of 'good death' in this population. In LTC, death is experienced frequently and is considered the ultimate outcome for most admissions. Much of the existing research on end-of-life care has focused on community dwelling cancer patients whose death trajectory is predictable and who may remain cognitively intact until actively dying. In contrast, the LTC population is older and more likely to suffer from dementia and experience chronic illness for long periods prior to death, and they follow a less predictable death trajectory. In this century, death became the province of older people and the assurance of a good death became the responsibility of those caring for them.

16 CFR 453.4 - Required purchase of funeral goods or funeral services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Required purchase of funeral goods or funeral services. 453.4 Section 453.4 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES FUNERAL INDUSTRY PRACTICES § 453.4 Required purchase of funeral goods or funeral services. (a) Casket for cremation provisions—(1) Unfair or...

21 CFR 114.5 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 114.5 Section...) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good manufacturing practice. The criteria in §§ 114.10, 114.80, 114.83, 114.89, and 114.100, as well as the criteria in part...

The Future of HPT Depends on Whether Practitioners Focus on Foundations or Fads

ERIC Educational Resources Information Center

Brethower, Dale M.

2012-01-01

The future of human performance technology (HPT) will be bright or dismal depending on how well HPT practitioners focus on careful and practical answers to three pivotal questions: What is good practice in human performance technology? What are the differences between good practice and bad? What are the connections between good research and…

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

Code of Federal Regulations, 2013 CFR

2013-04-01

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

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

Code of Federal Regulations, 2014 CFR

2014-04-01

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

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

Code of Federal Regulations, 2012 CFR

2012-04-01

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

Implementing Good Practices Programs to Encourage Production of High-Quality, Safer Produce in Mississippi

ERIC Educational Resources Information Center

Mahmoud, Barakat S. M.; Stafne, Eric T.; Coker, Christine H.; Bachman, Gary R.; Bell, Nicole

2016-01-01

Fifty-four growers/producers attended four 1-day good agricultural practices (GAP) and good handling practices (GHP) workshops at four locations in Mississippi. Pre- and post workshop survey data indicated that the participants' food safety knowledge increased by 15%. Furthermore, the workshops helped producers develop their own food safety plans.…

WHO Expert Committee on Specifications for Pharmaceutical Preparations. Fiftieth report.

PubMed

2016-01-01

The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new guidelines were adopted and recommended for use. Good pharmacopoeial practices; FIP-WHO technical guidelines: points to consider in the provision by health-care professionals of children-specific preparations that are not available as authorized products; Guidance on good manufacturing practices for biological products; Guidance on good manufacturing practices: inspection report, including Appendix 1: Model inspection report; Guidance on good data and record management practices; Good trade and distribution practices for starting materials; Guidelines on the conduct of surveys of the quality of medicines; Collaborative procedure between the World Health Organization (WHO) prequalification team and national regulatory authorities in the assessment and accelerated national registration of WHO-prequalified pharmaceutical products and vaccines; Guidance for organizations performing in vivo bioequivalence studies; and World Health Organization (WHO) general guidance on variations to multisource pharmaceutical products.

Reliability of conventional shade guides in teeth color determination.

PubMed

Todorović, Ana; Todorović, Aleksandar; Gostović, Aleksandra Spadijer; Lazić, Vojkan; Milicić, Biljana; Djurisić, Slobodan

2013-10-01

Color matching in prosthodontic therapy is a very important task because it influences the esthetic value of dental restorations. Visual shade matching represents the most frequently applied method in clinical practice. Instrumental measurements provide objective and quantified data in color assessment of natural teeth and restorations. In instrumental shade analysis, the goal is to achieve the smallest deltaE value possible, indicating the most accurate shade match. The aim of this study was to evaluate the reliability of commercially available ceramic shade guides. VITA Easyshade spectrophotometer (VITA, Germany) was used for instrumental color determination. Utilizing this device, color samples of ten VITA Classical and ten VITA 3D - Master shade guides were analyzed. Each color sample from all shade guides was measured three times and the basic parameters of color quality were examined: deltaL, deltaC, deltaH, deltaE, deltaElc. Based on these parameters spectrophotometer marks the shade matching as good, fair or adjust. After performing 1,248 measurements of ceramic color samples, frequency of evaluations adjust, fair and good were statistically significantly different between VITA Classical and VITA 3D Master shade guides (p = 0.002). There were 27.1% cases scored as adjust, 66.3% as fair and 6.7% as good. In VITA 3D - Master shade guides 30.9% cases were evaluated as adjust, 66.4% as fair and 2.7% cases as good. Color samples from different shade guides, produced by the same manufacturer, show variability in basic color parameters, which once again proves the lack of precision and nonuniformity of the conventional method.

Is harm reduction profitable? An analytical framework for corporate social responsibility based on an epidemic model of addictive consumption.

PubMed

Massin, Sophie

2012-06-01

This article aims to help resolve the apparent paradox of producers of addictive goods who claim to be socially responsible while marketing a product clearly identified as harmful. It advances that reputation effects are crucial in this issue and that determining whether harm reduction practices are costly or profitable for the producers can help to assess the sincerity of their discourse. An analytical framework based on an epidemic model of addictive consumption that includes a deterrent effect of heavy use on initiation is developed. This framework enables us to establish a clear distinction between a simple responsible discourse and genuine harm reduction practices and, among harm reduction practices, between use reduction practices and micro harm reduction practices. Using simulations based on tobacco sales in France from 1950 to 2008, we explore the impact of three corresponding types of actions: communication on damage, restraining selling practices and development of safer products on total sales and on the social cost. We notably find that restraining selling practices toward light users, that is, preventing light users from escalating to heavy use, can be profitable for the producer, especially at early stages of the epidemic, but that such practices also contribute to increase the social cost. These results suggest that the existence of a deterrent effect of heavy use on the initiation of the consumption of an addictive good can shed new light on important issues, such as the motivations for corporate social responsibility and the definition of responsible actions in the particular case of harm reduction. Copyright © 2012 Elsevier Ltd. All rights reserved.

Knowledge and Preventive Practices related to Avian Influenza among Poultry Workers of Kamalamai Municipality, Sindhuli, Nepal.

PubMed

Shrestha, R; Shrestha, K B; Ghimire, S; Shrestha, N

2016-01-01

Avian influenza (AI) is currently a threat to global health. Prevention and control of AI depends on the knowledge and preventive practices of the poultry workers as well as of general population. This study aims to assess knowledge and preventive practices related to AI among poultry workers. Cross-sectional study was carried out among poultry workers of Kamalamai Municipality, Sindhuli. Data was collected from randomly selected 122 respondents through face-to-face interview. The collected data was entered in Epi-data version 3.1 and analyzed in terms of descriptive statistics (proportion, 95% CI, mean and standard deviation) by using SPSS, version 20. A scoring system was used to assess knowledge and preventive practices. Out of total, 93.4% (95% CI, 87.6- 96.6%) of the respondents had heard about AI. More than half (54.9%) of the respondents had poor knowledge on AI. Only 5.3% of respondents had good preventive practice against AI. 30.3% respondents had good knowledge and good practice and 24.6% had poor knowledge as well as poor practice. 20.5% of the respondents had good practice but poor knowledge, whereas, 24.6% had good knowledge but poor practice towards prevention. The knowledge and practice of AI among poultry workers were low. The groups should be targeted for appropriate intervention based on whether they lack knowledge or practice or both.

Management of a pregnant woman dependent on haemodialysis.

PubMed

Walsh, Anna-Marie

2002-01-01

This is a case study of a woman who became pregnant whilst receiving haemodialysis in a London teaching hospital. She courageously disregarded the doctors' advise to abort the fetus. The doctors advised her to wait until she had a kidney transplant to become pregnant again, rather than increase maternal and fetal risk on dialysis. She was due to have a live-related transplant from her father in the spring. The case study describes a practical account in detailed measure to equip nurses with the knowledge to provide specialised care to high-risk dialysis expecting mothers. The main problems in this case study were trying to manage the mother's dialysis regime, control her anaemia, ensure good nutritional levels and gain accurate daily weights.

Good Practice and Recommendations for Research Team Leadership

DTIC Science & Technology

2017-05-01

ARL-SR-0372 ● MAY 2017 US Army Research Laboratory Good Practice and Recommendations for Research Team Leadership by Mark L...Do not return it to the originator. ARL-SR-0372 ● MAY 2017 US Army Research Laboratory Good Practice and Recommendations for...information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services , Directorate for Information

Impacts of Good Practices on Cognitive Development, Learning Orientations, and Graduate Degree Plans during the First Year of College

ERIC Educational Resources Information Center

Cruce, Ty M.; Wolniak, Gregory C.; Seifert, Tricia A.; Pascarella, Ernest T.

2006-01-01

This study estimated separately the unique effects of three dimensions of good practice and the global effects of a composite measure of good practices on the cognitive development, orientations to learning, and educational aspirations of students during their first year of college. Analyses of longitudinal data from a representative sample of…

Knowledge for the good of the individual and society: linking philosophy, disciplinary goals, theory, and practice.

PubMed

McCurry, Mary K; Revell, Susan M Hunter; Roy, Sr Callista

2010-01-01

Nursing as a profession has a social mandate to contribute to the good of society through knowledge-based practice. Knowledge is built upon theories, and theories, together with their philosophical bases and disciplinary goals, are the guiding frameworks for practice. This article explores a philosophical perspective of nursing's social mandate, the disciplinary goals for the good of the individual and society, and one approach for translating knowledge into practice through the use of a middle-range theory. It is anticipated that the integration of the philosophical perspective and model into nursing practice will strengthen the philosophy, disciplinary goal, theory, and practice links and expand knowledge within the discipline. With the focus on humanization, we propose that nursing knowledge for social good will embrace a synthesis of the individual and the common good. This approach converges vital and agency needs described by Hamilton and the primacy of maintaining the heritage of the good within the human species as outlined by Maritain. Further, by embedding knowledge development in a changing social and health care context, nursing focuses on the goals of clinical reasoning and action. McCubbin and Patterson's Double ABCX Model of Family Adaptation was used as an example of a theory that can guide practice at the community and global level. Using the theory-practice link as a foundation, the Double ABCX model provides practising nurses with one approach to meet the needs of individuals and society. The integration of theory into nursing practice provides a guide to achieve nursing's disciplinary goals of promoting health and preventing illness across the globe. When nursing goals are directed at the synthesis of the good of the individual and society, nursing's social and moral mandate may be achieved.

Examples of Holistic Good Practices in Promoting and Protecting Mental Health in the Workplace: Current and Future Challenges.

PubMed

Sivris, Kelly C; Leka, Stavroula

2015-12-01

While attention has been paid to physical risks in the work environment and the promotion of individual employee health, mental health protection and promotion have received much less focus. Psychosocial risk management has not yet been fully incorporated in such efforts. This paper presents good practices in promoting mental health in the workplace in line with World Health Organization (WHO) guidance by identifying barriers, opportunities, and the way forward in this area. Semistructured interviews were conducted with 17 experts who were selected on the basis of their knowledge and expertise in relation to good practice identified tools. Interviewees were asked to evaluate the approaches on the basis of the WHO model for healthy workplaces. The examples of good practice for Workplace Mental Health Promotion (WMHP) are in line with the principles and the five keys of the WHO model. They support the third objective of the WHO comprehensive mental health action plan 2013-2020 for multisectoral implementation of WMHP strategies. Examples of good practice include the engagement of all stakeholders and representatives, science-driven practice, dissemination of good practice, continual improvement, and evaluation. Actions to inform policies/legislation, promote education on psychosocial risks, and provide better evidence were suggested for higher WMHP success. The study identified commonalities in good practice approaches in different countries and stressed the importance of a strong policy and enforcement framework as well as organizational responsibility for WMHP. For progress to be achieved in this area, a holistic and multidisciplinary approach was unanimously suggested as a way to successful implementation.

Examples of Holistic Good Practices in Promoting and Protecting Mental Health in the Workplace: Current and Future Challenges

PubMed Central

Sivris, Kelly C.; Leka, Stavroula

2015-01-01

Background While attention has been paid to physical risks in the work environment and the promotion of individual employee health, mental health protection and promotion have received much less focus. Psychosocial risk management has not yet been fully incorporated in such efforts. This paper presents good practices in promoting mental health in the workplace in line with World Health Organization (WHO) guidance by identifying barriers, opportunities, and the way forward in this area. Methods Semistructured interviews were conducted with 17 experts who were selected on the basis of their knowledge and expertise in relation to good practice identified tools. Interviewees were asked to evaluate the approaches on the basis of the WHO model for healthy workplaces. Results The examples of good practice for Workplace Mental Health Promotion (WMHP) are in line with the principles and the five keys of the WHO model. They support the third objective of the WHO comprehensive mental health action plan 2013–2020 for multisectoral implementation of WMHP strategies. Examples of good practice include the engagement of all stakeholders and representatives, science-driven practice, dissemination of good practice, continual improvement, and evaluation. Actions to inform policies/legislation, promote education on psychosocial risks, and provide better evidence were suggested for higher WMHP success. Conclusion The study identified commonalities in good practice approaches in different countries and stressed the importance of a strong policy and enforcement framework as well as organizational responsibility for WMHP. For progress to be achieved in this area, a holistic and multidisciplinary approach was unanimously suggested as a way to successful implementation. PMID:26929841

12 CFR 308.7 - Good faith certification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Good faith certification. 308.7 Section 308.7... PRACTICE AND PROCEDURE Uniform Rules of Practice and Procedure § 308.7 Good faith certification. (a... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

12 CFR 1780.7 - Good faith certification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Good faith certification. 1780.7 Section 1780.7... DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE General Rules § 1780.7 Good faith... record is well-grounded in fact and is warranted by existing law or a good faith, nonfrivolous argument...

12 CFR 263.7 - Good faith certification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Good faith certification. 263.7 Section 263.7... (CONTINUED) RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.7 Good faith... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

12 CFR 263.7 - Good faith certification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Good faith certification. 263.7 Section 263.7... RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.7 Good faith certification... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

12 CFR 263.7 - Good faith certification.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 4 2013-01-01 2013-01-01 false Good faith certification. 263.7 Section 263.7... (CONTINUED) RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.7 Good faith... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

12 CFR 308.7 - Good faith certification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Good faith certification. 308.7 Section 308.7... PRACTICE AND PROCEDURE Uniform Rules of Practice and Procedure § 308.7 Good faith certification. (a... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

12 CFR 263.7 - Good faith certification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 4 2012-01-01 2012-01-01 false Good faith certification. 263.7 Section 263.7... (CONTINUED) RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.7 Good faith... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

12 CFR 308.7 - Good faith certification.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Good faith certification. 308.7 Section 308.7... PRACTICE AND PROCEDURE Uniform Rules of Practice and Procedure § 308.7 Good faith certification. (a... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

12 CFR 308.7 - Good faith certification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Good faith certification. 308.7 Section 308.7... PRACTICE AND PROCEDURE Uniform Rules of Practice and Procedure § 308.7 Good faith certification. (a... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

12 CFR 308.7 - Good faith certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Good faith certification. 308.7 Section 308.7... PRACTICE AND PROCEDURE Uniform Rules of Practice and Procedure § 308.7 Good faith certification. (a... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

12 CFR 1780.7 - Good faith certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Good faith certification. 1780.7 Section 1780.7... DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE General Rules § 1780.7 Good faith... record is well-grounded in fact and is warranted by existing law or a good faith, nonfrivolous argument...

12 CFR 263.7 - Good faith certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Good faith certification. 263.7 Section 263.7... RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.7 Good faith certification... in fact and is warranted by existing law or a good faith argument for the extension, modification, or...

Mobilising Open Access to Research Data: Recommendations from the RECODE project

NASA Astrophysics Data System (ADS)

Finn, Rachel; Sveinsdottir, Thordis

2015-04-01

This paper will introduce the findings and policy recommendations from the FP7 project RECODE (Policy RECommendations for Open Access to Research Data in Europe) which aims to leverage existing networks, communities and projects to address challenges within the open access and data dissemination and preservation sector. We will introduce the key recommendations, which provide solutions relevant to opening access to PSI. The project is built on case study research of five scientific disciplines with the aim of recognizing and working with disciplinary fragmentation associated with open access to research data. The RECODE findings revealed that the mobilisation of open access to research data requires a partnership approach for developing a coherent and flexible ecosystem that is easy and transparent to embed in research practice and process. As such, the development of open access to research data needs to be: • Informed by research practices and processes in different fields • Supported by an integrated institutional and technological data infrastructure and guided by ethical and regulatory frameworks • Underpinned by infrastructure and guiding frameworks that allow for differences in disciplinary research and data management practices • Characterised by a partnership approach involving the key stakeholders, researchers, and institutions The proposed presentation will examine each of these aspects in detail and use information and good practices from the RECODE project to consider how stakeholders within the PSI movement might action each of these points. It will also highlight areas where RECODE findings and good practice recommendations have clear relevance for the PSI sector.

Simulation of changes on the psychosocial risk in the nursing personnel after implementing the policy of good practices on the risk treatment.

PubMed

Bolívar Murcia, María Paula; Cruz González, Joan Paola; Rodríguez Bello, Luz Angélica

2018-02-01

Evaluate the change over time of psychosocial risk management for the nursing personnel of an intermediate complexity clinic of Bogota (Colombia). Descriptive and correlational research performed under the approach of risk management (identification, analysis, assessment and treatment). The psychosocial risk of the nursing personnel was studied through 10-year system dynamics models (with and without the implementation of the policy of good practices on the risk treatment) in two scenarios: when the nursing personnel works shifts of 6 hours (morning or afternoon) and when they work over 12 hours (double shift or night shift). When implementing a policy of good practices on the risk treatment, the double shift scenario shows an improvement among 25% to 88% in the variables of: health, labor motivation, burnout, service level and productivity; as well as in the variables of the organization associated to number of patients, nursing personnel and profit. Likewise, the single shift scenario with good practices improves in all the above-mentioned variables and generates stability on the variables of absenteeism and resignations. The best scenario is the single shift scenario with the application of good practices of risk treatment in comparison with the double shift scenario with good practices, which allows concluding that the good practices have a positive effect on the variables of nursing personnel and on those associated to the organization. Copyright© by the Universidad de Antioquia.

European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy.

PubMed

van Schaik, I N; Bouche, P; Illa, I; Léger, J-M; Van den Bergh, P; Cornblath, D R; Evers, E M A; Hadden, R D M; Hughes, R A C; Koski, C L; Nobile-Orazio, E; Pollard, J; Sommer, C; van Doorn, P A

2006-08-01

Several diagnostic criteria for multifocal motor neuropathy have been proposed in recent years and a beneficial effect of intravenous immunoglobulin (IVIg) and various other immunomodulatory drugs has been suggested in several trials and uncontrolled studies. The objectives were to prepare consensus guidelines on the definition, investigation and treatment of multifocal motor neuropathy. Disease experts and a patient representative considered references retrieved from MEDLINE and the Cochrane Library in July 2004 and prepared statements which were agreed in an iterative fashion. The Task Force agreed good practice points to define clinical and electrophysiological diagnostic criteria for multifocal motor neuropathy and investigations to be considered. The principal recommendations and good practice points were: (i) IVIg (2 g/kg given over 2-5 days) should be considered as the first line treatment (level A recommendation) when disability is sufficiently severe to warrant treatment. (ii) Corticosteroids are not recommended (good practice point). (iii) If initial treatment with IVIg is effective, repeated IVIg treatment should be considered (level C recommendation). The frequency of IVIg maintenance therapy should be guided by the individual response (good practice point). Typical treatment regimens are 1 g/kg every 2-4 weeks or 2 g/kg every 4-8 weeks (good practice point). (iv) If IVIg is not or not sufficiently effective then immunosuppressive treatment may be considered. Cyclophosphamide, ciclosporin, azathioprine, interferon beta1a, or rituximab are possible agents (good practice point). (v) Toxicity makes cyclophosphamide a less desirable option (good practice point).

7 CFR 1437.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (including ornamental fish), and floriculture, an environment in which everything that can practicably be..., as determined by CCC. Good farming practices means the cultural practices generally used for the crop... good farming practices. T-Yield means the yield which is based on the county expected yield of the crop...

First practical applications of eye temperature measurements for estimation of the time of death in casework. Report of three cases.

PubMed

Kaliszan, Michał

2012-06-10

This paper presents first three successive cases of death where at scene measurements of the internal eyeball temperature soon after death allowed to precisely estimate the times of deaths based on this data (33.1°C, 32.2°C and 29.5°C, respectively), which were later confirmed during the police investigation. Simultaneously the rectal temperatures in all three cases were measured and appeared to be between 36.3 and 36.8°C-reflecting a living individual's body temperature. Thanks to a significantly faster postmortem decrease of the eye temperature and a residual or nonexistent plateau effect affecting the eye, using the formula developed in previous comprehensive studies in pigs, the time of death in real cases could be estimated with good precision: 1 h 33 min, 2 h 24 min and 3 h 17 min since death respectively. The actual TOD established during investigation appeared to be: between 1 h 30 min and 1 h 50 min in case 1; 1 h 55 min in case 2 and between 2 h 55 min and 3 h 05 min in case 3. Such precise estimation, mainly due to the plateau effect lasting up to a few hours, could not have been done based only on rectal temperature, commonly measured in forensic practice. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

[Phronesis: Medicine's indispensable virtue].

PubMed

Moreno Villares, José Manuel

2014-01-01

Facing those who defend that Medicine is not but an applied science, Pellegrino argues that the ultimate goal of Medicine is facing to a human being in his illness condition. Thus, it is not sufficient to have scientific knowledge but proximity to man kindness. Cure is not the only goal -achievable in only a few cases- but healing, caring with a person as an ill person and as a person. For this reason, professional competence is not enough; the physician needs to have the necessary dispositions to be a good person, a good professional. To get the goals of Medicine, the physician has to achieve those qualities who allow him to do the good he is intended to, that is, he needs to be virtuous. Prudence -phronesis- is the virtue that allows him to apply a general rule to a particular case and, furthermore, addresses his actions to be not only technically correct, but excellent. Prudence is, then, the link between intellectual virtues and moral virtues. Pellegrino's main objective has been to elaborate a Philosophy of Medicine, different from the Philosophy of Science, useful for clinical practice and used by clinical practitioners. By nurturing prudence, a small bit of the final goal is reached: the healing, the goodness for the sick. This should be possible if we are embedded in a moral community, and for Pellegrino, sharing knowledge and ethical values is the way of being part of a moral community.

Implementing people-centred health systems governance in 3 provinces and 11 districts of Afghanistan: a case study.

PubMed

Anwari, Zelaikha; Shukla, Mahesh; Maseed, Basir Ahmad; Wardak, Ghulam Farooq Mukhlis; Sardar, Sakhi; Matin, Javid; Rashed, Ghulam Sayed; Hamedi, Sayed Amin; Sahak, Hedayatullah; Aziz, Abdul Hakim; Boyd-Boffa, Mariah; Trasi, Reshma

2015-01-01

Previous studies show that health systems governance influences health system performance and health outcomes. However, there are few examples of how to implement and monitor good governing practices in fragile and conflict affected environments. Good governance has the potential to make the health system people-centered. More research is needed on implementing a people-centered governance approach in these environments. We piloted an intervention that placed a people-centred health systems governance approach in the hands of multi-stakeholder committees that govern provincial and district health systems. We report the results of this intervention from three provinces and eleven districts in Afghanistan over a six month period. This mixed-methods exploratory case study uses analysis of governance self-assessment scores, health management information system data on health system performance, and focus group discussions. The outcomes of interest are governance scores and health system performance indicators. We document the application of a people-centred health systems governance conceptual model based on applying four effective governing practices: cultivating accountability, engaging with stakeholders, setting a shared strategic direction, and stewarding resources responsibly. We present a participatory approach where health system leaders identify and act on opportunities for making themselves and their health systems more accountable and responsive to the needs of the communities they serve. We found that health systems governance can be improved in fragile and conflict affected environments, and that consistent application of the effective governing practices is key to improving governance. Intervention was associated with a 20% increase in antenatal care visit rate in pilot provinces. Focus group discussions showed improvements across the four governing practices, including: establishment of new sub-committees that oversee financial transparency and governance, collaboration with diverse stakeholders, sharper focus on community health needs, more frequent presentation of service delivery data, and increased use of data for decision making. Our findings have implications for policy and practice within and beyond Afghanistan. Governance is central to making health systems responsive to the needs of people who access and provide services. We provide a practical approach to improving health systems governance in fragile and conflict affected environments.

Decision method for optimal selection of warehouse material handling strategies by production companies

NASA Astrophysics Data System (ADS)

Dobos, P.; Tamás, P.; Illés, B.

2016-11-01

Adequate establishment and operation of warehouse logistics determines the companies’ competitiveness significantly because it effects greatly the quality and the selling price of the goods that the production companies produce. In order to implement and manage an adequate warehouse system, adequate warehouse position, stock management model, warehouse technology, motivated work force committed to process improvement and material handling strategy are necessary. In practical life, companies have paid small attantion to select the warehouse strategy properly. Although it has a major influence on the production in the case of material warehouse and on smooth costumer service in the case of finished goods warehouse because this can happen with a huge loss in material handling. Due to the dynamically changing production structure, frequent reorganization of warehouse activities is needed, on what the majority of the companies react basically with no reactions. This work presents a simulation test system frames for eligible warehouse material handling strategy selection and also the decision method for selection.

Management of corneal decompensation 4 decades after Sputnik intraocular lens implantation.

PubMed

Hirji, Nashila; Nanavaty, Mayank A

2015-01-01

We report an unusual case of corneal decompensation occurring four decades after complicated cataract extraction with implantation of a Sputnik intraocular lens (IOL) and highlight the clinical and practical issues faced in managing corneal decompensation with a Sputnik IOL. A 72-year-old woman presented with deterioration of the vision in her left eye, four decades after intracapsular cataract extraction with Sputnik IOL implantation. Ocular examination revealed diffuse corneal edema and thickened vitreous strands in the anterior chamber. Her best-corrected visual acuity (BCVA) worsened to 6/60 within 3 months. Anterior vitrectomy and inferior iridectomy combined with Desçemet-stripping automated endothelial keratoplasty was performed. The procedure was successful, with the patient achieving best-corrected visual acuity of 6/6 at 8 months postoperatively. Corneal decompensation after Sputnik IOL implantation can occur four decades later. When the historical preoperative visual acuity is good in such cases, careful anterior vitrectomy with Desçemet-stripping automated endothelial keratoplasty provides good visual rehabilitation.

Conducting interactive experiments online.

PubMed

Arechar, Antonio A; Gächter, Simon; Molleman, Lucas

2018-01-01

Online labor markets provide new opportunities for behavioral research, but conducting economic experiments online raises important methodological challenges. This particularly holds for interactive designs. In this paper, we provide a methodological discussion of the similarities and differences between interactive experiments conducted in the laboratory and online. To this end, we conduct a repeated public goods experiment with and without punishment using samples from the laboratory and the online platform Amazon Mechanical Turk. We chose to replicate this experiment because it is long and logistically complex. It therefore provides a good case study for discussing the methodological and practical challenges of online interactive experimentation. We find that basic behavioral patterns of cooperation and punishment in the laboratory are replicable online. The most important challenge of online interactive experiments is participant dropout. We discuss measures for reducing dropout and show that, for our case study, dropouts are exogenous to the experiment. We conclude that data quality for interactive experiments via the Internet is adequate and reliable, making online interactive experimentation a potentially valuable complement to laboratory studies.

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

PubMed

Hyde, Tiffany D

2014-01-01

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

A confidence building exercise in data and identifiability: Modeling cancer chemotherapy as a case study.

PubMed

Eisenberg, Marisa C; Jain, Harsh V

2017-10-27

Mathematical modeling has a long history in the field of cancer therapeutics, and there is increasing recognition that it can help uncover the mechanisms that underlie tumor response to treatment. However, making quantitative predictions with such models often requires parameter estimation from data, raising questions of parameter identifiability and estimability. Even in the case of structural (theoretical) identifiability, imperfect data and the resulting practical unidentifiability of model parameters can make it difficult to infer the desired information, and in some cases, to yield biologically correct inferences and predictions. Here, we examine parameter identifiability and estimability using a case study of two compartmental, ordinary differential equation models of cancer treatment with drugs that are cell cycle-specific (taxol) as well as non-specific (oxaliplatin). We proceed through model building, structural identifiability analysis, parameter estimation, practical identifiability analysis and its biological implications, as well as alternative data collection protocols and experimental designs that render the model identifiable. We use the differential algebra/input-output relationship approach for structural identifiability, and primarily the profile likelihood approach for practical identifiability. Despite the models being structurally identifiable, we show that without consideration of practical identifiability, incorrect cell cycle distributions can be inferred, that would result in suboptimal therapeutic choices. We illustrate the usefulness of estimating practically identifiable combinations (in addition to the more typically considered structurally identifiable combinations) in generating biologically meaningful insights. We also use simulated data to evaluate how the practical identifiability of the model would change under alternative experimental designs. These results highlight the importance of understanding the underlying mechanisms rather than purely using parsimony or information criteria/goodness-of-fit to decide model selection questions. The overall roadmap for identifiability testing laid out here can be used to help provide mechanistic insight into complex biological phenomena, reduce experimental costs, and optimize model-driven experimentation. Copyright © 2017. Published by Elsevier Ltd.

[What everybody should know about good clinical practices].

PubMed

Osorio, Lyda

2015-01-01

An increasing number of countries are adopting good clinical practices guidelines as part of the regulation of clinical studies to register pharmaceutical products and other health-related products. Consequently, all parties involved in the research and development of these products should know them, implement them and ensure their compliance. However, good clinical practices guidelines are just one of the initiatives seeking to achieve the highest ethical and scientific standards in health research and in other areas where humans are research subjects. This review defines such practices and their objectives presenting in a practical manner their legal framework in Colombia, and clarifying their application in studies where interventions use no medications or those that are not clinical trials. Finally, the work discusses the challenges to ensure that good clinical practices contribute to the protection of research participants, the education of trustworthy health professionals, and a culture of respect for human beings.

Using shared goal setting to improve access and equity: a mixed methods study of the Good Goals intervention in children's occupational therapy.

PubMed

Kolehmainen, Niina; MacLennan, Graeme; Ternent, Laura; Duncan, Edward A S; Duncan, Eilidh M; Ryan, Stephen B; McKee, Lorna; Francis, Jill J

2012-08-16

Access and equity in children's therapy services may be improved by directing clinicians' use of resources toward specific goals that are important to patients. A practice-change intervention (titled 'Good Goals') was designed to achieve this. This study investigated uptake, adoption, and possible effects of that intervention in children's occupational therapy services. Mixed methods case studies (n = 3 services, including 46 therapists and 558 children) were conducted. The intervention was delivered over 25 weeks through face-to-face training, team workbooks, and 'tools for change'. Data were collected before, during, and after the intervention on a range of factors using interviews, a focus group, case note analysis, routine data, document analysis, and researchers' observations. Factors related to uptake and adoptions were: mode of intervention delivery, competing demands on therapists' time, and leadership by service manager. Service managers and therapists reported that the intervention: helped therapists establish a shared rationale for clinical decisions; increased clarity in service provision; and improved interactions with families and schools. During the study period, therapists' behaviours changed: identifying goals, odds ratio 2.4 (95% CI 1.5 to 3.8); agreeing goals, 3.5 (2.4 to 5.1); evaluating progress, 2.0 (1.1 to 3.5). Children's LoT decreased by two months [95% CI -8 to +4 months] across the services. Cost per therapist trained ranged from £1,003 to £1,277, depending upon service size and therapists' salary bands. Good Goals is a promising quality improvement intervention that can be delivered and adopted in practice and may have benefits. Further research is required to evaluate its: (i) impact on patient outcomes, effectiveness, cost-effectiveness, and (ii) transferability to other clinical contexts.

Temporal, thermal, and light stability of continuously tunable cholesteric liquid crystal laser array.

PubMed

Jeong, Mi-Yun; Chung, Ki Soo; Wu, Jeong Weon

2014-11-01

Fine-structured polymerized cholesteric liquid crystal (PCLC) wedge laser devices have been realized, with high fine spatial tunability of the lasing wavelength. With resolution less than 0.3 nm in a broad spectral range, more than one hundred laser lines could be obtained in a PCLC cell without extra devices. For practical device application, we studied the stability of the device in detail over time, and in response to strong external light sources, and thermal perturbation. The PCLC wedge cells had good temporal stability for 1 year and showed good stability for strong perturbations, with the lasing wavelength shifting less than 1 nm, while the laser peak intensities decreased by up to 34%, and the high energy band edge of the photonic band gap (PBG) was red shifted 3 nm by temperature perturbation. However, when we consider the entire lasing spectrum for the PCLC cell, the 1-nm wavelength shift may not matter. Although the laser peak intensities were decreased by up to 34% in total for all of the perturbation cases, the remaining 34% laser peak intensity is considerable extent to make use. This good stability of the PCLC laser device is due to the polymerization of the CLC by UV curing. This study will be helpful for practical CLC laser device development.

[Criminal liability in case of medical acts considered to be incompetent: article 6 of the new Italian Law 8 March 2017, n.24].

PubMed

Renzulli, Lorenzo

2017-01-01

In Italy, Law n. 24 of 8 March 2017, Article 6, introduces in the current criminal code, Article 590 sexies entitled "Medical liability in case of death and personal lesions", which follows article 590 quinquies. The new article states that a healthcare professional who has acted in accordance with guidelines approved by the National Health Institute or, if no such guidelines exist, in accordance with good clinical practices, is not criminally liable in case of death or personal lesions due to actions that could be considered to be incompetent. We discuss criminal liability of health professionals in Italy in light of this new law, and decriminalization in case of adverse event due to incompetence, also in the context of medical care provided by different health professionals.

Guidelines for Good Epidemiology Practices for Occupational and Environmental Epidemiologic Research. The Chemical Manufacturers Association's Epidemiology Task Group.

PubMed

1991-12-01

The Guidelines for Good Epidemiology Practices (GEPs) for Occupational and Environmental Epidemiologic Research address the conduct of studies generally undertaken to answer questions about human health in relationship to the work place or the environment. The GEPs propose minimum practices and procedures that should be considered to help ensure the quality and integrity of data used in epidemiologic research and to provide adequate documentation of the research methods. The GEPs address the process of conducting individual epidemiologic studies and do not prescribe specific research methods. The Guidelines for Good Epidemiology Practices propose minimum practices and procedures in the following areas: I. Organization and Personnel II. Facilities, Resource Commitment, and Contractors III. Protocol IV. Review and Approval V. Study Conduct VI. Communication VII. Archiving VIII. Quality Assurance Although the Guidelines for Good Epidemiology Practices will not guarantee good epidemiology, they do provide a useful framework for ensuring that all research issues are adequately addressed. This framework is proposed as a first step in improving epidemiologic research practices through adherence to sound scientific research principles. Appendices provide an overview of standard operating procedures, a glossary of terms used in the Guidelines, and suggested references on occupational epidemiology methods.

16 CFR 301.48a - Guaranties not received in good faith.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Guaranties not received in good faith. 301.48a Section 301.48a Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF... received in good faith. A guaranty shall not be deemed to have been received in good faith within the...

16 CFR 301.48a - Guaranties not received in good faith.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Guaranties not received in good faith. 301.48a Section 301.48a Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF... received in good faith. A guaranty shall not be deemed to have been received in good faith within the...

16 CFR 301.48a - Guaranties not received in good faith.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Guaranties not received in good faith. 301.48a Section 301.48a Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF... received in good faith. A guaranty shall not be deemed to have been received in good faith within the...

16 CFR 301.48a - Guaranties not received in good faith.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Guaranties not received in good faith. 301.48a Section 301.48a Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF... received in good faith. A guaranty shall not be deemed to have been received in good faith within the...

Media Ethics: Where Do You Draw the Line? A Case Study Approach to Understanding News Coverage and Journalistic Decision-Making. For Students and Teachers in High School and College.

ERIC Educational Resources Information Center

Stark, Rosalind G.

This teaching package, for teachers and students in high school and college, has been developed to give students an in-depth look at the media in the United States, with an emphasis on the values, standards, and practices of good journalism. The material will have particular use in journalism courses and in social studies (history, government,…

Challenges of Maintaining Good Clinical Laboratory Practices in Low-Resource Settings:  A Health Program Evaluation Framework Case Study From East Africa.

PubMed

Zhang, Helen L; Omondi, Michael W; Musyoka, Augustine M; Afwamba, Isaac A; Swai, Remigi P; Karia, Francis P; Muiruri, Charles; Reddy, Elizabeth A; Crump, John A; Rubach, Matthew P

2016-08-01

Using a clinical research laboratory as a case study, we sought to characterize barriers to maintaining Good Clinical Laboratory Practice (GCLP) services in a developing world setting. Using a US Centers for Disease Control and Prevention framework for program evaluation in public health, we performed an evaluation of the Kilimanjaro Christian Medical Centre-Duke University Health Collaboration clinical research laboratory sections of the Kilimanjaro Clinical Research Institute in Moshi, Tanzania. Laboratory records from November 2012 through October 2014 were reviewed for this analysis. During the 2-year period of study, seven instrument malfunctions suspended testing required for open clinical trials. A median (range) of 9 (1-55) days elapsed between instrument malfunction and biomedical engineer service. Sixteen (76.1%) of 21 suppliers of reagents, controls, and consumables were based outside Tanzania. Test throughput among laboratory sections used a median (range) of 0.6% (0.2%-2.7%) of instrument capacity. Five (55.6%) of nine laboratory technologists left their posts over 2 years. These findings demonstrate that GCLP laboratory service provision in this setting is hampered by delays in biomedical engineer support, delays and extra costs in commodity procurement, low testing throughput, and high personnel turnover. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A comparative presentation of implementation of ISO 22000 versus HACCP and FMEA in a small size Greek factory producing smoked trout: a case study.

PubMed

Arvanitoyannis, Ioannis S; Palaiokostas, Christos; Panagiotaki, Panagiota

2009-02-01

ISO 22000 is the new standard bound to replace HACCP on issues related to food safety. Although several companies, especially the big ones, have either implemented or are on the point of implementing ISO 22000, there are many others which are rather timid and/or reluctant to implement it. The main reason behind that is the lack of information and the fear that the new standard is too demanding in terms of bureaucratic work. This paper aims at making a comparative presentation of how the two systems can be applied to a small smoked salmon producing company thereby facilitating the emergence of the differences. The main difference is that in ISO 22000 systems like Good Manufacturing Practice and Good Hygiene Practice are prerequisites thus leading to lower number of CCPs. In this case study for example, the number of CCPs dropped from eight (8) in HACCP to four (4) in ISO 22000. Furthermore, the Failure Mode and Effect Analysis was applied to the smoked trout manufacturing process in an attempt to calculate quantitatively the Risk Priority Number (RPN) and to find out whether it can be effectively correlated to ISO 22000 and/or HACCP. RPN was found to be higher than 130 for eight steps, in close agreement with HACCP, thereby indicating that corrective actions will have to be undertaken.

Reference-Frame-Independent and Measurement-Device-Independent Quantum Key Distribution Using One Single Source

NASA Astrophysics Data System (ADS)

Li, Qian; Zhu, Changhua; Ma, Shuquan; Wei, Kejin; Pei, Changxing

2018-04-01

Measurement-device-independent quantum key distribution (MDI-QKD) is immune to all detector side-channel attacks. However, practical implementations of MDI-QKD, which require two-photon interferences from separated independent single-photon sources and a nontrivial reference alignment procedure, are still challenging with current technologies. Here, we propose a scheme that significantly reduces the experimental complexity of two-photon interferences and eliminates reference frame alignment by the combination of plug-and-play and reference frame independent MDI-QKD. Simulation results show that the secure communication distance can be up to 219 km in the finite-data case and the scheme has good potential for practical MDI-QKD systems.

An audit of bronchoscopy practice in the United Kingdom: a survey of adherence to national guidelines

PubMed Central

Honeybourne, D.; Neumann, C. S.

1997-01-01

BACKGROUND: Both patient and staff safety are of major importance during the procedure of fibreoptic bronchoscopy. Patient safety depends partly on adequate disinfection of instruments and accessories used as well as careful monitoring during the procedure. Adequate facilities, manpower and training are also essential. Staff safety depends partly on adequate procedures to minimise any risks of sensitisation to agents such as glutaraldehyde. An audit was carried out of bronchoscopy procedures in hospitals in the UK and the findings were compared with published guidelines on good practice and clinical consensus. METHODS: A postal questionnaire was sent to 218 bronchoscopy units in the UK. Findings were then compared with published evidence of good practice in the areas of disinfection, including the use of glutaraldehyde, patient monitoring, manpower, facilities, and training. RESULTS: A 73% response rate was obtained. Recommended minimum disinfection times before and after routine bronchoscopies were not achieved by 35% of units. No disinfection was carried out in 34% of units before emergency bronchoscopies and in 19% of units after suspected cases of tuberculosis. Adequate rinsing of the bronchoscope with sterile or filtered water was not carried out by 43% of units. Contrary to recommendations, 31% of departments were still using glutaraldehyde in the patient examination room and inadequate room ventilation was common. Protective clothing was often not worn by staff during bronchoscopy. Inadequate intravenous access and use of supplementary oxygen were found in many units. Practice standards were higher in departments where dedicated bronchoscopy/endoscopy units of the hospital were used, and also where staff had been on external training courses. CONCLUSIONS: This audit has shown that many units do not adhere to guidelines on disinfection procedures and patient monitoring. Unnecessary potential risks due to staff exposure to glutaraldehyde were apparent. National guidelines on good practice are not being followed in areas which may potentially affect patient and staff safety. 


 PMID:9337830

TH-E-19A-01: Quality and Safety in Radiation Therapy

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

Ford, E; Ezzell, G; Miller, B

2014-06-15

Clinical radiotherapy data clearly demonstrate the link between the quality and safety of radiation treatments and the outcome for patients. The medical physicist plays an essential role in this process. To ensure the highest quality treatments, the medical physicist must understand and employ modern quality improvement techniques. This extends well beyond the duties traditionally associated with prescriptive QA measures. This session will review the current best practices for improving quality and safety in radiation therapy. General elements of quality management will be reviewed including: what makes a good quality management structure, the use of prospective risk analysis such as FMEA,more » and the use of incident learning. All of these practices are recommended in society-level documents and are incorporated into the new Practice Accreditation program developed by ASTRO. To be effective, however, these techniques must be practical in a resource-limited environment. This session will therefore focus on practical tools such as the newly-released radiation oncology incident learning system, RO-ILS, supported by AAPM and ASTRO. With these general constructs in mind, a case study will be presented of quality management in an SBRT service. An example FMEA risk assessment will be presented along with incident learning examples including root cause analysis. As the physicist's role as “quality officer” continues to evolve it will be essential to understand and employ the most effective techniques for quality improvement. This session will provide a concrete overview of the fundamentals in quality and safety. Learning Objectives: Recognize the essential elements of a good quality management system in radiotherapy. Understand the value of incident learning and the AAPM/ASTRO ROILS incident learning system. Appreciate failure mode and effects analysis as a risk assessment tool and its use in resource-limited environments. Understand the fundamental principles of good error proofing that extends beyond traditional prescriptive QA measures.« less

Importance and globalization status of good manufacturing practice (GMP) requirements for pharmaceutical excipients

PubMed Central

Abdellah, Abubaker; Noordin, Mohamed Ibrahim; Wan Ismail, Wan Azman

2013-01-01

Pharmaceutical excipients are no longer inert materials but it is effective and able to improve the characteristics of the products’ quality, stability, functionality, safety, solubility and acceptance of patients. It can interact with the active ingredients and alter the medicament characteristics. The globalization of medicines’ supply enhances the importance of globalized good manufacturing practice (GMP) requirements for pharmaceutical excipients. This review was intended to assess the globalization status of good manufacturing practice (GMP) requirements for pharmaceutical excipients. The review outcomes demonstrate that there is a lack of accurately defined methods to evaluate and measure excipients’ safety. Furthermore good manufacturing practice requirements for excipients are not effectively globalized. PMID:25685037

WHO Expert Committee on Specifications for Pharmaceutical Preparations.

PubMed

2011-01-01

The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new guidelines were adopted and recommended for use: procedure for adoption of International Chemical Reference Substances; WHO good practices for pharmaceutical microbiology laboratories; good manufacturing practices: main principles for pharmaceutical products; good manufacturing practices for blood establishments (jointly with the Expert Committee on Biological Standardization); guidelines on good manufacturing practices for heating, ventilation and air-conditioning systems for non-sterile pharmaceutical dosage forms; good manufacturing practices for sterile pharmaceutical products; guidelines on transfer of technology in pharmaceutical manufacturing; good pharmacy practice: standards for quality of pharmacy services (joint FIP/WHO); model guidance for the storage and transport of time- and temperature-sensitive pharmaceutical products (jointly with the Expert Committee on Biological Standardization); procedure for prequalification of pharmaceutical products; guide on submission of documentation for prequalification of innovator finished pharmaceutical products approved by stringent regulatory authorities; prequalification of quality control laboratories: procedure for assessing the acceptability, in principle, of quality control laboratories for use by United Nations agencies; guidelines for preparing a laboratory information file; guidelines for drafting a site master file; guidelines on submission of documentation for a multisource (generic) finished product: general format: preparation of product dossiers in common technical document format.

Variable implementation of good practice recommendations for the assessment and management of UK children with neurodisability.

PubMed

Gray, L; Gibbs, J; Jolleff, N; Williams, J; McConachie, H; Parr, J R

2015-11-01

The aims of this study were to determine whether UK child development teams (CDTs) have implemented good practice recommendations for the co-ordinated assessment and support of children with neurodisability and to explore some of the factors associated with variations in good practice implementation. Surveys were sent to every UK CDT in 2009/2010. Responses about CDT provision and ways of working were compared with good practice recommendations from national policy documents and professional organizations. The extent to which CDTs in England and Wales met 11 selected good practice recommendations was scored; teams in Scotland and Northern Ireland were given a score out of 9 to reflect the optional use of the common assessment framework and early support materials in these countries. Responses were received from 225/240 (94%) UK CDTs. Thirty-seven per cent of CDTs in England and Wales had implemented nine or more of the 11 recommendations. Fifty-nine per cent of teams in Scotland and 78% of teams in Northern Ireland met between six and nine recommendations of good working practice. Higher levels of implementation of recommendations were found when the CDT had a Child Development Centre base and for teams who had received increased funding in the 5 years preceding the survey. There was considerable variability in the degree to which CDTs implemented good practice recommendations for the diagnosis and management of children with neurodisability. Evidence about child and parent satisfaction, and the effectiveness of CDT practices and provision, is required, so policymakers, healthcare commissioners and clinicians can provide the most appropriate services to children with neurodisability and their families. © 2015 John Wiley & Sons Ltd.

9 CFR 149.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... generates a written record documenting a pork production site's adherence to the required good production... production site for compliance with good production practices and other program requirements of the Trichinae... or higher, based on adherence to good production practices and other program requirements as provided...

9 CFR 149.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... generates a written record documenting a pork production site's adherence to the required good production... production site for compliance with good production practices and other program requirements of the Trichinae... or higher, based on adherence to good production practices and other program requirements as provided...

Diabetes and Diabetic Retinopathy: Knowledge, Attitude, Practice (KAP) among Diabetic Patients in A Tertiary Eye Care Centre

PubMed Central

Srinivasan, Nithin Keshav; John, Deepa; Rebekah, Grace; Kujur, Evon Selina; Paul, Padma

2017-01-01

Introduction Diabetic retinopathy is becoming an increasingly important cause of visual impairment in India. Many diabetic patients who come to our centre have undetected, advanced diabetic retinopathy. If diabetic retinopathy had been detected earlier in these patients, irreversible visual impairment could have been prevented. Aim To document Knowledge, Attitude and Practice (KAP) patterns of diabetic patients regarding diabetes and diabetic retinopathy, to determine association between them, and to identify barriers to compliance with follow up and treatment regimes. Materials and Methods This was a hospital-based, cross-sectional study, conducted at the Department of Ophthalmology at Christian Medical College, Vellore, Tamil Nadu, India, over a six-month period from June 2013 to November 2013. Two hundred and eighty eight diabetic patients, who fulfilled the eligibility criteria, were included in the study. KAP of patients was assessed using a 45-point, verbally administered questionnaire. Patients were placed in different categories, such as, ‘good/ poor’ knowledge, ‘positive/negative’ attitude and ‘good/poor’ practice. Data were analysed using Chi-square test and binary logistic regression, as appropriate. The proportion of patients with ‘good/poor’ knowledge, ‘positive/negative’ attitude and ‘good/poor’ practice, and the association between KAP were studied. Barriers to compliance with follow up/treatment regimes were identified. Results Out of the 288 patients in the study, 42% had good knowledge about diabetes, but only 4.5% had good knowledge about retinopathy. Good knowledge about diabetes was significantly associated with positive attitude towards diabetes and good practice patterns regarding retinopathy; awareness of retinopathy was also significantly associated with good practice. A total of 61.1% of patients did not have periodic eye examination; most common barrier identified was lack of awareness about the necessity for this (38.5%). Conclusion Good knowledge about the disease was significantly associated with positive attitude and good practice patterns. Knowledge about diabetic retinopathy was poor among the patients in our study. Lack of awareness concerning the need for screening for retinopathy was a major barrier to regular screening. There is an urgent need to educate diabetic patients about this potentially blinding complication of diabetes. PMID:28892947

The Utilization of the Seven Principles for Good Practices of Full-Time and Adjunct Faculty in Teaching Health & Science in Community Colleges

ERIC Educational Resources Information Center

Musaitif, Linda M.

2013-01-01

Purpose: The purpose of this study was to determine the degree to which undergraduate full-time and adjunct faculty members in the health and science programs at community colleges in Southern California utilize the seven principles of good practice as measured by the Faculty Inventory of the Seven Principles for Good Practice in Undergraduate…

Guide to good practices for operations and administration updates through required reading

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

Not Available

1992-12-01

The purpose of this Guide to Good Practices is to provide Department of Energy (DOE) contractors with information that can be used to validate and/or modify existing programs relative to Conduct of Operations. This Guide to Good Practices is part of a series of guides designed to enhance the guidelines set forth in DOE Order 5480. 19, Conduct of Operations Requirements for DOE Facilities.'' (JDB)

Guide to good practices for operations and administration updates through required reading

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

Not Available

1992-12-01

The purpose of this Guide to Good Practices is to provide Department of Energy (DOE) contractors with information that can be used to validate and/or modify existing programs relative to Conduct of Operations. This Guide to Good Practices is part of a series of guides designed to enhance the guidelines set forth in DOE Order 5480. 19, ``Conduct of Operations Requirements for DOE Facilities.`` (JDB)

CHRODIS criteria applied to the MASK (MACVIA-ARIA Sentinel NetworK) Good Practice in allergic rhinitis: a SUNFRAIL report.

PubMed

Bousquet, J; Onorato, G L; Bachert, C; Barbolini, M; Bedbrook, A; Bjermer, L; de Sousa, J Correia; Chavannes, N H; Cruz, A A; De Manuel Keenoy, E; Devillier, P; Fonseca, J; Hun, S; Kostka, T; Hellings, P W; Illario, M; Ivancevich, J C; Larenas-Linnemann, D; Millot-Keurinck, J; Ryan, D; Samolinski, B; Sheikh, A; Yorgancioglu, A; Agache, I; Arnavielhe, S; Bewick, M; Annesi-Maesano, I; Anto, J M; Bergmann, K C; Bindslev-Jensen, C; Bosnic-Anticevich, S; Bouchard, J; Caimmi, D P; Camargos, P; Canonica, G W; Cardona, V; Carriazo, A M; Cingi, C; Colgan, E; Custovic, A; Dahl, R; Demoly, P; De Vries, G; Fokkens, W J; Fontaine, J F; Gemicioğlu, B; Guldemond, N; Gutter, Z; Haahtela, T; Hellqvist-Dahl, B; Jares, E; Joos, G; Just, J; Khaltaev, N; Keil, T; Klimek, L; Kowalski, M L; Kull, I; Kuna, P; Kvedariene, V; Laune, D; Louis, R; Magnan, A; Malva, J; Mathieu-Dupas, E; Melén, E; Menditto, E; Morais-Almeida, M; Mösges, R; Mullol, J; Murray, R; Neffen, H; O'Hehir, R; Palkonen, S; Papadopoulos, N G; Passalacqua, G; Pépin, J L; Portejoie, F; Price, D; Pugin, B; Raciborski, F; Simons, F E R; Sova, M; Spranger, O; Stellato, C; Todo Bom, A; Tomazic, P V; Triggiani, M; Valero, A; Valovirta, E; VandenPlas, O; Valiulis, A; van Eerd, M; Ventura, M T; Wickman, M; Young, I; Zuberbier, T; Zurkuhlen, A; Senn, A

2017-01-01

A Good Practice is a practice that works well, produces good results, and is recommended as a model. MACVIA-ARIA Sentinel Network (MASK), the new Allergic Rhinitis and its Impact on Asthma (ARIA) initiative, is an example of a Good Practice focusing on the implementation of multi-sectoral care pathways using emerging technologies with real life data in rhinitis and asthma multi-morbidity. The European Union Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS) has developed a checklist of 28 items for the evaluation of Good Practices. SUNFRAIL (Reference Sites Network for Prevention and Care of Frailty and Chronic Conditions in community dwelling persons of EU Countries), a European Union project, assessed whether MASK is in line with the 28 items of JA-CHRODIS. A short summary was proposed for each item and 18 experts, all members of ARIA and SUNFRAIL from 12 countries, assessed the 28 items using a Survey Monkey-based questionnaire. A visual analogue scale (VAS) from 0 (strongly disagree) to 100 (strongly agree) was used. Agreement equal or over 75% was observed for 14 items (50%). MASK is following the JA-CHRODIS recommendations for the evaluation of Good Practices.

Tools to share good chairside teaching practice: a clinical scenario and appreciative questionnaire.

PubMed

Sweet, J; Wilson, J; Pugsley, L; Schofield, M

2008-12-13

This article provides a scenario for analysis of good chairside teaching practice to serve as a starting point for continued discussion in this complex field. Documented issues of good chairside teaching practice are cross-referenced to a clinical scenario with explanations in the form of a commentary. This provided the context for generating a set of questions that are provided as tools to support good chairside practice. These tools are designed to be used with 'Appreciative Inquiry', which claims that there is much to be gained by discovering where excellence is possible and elaborating upon this. Although this process can be carried out in single units or departments, it is proposed that collaboration between institutions would allow sharing of valuable innovations and greater understanding of educational training, production of good practice guidance and professional development of staff. This article is the third in a series of three and provides a scaffold for a scenario and questions to encourage collaboration in evolving and sharing good chairside teaching practice. The first article investigated the perceptions of stakeholders in chairside teaching at a single dental school and the second evaluated chairside teaching on a UK wide scale. A further accompanying article reviews some of the educational methodology and innovations in teaching and learning that may be applied to dentistry.

Family systems ideas in the 10-minute consultation: using a reflecting partner or observing team in a surgery.

PubMed

Mayer, R; Graham, H; Schuberth, C; Launer, J; Tomson, D; Czauderna, J

1996-04-01

Family therapy and the ideas that underlie it have not had much impact on general practice, although there is good reason to think this could be a useful approach. As a group of general practitioners (and a practice nurse) with experience of family therapy, we were interested in demonstrating whether family therapy methods could usefully inform general practice consultations. Two surgeries were observed by the general practitioner's colleagues. Selected cases are discussed to illustrate the impact of the use of family therapy ideas and a reflecting colleague or team. Family therapy ideas can be a helpful framework within which to think about both demanding and ordinary consultations. Inviting a colleague to contribute respectfully could be useful both as a method of teaching, and in resolving difficult or faltering consultations.

76 FR 24291 - Proposed National Marketing Agreement Regulating Leafy Green Vegetables; Recommended Decision and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

... Practices (GAPs) and Good Manufacturing Practices (GMPs), and United States Department of Agriculture (USDA) Good Handling Practices (GHPs). The program would be voluntary, and cover both United States and... referred to as the ``Act'', and the applicable rules of practice and procedure governing the formulation of...

To Group or Not to Group? Good Practice for Housing Male Laboratory Mice

PubMed Central

Kappel, Sarah; Hawkins, Penny; Mendl, Michael T.

2017-01-01

Simple Summary Wild mice live in territories inhabited by one adult male, several females, and their offspring. This cannot be replicated in the laboratory, so male mice are usually housed in single-sex groups or individually. However, there can be serious animal welfare problems associated with both these approaches, such as lack of social contact when housed individually or aggression between males when kept in groups. Group housing is widely recommended to give male laboratory mice the opportunity to behave as ‘social animals’, but social stress can be detrimental to the welfare of these animals, even without injurious fighting. All of this can also affect the quality of the science, giving rise to ethical concerns. This review discusses whether it is in the best welfare interests of male mice to be housed in groups, or alone. We conclude that it is not possible to give general recommendations for good practice for housing male laboratory mice, as responses to single- and group-housing can be highly context-dependent. The welfare implications of housing protocols should be researched and considered in each case. Abstract It is widely recommended to group-house male laboratory mice because they are ‘social animals’, but male mice do not naturally share territories and aggression can be a serious welfare problem. Even without aggression, not all animals within a group will be in a state of positive welfare. Rather, many male mice may be negatively affected by the stress of repeated social defeat and subordination, raising concerns about welfare and also research validity. However, individual housing may not be an appropriate solution, given the welfare implications associated with no social contact. An essential question is whether it is in the best welfare interests of male mice to be group- or singly housed. This review explores the likely impacts—positive and negative—of both housing conditions, presents results of a survey of current practice and awareness of mouse behavior, and includes recommendations for good practice and future research. We conclude that whether group- or single-housing is better (or less worse) in any situation is highly context-dependent according to several factors including strain, age, social position, life experiences, and housing and husbandry protocols. It is important to recognise this and evaluate what is preferable from animal welfare and ethical perspectives in each case. PMID:29186765

Reflection: a critical proficiency essential to the effective development of a high competence in communication.

PubMed

Adams, Cindy L; Nestel, Debra; Wolf, Peter

2006-01-01

Reflection, or the ability to step back from an experience and consider it critically, in an analytical, non-subjective manner, is an essential aspect of problem solving and decision making, and also of effective communication with clients and colleagues. Reflective practice has been described as the essence of professionalism and is therefore a core professional skill; rarely, however, has it been explicitly taught in veterinary curricula, and it has only a recent history in undergraduate human medical curricula. We describe here two preliminary case studies, one in a veterinary medical education context and the other within a human medical education framework, as examples of approaches to assessing a student's ability for ''reflection.'' The case studies also illustrate some of the key principles. Both of the case studies described had as their end goal the enhancement of communication skills through critical reflection. At Monash University, Australia, the majority of students were assessed as being at a level of ''reflection in development.'' The students in the Ontario Veterinary College case study showed moderately good use of self-awareness and critical reflection as a basis for modifying and integrating communication skills into practice. While both preliminary case studies point to the fact that students recognize the importance of communication and value the opportunity to practice it, few students in either case study identified the importance of reflection for lifelong learning and professional competence. Opportunities to complete critical reflection exercises in other parts of curricula and outside of communication would likely reinforce its importance as a generic skill. Ongoing scholarly approaches to teaching, learning, and evaluating reflection and self-awareness are needed.

The Instrument for Measuring the Implementation Situation of Traditional Chinese Medicine Guideline: Evaluation and Application

PubMed Central

Wang, Yangyang; Chen, Yaolong; Wang, Xiaoyun; Deng, Jingwen

2017-01-01

Clinical practice guidelines play an important role in reducing the variations in clinical practices and improving the quality of care. To assess the real effect, measuring its implementation situation is needed. The implementation situation can be reflected by testing the consistency between the actual clinical practice and the guideline. We constructed an instrument to measure the implementation situation of Traditional Chinese Medicine (TCM) guideline through consistency testing. The main objectives of our study were to validate the instrument and evaluate the implementation situation of menopause syndrome guideline of TCM, using the data from the consistency test of comparing the medical records with the guideline. A total of 621 cases were included for data analysis. Cronbach's Alpha coefficient is 0.73. The model fit of 7 items in four dimensions was good (SRMR = 0.04; GFI = 0.97; NFI = 0.97; TLI = 0.96; CFI = 0.98; AGFI = 0.90). This instrument is of good reliability and validity. It can help the guideline developers to measure the implementation situation, find the reasons affecting the implementation, and revise the guideline. The method of using consistency test to measure the implementation situation may provide a sample for evaluating the guideline implementation in other fields. PMID:29234379

Performance of FFT methods in local gravity field modelling

NASA Technical Reports Server (NTRS)

Forsberg, Rene; Solheim, Dag

1989-01-01

Fast Fourier transform (FFT) methods provide a fast and efficient means of processing large amounts of gravity or geoid data in local gravity field modelling. The FFT methods, however, has a number of theoretical and practical limitations, especially the use of flat-earth approximation, and the requirements for gridded data. In spite of this the method often yields excellent results in practice when compared to other more rigorous (and computationally expensive) methods, such as least-squares collocation. The good performance of the FFT methods illustrate that the theoretical approximations are offset by the capability of taking into account more data in larger areas, especially important for geoid predictions. For best results good data gridding algorithms are essential. In practice truncated collocation approaches may be used. For large areas at high latitudes the gridding must be done using suitable map projections such as UTM, to avoid trivial errors caused by the meridian convergence. The FFT methods are compared to ground truth data in New Mexico (xi, eta from delta g), Scandinavia (N from delta g, the geoid fits to 15 cm over 2000 km), and areas of the Atlantic (delta g from satellite altimetry using Wiener filtering). In all cases the FFT methods yields results comparable or superior to other methods.

21 CFR 184.1452 - Manganese gluconate.

Code of Federal Regulations, 2012 CFR

2012-04-01

....1(b)(1), the ingredient is used in food with no limitation other than current good manufacturing... ingredient is based upon the following current good manufacturing practice conditions of use: (1) The... is used in the following foods at levels not to exceed current good manufacturing practice: baked...

21 CFR 184.1452 - Manganese gluconate.

Code of Federal Regulations, 2013 CFR

2013-04-01

....1(b)(1), the ingredient is used in food with no limitation other than current good manufacturing... ingredient is based upon the following current good manufacturing practice conditions of use: (1) The... is used in the following foods at levels not to exceed current good manufacturing practice: baked...

21 CFR 184.1452 - Manganese gluconate.

Code of Federal Regulations, 2011 CFR

2011-04-01

....1(b)(1), the ingredient is used in food with no limitation other than current good manufacturing... ingredient is based upon the following current good manufacturing practice conditions of use: (1) The... is used in the following foods at levels not to exceed current good manufacturing practice: baked...

21 CFR 184.1452 - Manganese gluconate.

Code of Federal Regulations, 2010 CFR

2010-04-01

....1(b)(1), the ingredient is used in food with no limitation other than current good manufacturing... ingredient is based upon the following current good manufacturing practice conditions of use: (1) The... is used in the following foods at levels not to exceed current good manufacturing practice: baked...

Documentation: Records and Reports.

PubMed

Akers, Michael J

2017-01-01

This article deals with documentation to include the beginning of documentation, the requirements of Good Manufacturing Practice reports and records, and the steps that can be taken to minimize Good Manufacturing Practice documentation problems. It is important to remember that documentation for 503a compounding involves the Formulation Record, Compounding Record, Standard Operating Procedures, Safety Data Sheets, etc. For 503b outsourcing facilities, compliance with Current Good Manufacturing Practices is required, so this article is applicable to them. For 503a pharmacies, one can see the development and modification of Good Manufacturing Practice and even observe changes as they are occurring in 503a documentation requirements and anticipate that changes will probably continue to occur. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

Building a model for day case hiatal surgery - Lessons learnt over a 10 year period in a high volume unit: A case series.

PubMed

Mistry, Pritesh; Zaman, Shafquat; Shapey, Iestyn; Daskalakis, Markos; Nijjar, Rajwinder; Richardson, Martin; Super, Paul; Singhal, Rishi

2018-06-01

Laparoscopic anti-reflux surgery has become the standard treatment for symptomatic gastro-oesophageal reflux disease refractory to medical therapy. Successful anti-reflux surgery involves safe, minimally invasive surgery, resulting in symptom resolution with minimal side effects. This study aims to assess the feasibility and safety of day case anti-reflux surgery focussing on peri- and post-operative outcomes as a measure of success. Data was collected from the hospital database from 2003 to 2012. Data collection included demographics, surgeon, mode of admission, length of stay and complications. Electronic records were independently scrutinised for all patients with a length of stay of more than two nights. 723 patients underwent laparoscopic fundoplication ± small hiatus hernia repair (<5 cm) with a day case rate of 67.1%. The 30 day readmission rate in these patients was 2.9% (21/723 patients). Nine patients had a failure of their initial laparoscopic fundoplication (defined as recurrence of symptoms). Three patients required a re-operation within 12 months of their initial procedure (re-operation rate = 0.41% (3/723 patients)). Laparoscopic hiatal surgery can be performed safely as a day case in high volume specialist centres with good outcomes. Raising the national standard for day case fundoplication promotes good practice and should be the model for future commissioning. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

40 CFR 792.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) GOOD LABORATORY PRACTICE STANDARDS General Provisions § 792.1 Scope. (a) This part prescribes good laboratory practices for conducting studies relating to health effects, environmental effects, and chemical...

40 CFR 792.1 - Scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) GOOD LABORATORY PRACTICE STANDARDS General Provisions § 792.1 Scope. (a) This part prescribes good laboratory practices for conducting studies relating to health effects, environmental effects, and chemical...

A comprehensive clinical assessment tool to inform policy and practice: applications of the minimum data set.

PubMed

Mor, Vincent

2004-04-01

The Minimum Data Set (MDS) for nursing home (NH) resident assessment, designed to assess elders functional status and care needs, exemplifies how the information needs of clinical practice are congruent with those of research. Building on a review of the published literature, this article describes the development of the MDS, its reliability and validity testing, as well as the variety of different policy and research uses to which it has been applied. Interrater reliability of items and internal consistency of MDS summary scales is generally good to excellent. Validation studies reveal good correspondence to research quality instruments for cognition, activities of daily living, and diagnoses with more variable results for vision, pain, mood, and behavior scales. To date, no consistent evidence suggests that applications of MDS data for case-mix reimbursement and quality indicator monitoring systematically bias the data. Although facility variation in data quality could compromise some applications, creation of the MDS as a clinical tool for care planning provides an example of how assessment tools with clinical use can be used in administrative databases for research and policy applications.

Good Policy, Good Practice II. Improving Outcomes and Productivity in Higher Education: A Guide for Policymakers

ERIC Educational Resources Information Center

Brenneman, Meghan Wilson; Callan, Patrick M.; Ewell, Peter T.; Finney, Joni E.; Jones, Dennis P.; Zis, Stacey

2010-01-01

This new edition of "Good Policy, Good Practice II" revises and updates the authors' 2007 publication. Like the earlier edition, it responds to one of the questions that is raised most frequently in the authors' work with public policy and education leaders as they begin to address the national and state imperatives to increase the proportion of…

Global perspectives on ensuring the safety of pharmaceutical products in the distribution process
.

PubMed

Jeong, Sohyun; Ji, Eunhee

2018-01-01

The distribution of counterfeit or falsified drugs is increasing worldwide. This can contribute to the high burden of disease and cost to society and is of global concern with the worldwide circulation of pharmaceuticals. The preparation and implementation of good distribution practice should be one of the most important aspects of ensuring safe drug circulation and administration. This research aimed to compare and analyze good distribution practice guidelines from advanced countries and international organizations, and to evaluate the status of the current good distribution practice guidelines in the world. Advanced pharmaceutical countries and international organizations, such as the World Health Organization, European Union, Pharmaceutical Inspection Co-operation Scheme, United States of America, Canada, and Australia, which have stable good distribution practice guidelines and public confidence, were included in the analysis. The World Health Organization and European Union guidelines are models for standardized good distribution practice for nations worldwide. The United States of America has a combination of four different series of distribution practices which have a unique structure and detailed content compared to those of other countries. The Canadian guidelines focus on temperature control during storage and transportation. The Australian guidelines apply to both classes of medicinal products and medical devices and need separate standardization. Transparent information about the Internet chain, international cooperation regarding counterfeiting, a high-standard qualification of sellers and customers, and technology to track and trace the whole life cycle of drugs should be the main focus of future good distribution practice guidelines worldwide.
.

Surgical repair of a rupture of the pectoralis major muscle

PubMed Central

Pochini, Alberto De Castro; Andreoli, Carlos Vicente; Ejnisman, Benno; Maffulli, Nicola

2015-01-01

Muscle rupture is rarely treated surgically. Few reports of good outcomes after muscular suture have been published. Usually, muscular lesions or partial ruptures heal with few side effects or result in total recovery. We report a case of an athlete who was treated surgically to repair a total muscular rupture in the pectoralis major muscle. After 6 months, the athlete returned to competitive practice. After a 2-year follow-up, the athlete still competes in skateboard championships. PMID:25716033

National Computer Security Conference Proceedings (10th): Computer Security--From Principles to Practices, 21-24 September 1987

DTIC Science & Technology

1987-09-24

Some concerns take on rating (e.g., ’Zl’) that adequately reflects increased significance in the network how well the system provides each service...to how well a M.•.imum, Fair, Good); however, in specific spicific approach may be expected to achieve cases, ratings such as "plesent" or "approved...established thresholds, Supportive policies include idertification and and for detecting the fact that access to a authentication policies as well as

System modeling with the DISC framework: evidence from safety-critical domains.

PubMed

Reiman, Teemu; Pietikäinen, Elina; Oedewald, Pia; Gotcheva, Nadezhda

2012-01-01

The objective of this paper is to illustrate the development and application of the Design for Integrated Safety Culture (DISC) framework for system modeling by evaluating organizational potential for safety in nuclear and healthcare domains. The DISC framework includes criteria for good safety culture and a description of functions that the organization needs to implement in order to orient the organization toward the criteria. Three case studies will be used to illustrate the utilization of the DISC framework in practice.

The ethical dimensions of wildlife disease management in an evolutionary context.

PubMed

Crozier, Gkd; Schulte-Hostedde, Albrecht I

2014-08-01

Best practices in wildlife disease management require robust evolutionary ecological research (EER). This means not only basing management decisions on evolutionarily sound reasoning, but also conducting management in a way that actively contributes to the on-going development of that research. Because good management requires good science, and good science is 'good' science (i.e., effective science is often science conducted ethically), good management therefore also requires practices that accord with sound ethical reasoning. To that end, we propose a two-part framework to assist decision makers to identify ethical pitfalls of wildlife disease management. The first part consists of six values - freedom, fairness, well-being, replacement, reduction, and refinement; these values, developed for the ethical evaluation of EER practices, are also well suited for evaluating the ethics of wildlife disease management. The second part consists of a decision tree to help identify the ethically salient dimensions of wildlife disease management and to guide managers toward ethically responsible practices in complex situations. While ethical reasoning cannot be used to deduce from first principles what practices should be undertaken in every given set of circumstances, it can establish parameters that bound what sorts of practices will be acceptable or unacceptable in certain types of scenarios.

47 CFR 73.508 - Standards of good engineering practice.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Standards of good engineering practice. 73.508 Section 73.508 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES... engineering practice. (a) All noncommercial educational stations and LPFM stations operating with more than 10...

47 CFR 73.508 - Standards of good engineering practice.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 4 2014-10-01 2014-10-01 false Standards of good engineering practice. 73.508 Section 73.508 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES... engineering practice. (a) All noncommercial educational stations and LPFM stations operating with more than 10...

47 CFR 73.508 - Standards of good engineering practice.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 4 2012-10-01 2012-10-01 false Standards of good engineering practice. 73.508 Section 73.508 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES... engineering practice. (a) All noncommercial educational stations and LPFM stations operating with more than 10...

47 CFR 73.508 - Standards of good engineering practice.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 4 2013-10-01 2013-10-01 false Standards of good engineering practice. 73.508 Section 73.508 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES... engineering practice. (a) All noncommercial educational stations and LPFM stations operating with more than 10...

47 CFR 73.508 - Standards of good engineering practice.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Standards of good engineering practice. 73.508 Section 73.508 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES... engineering practice. (a) All noncommercial educational stations and LPFM stations operating with more than 10...

76 FR 49509 - Records Schedules; Availability and Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... Agency (N1-258-09-3, 1 item, 1 temporary item). Good Farming Practice Documentation, including producer... reconsideration of adverse good farming practice determinations. 3. Department of Agriculture, Risk Management... materials, legislation files, negotiation files, review files, unfair trade practices files, and...

76 FR 55067 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... Pharmaceutical Current Good Manufacturing Practice AGENCY: Food and Drug Administration, HHS. ACTION: Notice... Good Manufacturing Practice--(OMB Control Number 0910-0563)--Extension The guidance is intended to... products, on how to resolve disputes of scientific and technical issues relating to current good...

21 CFR 184.1449 - Manganese citrate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... § 184.1(b)(1), the ingredient is used in food with no limitation other than current good manufacturing... ingredient is based upon the following current good manufacturing practice conditions of use: (1) The... is used in the following foods at levels not to exceed current good manufacturing practice: baked...

I Am Mentor, I Am Coach

ERIC Educational Resources Information Center

Augustine-Shaw, Donna; Reilly, Marceta

2017-01-01

Preparing good leaders depends not only on providing good initial professional learning, but also on creating a strong support structure during the early years of practice. However, what good mentoring looks and sounds like varies widely in practice. Many mentoring programs for education leaders consist of buddy-like relationships that provide…

Images of otoscopy: rate and extent of non-compliance with good practice standards.

PubMed

Crundwell, G; Harmer, J; Maltby, M; Mills, T; Neumann, C; Walsh, L; Baguley, D

2015-01-01

The British Society of Audiology has produced clear guidelines as to how otoscopy should be undertaken; however, no nationally recognised guidelines exist for the wider clinical community. Images of otoscopy appear in many books, journals, magazines and websites. This study aimed to determine the rate of non-compliance with good practice in images of otoscopy, the seriousness of the breach, and whether this is more common in sites for professionals or the general public. Google Images was searched using the terms 'otoscopy' and 'ear examination'. A total of 200 images were identified and collated. The images were reviewed for compliance with good practice standards. Only 12.75 per cent of the images were graded as having no breach of good practice standards. Professional websites have a responsibility to show best practice. When choosing an image, the source of the image needs to be carefully considered.

Evolution of global contribution in multi-level threshold public goods games with insurance compensation

NASA Astrophysics Data System (ADS)

Du, Jinming; Tang, Lixin

2018-01-01

Understanding voluntary contribution in threshold public goods games has important practical implications. To improve contributions and provision frequency, free-rider problem and assurance problem should be solved. Insurance could play a significant, but largely unrecognized, role in facilitating a contribution to provision of public goods through providing insurance compensation against the losses. In this paper, we study how insurance compensation mechanism affects individuals’ decision-making under risk environments. We propose a multi-level threshold public goods game model where two kinds of public goods games (local and global) are considered. Particularly, the global public goods game involves a threshold, which is related to the safety of all the players. We theoretically probe the evolution of contributions of different levels and free-riders, and focus on the influence of the insurance on the global contribution. We explore, in both the cases, the scenarios that only global contributors could buy insurance and all the players could. It is found that with greater insurance compensation, especially under high collective risks, players are more likely to contribute globally when only global contributors are insured. On the other hand, global contribution could be promoted if a premium discount is given to global contributors when everyone buys insurance.

Automating Initial Guess Generation for High Fidelity Trajectory Optimization Tools

NASA Technical Reports Server (NTRS)

Villa, Benjamin; Lantoine, Gregory; Sims, Jon; Whiffen, Gregory

2013-01-01

Many academic studies in spaceflight dynamics rely on simplified dynamical models, such as restricted three-body models or averaged forms of the equations of motion of an orbiter. In practice, the end result of these preliminary orbit studies needs to be transformed into more realistic models, in particular to generate good initial guesses for high-fidelity trajectory optimization tools like Mystic. This paper reviews and extends some of the approaches used in the literature to perform such a task, and explores the inherent trade-offs of such a transformation with a view toward automating it for the case of ballistic arcs. Sample test cases in the libration point regimes and small body orbiter transfers are presented.

Casuistry and its communitarian critics.

PubMed

Kuczewski, Mark G

1994-06-01

Communitarian critics have derided case-based reasoning for ignoring the need to arrive at a shared hierarchy of goods prior to case resolution. They claim that such a failure means that casuistry depends on either a naive metaphysical realism or an ethical conventionalism. Casuistry does embrace a certain unobjectionable moral realism and can require appeals to narrative histories, but despite this dependence on the surrounding culture, casuists possess a way to remain critical of society through the concept of practical wisdom and the use of a moral taxonomy. Therefore, casuistry's viability depends upon the existence and employment of this Aristotelian virtue. Furthermore, the casuistry that emerges is a sophisticated type of communitarianism rather than a free-standing method.

Transurethral Resection of the Prostate, Bladder Explosion and Hyponatremic Encephalopathy: A Rare Case Report of Malpractice.

PubMed

Vacchiano, Giuseppe; Rocca, Aldo; Compagna, Rita; Zamboli, Anna Ginevra Immacolata; Cirillo, Vera; Di Domenico, Lorenza; Di Nardo, Veronica; Servillo, Giuseppe; Amato, Bruno

2017-01-01

We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability.

Transurethral Resection of the Prostate, Bladder Explosion and Hyponatremic Encephalopathy: A Rare Case Report of Malpractice

PubMed Central

Vacchiano, Giuseppe; Rocca, Aldo; Compagna, Rita; Zamboli, Anna Ginevra Immacolata; Cirillo, Vera; Di Domenico, Lorenza; Di Nardo, Veronica; Servillo, Giuseppe; Amato, Bruno

2017-01-01

Abstract We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability. PMID:28435905

Orthodontics

PubMed Central

Hemrend, Bernard; Altuna, Gurkan; Tompson, Bryan

1989-01-01

The authors of this article offer an introduction to the field of orthodontics. They present the latest advances in orthodontic appliances and some of the possible consequences of orthodontic treatment. They discuss a number of cases and offer examples of some of the more common problems that the orthodontist is asked to treat. Such cases include severe Class II, division 1 malocclusion, surgical orthodontics, “long-face” syndrome, adult orthodontics-TMJ-periodontics, late adult growth, and post-retention changes. Practical information useful to the physician who encounters patient with these disorders is balanced with good research data to support the various claims. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9 PMID:21249042

Sustainable Sizing.

PubMed

Robinette, Kathleen M; Veitch, Daisy

2016-08-01

To provide a review of sustainable sizing practices that reduce waste, increase sales, and simultaneously produce safer, better fitting, accommodating products. Sustainable sizing involves a set of methods good for both the environment (sustainable environment) and business (sustainable business). Sustainable sizing methods reduce (1) materials used, (2) the number of sizes or adjustments, and (3) the amount of product unsold or marked down for sale. This reduces waste and cost. The methods can also increase sales by fitting more people in the target market and produce happier, loyal customers with better fitting products. This is a mini-review of methods that result in more sustainable sizing practices. It also reviews and contrasts current statistical and modeling practices that lead to poor fit and sizing. Fit-mapping and the use of cases are two excellent methods suited for creating sustainable sizing, when real people (vs. virtual people) are used. These methods are described and reviewed. Evidence presented supports the view that virtual fitting with simulated people and products is not yet effective. Fit-mapping and cases with real people and actual products result in good design and products that are fit for person, fit for purpose, with good accommodation and comfortable, optimized sizing. While virtual models have been shown to be ineffective for predicting or representing fit, there is an opportunity to improve them by adding fit-mapping data to the models. This will require saving fit data, product data, anthropometry, and demographics in a standardized manner. For this success to extend to the wider design community, the development of a standardized method of data collection for fit-mapping with a globally shared fit-map database is needed. It will enable the world community to build knowledge of fit and accommodation and generate effective virtual fitting for the future. A standardized method of data collection that tests products' fit methodically and quantitatively will increase our predictive power to determine fit and accommodation, thereby facilitating improved, effective design. These methods apply to all products people wear, use, or occupy. © 2016, Human Factors and Ergonomics Society.

Good documentation practice in clinical research

PubMed Central

Bargaje, Chitra

2011-01-01

One of the most common inspection findings in investigator site inspections is lack of reliable, accurate and adequate source documentation. This also happens to be the most common pitfall identified during sponsor audits. The importance of good documentation practice needs to be emphasized to investigator sites to ensure that the study results are built on the foundation of credible and valid data. This article focuses on the key principles of good documentation practice and offers suggestions for improvement. PMID:21731856

Good documentation practice in clinical research.

PubMed

Bargaje, Chitra

2011-04-01

One of the most common inspection findings in investigator site inspections is lack of reliable, accurate and adequate source documentation. This also happens to be the most common pitfall identified during sponsor audits. The importance of good documentation practice needs to be emphasized to investigator sites to ensure that the study results are built on the foundation of credible and valid data. This article focuses on the key principles of good documentation practice and offers suggestions for improvement.

'Chipping in': clinical psychologists' descriptions of their use of formulation in multidisciplinary team working.

PubMed

Christofides, Stella; Johnstone, Lucy; Musa, Meyrem

2012-12-01

To investigate clinical psychologists' accounts of their use of psychological case formulation in multidisciplinary teamwork. A qualitative study using inductive thematic analysis. Ten clinical psychologists working in community and inpatient adult mental health services who identified themselves as using formulation in their multidisciplinary team work participated in semi-structured interviews. Psychological hypotheses were described as shared mostly through informal means such as chipping in ideas during a team discussion rather than through explicit means such as staff training or case presentations that usually only took place once participants had spent time developing their role within the team. Service context and staff's prior experience were also factors in how explicitly formulation was discussed. Participants reported that they believed that this way of working, although often not formally recognized, was valuable and improved the quality of clinical services provided. More investigation into this under-researched but important area of clinical practice is needed, in order to share ideas and support good practice. ©2011 The British Psychological Society.

How to develop and write a case for technical writing

NASA Technical Reports Server (NTRS)

Couture, B.; Goldstein, J.

1981-01-01

Case of different sizes and shapes for teaching technical writing to engineers at Wayne State University have been developed. The case approach was adopted for some assignments because sophomores and juniors lacked technical expertise and professional knowledge of the engineering world. Cases were found to be good exercises, providing realistic practice in specific writing tasks or isolating particular skills in the composing process. A special kind of case which narrates the experiences of one technical person engaged in the problem-solving process in a professional rhetorical situation was developed. This type of long, realistic fiction is called a an "holistic" case. Rather than asking students to role-play a character, an holistic case realistically encompasses the whole of the technical writing process. It allows students to experience the total communication act in which the technical task and data are fully integrated into the rhetorical situation and gives an opportunity to perform in a realistic context, using skills and knowledge required in communication on the job. It is believed that the holistic case most fully exploits the advantages of the case method for students of professional communication.

The confusion in complying with good manufacturing practice requirements in Malaysia

NASA Astrophysics Data System (ADS)

Jali, Mohd Bakri; Ghani, Maaruf Abdul; Nor, Norazmir Md

2016-11-01

Food manufacturing operations need to fulfil regulatory requirements related to hygiene and good manufacturing practices (GMP) to successfully market their products as safe and quality products. GMP based on its ten elements used as guidelines to ensure control over biological, chemical and physical hazards. This study aims to investigate the confusion for design and facilities elements among food industries. Both qualitative and quantitative techniques are used as systematic tools. Design and facilities elements lay a firm foundation for good manufacturing practice to ensure food hygiene and should be used in conjunction with each specific code of hygiene practice and guidelines.

Development of good modelling practice for phsiologically based pharmacokinetic models for use in risk assessment: The first steps

EPA Science Inventory

The increasing use of tissue dosimetry estimated using pharmacokinetic models in chemical risk assessments in multiple countries necessitates the need to develop internationally recognized good modelling practices. These practices would facilitate sharing of models and model eva...

Evaluation Instruments and Good Practices in Online Education

ERIC Educational Resources Information Center

Baldwin, Sally J.; Trespalacios, Jesús

2017-01-01

Chickering and Gamson's (1987) "Seven Principles for Good Practice in Undergraduate Education" offers extensively researched and validated tenets for best practices in higher education. After a review of the literature, twenty-eight evaluation instruments currently used to design and review online courses in higher education institutions…

Paediatric day-case neurosurgery in a resource challenged setting: Pattern and practice

PubMed Central

Owojuyigbe, Afolabi Muyiwa; Komolafe, Edward O.; Adenekan, Anthony T.; Dada, Muyiwa A.; Onyia, Chiazor U.; Ogunbameru, Ibironke O.; Owagbemi, Oluwafemi F.; Talabi, Ademola O.; Faponle, Fola A.

2016-01-01

Background: It has been generally observed that children achieve better convalescence in the home environment especially if discharged same day after surgery. This is probably due to the fact that children generally tend to feel more at ease in the home environment than in the hospital setting. Only few tertiary health institutions provide routine day-case surgery for paediatric neurosurgical patients in our sub-region. Objective: To review the pattern and practice of paediatric neurosurgical day-cases at our hospital. Patients and Methods: A prospective study of all paediatric day-case neurosurgeries carried out between June 2011 and June 2014. Results: A total of 53 patients (34 males and 19 females) with age ranging from 2 days to 14 years were seen. Majority of the patients (77.4%) presented with congenital lesions, and the most common procedure carried out was spina bifida repair (32%) followed by ventriculoperitoneal shunt insertion (26.4%) for hydrocephalus. Sixty-eight percentage belonged to the American Society of Anesthesiologists physical status class 2, whereas the rest (32%) belonged to class 1. General anaesthesia was employed in 83% of cases. Parenteral paracetamol was used for intra-operative analgesia for most of the patients. Two patients had post-operative nausea and vomiting and were successfully managed. There was no case of emergency re-operation, unplanned admission, cancellation or mortality. Conclusion: Paediatric day-case neurosurgery is feasible in our environment. With careful patient selection and adequate pre-operative preparation, good outcome can be achieved. PMID:27251657

The development of leadership outcome-indicators evaluating the contribution of clinical specialists and advanced practitioners to health care: a secondary analysis.

PubMed

Elliott, Naomi; Begley, Cecily; Kleinpell, Ruth; Higgins, Agnes

2014-05-01

To report a secondary analysis of data collected from the case study phase of a national study of advanced practitioners and to develop leadership outcome-indicators appropriate for advanced practitioners. In many countries, advanced practitioners in nursing and midwifery have responsibility as leaders for health care development, but without having leadership outcome measures available they are unable to demonstrate the results of their activities. In Ireland, a sequential mixed method research study was used to develop a validated tool for the evaluation of clinical specialists and advanced practitioners. Despite strong evidence of leadership activities, few leadership-specific outcomes were generated from the primary analysis. Secondary analysis of a multiple case study data set. Data set comprised 23 case studies of advanced practitioner/clinical specialists from 13 sites across each region in Ireland from all divisions of the Nursing Board Register. Data were collected 2008-2010. Data sources included non-participant observation (n = 92 hours) of advanced practitioners in practice, interviews with clinicians (n = 21), patients (n = 20) and directors of nursing/midwifery (n = 13) and documents. Analysis focused on leadership outcome-indicator development in line with the National Health Service's Good Indicators Guide. The four categories of leadership outcomes for advanced practitioner developed were as follows: (i) capacity and capability building of multidisciplinary team; (ii) measure of esteem; (iii) new initiatives for clinical practice and healthcare delivery; and (iv) clinical practice based on evidence. The proposed set of leadership outcome-indicators derived from a secondary analysis captures the complexity of leadership in practice. They add to existing clinical outcomes measuring advanced practice. © 2013 John Wiley & Sons Ltd.

Training anesthesiology residents in providing anesthesia for awake craniotomy: learning curves and estimate of needed case load.

PubMed

Bilotta, Federico; Titi, Luca; Lanni, Fabiana; Stazi, Elisabetta; Rosa, Giovanni

2013-08-01

To measure the learning curves of residents in anesthesiology in providing anesthesia for awake craniotomy, and to estimate the case load needed to achieve a "good-excellent" level of competence. Prospective study. Operating room of a university hospital. 7 volunteer residents in anesthesiology. Residents underwent a dedicated training program of clinical characteristics of anesthesia for awake craniotomy. The program was divided into three tasks: local anesthesia, sedation-analgesia, and intraoperative hemodynamic management. The learning curve for each resident for each task was recorded over 10 procedures. Quantitative assessment of the individual's ability was based on the resident's self-assessment score and the attending anesthesiologist's judgment, and rated by modified 12 mm Likert scale, reported ability score visual analog scale (VAS). This ability VAS score ranged from 1 to 12 (ie, very poor, mild, moderate, sufficient, good, excellent). The number of requests for advice also was recorded (ie, resident requests for practical help and theoretical notions to accomplish the procedures). Each task had a specific learning rate; the number of procedures necessary to achieve "good-excellent" ability with confidence, as determined by the recorded results, were 10 procedures for local anesthesia, 15 to 25 procedures for sedation-analgesia, and 20 to 30 procedures for intraoperative hemodynamic management. Awake craniotomy is an approach used increasingly in neuroanesthesia. A dedicated training program based on learning specific tasks and building confidence with essential features provides "good-excellent" ability. © 2013 Elsevier Inc. All rights reserved.

An audit of management of differentiated thyroid cancer in specialist and non-specialist clinic settings.

PubMed

Kumar, H; Daykin, J; Holder, R; Watkinson, J C; Sheppard, M C; Franklyn, J A

2001-06-01

Thyroid cancer is the most common endocrine malignancy but is none the less rare. Some aspects of its management remain controversial. Previous audits of patient management in the United Kingdom have revealed deficiencies, especially in communication between specialists. We have audited patient management in a large university-associated teaching hospital, assessing points of good practice identified from published guidelines and reviews, and have compared findings in groups of patients managed jointly by specialists with an interest in thyroid cancer (including surgeon, endocrinologist and oncologist) with a group managed by other clinicians outside that setting. Retrospective case-note review of 205 patients with differentiated (papillary or follicular) cancer including group A (n = 134; managed in a specialist multi-disciplinary clinic setting) and group B (n = 71; managed in other clinic settings). Points of good practice investigated were adequacy of surgery, surgical complications, prescription and adequacy of T4 treatment, adequacy of monitoring by measurement of serum thyroglobulin and action taken and appropriate administration of ablative radioiodine. Deficiencies in management of the cohort as a whole were identified, including inadequate surgery and inadequate TSH suppression in approximately one-fifth of the cases. Monitoring with thyroglobulin measurements and action when serum thyroglobulin was high were also inadequate in some cases and ablative radioiodine was not given, despite being indicated in 11.7% of the cohort. Inadequate surgery and failure to administer radioiodine were less common in those managed in a specialist clinic setting than in those managed in other clinic settings. The findings highlight the need for locally agreed protocols in managing relatively rare endocrine disorders such as thyroid cancer and argue in favour of centralization of expertise and patient management in multi-disciplinary specialist clinic settings.

A knowledge infrastructure for occupational safety and health.

PubMed

van Dijk, Frank J H; Verbeek, Jos H; Hoving, Jan L; Hulshof, Carel T J

2010-12-01

Occupational Safety and Health (OSH) professionals should use scientific evidence to support their decisions in policy and practice. Although examples from practice show that progress has been made in evidence-based decision making, there is a challenge to improve and extend the facilities that support knowledge translation in practice. A knowledge infrastructure that supports OSH practice should include scientific research, systematic reviews, practice guidelines, and other tools for professionals such as well accessible virtual libraries and databases providing knowledge, quality tools, and good learning materials. A good infrastructure connects facilities with each other and with practice. Training and education is needed for OSH professionals in the use of evidence to improve effectiveness and efficiency. New initiatives show that occupational health can profit from intensified international collaboration to establish a good functioning knowledge infrastructure.

Solving the "Personhood Jigsaw Puzzle" in Residential Care Homes for the Elderly in the Hong Kong Chinese Context.

PubMed

Kong, Sui-Ting; Fang, Christine Meng-Sang; Lou, Vivian W Q

2017-02-01

End-of-life care studies on the nature of personhood are bourgeoning; however, the practices utilized for achieving personhood in end-of-life care, particularly in a cultural context in which interdependent being and collectivism prevail, remain underexplored. This study seeks to examine and conceptualize good practices for achieving the personhood of the dying elderly in residential care homes in a Chinese context. Twelve interviews were conducted with both medical and social care practitioners in four care homes to collect narratives of practitioners' practices. Those narratives were utilized to develop an "end-of-life case graph." Constant comparative analysis led to an understanding of the practice processes, giving rise to a process model of "solving the personhood jigsaw puzzle" that includes "understanding the person-in-relationship and person-in-time," "identifying the personhood-inhibiting experiences," and "enabling personalized care for enhanced psychosocial outcomes." Findings show how the "relational personhood" of the elderly can be maintained when physical deterioration and even death are inevitable.

Diabetes management. Analysis of the American Diabetes Association's clinical practice recommendations.

PubMed

Strano-Paul, L; Phanumas, D

2000-04-01

Type 2 diabetes generally develops in persons older than age 45 and comprises more than 90% of the estimated 15 million diabetes cases identified in the United States. Due to the burgeoning population of older Americans and the increased prevalence of obesity and sedentariness, type 2 diabetes is nearing epidemic proportions. Tight glycemic control combined with good diet and regular exercise can reduce the incidence of complications associated with unchecked disease. To help physicians and patients achieve such objectives, the American Diabetes Association publishes clinical practice recommendations that propose the most effective methods for screening, diagnosis, and disease management. The position statements presenting the standard of care for treatment of diabetes are reviewed and critiqued from an evidence-based medicine perspective.

A Critique of Health System Performance Measurement.

PubMed

Lynch, Thomas

2015-01-01

Health system performance measurement is a ubiquitous phenomenon. Many authors have identified multiple methodological and substantive problems with performance measurement practices. Despite the validity of these criticisms and their cross-national character, the practice of health system performance measurement persists. Theodore Marmor suggests that performance measurement invokes an "incantatory response" wrapped within "linguistic muddle." In this article, I expand upon Marmor's insights using Pierre Bourdieu's theoretical framework to suggest that, far from an aberration, the "linguistic muddle" identified by Marmor is an indicator of a broad struggle about the representation and classification of public health services as a public good. I present a case study of performance measurement from Alberta, Canada, examining how this representational struggle occurs and what the stakes are. © The Author(s) 2015.

29 CFR 790.18 - “Administrative practice or enforcement policy.”

Code of Federal Regulations, 2011 CFR

2011-07-01

... Faith Reliance on Administrative Regulations, Etc. § 790.18 “Administrative practice or enforcement... employee, because of reliance in good faith on an administrative practice or enforcement policy only (1... acts or omissions led the employer to believe in good faith that such acts or omissions were not...

29 CFR 790.18 - “Administrative practice or enforcement policy.”

Code of Federal Regulations, 2013 CFR

2013-07-01

... Faith Reliance on Administrative Regulations, Etc. § 790.18 “Administrative practice or enforcement... employee, because of reliance in good faith on an administrative practice or enforcement policy only (1... acts or omissions led the employer to believe in good faith that such acts or omissions were not...

29 CFR 790.18 - “Administrative practice or enforcement policy.”

Code of Federal Regulations, 2012 CFR

2012-07-01

... Faith Reliance on Administrative Regulations, Etc. § 790.18 “Administrative practice or enforcement... employee, because of reliance in good faith on an administrative practice or enforcement policy only (1... acts or omissions led the employer to believe in good faith that such acts or omissions were not...

9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

Code of Federal Regulations, 2012 CFR

2012-01-01

... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...

9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

Code of Federal Regulations, 2014 CFR

2014-01-01

... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...

9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

Code of Federal Regulations, 2013 CFR

2013-01-01

... rodent population and other pests under control; (6) Tailor vaccination programs to needs of farm and... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...

16 CFR 453.3 - Misrepresentations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Misrepresentations. (a) Embalming provisions—(1) Deceptive acts or practices. In selling or offering to sell funeral... practices. In selling or offering to sell funeral goods or funeral services to the public, it is a deceptive... practices. In selling or offering to sell funeral goods and funeral services to the public, it is a...

9 CFR 147.26 - Procedures for establishing isolation and maintaining sanitation and good management practices...

Code of Federal Regulations, 2011 CFR

2011-01-01

... and maintaining sanitation and good management practices for the control of Salmonella and Mycoplasma... management practices for the control of Salmonella and Mycoplasma infections. (a) The following procedures...) Allow no visitors except under controlled conditions to minimize the introduction of Salmonella and...

Inter-observer agreement for Crohn's disease sub-phenotypes using the Montreal Classification: How good are we? A multi-centre Australasian study.

PubMed

Krishnaprasad, Krupa; Andrews, Jane M; Lawrance, Ian C; Florin, Timothy; Gearry, Richard B; Leong, Rupert W L; Mahy, Gillian; Bampton, Peter; Prosser, Ruth; Leach, Peta; Chitti, Laurie; Cock, Charles; Grafton, Rachel; Croft, Anthony R; Cooke, Sharon; Doecke, James D; Radford-Smith, Graham L

2012-04-01

Crohn's disease (CD) exhibits significant clinical heterogeneity. Classification systems attempt to describe this; however, their utility and reliability depends on inter-observer agreement (IOA). We therefore sought to evaluate IOA using the Montreal Classification (MC). De-identified clinical records of 35 CD patients from 6 Australian IBD centres were presented to 13 expert practitioners from 8 Australia and New Zealand Inflammatory Bowel Disease Consortium (ANZIBDC) centres. Practitioners classified the cases using MC and forwarded data for central blinded analysis. IOA on smoking and medications was also tested. Kappa statistics, with pre-specified outcomes of κ>0.8 excellent; 0.61-0.8 good; 0.41-0.6 moderate and ≤0.4 poor, were used. 97% of study cases had colonoscopy reports, however, only 31% had undergone a complete set of diagnostic investigations (colonoscopy, histology, SB imaging). At diagnosis, IOA was excellent for age, κ=0.84; good for disease location, κ=0.73; only moderate for upper GI disease (κ=0.57) and disease behaviour, κ=0.54; and good for the presence of perianal disease, κ=0.6. At last follow-up, IOA was good for location, κ=0.68; only moderate for upper GI disease (κ=0.43) and disease behaviour, κ=0.46; but excellent for the presence/absence of perianal disease, κ=0.88. IOA for immunosuppressant use ever and presence of stricture were both good (κ=0.79 and 0.64 respectively). IOA using MC is generally good; however some areas are less consistent than others. Omissions and inaccuracies reduce the value of clinical data when comparing cohorts across different centres, and may impair the ability to translate genetic discoveries into clinical practice. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Reminiscence and Recall: a practical guide to reminiscence work Faith Gibson Reminiscence and Recall: a practical guide to reminiscence work Age Concern, England Edition: 3rd £14.99 310 0 86242 411 9 0862424119 [Formula: see text].

PubMed

2007-02-01

This compact book contains everything that anyone might want to know about reminiscence work. The introduction clearly states a philosophy which makes the case for reminiscence work while indicating what aspects of good practice should underpin it as an activity. References to 'personal worth and identity' (p5) and 'a lifetime of experience' (p6) are backed up with chapters where examples of work with people with dementia or who are depressed, people with learning difficulties, people with sensory impairment or who are bereaved or terminally ill. While the book is written for a wide range of readers, it has obvious importance for nurses supporting adults in the community, in hospital and in care settings generally.

Clinical examination & record-keeping: Part 2: History taking.

PubMed

Hadden, A M

2017-12-15

This article is the second part of a BDJ series of Practice papers on the subject of clinical examination and related record keeping. The series is taken from the Faculty of General Dental Practice UK (FGDP[UK]) 2016 Good Practice Guidelines book on this topic, edited by A. M. Hadden. This particular article discusses history taking, where information may be gathered prior to the patient seeing the clinician or, in some cases, this may be carried out chairside by the individual. The information gathered can include a medical history, socio-behavioural history, and patient anxiety levels. It is important to note that throughout this article (and the BDJ series and associated FGDP[UK] book), the specific guidelines will be marked as follows: A: Aspirational, B: Basic, C: Conditional. Further information about this guideline notation system is provided in Part 1 of this series ( 2017; 223: 765-768).

Pay attention to reflux/feed entry design

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

Fleming, B.; Martin, G.R.; Hartman, E.L.

1996-01-01

Trays generally are forgiving pieces of equipment and can conceal the effects of poorly designed feed and reflux entries. When one tries to push a tower to its hydraulic limit, however, poor entry design can penalize the performance of the trays and result in a lower final capacity. Normally, new towers are not as susceptible to entry design problems as ones being revamped. This is because new towers usually have some degree of capacity oversizing.Standard design practices used for new columns having spare capacity, though, may not be suitable for revamped towers. In this article, the authors detail the basicmore » principles of reflux and feed entry design, good practices to follow, and poor practices to avoid. They also include a case study of a large-diameter light hydrocarbon splitter revamped with high capacity trays to illustrate the potential pitfalls associated with incorrectly designed reflux and feed entry arrangements.« less

Good cell culture practices &in vitro toxicology.

PubMed

Eskes, Chantra; Boström, Ann-Charlotte; Bowe, Gerhard; Coecke, Sandra; Hartung, Thomas; Hendriks, Giel; Pamies, David; Piton, Alain; Rovida, Costanza

2017-12-01

Good Cell Culture Practices (GCCP) is of high relevance to in vitro toxicology. The European Society of Toxicology In Vitro (ESTIV), the Center for Alternatives for Animal Testing (CAAT) and the In Vitro Toxicology Industrial Platform (IVTIP) joined forces to address by means of an ESTIV 2016 pre-congress session the different aspects and applications of GCCP. The covered aspects comprised the current status of the OECD guidance document on Good In Vitro Method Practices, the importance of quality assurance for new technological advances in in vitro toxicology including stem cells, and the optimized implementation of Good Manufacturing Practices and Good Laboratory Practices for regulatory testing purposes. General discussions raised the duality related to the difficulties in implementing GCCP in an academic innovative research framework on one hand, and on the other hand, the need for such GCCP principles in order to ensure reproducibility and robustness of in vitro test methods for toxicity testing. Indeed, if good cell culture principles are critical to take into consideration for all uses of in vitro test methods for toxicity testing, the level of application of such principles may depend on the stage of development of the test method as well as on the applications of the test methods, i.e., academic innovative research vs. regulatory standardized test method. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Qualitative evaluation of employer requirements associated with occupational health and safety as good practice in small-scale enterprises].

PubMed

Kuroki, Naomi; Miyashita, Nana; Hino, Yoshiyuki; Kayashima, Kotaro; Fujino, Yoshihisa; Takada, Mikio; Nagata, Tomohisa; Yamataki, Hajime; Sakuragi, Sonoko; Kan, Hirohiko; Morita, Tetsuya; Ito, Akiyoshi; Mori, Koji

2009-09-01

The purpose of this study was to identify what motivates employers to promote good occupational health and safety practices in small-scale enterprises. Previous studies have shown that small-scale enterprises generally pay insufficient attention to issues of occupational health and safety. These findings were mainly derived from questionnaire based surveys. Nevertheless, some small-scale enterprises in which employers exercise good leadership do take a progressive approach to occupational health and safety. Although good practices can be identified in small-scale enterprises, it remains unclear what motivates employers in small-scale enterprises to actively implement occupational health and safety practices. We speculated that identifying employer motivations in promoting occupational health would help to spread good practices among small-scale enterprises. Using a qualitative approach based on the KJ methods, we interviewed ten employers who actively promote occupational health and safety in the workplace. The employers were asked to discuss their views of occupational health and safety in their own words. A semi-structured interview format was used, and transcripts were made of the interviews. Each transcript was independently coded by two or more researchers. These transcripts and codes were integrated and then the research group members discussed the heading titles and structural relationships between them according to the KJ method. Qualitative analysis revealed that all the employers expressed a strong interest in a "good company" and "good management". They emphasized four elements of "good management", namely "securing human resources", "trust of business partners", "social responsibility" and "employer's health condition itself", and considered that addressing occupational health and safety was essential to the achievement of these four elements. Consistent with previous findings, the results showed that implementation of occupational health and safety activities depended on "cost", "human resources", "time to perform", and "advisory organization". These results suggest that employer awareness of the relationship between good management and occupational health is essential to the implementation of occupational health and safety practices in small-scale enterprises.

Robot decisions: on the importance of virtuous judgment in clinical decision making.

PubMed

Gelhaus, Petra

2011-10-01

The aim of this article is to argue for the necessity of emotional professional virtues in the understanding of good clinical practice. This understanding is required for a proper balance of capacities in medical education and further education of physicians. For this reason an ideal physician, incarnating the required virtues, skills and knowledge is compared with a non-emotional robot that is bound to moral rules. This fictive confrontation is meant to clarify why certain demands on the personality of the physician are justified, in addition to a rule- and principle-based moral orientation and biomedical knowledge and skills. Philosophical analysis of thought experiments inspired by science fiction literature by Isaac Asimov. Although prima facie a rule-oriented robot seems more reliable and trustworthy, the complexity of clinical judgment is not met by an encompassing and never contradictory set of rules from which one could logically derive decisions. There are different ways how the robot could still work, but at the cost of the predictability of its behaviour and its moral orientation. In comparison, a virtuous human doctor who is also bound to these rules, although less strictly, will more reliably keep at moral objectives, be understandable, be more flexible in case the rules come to their limits, and will be more predictable in these critical situations. Apart from these advantages of the virtuous human doctor referring to her own person, the most problematic deficit of the robot is its lacking deeper understanding of the inner mental events of patients which makes good contact, good communication and good influence impossible. Although an infallibly rule-oriented robot seems more reliable at first view, in situations that require complex decisions like clinical practice the agency of a moral human person is more trustworthy. Furthermore, the understanding of the patient's emotions must remain insufficient for a non-emotional, non-human being. Because these are crucial preconditions for good clinical practice, enough attention should be given to develop these virtues and emotional skills, in addition to the usual attention on knowledge, technical skills and the obedience to moral rules and principles. © 2011 Blackwell Publishing Ltd.

"Inclusive Working Life" in Norway--experience from "Models of Good Practice" enterprises.

PubMed

Lie, Arve

2008-08-01

To determine whether enterprises belonging to the Bank of Models of Good Practice were more successful than average Norwegian enterprises in the reduction of sickness absence, promotion of early return to work, and prevention of early retirement. In 2004 we selected 86 enterprises with a total of approximately 90000 employees from the Inclusive Working Life (IWL) Bank of Models of Good Practice. One representative of workers and one of management from each enterprise received a questionnaire on the aims, organization, and the results of the IWL program by mail. Data on sickness absence, use of early retirement, and disability retirement in the 2000-2004 period were collected from the National Insurance Registry. Data on comparable enterprises were obtained from the National Bureau of Statistics. The response rate was 65%. Although the IWL campaign was directed at reducing sickness absence, preventing early retirement, and promoting employment of the functionally impaired, most attention was paid to reducing sickness absence. Sickness absence rate in Models of Good Practice enterprises (8.2%) was higher than in comparable enterprises that were not part of the Models of Good Practice (6.9%). Implementation of many IWL activities, empowerment and involvement of employees, and good cooperation with the occupational health service were associated with a lower rate of sickness absence. On average, 0.7% new employees per year received disability pension, which is a significantly lower percentage than expected on the basis of the rate of 1.3% per year in comparable enterprises. Frequent use of disability pensioning was associated with high rate of sickness absence and having many employees older than 50 years. On average, 0.4% employees per year received early retirement compensation, which was expected on the basis of national estimates. Frequent use of early retirement was associated with having many employees older than 50 years. Models of Good Practice enterprises had a higher than expected sickness absence rate. This indicates that it is difficult to identify Models of Good Practice enterprises and that they cannot be treated as role model enterprises. Good cooperation with the occupational health service and the empowerment and involvement of the employees is associated with a low sickness absence rate.

A realist evaluation of the management of a well- performing regional hospital in Ghana

PubMed Central

2010-01-01

Background Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. Methods We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. Results We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. Conclusion This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers. PMID:20100330

A realist evaluation of the management of a well-performing regional hospital in Ghana.

PubMed

Marchal, Bruno; Dedzo, McDamien; Kegels, Guy

2010-01-25

Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers.

Improving brain computer interface research through user involvement - The transformative potential of integrating civil society organisations in research projects

PubMed Central

Wakunuma, Kutoma; Rainey, Stephen; Hansen, Christian

2017-01-01

Research on Brain Computer Interfaces (BCI) often aims to provide solutions for vulnerable populations, such as individuals with diseases, conditions or disabilities that keep them from using traditional interfaces. Such research thereby contributes to the public good. This contribution to the public good corresponds to a broader drive of research and funding policy that focuses on promoting beneficial societal impact. One way of achieving this is to engage with the public. In practical terms this can be done by integrating civil society organisations (CSOs) in research. The open question at the heart of this paper is whether and how such CSO integration can transform the research and contribute to the public good. To answer this question the paper describes five detailed qualitative case studies of research projects including CSOs. The paper finds that transformative impact of CSO integration is possible but by no means assured. It provides recommendations on how transformative impact can be promoted. PMID:28207882

Testing goodness of fit in regression: a general approach for specified alternatives.

PubMed

Solari, Aldo; le Cessie, Saskia; Goeman, Jelle J

2012-12-10

When fitting generalized linear models or the Cox proportional hazards model, it is important to have tools to test for lack of fit. Because lack of fit comes in all shapes and sizes, distinguishing among different types of lack of fit is of practical importance. We argue that an adequate diagnosis of lack of fit requires a specified alternative model. Such specification identifies the type of lack of fit the test is directed against so that if we reject the null hypothesis, we know the direction of the departure from the model. The goodness-of-fit approach of this paper allows to treat different types of lack of fit within a unified general framework and to consider many existing tests as special cases. Connections with penalized likelihood and random effects are discussed, and the application of the proposed approach is illustrated with medical examples. Tailored functions for goodness-of-fit testing have been implemented in the R package global test. Copyright © 2012 John Wiley & Sons, Ltd.

Twenty years of audiology in a patient with Norrie disease.

PubMed

Halpin, Chris; Sims, Katherine

2008-11-01

To describe disease progression and treatment outcomes over a 20-year period (ages 5-25) in a young man with Norrie disease (occuloacousticocerebral dysplasia), ND; OMIM #310600. Affected individuals are born blind and develop progressive sensory loss with onset in adolescence. This disease is X-linked and has been associated with mutations of the NDP gene (Xp11.4). The patient was followed using repeated audiograms, as well as reports of educational progress and hearing aid use. The specific mutation was found by molecular analysis. The patient demonstrated progressive sensory loss with good preservation of word recognition. The loss was initially high frequency and asymmetric in adolescence and became more severe, more symmetric and affected practically all frequencies by the end of childhood. Educational progress was affected by the cognitive effects of the syndrome, and hearing aid use was very effective. A bilateral progressive sensory loss with good preservation of word recognition was documented in detail. The residual word recognition supported good use of hearing aids in this case.

Pay for performance of Estonian family doctors and impact of different practice- and patient-related characteristics on a good outcome: A quantitative assessment.

PubMed

Merilind, Eero; Salupere, Rauno; Västra, Katrin; Kalda, Ruth

2016-01-01

Several practice- and patient-related characteristics are reported to have an influence on a good quality outcome. Estonia started the pay-for-performance (P4P) system for family doctors (FDs) in 2006. Every year the number of FDs participating in P4P has increased, but only half of the FDs achieved good outcome. The aim of this study was to find out which practice- and patient-related characteristics could have an impact on a good outcome. The study was conducted using the database from the Estonian Health Insurance Fund. All working FDs were divided into two groups (with "good" and "poor" outcomes) according their achievements in P4P. We chose characteristics which described structure (practice list size, number of doctors, composition of FDs list: age, number of chronically ill patients) during the observation period 2006-2012. During the observation period 2006-2012, the number of FDs with a good outcome in P4P increased from 6% (2006) to 53% (2012). The high number of FDs in primary care teams, longer experience of participation in P4P and the smaller number of patients on FDs' lists all have an impact on a good outcome. The number of chronically ill patients in FDs lists has no significant effect on an outcome, but P4P increases the number of disease-diagnosed patients. Different practice and patient-related characteristics have an impact on a good outcome. As workload increases, smaller lists of FDs patients or increased staff levels are needed in order to maintain a good outcome. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Student responses to the introduction of case-based learning and practical activities into a theoretical obstetrics and gynaecology teaching programme

PubMed Central

Massonetto, Júlio Cesar; Marcellini, Cláudio; Assis, Paulo Sérgio Ribeiro; de Toledo, Sérgio Floriano

2004-01-01

Background The fourth-year Obstetrics and Gynaecology course at our institution had previously been taught using theory classes alone. A new teaching model was introduced to provide a better link with professional practice. We wished to evaluate the impact of the introduction of case discussions and other practical activities upon students' perceptions of the learning process. Methods Small-group discussions of cases and practical activities were introduced for the teaching of a fourth-year class in 2003 (Group II; 113 students). Comparisons were made with the fourth-year class of 2002 (Group I; 108 students), from before the new programme was introduced. Students were asked to rate their satisfaction with various elements of the teaching programme. Statistical differences in their ratings were analysed using the chi-square and Bonferroni tests. Results Group II gave higher ratings to the clarity of theory classes and lecturers' teaching abilities (p < 0.05) and lecturers' punctuality (p < 0.001) than did Group I. Group II had greater belief that the knowledge assessment tests were useful (p < 0.001) and that their understanding of the subject was good (p < 0.001) than did Group I. Group II gave a higher overall rating to the course (p < 0.05) than did Group I. However, there was no difference in the groups' assessments of the use made of the timetabled hours available for the subject or lecturers' concern for students' learning. Conclusions Students were very receptive to the new teaching model. PMID:15569385

Concluding comments: maximizing good patient care and minimizing potential liability when considering complementary and alternative medicine.

PubMed

Gilmour, Joan; Harrison, Christine; Vohra, Sunita

2011-11-01

Our goal for this supplemental issue of Pediatrics was to consider what practitioners, parents, patients, institutions, and policy-makers need to take into account to make good decisions about using complementary and alternative medicine (CAM) to treat children and to develop guidelines for appropriate use. We began by explaining underlying concepts and principles in ethical, legal, and clinical reasoning and then used case scenarios to explore how they apply and identify gaps that remain in practice and policy. In this concluding article, we review our major findings, summarize our recommendations, and suggest further research. We focus on several key areas: practitioner and patient/parent relationships; decision-making; dispute resolution; standards of practice; hospital/health facility policies; patient safety; education; and research. Ethical principles, standards, and rules applicable when making decisions about conventional care for children apply to decision-making about CAM as well. The same is true of legal reasoning. Although CAM use has seldom led to litigation, general legal principles relied on in cases involving conventional medical care provide the starting point for analysis. Similarly, with respect to clinical decision-making, clinicians are guided by clinical judgment and the best interests of their patient. Whether a therapy is CAM or conventional, clinicians must weigh the relative risks and benefits of therapeutic options and take into account their patient's values, beliefs, and preferences. Consequently, many of our observations apply to conventional and CAM care and to both adult and pediatric patients.

Health governance: principal-agent linkages and health system strengthening.

PubMed

Brinkerhoff, Derick W; Bossert, Thomas J

2014-09-01

Governance is increasingly recognized as an important factor in health system performance, yet conceptually and practically it remains poorly understood and subject to often vague and competing notions of both what its role is and how to address its weaknesses. This overview article for the symposium on health governance presents a model of health governance that focuses on the multiplicity of societal actors in health systems, the distribution of roles and responsibilities among them and their ability and willingness to fulfil these roles and responsibilities. This focus highlights the principal-agent linkages among actors and the resulting incentives for good governance and health system performance. The discussion identifies three disconnects that constitute challenges for health system strengthening interventions that target improving governance: (1) the gap between the good governance agenda and existing capacities, (2) the discrepancy between formal and informal governance and (3) the inattention to sociopolitical power dynamics. The article summarizes the three country cases in the symposium and highlights their governance findings: health sector reform in China, financial management of health resources in Brazilian municipalities and budget reform in hospitals in Lesotho. The concluding sections clarify how the three cases apply the model's principal-agent linkages and highlight the importance of filling the gaps remaining between problem diagnosis and the development of practical guidance that supports 'best fit' solutions and accommodates political realities in health systems strengthening. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Workplace etiquette for the medical practice employee.

PubMed

Hills, Laura

2010-01-01

Medical practice workplace etiquette is slowly being modified and fine-tuned. New workplace etiquette rules have become necessary because of advances in communications technology, shifting norms, and expectations of what constitutes good manners. Today's medical practice employees must concern themselves with traditional workplace manners but also the manners that come into play when they make or receive cell phone calls, text messages, and e-mails, and when they use social networking media outside of work. This article offers 25 rules for good manners in the medical practice that relate to the ways employees interact with people today, whether face-to-face or when using electronic communications technologies. It offers practical guidelines for making introductions both inside and outside the medical practice. This article also provides a self-quiz to help medical practice employees assess their workplace etiquette intelligence and 12 tips for good workplace table manners.

Reliability of clinical impact grading by healthcare professionals of common prescribing error and optimisation cases in critical care patients.

PubMed

Bourne, Richard S; Shulman, Rob; Tomlin, Mark; Borthwick, Mark; Berry, Will; Mills, Gary H

2017-04-01

To identify between and within profession-rater reliability of clinical impact grading for common critical care prescribing error and optimisation cases. To identify representative clinical impact grades for each individual case. Electronic questionnaire. 5 UK NHS Trusts. 30 Critical care healthcare professionals (doctors, pharmacists and nurses). Participants graded severity of clinical impact (5-point categorical scale) of 50 error and 55 optimisation cases. Case between and within profession-rater reliability and modal clinical impact grading. Between and within profession rater reliability analysis used linear mixed model and intraclass correlation, respectively. The majority of error and optimisation cases (both 76%) had a modal clinical severity grade of moderate or higher. Error cases: doctors graded clinical impact significantly lower than pharmacists (-0.25; P < 0.001) and nurses (-0.53; P < 0.001), with nurses significantly higher than pharmacists (0.28; P < 0.001). Optimisation cases: doctors graded clinical impact significantly lower than nurses and pharmacists (-0.39 and -0.5; P < 0.001, respectively). Within profession reliability grading was excellent for pharmacists (0.88 and 0.89; P < 0.001) and doctors (0.79 and 0.83; P < 0.001) but only fair to good for nurses (0.43 and 0.74; P < 0.001), for optimisation and error cases, respectively. Representative clinical impact grades for over 100 common prescribing error and optimisation cases are reported for potential clinical practice and research application. The between professional variability highlights the importance of multidisciplinary perspectives in assessment of medication error and optimisation cases in clinical practice and research. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

76 FR 2123 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

...; Current Good Manufacturing Practice Quality System Regulation AGENCY: Food and Drug Administration, HHS... information entitled ``Current Good Manufacturing Practice Quality System Regulation'' has been approved by...

40 CFR 68.56 - Maintenance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL... testing procedures shall follow recognized and generally accepted good engineering practices. The...' recommendations, industry standards or codes, good engineering practices, and prior operating experience. ...

40 CFR 68.56 - Maintenance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL... testing procedures shall follow recognized and generally accepted good engineering practices. The...' recommendations, industry standards or codes, good engineering practices, and prior operating experience. ...

40 CFR 68.56 - Maintenance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL... testing procedures shall follow recognized and generally accepted good engineering practices. The...' recommendations, industry standards or codes, good engineering practices, and prior operating experience. ...

40 CFR 68.56 - Maintenance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL... testing procedures shall follow recognized and generally accepted good engineering practices. The...' recommendations, industry standards or codes, good engineering practices, and prior operating experience. ...

40 CFR 68.56 - Maintenance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL... testing procedures shall follow recognized and generally accepted good engineering practices. The...' recommendations, industry standards or codes, good engineering practices, and prior operating experience. ...

21 CFR 184.1143 - Ammonium sulfate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... chapter, and processing aid as defined in § 170.3(o)(24) of this chapter. (d) The ingredient is used in food at levels not to exceed good manufacturing practice in accordance with § 184.1(b)(1). Current good manufacturing practice results in a maximum level, as served, of 0.15 percent for baked goods as defined in...

A hybrid brain-computer interface based on the fusion of electroencephalographic and electromyographic activities

NASA Astrophysics Data System (ADS)

Leeb, Robert; Sagha, Hesam; Chavarriaga, Ricardo; Millán, José del R.

2011-04-01

Hybrid brain-computer interfaces (BCIs) are representing a recent approach to develop practical BCIs. In such a system disabled users are able to use all their remaining functionalities as control possibilities in parallel with the BCI. Sometimes these people have residual activity of their muscles. Therefore, in the presented hybrid BCI framework we want to explore the parallel usage of electroencephalographic (EEG) and electromyographic (EMG) activity, whereby the control abilities of both channels are fused. Results showed that the participants could achieve a good control of their hybrid BCI independently of their level of muscular fatigue. Thereby the multimodal fusion approach of muscular and brain activity yielded better and more stable performance compared to the single conditions. Even in the case of an increasing muscular fatigue a good control (moderate and graceful degradation of the performance compared to the non-fatigued case) and a smooth handover could be achieved. Therefore, such systems allow the users a very reliable hybrid BCI control although they are getting more and more exhausted or fatigued during the day.

A Wall-Distance-Free k-ω SST Turbulence Model

NASA Astrophysics Data System (ADS)

Gleize, Vincent; Burnley, Victor

2001-11-01

In the calculation of flows around aircraft and aerodynamic bodies, the Shear-Stress Transport (SST) model by Menter has been used extensively due to its good prediction of flows with adverse pressure gradients. One main drawback of this model is the need to calculate the distance from the wall. While this is not a serious drawback for steady state calculations on non-moving grids, this calculation can become very cumbersome and expensive for unsteady simulations, especially when using unstructured grids. In this case, the wall-distance needs to be determined after each iteration. To avoid this problem, a new model is proposed which provides the benefits of the SST correction and avoids the freestream dependency of the solution, while not requiring the wall-distance. The first results for a wide range of test cases show that this model produces very good agreement with experimental data for flows with adverse pressure gradients, separation zones and shock-boundary layer interactions, closely matching the results obtained with the original SST model. This model should be very useful for unsteady calculations, such as store separation, grid adaptation, and other practical flows.

Virtue Ethics, Care Ethics, and "The Good Life of Teaching"

ERIC Educational Resources Information Center

Silverman, Marissa

2012-01-01

In "The Good Life of Teaching: An Ethics of Professional Practice," Chris Higgins (2011) reminds people that "self-interest and altruism, personal freedom and social roles, and practical wisdom and personhood" have been ancient philosophical topics that remain vitally important in the practice of contemporary teaching and learning. One of the most…

Assuring Best Practice in Technology-Enhanced Learning Environments

ERIC Educational Resources Information Center

Keppell, Mike; Suddaby, Gordon; Hard, Natasha

2015-01-01

This paper documents the development and findings of the Good Practice Report on Technology-Enhanced Learning and Teaching funded by the Australian Learning and Teaching Council (ALTC). Developing the Good Practice Report required a meta-analysis of 33 ALTC learning and teaching projects relating to technology funded between 2006 and 2010. This…

Discrimination and Good Practice Activities in Education: Trends and Developments in the 27 EU Member States

ERIC Educational Resources Information Center

Pollak, Alexander

2008-01-01

The European Union Agency for Fundamental Rights collects, through its network of observation points, information on discrimination and good practice in the areas of legislation, employment, housing, racist violence, and education. Data on education includes information on: access to education for vulnerable groups, discriminatory practices,…

Good Laboratory Practice. Part 1. An Introduction

ERIC Educational Resources Information Center

Wedlich, Richard C.; Libera, Agata E.; Pires, Amanda; Therrien, Matthew T.

2013-01-01

The Good Laboratory Practice (GLP) regulations were put into place in 1978. They establish a standard of practice to ensure that results from the nonclinical laboratory study reported to the U.S. Food and Drug Administration (FDA) are valid and that the study report accurately reflects the conduct of the study. While the GLP regulations promulgate…

A Rare Case of Anal and Perianal Chemical Burn in a Child due to Potassium Permanganate Crystals.

PubMed

Dash, Suvashis; Bhojani, Jatin; Sharma, Sharadendu

2018-02-09

Many chemicals used as medical treatments can cause chemical burns as an untoward side effect. One of such chemicals is potassium permanganate. It is a caustic chemical used as a disinfectant. The most common sites of burn by potassium permanganate are exposed sites like the face and hands. Chemical burns in the perianal and anal region are rare in clinical practice and even sparser in the pediatric age group. In this article, we report a case of perianal and anal chemical burn in an 18-month-old, male child, caused by potassium permanganate crystal applied wrongly for the treatment of pinworm infestation. As a chemical burn in this region can have serious complications, it is necessary to be vigilant when using such chemicals in these cases. Early and timely management in such cases leads to good outcomes. This is the first of such cases of chemical burn caused by potassium permanganate in the anal and perianal region.

ASSESSMENT OF GOOD PRACTICES IN HOSPITAL FOOD SERVICE BY COMPARING EVALUATION TOOLS.

PubMed

Macedo Gonçalves, Juliana; Lameiro Rodrigues, Kelly; Santiago Almeida, Ângela Teresinha; Pereira, Giselda Maria; Duarte Buchweitz, Márcia Rúbia

2015-10-01

since food service in hospitals complements medical treatment, it should be produced in proper hygienic and sanitary conditions. It is a well-known fact that food-transmitted illnesses affect with greater severity hospitalized and immunosuppressed patients. good practices in hospital food service are evaluated by comparing assessment instruments. good practices were evaluated by a verification list following Resolution of Collegiate Directory n. 216 of the Brazilian Agency for Sanitary Vigilance. Interpretation of listed items followed parameters of RCD 216 and the Brazilian Association of Collective Meals Enterprises (BACME). Fisher's exact test was applied to detect whether there were statistically significant differences. Analysis of data grouping was undertaken with Unweighted Pair-group using Arithmetic Averages, coupled to a correlation study between dissimilarity matrixes to verify disagreement between the two methods. Good Practice was classified with mean total rates above 75% by the two methods. There were statistically significant differences between services and food evaluated by BACME instrument. Hospital Food Services have proved to show conditions of acceptable good practices. the comparison of interpretation tools based on RCD n. 216 and BACME provided similar results for the two classifications. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Reducing risk for mother-to-infant transmission of hepatitis C virus: a systematic review for the U.S. Preventive Services Task Force.

PubMed

Cottrell, Erika Barth; Chou, Roger; Wasson, Ngoc; Rahman, Basmah; Guise, Jeanne-Marie

2013-01-15

Mother-to-infant transmission is the leading cause of childhood hepatitis C virus (HCV) infection, with up to 4000 new cases each year in the United States. To evaluate effects of mode of delivery, labor management strategies, and breastfeeding practices on risk for mother-to-infant transmission of HCV. MEDLINE (1947 to May 2012), the Cochrane Library Database, clinical trial registries, and reference lists. Randomized trials and observational studies on mode of delivery, labor management strategies, and breastfeeding practices and risk for mother-to-infant transmission of HCV. Investigators abstracted and reviewed study details and quality using predefined criteria. Eighteen observational studies evaluated the association between mode of delivery, labor management strategies, or breastfeeding practices and risk for mother-to-infant HCV transmission. Fourteen studies (2 good-quality, 4 fair-quality, and 8 poor-quality studies) found no clear association between mode of delivery (vaginal versus cesarean delivery) and risk for transmission. Two studies (1 good-quality and 1 poor-quality study) reported an association between prolonged duration of ruptured membranes and increased risk for transmission. Fourteen studies (2 good-quality, 2 fair-quality, and 10 poor-quality studies) found no association between breastfeeding and risk for transmission. Only English-language articles were included. Studies were observational, and most had important methodological shortcomings, including failure to adjust for potential confounders and small sample sizes. No intervention has been clearly demonstrated to reduce the risk for mother-to-infant HCV transmission. Avoidance of breastfeeding does not seem to be indicated for reducing transmission risk. Agency for Healthcare Research and Quality.

21 CFR 225.1 - Current good manufacturing practice.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic Act... the methods used in, or the facilities or controls used for, its manufacture, processing, packing, or...

21 CFR 225.1 - Current good manufacturing practice.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic Act... the methods used in, or the facilities or controls used for, its manufacture, processing, packing, or...

21 CFR 225.1 - Current good manufacturing practice.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic Act... the methods used in, or the facilities or controls used for, its manufacture, processing, packing, or...

21 CFR 225.1 - Current good manufacturing practice.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic Act... the methods used in, or the facilities or controls used for, its manufacture, processing, packing, or...

21 CFR 26.15 - Monitoring continued equivalence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM... COMMUNITY Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.15 Monitoring... number of joint inspections; and the conduct of common training sessions. ...

21 CFR 26.15 - Monitoring continued equivalence.

Code of Federal Regulations, 2011 CFR

2011-04-01

... MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM... COMMUNITY Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.15 Monitoring... number of joint inspections; and the conduct of common training sessions. ...

Overseas-trained doctors in Indigenous rural health services: negotiating professional relationships across cultural domains.

PubMed

Durey, Angela; Hill, Peter; Arkles, Rachelle; Gilles, Marisa; Peterson, Katia; Wearne, Susan; Canuto, Condy; Pulver, Lisa Jackson

2008-12-01

To examine how OTDs and staff in rural and remote Indigenous health contexts communicate and negotiate identity and relationships, and consider how this may influence OTDs' transition, integration and retention. Ten case studies were conducted in rural and remote settings across Australia, each of an OTD providing primary care in a substantially Indigenous practice population, his/her partner, co-workers and Indigenous board members associated with the health service. Cases were purposefully sampled to ensure diversity in gender, location and country of origin. Identity as 'fluid' emerged as a key theme in effective communication and building good relationships between OTDs and Indigenous staff. OTDs enter a social space where their own cultural and professional beliefs and practices intersect with the expectations of culturally safe practice shaped by the Australian Indigenous context. These are negotiated through differences in language, role expectation, practice, status and identification with locus with uncertain outcomes. Limited professional and cultural support often impeded this process. The reconstruction of OTDs' identities and mediating beyond predictable barriers to cultural engagement contributes significantly not only to OTDs' integration and, to a lesser extent, their retention, but also to maximising effective communication across cultural domains. Retention of OTDs working in Indigenous health contexts rests on a combination of OTDs' capacity to adapt culturally and professionally to this complex environment, and of effective strategies to support them.

Towards a Better Understanding of CMMI and Agile Integration - Multiple Case Study of Four Companies

NASA Astrophysics Data System (ADS)

Pikkarainen, Minna

The amount of software is increasing in the different domains in Europe. This provides the industries in smaller countries good opportunities to work in the international markets. Success in the global markets however demands the rapid production of high quality, error free software. Both CMMI and agile methods seem to provide a ready solution for quality and lead time improvements. There is not, however, much empirical evidence available either about 1) how the integration of these two aspects can be done in practice or 2) what it actually demands from assessors and software process improvement groups. The goal of this paper is to increase the understanding of CMMI and agile integration, in particular, focusing on the research question: how to use ‘lightweight’ style of CMMI assessments in agile contexts. This is done via four case studies in which assessments were conducted using the goals of CMMI integrated project management and collaboration and coordination with relevant stakeholder process areas and practices from XP and Scrum. The study shows that the use of agile practices may support the fulfilment of the goals of CMMI process areas but there are still many challenges for the agile teams to be solved within the continuous improvement programs. It also identifies practical advices to the assessors and improvement groups to take into consideration when conducting assessment in the context of agile software development.

Feasibility, acceptability and effectiveness of an online alternative to face-to-face consultation in general practice: a mixed-methods study of webGP in six Devon practices

PubMed Central

Carter, Mary; Fletcher, Emily; Sansom, Anna; Warren, Fiona C; Campbell, John L

2018-01-01

Objectives To evaluate the feasibility, acceptability and effectiveness of webGP as piloted by six general practices. Methods Mixed-methods evaluation, including data extraction from practice databases, general practitioner (GP) completion of case reports, patient questionnaires and staff interviews. Setting General practices in NHS Northern, Eastern and Western Devon Clinical Commissioning Group’s area approximately 6 months after implementing webGP (February–July 2016). Participants Six practices provided consultations data; 20 GPs completed case reports (regarding 61 e-consults); 81 patients completed questionnaires; 5 GPs and 5 administrators were interviewed. Outcome measures Attitudes and experiences of practice staff and patients regarding webGP. Results WebGP uptake during the evaluation was small, showing no discernible impact on practice workload. The completeness of cross-sectional data on consultation workload varied between practices. GPs judged 41/61 (72%) of webGP requests to require a face-to-face or telephone consultation. Introducing webGP appeared to be associated with shifts in responsibility and workload between practice staff and between practices and patients. 81/231 patients completed a postal survey (35.1% response rate). E-Consulters were somewhat younger and more likely to be employed than face-to-face respondents. WebGP appeared broadly acceptable to patients regarding timeliness and quality/experience of care provided. Similar problems were presented by all respondents. Both groups appeared equally familiar with other practice online services; e-consulters were somewhat more likely to have used them. From semistructured staff interviews, it appeared that, while largely acceptable within practice, introducing e-consults had potential for adverse interactions with pre-existing practice systems. Conclusions There is potential to assess the impact of new systems on consultation patterns by extracting routine data from practice databases. Staff and patients noticed subtle changes to responsibilities associated with online options. Greater uptake requires good communication between practice and patients, and organisation of systems to avoid conflicts and misuse. Further research is required to evaluate the full potential of webGP in managing practice workload. PMID:29449293

Science and the art of case reporting in medicine.

PubMed

Pramono, Laurentius A

2013-10-01

The case report is one type of article published in medical journals. Not all case reports can be published. Case reports worth publishing are case reports that have good teaching points and good clinical messages. Writing case reports need academic and clinical skills, along with a taste of art to interest readers to read and study about the case we report. Case reports are expected to be a good tool to all clinicians to build their clinical reasoning and sharpen their clinical instincts.

[Good practices and techniques for prevention of accidents at work and occupational diseases. New database of Inail].

PubMed

Bindi, L; Ossicini, A

2007-01-01

The project "The publication of good practices and good techniques for prevention" is one the priorities of nail. This computerized system for the collection of good practices and standards of Good Technology is aimed to health and safety of workers. The basic objective of the database is to provide a valuable tool, usable, dynamic and implemented, in order to facilitate and direct the access to BP and BT it by people responsible for SSL. At the same time constitutes a tool strategically important for enterprises (especially SMEs) in terms of technological innovation and competitiveness, related to the prevention, safety and health of workers. The realization of this project has involved many of the professionals (chemists, engineers, doctors, biologists, geologists, etc.), and everyone gives his intake of qualified professional competence.

Do quality indicators for general practice teaching practices predict good outcomes for students?

PubMed

Bartlett, Maggie; Potts, Jessica; McKinley, Bob

2016-07-01

Keele medical students spend 113 days in general practices over our five-year programme. We collect practice data thought to indicate good quality teaching. We explored the relationships between these data and two outcomes for students; Objective Structured Clinical Examination (OSCE) scores and feedback regarding the placements. Though both are surrogate markers of good teaching, they are widely used. We collated practice and outcome data for one academic year. Two separate statistical analyses were carried out: (1) to determine how much of the variation seen in the OSCE scores was due to the effect of the practice and how much to the individual student. (2) to identify practice characteristics with a relationship to student feedback scores. (1) OSCE performance: 268 students in 90 practices: six quality indicators independently influenced the OSCE score, though without linear relationships and not to statistical significance. (2) Student satisfaction: 144 students in 69 practices: student feedback scores are not influenced by practice characteristics. The relationships between the quality indicators we collect for practices and outcomes for students are not clear. It may be that neither the quality indicators nor the outcome measures are reliable enough to inform decisions about practices' suitability for teaching.

[Perthes disease--results of a containment-oriented therapy concept].

PubMed

Rühmann, O; Lazović, D; Wirth, C J; Gossé, F; Franke, J

1997-01-01

In a retrospective study a treatment concept for Perthes' disease dependent on the containment was applied. 49 hips of 41 children (9 female, 32 male) were treated between 01. 01. 1990 and 31. 12. 1995. In our concept of treatment a varus femoral osteotomy was performed in 28 cases with not contained hips or less than 4/5 coverage of the femoral head (X-ray/MRI). The other 21 well contained hips with 4/5 coverage or more were treated conservatively with physiotherapy and in case of joint effusion and pain additionally with the use of crutches (partial weight bearing) and anti-inflammatory medication. The average age in the non-operative group at the time of first investigation was 4 years and 9 months (3 y./1 m. to 7 y./1 m.) and 6 years and 3 months (4 y/2 m. to 10 y/0 m.) at our last examination (mean follow up 17.7 months, range of 6 to 72 months). At the time of indication for a varus femoral osteotomy the patients had an average age 6 years and 1 month (3 y./6 m. to 10 y./2 m.), the mean age at the last postoperative examination was 7 years and 11 months (4 y./8 m. to 12 y./5 m.) with an average follow up of 21.5 months (6 to 77 months). For the conservatively treated children we achieved good results (still well contained hips with 4/5 coverage, no decrease of function, no increase of pain) in 85.7% (18 of 21 cases). In 85.7% (24 of 28 cases) we found good results (well contained hips, increase of coverage, no decrease of function, no increase of pain) in the operation group. The presented concept of therapy in Perthes' disease was practicable for all patients and included the possibility of decision for operative or non-operative treatment. In both groups we achieved good results in 85.7% of the cases.

Helping Displaced Older Workers Get Back into Employment: Good Practice Guide

ERIC Educational Resources Information Center

Callahan, Victor J.; Bowman, Kaye

2015-01-01

This good practice guide is based on the report "Industry Restructuring and Job Loss: Helping Older Workers Get Back into Employment" by Victor J. Callan and Kaye Bowman. The aim of the research was to identify evidence-based practices that led to successful skills transfer, re-skilling, training and the attainment of new jobs for older…

A Lesson Plan for the Enhancement of Training and Research in Academia by the Adaptation and Adoption of Good Laboratory Practice Guidelines

ERIC Educational Resources Information Center

Sitaraman, Ramakrishnan

2010-01-01

The implementation of good laboratory practices (GLPs) is recognized by the biotechnology and pharmaceutical industries as being critical for ensuring the international acceptability of products. However, as universities and colleges (and research organizations) do not necessarily work under similar constraints, actual laboratory practices vary…

Addressing the Challenge of Diversity in the Graduate Ranks: Good Practices Yield Good Outcomes

ERIC Educational Resources Information Center

Thompson, Nancy L.; Campbell, Andrew G.

2013-01-01

In this paper, we examine the impact of implementing three systemic practices on the diversity and institutional culture in biomedical and public health PhD training at Brown University. We hypothesized that these practices, designed as part of the National Institutes of Health-funded Initiative to Maximize Student Development (IMSD) program in…

Knowledge, Attitudes and Practices Regarding Risk to Human Infection due to Mycobacterium bovis among Cattle Farming Communities in Western Uganda.

PubMed

Kazoora, H B; Majalija, S; Kiwanuka, N; Kaneene, J B

2016-12-01

A cross-sectional study involving multistage cluster sampling was undertaken in Kashari county, Mbarara district, western Uganda, in which quantitative and qualitative approaches were utilized to determine the knowledge, attitudes and practices regarding risk of human infection with zoonotic tuberculosis due to Mycobacterium bovis among cattle farmers. Of 496 respondents, 50% were farm owners and 50% herdsmen. Males were 70.9% of all the study participants. Among these, 37.5% had good knowledge, 41.4% had positive attitudes and 75.2% good practices regarding zoonotic tuberculosis. In the multivariable model, good knowledge was associated with having ever received health education, spending more than 5 years keeping cattle, having heard of cattle condemned at the abattoir due to tuberculosis and marital status. Positive attitudes were associated with having ever received health education, having heard of cattle condemned at the abattoir due to tuberculosis and being a farm owner versus being a herdsman. Good practices were associated with health education and good knowledge of the disease. Overall, knowledge and attitudes towards zoonotic tuberculosis due to M. bovis in humans was found to be low. While the majority of the respondents reported good practices, there were some still consuming raw milk and its products, which may predispose them to infection and indicates the need for greater outreach for zoonotic tuberculosis education. © 2016 Blackwell Verlag GmbH.

Perceiving the moral dimension of practice: insights from Murdoch, Vetlesen, and Aristotle.

PubMed

Scott, P Anne

2006-07-01

This paper situates the moral domain of practice within the context of a particular description of nursing practice - one that sees human interaction at the heart of that practice. Such a description fits not only with professional rhetoric but also with literature from patients and recent empirical work exploring the nature of nursing practice. Martha Levine in her 1977 description of ethics, within the context of nursing practice, indicated that what was important from an ethical perspective was how we interact with each other, with patients and colleagues, on a daily basis. What enables such interaction to display moral sensitivity, insight into patient need, and a focus on the good for the patient? Of relevance when answering this question is the empirical evidence indicating that professional socialization, as a nurse or a doctor, may dull the individual's moral sense. If this is the case, cognizance needs to be taken of such evidence when identifying theoretical approaches from mainstream ethics that may provide insight and value for nurse education. It is suggested that such insight and value can be gained from a consideration of the work of Aristotle, Murdoch, and Vetlesen.

Sexual ethics and communal judgments: on the pluralism of virtues, values, and practices.

PubMed

Lustig, B Andrew

1998-04-01

Different judgments by Christian communities on issues in sexual ethics involve different weightings of various sources of moral authority, different understandings of the normativity of the natural, and different assessments of the scope of freedom to be exercised in relation to the goods of marriage. These fundamental differences of interpretation can be exemplified by the ongoing Roman Catholic discussion of the legitimacy of voluntary sterilization in certain "hard cases." The contributors to this issue of Christian Bioethics, in their spirited exchange on that issue, exemplify the need for careful attention to the ways that differences of theological emphasis and moral method lead to different judgements in particular cases, both within and between particular Christian communities.

Severe acute respiratory syndrome (SARS): knowledge, attitudes, practices and sources of information among physicians answering a SARS fever hotline service.

PubMed

Deng, J-F; Olowokure, B; Kaydos-Daniels, S C; Chang, H-J; Barwick, R S; Lee, M-L; Deng, C-Y; Factor, S H; Chiang, C-E; Maloney, S A

2006-01-01

In June 2003, Taiwan introduced a severe acute respiratory syndrome (SARS) telephone hotline service to provide concerned callers with rapid access to information, advice and appropriate referral where necessary. This paper reports an evaluation of the knowledge, attitude, practices and sources of information relating to SARS among physicians who staffed the SARS fever hotline service. A retrospective survey was conducted using a self-administered postal questionnaire. Participants were physicians who staffed a SARS hotline during the SARS epidemic in Taipei, Taiwan from June 1 to 10, 2003. A response rate of 83% was obtained. All respondents knew the causative agent of SARS, and knowledge regarding SARS features and preventive practices was good. However, only 54% of respondents knew the incubation period of SARS. Hospital guidelines and news media were the major information sources. In responding to two case scenarios most physicians were likely to triage callers at high risk of SARS appropriately, but not callers at low risk. Less than half of all respondents answered both scenarios correctly. The results obtained suggest that knowledge of SARS was generally good although obtained from both medical and non-medical sources. Specific knowledge was however lacking in certain areas and this affected the ability to appropriately triage callers. Standardized education and assessment of prior knowledge of SARS could improve the ability of physicians to triage callers in future outbreaks.

Good practices : incorporating safety into resurfacing and restoration projects

DOT National Transportation Integrated Search

2006-12-01

Integrating safety improvements into resurfacing and restoration projects is a subject of long-standing interest by Federal, State, and local transportation agencies. A Scan Tour was conducted to identify and subsequently observe good practices in th...

The principles and best practice of question writing for postgraduate examinations.

PubMed

Hayes, Kevin; McCrorie, Peter

2010-12-01

Postgraduate medical education has changed enormously in the last 10 years presenting huge logistical challenges for local, regional and national organisations. Assessment is under change in line with major revisions of postgraduate curricula. Old methods of assessment are changing to newer evidence-based methods supported by ongoing research into good practice. This review examines the purpose and practical considerations of written assessment, the pros and cons of different assessment methods and how good practice can be evaluated and quality assured. Good quality assessment comes at a cost in terms of time and money, and organisations need to invest in their assessment strategies to ensure the highest possible standards. Copyright © 2010 Elsevier Ltd. All rights reserved.

Robust data enables managers to promote good practice.

PubMed

Bassett, Sally; Westmore, Kathryn

2012-11-01

This is the third in a series of articles examining the components of good corporate governance. The effective and efficient use of information and sources of information is crucial for good governance. This article explores the ways in which boards and management can obtain and use information to monitor performance and promote good practice, and how boards can be assured about the quality of information on which they rely. The final article in this series will look at the role of accountability in corporate governance.

Integrated low-intensity biofeedback therapy in fecal incontinence: evidence that "good" in-home anal sphincter exercise practice makes perfect.

PubMed

Vasant, D H; Solanki, K; Balakrishnan, S; Radhakrishnan, N V

2017-01-01

Biofeedback therapy (BFT) is an established treatment for fecal incontinence (FI), with access often being restricted to tertiary centers due to resources and the perceived requirement for high-intensity regimes. However, the optimal regime remains unknown. We evaluated outcomes from our low-intensity integrated BFT program in a secondary care center. Outcomes of our BFT service for FI were evaluated retrospectively. Response was defined by ≥50% improvement in FI frequency from baseline or complete continence. Responders were compared to non-responders for factors including symptoms, manometry data, sphincter exercise technique and duration of practice, and the number and frequency of sessions. Where patients dropped out, outcomes and the reason for dropout were obtained retrospectively. Fecal incontinence patients (n=205, median 62 years, 72% female) attended a median (IQR) 3 (2) BFT sessions with 55 (36) days between visits. Overall, 146/205 (71%) responded with 97/205 (47%) achieving continence. Fecal incontinence frequency improved dramatically in completed cases (P=0.000). While non-response was associated with males (P=0.03) and dropout (P=0.000), "good" anal sphincter exercise technique (P=0.008) and longer in-home practice (P=0.007) and more sessions (P=0.04) were associated with response. Dropout rate was 80/205 (39%), with the reason for dropout being obtained in 80%. Despite low-intensity BFT, comparable outcomes to data from tertiary centers were achieved. Our data emphasize the importance of technique and in-home practice of anal sphincter exercises. Customizing BFT intensity based on predictive factors and encouraging in-home practice may optimize outcomes, reduce dropout rates, and rationalize resources. © 2016 John Wiley & Sons Ltd.

Exploring cases of practical wisdom (phronesis) in postsecondary teaching

NASA Astrophysics Data System (ADS)

Connolly, Mark R.

Despite growing interest in improving postsecondary teaching over the past two and a half decades, evidence suggests that these efforts have not made much difference in faculty teaching practices and their effects on student learning. One purported reason for this lack of success is that postsecondary instructors are not formally trained as teachers and instead base their teaching approach on personal, non-scientific forms of knowledge---namely, emulation, trial-and-error, and habit. The prevailing view in higher education holds that postsecondary instructors should learn to teach through the proper application of scientifically derived theory to practice, and that the best source of knowledge about effective teaching practices is education researchers rather than the instructors themselves. In contrast to this modernist view about pedagogical knowledge, this thesis argues that teaching should be viewed instead as what Aristotle called praxis (morally appropriate action), for which phronesis, or practical-moral judgment, is held as the most important form of pedagogical reasoning and knowledge. On this view, good teaching combines practical knowledge of certain educational "goods" or values with sound judgment about what, in a particular situation, constitutes an appropriate expression of those values. To illustrate how teaching is an activity dependent upon practical-moral judgment, the study investigated teaching-related dilemmas of three science professors at a research-extensive university through classroom observations and interviews. An analytic lens of agency stances (Pendlebury, 1995) used the interplay between the respondents' teaching-related aims and the particulars of the "problem" at hand as a way of discerning instances when respondents took a phronesic (practical-moral) stance to their teaching. The study suggested that the three respondents took different approaches to making sense of contextual particularities and balancing competing teaching-related ends. To help those who view teaching as an instrumental, technical activity move toward a notion of teaching being primarily a practical-moral activity, the different purposes of means-end reasoning and practical-moral judgment must be made explicit. Current approaches to improving postsecondary teaching, such as the scholarship of teaching and learning, can be leveraged as sites for the exercise and cultivation of phronesis.

A Critical Review of an Authentic and Transformative Environmental Justice and Health Community — University Partnership

PubMed Central

Wilson, Sacoby; Campbell, Dayna; Dalemarre, Laura; Fraser-Rahim, Herb; Williams, Edith

2014-01-01

Distressed neighborhoods in North Charleston (SC, USA) are impacted by the cumulative effects of multiple environmental hazards and expansion of the Port of Charleston. The Low Country Alliance for Model Communities (LAMC) built an environmental justice partnership to address local concerns. This case study examines the process of building and sustaining a successful transformative and authentic community-university partnership. We apply the framework established by Community-Campus Partnerships for Health (CCPH), focusing on four of the nine principles of Good Practice of Community Campus Partnerships. PMID:25514142

Surviving self-employment: a personal case history.

PubMed

Kasnot, K

1993-01-01

In the popular perception of what determines one's success as a free-lance illustrator, issues other than natural talent or artistic ability are seldom emphasized. In addition to a firm philosophical foundation and a good work ethic, the organization and management of practical concerns play significant roles in the successful operation of any free-lance business. Presented as a personal history, this article discusses some of the most important, yet most neglected, issues that are essential to the economic security and survival of anyone considering a career as a free-lance illustrator.

The planning and construction of Distributed Energy System in Qingdao Sino-German Eco-park

NASA Astrophysics Data System (ADS)

Wei, Cun; Zhang, Gaijing; Song, Peipei

2018-04-01

This paper introduce the development and characteristics of new energy, Eco-city and Distributed Energy System in China, a case study of Qingdao Sino-German Eco-park, research on practical application about planning and construction of Distributed Energy System in Eco-city. Results show that: we must first do a good job in energy planning, giving full play to their own advantages, and Distributed Energy System based renewable energy resources is a promising option for reducing emissions from electricity generation in Eco-city.

Investigation on the Success of Peasant Entrepreneurs

NASA Astrophysics Data System (ADS)

Li, Guohao; Wu, Bing; Bai, Guanglin

Peasant entrepreneurs are one important force to promote the development of new rural construction, so it has practical significance to study success factors of peasant entrepreneurs. 40 cases involving peasant entrepreneurs are studied through content analysis method and the results show that: (1) Making good use of existing resources in rural areas is a key factor for peasant entrepreneurs; (2) hard work, strong willness, tactics and courage, social responsibility are four most important success factors; (3) 23 items of success factor can be summarized into three categorized, personality traits, abilities, and behavior characteristics.

A review of some exact solutions to the planar equations of motion of a thrusting spacecraft

NASA Technical Reports Server (NTRS)

Petropoulos, A. E.; Sims, J. A.

2002-01-01

With the complexities in computing optimal low thrust trajectories, easily-computed, good sub-optimal trajectories provide both a practical alternative for mission designers and a starting point for optimisation. The present paper collects in one place for easy reference and comparison several exact solutions that have been obtained in the literature over the last few decades: the logarithmic spiral, Pinkham's variant thereof, Forbes spiral, the exponential sinusoid, the case of constant radial thrust, Markopoulos's Keplerian thrust arcs, Lawden's spiral, and the analogous Bishop and Azimov spiral.

A Business Case Framework for Planning Clinical Nurse Specialist-Led Interventions.

PubMed

Bartlett Ellis, Rebecca J; Embree, Jennifer L; Ellis, Kurt G

2015-01-01

The purpose of this article is to describe a business case framework that can guide clinical nurse specialists (CNS) in clinical intervention development. Increased emphasis on cost-effective interventions in healthcare requires skills in analyzing the need to make the business case, especially for resource-intensive interventions. This framework assists the CNS to anticipate resource use and then consider if the intervention makes good business sense. We describe a business case framework that can assist the CNS to fully explore the problem and determine if developing an intervention is a good investment. We describe several analyses that facilitate making the business case to include the following: problem identification and alignment with strategic priorities, needs assessment, stakeholder analysis, market analysis, intervention implementation planning, financial analysis, and outcome evaluation. The findings from these analyses can be used to develop a formal proposal to present to hospital leaders in a position to make decisions. By aligning intervention planning with organizational priorities and engaging patients in the process, interventions will be more likely to be implemented in practice and produce robust outcomes. The business case framework can be used to justify to organization decision makers the need to invest resources in new interventions that will make a difference for quality outcomes as well as the financial bottom line. This framework can be used to plan interventions that align with organizational strategic priorities, plan for associated costs and benefits, and outcome evaluation. Clinical nurse specialists are well positioned to lead clinical intervention projects that will improve the quality of patient care and be cost-effective. To do so requires skill development in making the business case.

The integrity of science - lost in translation?

PubMed

Kaiser, Matthias

2014-04-01

This paper presents some selected issues currently discussed about the integrity of science, and it argues that there exist serious challenges to integrity in the various sciences. Due to the involved conceptual complexities, even core definitions of scientific integrity have been disputed, and core cases of scientific misconduct influenced the public discussion about them. It is claimed that ethics and law may not always go well together in matters of scientific integrity. Explanations of the causes of scientific misconduct vary, and defining good scientific practices is not a straightforward task. Even though the efficacy of ethics courses to improve scientific integrity can be doubted, and universities probably need to come up with more innovative formats to improve ethics in scientific training, ethics talk may be the only practical remedy. Copyright © 2014. Published by Elsevier Ltd.

A wavenumber approach to analysing the active control of plane waves with arrays of secondary sources

NASA Astrophysics Data System (ADS)

Elliott, Stephen J.; Cheer, Jordan; Bhan, Lam; Shi, Chuang; Gan, Woon-Seng

2018-04-01

The active control of an incident sound field with an array of secondary sources is a fundamental problem in active control. In this paper the optimal performance of an infinite array of secondary sources in controlling a plane incident sound wave is first considered in free space. An analytic solution for normal incidence plane waves is presented, indicating a clear cut-off frequency for good performance, when the separation distance between the uniformly-spaced sources is equal to a wavelength. The extent of the near field pressure close to the source array is also quantified, since this determines the positions of the error microphones in a practical arrangement. The theory is also extended to oblique incident waves. This result is then compared with numerical simulations of controlling the sound power radiated through an open aperture in a rigid wall, subject to an incident plane wave, using an array of secondary sources in the aperture. In this case the diffraction through the aperture becomes important when its size is compatible with the acoustic wavelength, in which case only a few sources are necessary for good control. When the size of the aperture is large compared to the wavelength, and diffraction is less important but more secondary sources need to be used for good control, the results then become similar to those for the free field problem with an infinite source array.

Explaining and modeling the concentration and loading of Escherichia coli in a stream-A case study.

PubMed

Wang, Chaozi; Schneider, Rebecca L; Parlange, Jean-Yves; Dahlke, Helen E; Walter, M Todd

2018-09-01

Escherichia coli (E. coli) level in streams is a public health indicator. Therefore, being able to explain why E. coli levels are sometimes high and sometimes low is important. Using citizen science data from Fall Creek in central NY we found that complementarily using principal component analysis (PCA) and partial least squares (PLS) regression provided insights into the drivers of E. coli and a mechanism for predicting E. coli levels, respectively. We found that stormwater, temperature/season and shallow subsurface flow are the three dominant processes driving the fate and transport of E. coli. PLS regression modeling provided very good predictions under stormwater conditions (R 2  = 0.85 for log (E. coli concentration) and R 2  = 0.90 for log (E. coli loading)); predictions under baseflow conditions were less robust. But, in our case, both E. coli concentration and E. coli loading were significantly higher under stormwater condition, so it is probably more important to predict high-flow E. coli hazards than low-flow conditions. Besides previously reported good indicators of in-stream E. coli level, nitrate-/nitrite-nitrogen and soluble reactive phosphorus were also found to be good indicators of in-stream E. coli levels. These findings suggest management practices to reduce E. coli concentrations and loads in-streams and, eventually, reduce the risk of waterborne disease outbreak. Copyright © 2018. Published by Elsevier B.V.

21 CFR 26.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN... regulatory systems means that the systems are sufficiently comparable to assure that the process of... require that the respective regulatory systems have identical procedures. (c) Good Manufacturing Practices...

40 CFR 68.73 - Mechanical integrity.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.73 Mechanical integrity. (a... accepted good engineering practices. (3) The frequency of inspections and tests of process equipment shall be consistent with applicable manufacturers' recommendations and good engineering practices, and more...

40 CFR 68.73 - Mechanical integrity.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.73 Mechanical integrity. (a... accepted good engineering practices. (3) The frequency of inspections and tests of process equipment shall be consistent with applicable manufacturers' recommendations and good engineering practices, and more...

40 CFR 68.73 - Mechanical integrity.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.73 Mechanical integrity. (a... accepted good engineering practices. (3) The frequency of inspections and tests of process equipment shall be consistent with applicable manufacturers' recommendations and good engineering practices, and more...

40 CFR 68.73 - Mechanical integrity.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.73 Mechanical integrity. (a... accepted good engineering practices. (3) The frequency of inspections and tests of process equipment shall be consistent with applicable manufacturers' recommendations and good engineering practices, and more...

Lean practices for quality results: a case illustration.

PubMed

Hwang, Pauline; Hwang, David; Hong, Paul

2014-01-01

Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations. The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital. Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals. An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices. Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific organisations and inter-organisational networks. Healthcare managers are adopting business practices that improve efficiency and productivity while ensuring their healthcare mission and guaranteeing that customer values are achieved. Shared understanding about complex goals (e.g. reducing waste and enhancing customer value) at the front-end is crucial for implementing successful lean practices. In particular, this study shows that nursing practices, which are both labour intensive and technology enabled, are good candidates for lean practice.

National Institutes of Health-Sponsored Clinical Islet Transplantation Consortium Phase 3 Trial: Manufacture of a Complex Cellular Product at Eight Processing Facilities.

PubMed

Ricordi, Camillo; Goldstein, Julia S; Balamurugan, A N; Szot, Gregory L; Kin, Tatsuya; Liu, Chengyang; Czarniecki, Christine W; Barbaro, Barbara; Bridges, Nancy D; Cano, Jose; Clarke, William R; Eggerman, Thomas L; Hunsicker, Lawrence G; Kaufman, Dixon B; Khan, Aisha; Lafontant, David-Erick; Linetsky, Elina; Luo, Xunrong; Markmann, James F; Naji, Ali; Korsgren, Olle; Oberholzer, Jose; Turgeon, Nicole A; Brandhorst, Daniel; Chen, Xiaojuan; Friberg, Andrew S; Lei, Ji; Wang, Ling-Jia; Wilhelm, Joshua J; Willits, Jamie; Zhang, Xiaomin; Hering, Bernhard J; Posselt, Andrew M; Stock, Peter G; Shapiro, A M James; Chen, Xiaojuan

2016-11-01

Eight manufacturing facilities participating in the National Institutes of Health-sponsored Clinical Islet Transplantation (CIT) Consortium jointly developed and implemented a harmonized process for the manufacture of allogeneic purified human pancreatic islet (PHPI) product evaluated in a phase 3 trial in subjects with type 1 diabetes. Manufacturing was controlled by a common master production batch record, standard operating procedures that included acceptance criteria for deceased donor organ pancreata and critical raw materials, PHPI product specifications, certificate of analysis, and test methods. The process was compliant with Current Good Manufacturing Practices and Current Good Tissue Practices. This report describes the manufacturing process for 75 PHPI clinical lots and summarizes the results, including lot release. The results demonstrate the feasibility of implementing a harmonized process at multiple facilities for the manufacture of a complex cellular product. The quality systems and regulatory and operational strategies developed by the CIT Consortium yielded product lots that met the prespecified characteristics of safety, purity, potency, and identity and were successfully transplanted into 48 subjects. No adverse events attributable to the product and no cases of primary nonfunction were observed. © 2016 by the American Diabetes Association.

National Institutes of Health–Sponsored Clinical Islet Transplantation Consortium Phase 3 Trial: Manufacture of a Complex Cellular Product at Eight Processing Facilities

PubMed Central

Balamurugan, A.N.; Szot, Gregory L.; Kin, Tatsuya; Liu, Chengyang; Czarniecki, Christine W.; Barbaro, Barbara; Bridges, Nancy D.; Cano, Jose; Clarke, William R.; Eggerman, Thomas L.; Hunsicker, Lawrence G.; Kaufman, Dixon B.; Khan, Aisha; Lafontant, David-Erick; Linetsky, Elina; Luo, Xunrong; Markmann, James F.; Naji, Ali; Korsgren, Olle; Oberholzer, Jose; Turgeon, Nicole A.; Brandhorst, Daniel; Chen, Xiaojuan; Friberg, Andrew S.; Lei, Ji; Wang, Ling-jia; Wilhelm, Joshua J.; Willits, Jamie; Zhang, Xiaomin; Hering, Bernhard J.; Posselt, Andrew M.; Stock, Peter G.; Shapiro, A.M. James

2016-01-01

Eight manufacturing facilities participating in the National Institutes of Health–sponsored Clinical Islet Transplantation (CIT) Consortium jointly developed and implemented a harmonized process for the manufacture of allogeneic purified human pancreatic islet (PHPI) product evaluated in a phase 3 trial in subjects with type 1 diabetes. Manufacturing was controlled by a common master production batch record, standard operating procedures that included acceptance criteria for deceased donor organ pancreata and critical raw materials, PHPI product specifications, certificate of analysis, and test methods. The process was compliant with Current Good Manufacturing Practices and Current Good Tissue Practices. This report describes the manufacturing process for 75 PHPI clinical lots and summarizes the results, including lot release. The results demonstrate the feasibility of implementing a harmonized process at multiple facilities for the manufacture of a complex cellular product. The quality systems and regulatory and operational strategies developed by the CIT Consortium yielded product lots that met the prespecified characteristics of safety, purity, potency, and identity and were successfully transplanted into 48 subjects. No adverse events attributable to the product and no cases of primary nonfunction were observed. PMID:27465220

Good Practice Guide: Bringing a Social Capital Approach into the Teaching of Adult Literacy and Numeracy

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2010

2010-01-01

This good practice guide is based on research that looked at how to teach adult literacy and numeracy using a social capital approach. The guide suggests ways vocational education and training (VET) practitioners can adopt a social capital approach to their teaching practice. A social capital approach refers to the process in which networks are…

Who Sleeps by Whom Revisited: A Method for Extracting the Moral Goods Implicit in Practice.

ERIC Educational Resources Information Center

Schweder, Richard A; And Others

1995-01-01

Explores the specific family practice of determining which family members share a bed or sleeping space. Discusses ways of extracting the moral principles implicit in the practice of arranging where family members sleep at night. Examines similarities and differences in the preferred moral goods of two culture regions--rural Hindu India and urban…

Good Practices in Undergraduate Education from the Students' and Faculty's View: Consensus or Disagreement. AIR 1996 Annual Forum Paper.

ERIC Educational Resources Information Center

Negron-Morales, Patricia; And Others

This study examined teaching practices in undergraduate education by surveying 180 undergraduate students and 29 faculty, most in the school of education, at the Rio Piedras Campus of the University of Puerto Rico. Factors investigated include: (1) degree of agreement between faculty and students on good teaching practices; (2) relationship…

The procurement of cells for the derivation of human embryonic stem cell lines for therapeutic use: recommendations for good practice.

PubMed

Murdoch, Alison; Braude, Peter; Courtney, Aidan; Brison, Daniel; Hunt, Charles; Lawford-Davies, James; Moore, Harry; Stacey, Glyn; Sethe, Sebastian

2012-03-01

The donation of human embryos for the derivation of embryonic stem cell lines that may be used in the development of therapeutic products raises more complex ethical, practical and regulatory problems than the donation of embryos for non-clinical research. This review considers these issues and offers recommendations for good practice.

21 CFR 4.4 - How can I comply with these current good manufacturing practice requirements for a co-packaged or...

Code of Federal Regulations, 2014 CFR

2014-04-01

... practice operating system in accordance with paragraph (b) of this section, the following requirements..., and the current good manufacturing practice operating system has been shown to comply with the drug... operating system has been shown to comply with the QS regulation, the following provisions of the drug CGMPs...

21 CFR 4.4 - How can I comply with these current good manufacturing practice requirements for a co-packaged or...

Code of Federal Regulations, 2013 CFR

2013-04-01

... practice operating system in accordance with paragraph (b) of this section, the following requirements..., and the current good manufacturing practice operating system has been shown to comply with the drug... operating system has been shown to comply with the QS regulation, the following provisions of the drug CGMPs...

AUSTRALIAN COMPETITION AND CONSUMER COMMISSION v ACN 117 372 915: SHOULD CONSUMER LAW REGULATE DOCTOR-PATIENT RELATIONS IN A CORPORATISED HEALTH CARE SYSTEM?

PubMed

Wallace, Jessica; Pyman, Ella; Faunce, Thomas

2015-09-01

In April 2015, North J of the Federal Court of Australia made a finding of unconscionable conduct against Advanced Medical Institute, a promoter and provider of erectile dysfunction treatment, in a case concerning unfair contract terms (Australian Competition and Consumer Commission vACN 117 372 915 Pty Ltd (in liq) (formerly Advanced Medical Institute Pty Ltd) [2015] FCA 368). The contract required a minimum 12-month commitment, with costs exceeding treatments available from general practitioners, and made refunds available only after all possible treatment plans were exhausted which included penile injections. This column analyses that case, particularly in respect to the consumer law standards of practice under which it was litigated. Those standards refer to patients as "consumers" yet North J made extensive reference to the Good Medical Practice: A Code of Conduct for Doctors in Australia, a text which refers to "patients", as evidence of what constitutes appropriate professional conduct or practice for the health profession. This column considers whether legislative and judicial categorisation of patients (a class of people presumptively suffering, sick and vulnerable) as "consumers" undermines the formal and informal protections accorded to patients under normative systems of medical ethics such as those represented by the Code. The case, it is argued, also illuminates the contemporary tensions between the ethical, legal and human rights standards required of doctors in their treatment of patients and the commercial interests of businesses.

A general heuristic for genome rearrangement problems.

PubMed

Dias, Ulisses; Galvão, Gustavo Rodrigues; Lintzmayer, Carla Négri; Dias, Zanoni

2014-06-01

In this paper, we present a general heuristic for several problems in the genome rearrangement field. Our heuristic does not solve any problem directly, it is rather used to improve the solutions provided by any non-optimal algorithm that solve them. Therefore, we have implemented several algorithms described in the literature and several algorithms developed by ourselves. As a whole, we implemented 23 algorithms for 9 well known problems in the genome rearrangement field. A total of 13 algorithms were implemented for problems that use the notions of prefix and suffix operations. In addition, we worked on 5 algorithms for the classic problem of sorting by transposition and we conclude the experiments by presenting results for 3 approximation algorithms for the sorting by reversals and transpositions problem and 2 approximation algorithms for the sorting by reversals problem. Another algorithm with better approximation ratio can be found for the last genome rearrangement problem, but it is purely theoretical with no practical implementation. The algorithms we implemented in addition to our heuristic lead to the best practical results in each case. In particular, we were able to improve results on the sorting by transpositions problem, which is a very special case because many efforts have been made to generate algorithms with good results in practice and some of these algorithms provide results that equal the optimum solutions in many cases. Our source codes and benchmarks are freely available upon request from the authors so that it will be easier to compare new approaches against our results.

Good surgeon: A search for meaning.

PubMed

Akopov, Andrey L; Artioukh, Dmitri Y

2017-01-01

The art and philosophy of surgery are not as often discussed as scientific discoveries and technological advances in the modern era of surgery. Although these are difficult to teach and pass on to the next generations of surgeons they are no less important for training good surgeons and maintaining their high standards. The authors of this review and opinion article tried to define what being a good surgeon really means and to look into the subject by analysing the essential conditions for being a good surgeon and the qualities that such a specialist should possess. In addition to a strong theoretic knowledge and practical skills and among the several described professional and personal characteristics, a good surgeon is expected to have common sense. It enables a surgeon to make a sound practical judgment independent of specialized medical knowledge and training. The possible ways of developing and/or enhancing common sense during surgical training and subsequent practice require separate analysis.

How to achieve safe, high-quality clinical studies with non-Medicinal Investigational Products? A practical guideline by using intra-bronchial carbon nanoparticles as case study.

PubMed

Berger, M; Kooyman, P J; Makkee, M; van der Zee, J S; Sterk, P J; van Dijk, J; Kemper, E M

2016-08-19

Clinical studies investigating medicinal products need to comply with laws concerning good clinical practice (GCP) and good manufacturing practice (GMP) to guarantee the quality and safety of the product, to protect the health of the participating individual and to assure proper performance of the study. However, there are no specific regulations or guidelines for non-Medicinal Investigational Products (non-MIPs) such as allergens, enriched food supplements, and air pollution components. As a consequence, investigators will avoid clinical research and prefer preclinical models or in vitro testing for e.g. toxicology studies. 1) briefly review the current guidelines and regulations for Investigational Medicinal Products; 2) present a standardised approach to ensure the quality and safety of non-MIPs in human in vivo research; and 3) discuss some lessons we have learned. We propose a practical line of approach to compose a clarifying product dossier (PD), comprising the description of the production process, the analysis of the raw and final product, toxicological studies, and a thorough risk-benefit-analysis. This is illustrated by an example from a human in vivo research model to study exposure to air pollutants, by challenging volunteers with a suspension of carbon nanoparticles (the component of ink cartridges for laser printers). With this novel risk-based approach, the members of competent authorities are provided with standardised information on the quality of the product in relation to the safety of the participants, and the scientific goal of the study.

21 CFR 172.870 - Hydroxypropyl cellulose.

Code of Federal Regulations, 2011 CFR

2011-04-01

... per anhydroglucose unit. The common name for this form of the additive is low substituted... colloid, stabilizer, suspending agent, or thickener, in accordance with good manufacturing practice. (2... additive is used in accordance with good manufacturing practice. [46 FR 50065, Oct. 9, 1981] ...

21 CFR 58.200 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.200 Purpose. (a) The purposes of... testing facility which has failed to comply with the requirements of the good laboratory practice...

21 CFR 58.200 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.200 Purpose. (a) The purposes of... testing facility which has failed to comply with the requirements of the good laboratory practice...

The Health Behavior Checklist: Factor structure in community samples and validity of a revised good health practices scale.

PubMed

Hampson, Sarah E; Edmonds, Grant W; Goldberg, Lewis R

2017-01-01

This study examined the factor structure and predictive validity of the commonly used multidimensional Health Behavior Checklist. A three-factor structure was found in two community samples that included men and women. The new 16-item Good Health Practices scale and the original Wellness Maintenance scale were the only Health Behavior Checklist scales to be related to cardiovascular and metabolic risk factors. While the other Health Behavior Checklist scales require further validation, the Good Health Practices scale could be used where more objective or longer measures are not feasible.

A case study of a multiply talented savant with an autism spectrum disorder: neuropsychological functioning and brain morphometry.

PubMed

Wallace, Gregory L; Happé, Francesca; Giedd, Jay N

2009-05-27

Neuropsychological functioning and brain morphometry in a savant (case GW) with an autism spectrum disorder (ASD) and both calendar calculation and artistic skills are quantified and compared with small groups of neurotypical controls. Good memory, mental calculation and visuospatial processing, as well as (implicit) knowledge of calendar structure and 'weak' central coherence characterized the cognitive profile of case GW. Possibly reflecting his savant skills, the superior parietal region of GW's cortex was the only area thicker (while areas such as the superior and medial prefrontal, middle temporal and motor cortices were thinner) than that of a neurotypical control group. Taken from the perspective of learning/practice-based models, skills in domains (e.g. calendars, art, music) that capitalize upon strengths often associated with ASD, such as detail-focused processing, are probably further enhanced through over-learning and massive exposure, and reflected in atypical brain structure.

A case study of a multiply talented savant with an autism spectrum disorder: neuropsychological functioning and brain morphometry

PubMed Central

Wallace, Gregory L.; Happé, Francesca; Giedd, Jay N.

2009-01-01

Neuropsychological functioning and brain morphometry in a savant (case GW) with an autism spectrum disorder (ASD) and both calendar calculation and artistic skills are quantified and compared with small groups of neurotypical controls. Good memory, mental calculation and visuospatial processing, as well as (implicit) knowledge of calendar structure and ‘weak’ central coherence characterized the cognitive profile of case GW. Possibly reflecting his savant skills, the superior parietal region of GW's cortex was the only area thicker (while areas such as the superior and medial prefrontal, middle temporal and motor cortices were thinner) than that of a neurotypical control group. Taken from the perspective of learning/practice-based models, skills in domains (e.g. calendars, art, music) that capitalize upon strengths often associated with ASD, such as detail-focused processing, are probably further enhanced through over-learning and massive exposure, and reflected in atypical brain structure. PMID:19528026

What makes a good GP? An empirical perspective on virtue in general practice

PubMed Central

Braunack-Mayer, A

2005-01-01

This paper takes a virtuist approach to medical ethics to explore, from an empirical angle, ideas about settled ways of living a good life. Qualitative research methods were used to analyse the ways in which a group of 15 general practitioners (GPs) articulated notions of good doctoring and the virtues in their work. I argue that the GPs, whose talk is analysed here, defined good general practice in terms of the ideals of accessibility, comprehensiveness, and continuity. They regarded these ideals significant both for the way they dealt with morally problematic situations and for how they conducted their professional lives more generally. In addition, I argue that the GPs who articulated these ideals most clearly were able to, in part, because they shared the experience of working in rural areas. This experience helped them to develop an understanding of the nature of general practice that their urban colleagues were less able to draw on. In that sense, the structural and organisational framework of general practice in rural areas provided the context for their understanding of ideals in general practice. PMID:15681671

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

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

Fischer, T.B.

1999-03-01

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

Exploring the Meanings that Dietitians Associate with their Role of Mother and Dietitian and How They Translate into Child-feeding Practices.

PubMed

Coughlin, Rebecca; Lordly, Daphne

2015-03-01

To explore the meanings that dietitians associate with their role of mother and dietitian and how they translate into child-feeding practices. The ideological case-study approach of Interpretative Phenomenological Analysis, a qualitative research design, was utilized. A convenience sample of 3 dietitians was recruited from the faculty of a university nutrition department. Dietitians participated in semi-structured interviews that were voice-recorded and transcribed. Data were thematically organized and interpreted using the theory of Symbolic Interactionism. Five themes were developed: the evolution of food-related practices, tensions between the role of dietitian and mother, mealtime interaction, integration of dietetic values in child-feeding practices, and the individuality of the mother. Dietitian mothers used various parenting styles when interacting with their children. Their beliefs about best practice in child-feeding correspond with the recommendations of their dietetic profession. Their perception of what it meant to be a good mother was influenced by their identity as a dietitian. Dietitian mothers need to be aware of the influence of professional discourse; professional thoughts can influence personal thoughts and actions related to child-feeding practices. Further exploration of the topic including maternal and child-feeding practices from the child's perspective is warranted.

Practical Formal Verification of Diagnosability of Large Models via Symbolic Model Checking

NASA Technical Reports Server (NTRS)

Cavada, Roberto; Pecheur, Charles

2003-01-01

This document reports on the activities carried out during a four-week visit of Roberto Cavada at the NASA Ames Research Center. The main goal was to test the practical applicability of the framework proposed, where a diagnosability problem is reduced to a Symbolic Model Checking problem. Section 2 contains a brief explanation of major techniques currently used in Symbolic Model Checking, and how these techniques can be tuned in order to obtain good performances when using Model Checking tools. Diagnosability is performed on large and structured models of real plants. Section 3 describes how these plants are modeled, and how models can be simplified to improve the performance of Symbolic Model Checkers. Section 4 reports scalability results. Three test cases are briefly presented, and several parameters and techniques have been applied on those test cases in order to produce comparison tables. Furthermore, comparison between several Model Checkers is reported. Section 5 summarizes the application of diagnosability verification to a real application. Several properties have been tested, and results have been highlighted. Finally, section 6 draws some conclusions, and outlines future lines of research.

Good Practices in Forensic Toxicology.

PubMed

Drummer, Olaf H

2017-01-01

This manuscript provides an overview for analysts, medical and scientific investigators, and laboratory administrators, the range of factors that should be considered to implement best practice forensic toxicology. These include laboratory influence over the collection of specimens, their proper transport and chain-of-custody before arrival in the laboratory. In addition, the laboratory needs to ensure properly trained staff use suitably validated and documented analytical procedures that meet the intended purpose and type of case in an accredited or suitably quality oriented management system. To assist the investigating officers laboratory results require an interpretation over their possible significance when sufficient details are available over the circumstances of the case. This requires a thorough understanding of the various factors that influence concentrations of substances and ultimately their likely physiological effect. These include consideration of the route of ingestion, influence over chronicity of usage on tissue concentrations and tolerance, possible combined drug effects or likely adverse reactions and consideration of relevant genetic factors that may have influenced pharmacokinetic or pharmacodynamic response. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Findings of the Work Improvement on Board (WIB) programme by the Fishery Agency in Japan.

PubMed

Hisamune, Shuji; Kogi, Kazutaka

2015-01-01

Concerns are growing about the safety and health of seamen exposed to high risks while working on vessels. Their accident rate in 2013 was 9.9 per 1000 workers, 5 times higher than that in industry. In order to mitigate the risks of seamen, we developed the Work Improvement on Board (WIB) programme by applying participatory action-oriented training (PAOT) methods that have proven effective for reducing work-related risks in small enterprises, construction sites, and agriculture. We analysed which features of the WIB programme would be most effective for facilitating the planning and implementation of practical improvements on vessels. We examined action -oriented tools used, including a WIB action checklist and good examples, and practical improvements proposed by the participants in 1-day or half-day WIB workshops. To study the effectiveness of the WIB programme, we analysed 1121 replies of a questionnaire distributed to 1459 participants of the programme. We compared the types of improvements achieved and the improvement costs in the WIB programme with those in other PAOT programmes. The impact of the WIB programme on promoting primary prevention by seamen and fishermen was discussed. The action checklist listing practical improvements on board and good example photos apparently facilitated the planning and implementation of improvements feasible on board. The participating crews could propose readily applicable improvements of their vessels within short time. In the case of workshops held in 10 harbours between August and October 2014, participants coming from 110 vessels presented 228 improvement proposals which were mostly feasible at low cost. Among the 1121 questionnaire replies from participants of the WIB programme, over 75% evaluated the programme as necessary, practical and easy-to-understand. These positive results led to the adoption of the WIB programme for training fishermen and seamen on commercial vessels by the Fishery Agency and the Ministry of Land, Infrastructure, Transport and Tourism. The Fishery Agency adopted plans to improve the working environment on fishing vessels by training 500 fishermen per year in the WIB programme from 2013 to 2018. The participatory work improvement programme can work in vessels when it utilises in a flexible manner local good practices and low-cost improvements as guides. The use of action-oriented tools such as a WIB action checklist and good examples seems important. We recommend the wide use of WIB methods in occupational safety and health management systems on board vessels in Japan and other countries.

Sustainability of organic food production: challenges and innovations.

PubMed

Niggli, Urs

2015-02-01

The greatest challenge for agriculture is to reduce the trade-offs between productivity and long-term sustainability. Therefore, it is interesting to analyse organic agriculture which is a given set of farm practices that emphasise ecological sustainability. Organic agriculture can be characterised as being less driven by off-farm inputs and being better embedded in ecosystem functions. The literature on public goods and non-commodity outputs of organic farms is overwhelming. Most publications address the positive effects of organic farming on soil fertility, biodiversity maintenance and protection of the natural resources of soil, water and air. As a consequence of focusing on public goods, organic agriculture is less productive. Meta-analyses show that organic agriculture yields range between 0·75 and 0·8 of conventional agriculture. Best practice examples from disadvantaged sites and climate conditions show equal or, in the case of subsistence farming in Sub-Saharan Africa, higher productivity of organic agriculture. Hence, organic agriculture is likely to be a good model for productive and sustainable food production. Underfunding in R&D addressing specific bottlenecks of organic agriculture are the main cause for both crop and livestock yield gaps. Therefore, the potential for improving the performance of organic agriculture through agricultural research is huge. Although organic farming is a niche in most countries, it is at the verge of becoming mainstream in leading European countries. Consumer demand has grown over the past two decades and does not seem to be a limiting factor for the future development of organic agriculture.

The barriers and motivators to learning infection control in clinical placements: interviews with midwifery students.

PubMed

Ward, Deborah J

2013-05-01

To investigate the barriers to and motivators for learning infection prevention and control as identified by midwifery students. Semi-structured interviews were undertaken with 15 undergraduate midwifery students within one large university. Data were analysed using Framework Analysis. Barriers to good clinical practice were identified by students which were concordant with previous literature related to reasons for non-compliance with infection control precautions. Issues such as competing demands specific to midwifery were also identified. Factors which act as barriers to learning good practice in placements included conflicting information and practices from different staff and placement areas and staff attitudes towards students who tried to comply with precautions. Motivators to good practice included the perceived vulnerability of infants to infection, the role modelling of good practice to new mothers and the monitoring of practice. This study demonstrated that midwifery students perceive barriers and motivators to learning infection prevention and control in their clinical placements. Many of the barriers identified are related to the attitudes and practices of qualified staff. Some of the motivators are related specifically to midwifery practice. Midwives need to be aware of the effects of what is observed in practice on midwifery students and how their practices and attitudes can influence learning both positively and negatively. As healthcare-associated infection and poor compliance with precautions are a global problem, this research should be of benefit to midwives and midwifery educators worldwide in terms of addressing barriers and ensuring better clinical education. Copyright © 2012 Elsevier Ltd. All rights reserved.

Trainee and training issues.

PubMed

Redfern, Nancy; Bartley, Catherine

2006-12-01

This chapter deals with the obligations of trainers and trainees to each other, the responsibilities of the programme and the conflicts of providing a service while training. Management of trainees with differing needs, such as those working part-time or returning to training after sickness, is reviewed. Assessment of performance and the obligation of consultants to identify, manage and support struggling trainees are discussed. Ethical discussion is based on the principles of autonomy, non-maleficence, beneficence, and justice to which fidelity is added. Case studies illustrating the application of ethical principles to work and decision-making are presented to stimulate debate. Opinions vary as to which principle carries more weight in individual cases, and how best to balance the conflicting requirements of the parties involved (patient, trainee,.trainer, employer, society). For all healthcare practitioners, the needs of patients remain our first concern. Acting in a consequentialist way, we must "maximise the good" and minimise the attendant harms in training. However, deontology states that certain sacrosanct rules and principles should never be breached. Doctors must abide by the duties of a doctor described in Good Medical Practice, maintaining standards in a way that ensures professional qualifications are respected. For the patient, there are advantages and disadvantages to receiving care in an educational setting. A 'teaching environment' tends to encourage and maintain high standards of practice from senior clinicians, but it also exposes patients to new learners, who are less efficient and polished and perhaps more prone to make errors. Learning has to fit round and complement the clinical and emotional needs of patients.

The Reality of Well-Being-Focused Design in Dementia Care: A Case Study of Acute Dementia Wards in the United Kingdom.

PubMed

Catt, Megan; Giridharan, Renganathan

2018-01-01

The study explored design for well-being within dementia care by investigating the adoption of well-being-focused design in real-world practice, through observing National Health Service (NHS) wards. Design for well-being is an approach that considers the psychological and physiological effects of architecture to improve health and well-being. The high psychological care requirement for dementia patients makes them a significant group to study in the evaluation of current hospital facilities. A literature review was conducted to frame the current theoretical perception of the key characteristics of a good environment for dementia care. A framework was generated to summarize and used as an assessment tool in a series of observational visits to NHS wards. Interviews with clinical staff focused on care outcomes and practicalities of implementing well-being-focused design, considering the historical and economical context. Key findings from the observations and interviews were analyzed for recurring themes. The ward observations and interviews provided insight into the current progression of well-being-led design in NHS hospitals in England. The research highlights key areas of success and factors that inhibit further progression. The case studies showed a good degree of ambition to utilize well-being-focused design, with belief among staff that the physical environment has a substantial role in the health and well-being of patients. Staff also felt that this approach is most effective for those in the less advanced stages of dementia. Despite the high level of support, the current degree of implementation appears to be varied.

Development of a cost-effectiveness analysis of leafy green marketing agreement irrigation water provisions.

PubMed

Jensen, Helen H; Pouliot, Sébastien; Wang, Tong; Jay-Russell, Michele T

2014-06-01

An analysis of the effectiveness of meeting the irrigation water provisions of the Leafy Green Marketing Agreement (LGMA) relative to its costs provides an approach to evaluating the cost-effectiveness of good agricultural practices that uses available data. A case example for lettuce is used to evaluate data requirements and provide a methodological example to determine the cost-effectiveness of the LGMA water quality provision. Both cost and field data on pathogen or indicator bacterial levels are difficult and expensive to obtain prospectively. Therefore, methods to use existing field and experimental data are required. Based on data from current literature and experimental studies, we calculate a cost-efficiency ratio that expresses the reduction in E. coli concentration per dollar expenditure on testing of irrigation water. With appropriate data, the same type of analysis can be extended to soil amendments and other practices and to evaluation of public benefits of practices used in production. Careful use of existing and experimental data can lead to evaluation of an expanded set of practices.

Conjoint analysis applications in health--a checklist: a report of the ISPOR Good Research Practices for Conjoint Analysis Task Force.

PubMed

Bridges, John F P; Hauber, A Brett; Marshall, Deborah; Lloyd, Andrew; Prosser, Lisa A; Regier, Dean A; Johnson, F Reed; Mauskopf, Josephine

2011-06-01

The application of conjoint analysis (including discrete-choice experiments and other multiattribute stated-preference methods) in health has increased rapidly over the past decade. A wider acceptance of these methods is limited by an absence of consensus-based methodological standards. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Good Research Practices for Conjoint Analysis Task Force was established to identify good research practices for conjoint-analysis applications in health. The task force met regularly to identify the important steps in a conjoint analysis, to discuss good research practices for conjoint analysis, and to develop and refine the key criteria for identifying good research practices. ISPOR members contributed to this process through an extensive consultation process. A final consensus meeting was held to revise the article using these comments, and those of a number of international reviewers. Task force findings are presented as a 10-item checklist covering: 1) research question; 2) attributes and levels; 3) construction of tasks; 4) experimental design; 5) preference elicitation; 6) instrument design; 7) data-collection plan; 8) statistical analyses; 9) results and conclusions; and 10) study presentation. A primary question relating to each of the 10 items is posed, and three sub-questions examine finer issues within items. Although the checklist should not be interpreted as endorsing any specific methodological approach to conjoint analysis, it can facilitate future training activities and discussions of good research practices for the application of conjoint-analysis methods in health care studies. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Framing patient consent for student involvement in pelvic examination: a dual model of autonomy.

PubMed

Carson-Stevens, Andrew; Davies, Myfanwy M; Jones, Rhiain; Chik, Aiman D Pawan; Robbé, Iain J; Fiander, Alison N

2013-11-01

Patient consent has been formulated in terms of radical individualism rather than shared benefits. Medical education relies on the provision of patient consent to provide medical students with the training and experience to become competent doctors. Pelvic examination represents an extreme case in which patients may legitimately seek to avoid contact with inexperienced medical students particularly where these are male. However, using this extreme case, this paper will examine practices of framing and obtaining consent as perceived by medical students. This paper reports findings of an exploratory qualitative study of medical students and junior doctors. Participants described a number of barriers to obtaining informed consent. These related to misunderstandings concerning student roles and experiences and insufficient information on the nature of the examination. Participants reported perceptions of the negative framing of decisions on consent by nursing staff where the student was male. Potentially coercive practices of framing of the decision by senior doctors were also reported. Participants outlined strategies they adopted to circumvent patients' reasons for refusal. Practices of framing the information used by students, nurses and senior doctors to enable patients to decide about consent are discussed in the context of good ethical practice. In the absence of a clear ethical model, coercion appears likely. We argue for an expanded model of autonomy in which the potential tension between respecting patients' autonomy and ensuring the societal benefit of well-trained doctors is recognised. Practical recommendations are made concerning information provision and clear delineations of student and patient roles and expectations.

Social support in the practices of informal providers: The case of patent and proprietary medicine vendors in Nigeria.

PubMed

Sieverding, Maia; Liu, Jenny; Beyeler, Naomi

2015-10-01

The social and institutional environments in which informal healthcare providers operate shape their health and business practices, particularly in contexts where regulatory enforcement is weak. In this study, we adopt a social capital perspective to understanding the social networks on which proprietary and patent medicine vendors (PPMVs) in Nigeria rely for support in the operation of their shops. Data are drawn from 70 in-depth interviews with PPMVs in three states, including interviews with local leaders of the PPMV professional association. We find that PPMVs primarily relied on more senior colleagues and formal healthcare professionals for informational support, including information about new medicines and advice on how to treat specific cases of illness. For instrumental support, including finance, start-up assistance, and intervention with regulatory agencies, PPMVs relied on extended family, the PPMVs with whom they apprenticed, and the leaders of their professional association. PPMVs' networks also provided continual reinforcement of what constitutes good PPMV practice through admonishments to follow scope of practice limitations. These informal reminders, as well as monitoring activities conducted by the professional association, served to reinforce PPMVs' concern with avoiding negative customer health outcomes, which were perceived to be detrimental to their business reputations. That PPMVs' networks both encouraged practices to reduce the likelihood of poor health outcomes, and provided advice regarding customers' health conditions, highlights the potential impact of informal providers' access to different forms of social capital on their delivery of health services, as well as their success as microenterprises. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of a rule base for decision making in general practice.

PubMed Central

Essex, B; Healy, M

1994-01-01

BACKGROUND. Decision making in general practice relies heavily on judgmental expertise. It should be possible to codify this expertise into rules and principles. AIM. A study was undertaken to evaluate the effectiveness, of rules from a rule base designed to improve students' and trainees' management decisions relating to patients seen in general practice. METHOD. The rule base was developed after studying decisions about and management of thousands of patients seen in one general practice over an eight year period. Vignettes were presented to 93 fourth year medical students and 179 general practitioner trainees. They recorded their perception and management of each case before and after being presented with a selection of relevant rules. Participants also commented on their level of agreement with each of the rules provided with the vignettes. A panel of five independent assessors then rated as good, acceptable or poor, the participants' perception and management of each case before and after seeing the rules. RESULTS. Exposure to a few selected rules of thumb improved the problem perception and management decisions of both undergraduates and trainees. The degree of improvement was not related to previous experience or to the stated level of agreement with the proposed rules. The assessors identified difficulties students and trainees experienced in changing their perceptions and management decisions when the rules suggested options they had not considered. CONCLUSION. The rules developed to improve decision making skills in general practice are effective when used with vignettes. The next phase is to transform the rule base into an expert system to train students and doctors to acquire decision making skills. It could also be used to provide decision support when confronted with difficult management decisions in general practice. PMID:8204334

Re-treatment decisions for failed posterior fillings by Finnish general practitioners.

PubMed

Heinikainen, Mia; Vehkalahti, Miira; Murtomaa, Heikki

2002-06-01

To evaluate treatment decisions of general dental practitioners (GDPs) in the private and public sector in cases of re-treatment of failed posterior fillings. A questionnaire on six cases from 400 GDPs, selected by stratified randomisation by gender, and main occupation (public vs. private sector). Others were all full-time dental teachers (DTs; n=47) representing clinical disciplines other than surgery and orthodontics. Restorative cases were described in detail, including figures drawn on four subcases involving the first permanent upper molar where the filling to be replaced increased in size from occlusal filling to the entire clinical crown. For each case, respondents chose the optimal treatment from eight alternatives, later re-classified as amalgam restoration, direct composite restoration, prosthetic restoration (indirect composite, cast gold inlay/onlay, ceramic inlay/onlay, ceramic crown, or bridge construction following tooth extraction). For re-treatment of the occlusal filling, composite restoration was preferred both by GDPs (92%) and DTs (83%). For three-surface fillings, prosthetic restorations were dominant in the private sector (OR=2.3; 95% CI: 1.4, 3.8; P<0.001). In total loss of the clinical crown, prosthetic restoration was chosen by all the DTs, public-sector dentists, and 95% of private-sector dentists. No more than 10% of GDPs chose amalgam and 2% gold; the rest chose composites. Treatment decisions were similar in public and private sectors for cases with the smallest and largest fillings. Wide variation in cases of medium-sized restorations indicated a lack of generally accepted guidelines of good clinical practice and of evidence-based treatment practice.

Examples of sex/gender sensitivity in epidemiological research: results of an evaluation of original articles published in JECH 2006-2014.

PubMed

Jahn, Ingeborg; Börnhorst, Claudia; Günther, Frauke; Brand, Tilman

2017-02-15

During the last decades, sex and gender biases have been identified in various areas of biomedical and public health research, leading to compromised validity of research findings. As a response, methodological requirements were developed but these are rarely translated into research practice. The aim of this study is to provide good practice examples of sex/gender sensitive health research. We conducted a systematic search of research articles published in JECH between 2006 and 2014. An instrument was constructed to evaluate sex/gender sensitivity in four stages of the research process (background, study design, statistical analysis, discussion). In total, 37 articles covering diverse topics were included. Thereof, 22 were evaluated as good practice example in at least one stage; two articles achieved highest ratings across all stages. Good examples of the background referred to available knowledge on sex/gender differences and sex/gender informed theoretical frameworks. Related to the study design, good examples calculated sample sizes to be able to detect sex/gender differences, selected sex/gender sensitive outcome/exposure indicators, or chose different cut-off values for male and female participants. Good examples of statistical analyses used interaction terms with sex/gender or different shapes of the estimated relationship for men and women. Examples of good discussions interpreted their findings related to social and biological explanatory models or questioned the statistical methods used to detect sex/gender differences. The identified good practice examples may inspire researchers to critically reflect on the relevance of sex/gender issues of their studies and help them to translate methodological recommendations of sex/gender sensitivity into research practice.

Understanding 'caring' through biopolitics: the case of nurses under the Nazi regime.

PubMed

Foth, Thomas

2013-10-01

These days, discussions of what might be the 'essence' or the 'core' of nursing and nursing practice sooner or later end in a discussion about the concept of care. Most of the 'newer' nursing theories use this concept as a theoretical core concept. Even though these theoretical approaches use the concept of care with very different philosophical foundations and theoretical consistency, they concur in defining care as the essence of nursing and thereby glorify goodness as the decisive characteristic of nursing. These theoretical approaches neglect the fact that nursing is above all a profession with a societal task and is characterized by an asymmetrical power relation between nurses and their patients. Based on the results of a research project that analysed the role nurses played in the killing of psychiatric patients in Germany during the Nazi regime, I demonstrate that an approach based on the concept of care is not able to explain how nurses were able to commit crimes of such atrocity. These crimes were bound to an emotional investment that sustained the production of 'life unworthy of living'. In the case of nurses under the Nazi regime, certainly a kind of sadism was at issue that can only be explained if we recognize that the social bond is characterized by a certain tension; 'goodness' that caring theories assign to the social bond always coexists with the capacity for destruction. Using the Foucauldian theoretical framework of biopower and biopolitics enables one to analyse violence and power as integral parts of nurses' practice. Seen from this perspective, the killing of patients was part of a biopolitical programme and not a relapse into barbarism. The concept of care obscures the political agenda of nursing and does not provide a critical and political framework to analysing nursing practice. © 2013 John Wiley & Sons Ltd.

Defense programs beryllium good practice guide

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

Herr, M.

1997-07-01

Within the DOE, it has recently become apparent that some contractor employees who have worked (or are currently working) with and around beryllium have developed chronic beryllium disease (CBD), an occupational granulomatous lung disorder. Respiratory exposure to aerosolized beryllium, in susceptible individuals, causes an immunological reaction that can result in granulomatous scarring of the lung parenchyma, shortness of breath, cough, fatigue, weight loss, and, ultimately, respiratory failure. Beryllium disease was originally identified in the 1940s, largely in the fluorescent light industry. In 1950, the Atomic Energy Commission (AEC) introduced strict exposure standards that generally curtailed both the acute and chronicmore » forms of the disease. Beginning in 1984, with the identification of a CBD case in a DOE contractor worker, there was increased scrutiny of both industrial hygiene practices and individuals in this workforce. To date, over 100 additional cases of beryllium-specific sensitization and/or CBD have been identified. Thus, a disease previously thought to be largely eliminated by the adoption of permissible exposure standards 45 years ago is still a health risk in certain workforces. This good practice guide forms the basis of an acceptable program for controlling workplace exposure to beryllium. It provides (1) Guidance for minimizing worker exposure to beryllium in Defense Programs facilities during all phases of beryllium-related work, including the decontamination and decommissioning (D&D) of facilities. (2) Recommended controls to be applied to the handling of metallic beryllium and beryllium alloys, beryllium oxide, and other beryllium compounds. (3) Recommendations for medical monitoring and surveillance of workers exposed (or potentially exposed) to beryllium, based on the best current understanding of beryllium disease and medical diagnostic tests available. (4) Site-specific safety procedures for all processes of beryllium that is likely to generate dusts, mists, fumes, or small particulates. A beryllium exposure control program should minimize airborne concentrations, the potential for and spread of contamination, the number of times individuals are exposed to beryllium, and the number of employees who may be potentially exposed.« less

Alternative Pathways to Apprenticeships. Good Practice Guide

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2015

2015-01-01

Apprenticeships are changing. The increasing proportions of people entering apprenticeships at various levels of ability and backgrounds are stimulating demand for alternative pathways to completions. This good practice guide assembles the key findings for education practitioners and workplace supervisors from three related research reports on…

Good Laboratory Practices of Materials Testing at NASA White Sands Test Facility

NASA Technical Reports Server (NTRS)

Hirsch, David; Williams, James H.

2005-01-01

An approach to good laboratory practices of materials testing at NASA White Sands Test Facility is presented. The contents include: 1) Current approach; 2) Data analysis; and 3) Improvements sought by WSTF to enhance the diagnostic capability of existing methods.

78 FR 32541 - Technical Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

... objectives in the most economical and practical manner; and maintaining good public relations with public... economical and practical manner; and maintaining good public relations with public, private and governmental... Enforcement for Mortgage Licensing Act of 2008,\\3\\ which were transferred to the CFPB. \\1\\ Public Law 111-203...

78 FR 76836 - Agency Information Collection Activities; Proposed Collection; Comment Request; Current Good...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-19

... Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements... of FDA's regulations regarding current good manufacturing practice (CGMP) for dietary supplements..., or Holding Operations for Dietary Supplements--21 CFR Part 111 (OMB Control Number 0910-0606...

75 FR 40840 - Agency Information Collection Activities; Proposed Collection; Comment Request; Current Good...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-14

... Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements... regulations regarding current good manufacturing practice (CGMP) for dietary supplements. DATES: Submit either... in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements--21 CFR Part 111...

40 CFR 51.164 - Stack height procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 51.164 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... source's stack height that exceeds good engineering practice or by any other dispersion technique, except... source based on a good engineering practice stack height that exceeds the height allowed by § 51.100(ii...

21 CFR 131.110 - Milk.

Code of Federal Regulations, 2014 CFR

2014-04-01

... nonfat dry milk. Milk may be homogenized. (b) Vitamin addition (Optional). (1) If added, vitamin A shall... Units thereof within limits of good manufacturing practice. (2) If added, vitamin D shall be present in... good manufacturing practice. (c) Optional ingredients. The following safe and suitable ingredients may...

76 FR 718 - General Administrative Regulations; Good-Performance Refunds

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-06

... demonstrate good farming practices, providing, in effect, a premium discount to individual producers... Refund program will specifically encourage sound management practices as well as encouraging insured... regardless of the size of their farming operation. The amount of work required of the insurance companies...

Emerging good practices for Translatability Assessment (TA) of Patient-Reported Outcome (PRO) measures.

PubMed

Acquadro, Catherine; Patrick, Donald L; Eremenco, Sonya; Martin, Mona L; Kuliś, Dagmara; Correia, Helena; Conway, Katrin

2017-01-01

This paper presents emerging Good Practices for Translatability Assessment (TA) of Patient-Reported Outcome (PRO) Measures. The ISOQOL Translation and Cultural Adaptation Special Interest Group (TCA-SIG) undertook the review of several TA approaches, with the collaboration of organizations who are involved in conducting TA, and members of the TCA-SIG. The effort led to agreement by the writing group on Good Practices for 1) the terminology to be used in referring to translatability process, 2) the best definition of TA, 3) the methodology that is recommended at each step of the process, 4) the persons involved in TA, 5) the timing of assessment, 6) the review criteria for TA, and 7) the recommendations to be made at the end of the TA process. With input from the TCA-SIG membership and in consultation with experts in the field, these emerging good practices can guide the future use of TA in the development of PROs.

WHO expert committee on specifications for pharmaceutical preparations. Fortieth report.

PubMed

2006-01-01

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. The report is complemented by a number of annexes. These include: a list of available International Chemical Reference Substances and International Infrared Spectra; supplementary guidelines on good manufacturing practices for heating, ventilation and air-conditioning systems for non-sterile pharmaceutical dosage forms; updated supplementary guidelines on good manufacturing practices for the manufacture of herbal medicines; supplementary guidelines on good manufacturing practices for validation; good distribution practices for pharmaceutical products; a model quality assurance system for procurement agencies (recommendations for quality assurance systems focusing on prequalification of products and manufacturers, purchasing, storage and distribution of pharmaceutical products); multisource (generic) pharmaceutical products: guidelines on registration requirements to establish interchangeability; a proposal to waive in vivo bioequivalence requirements for WHO Model List of Essential Medicines immediate-release, solid oral dosage forms; and additional guidance for organizations performing in vivo bioequivalence studies.

Clinical reasoning-embodied meaning-making in physiotherapy.

PubMed

Chowdhury, Anoop; Bjorbækmo, Wenche Schrøder

2017-07-01

This article examines physiotherapists' lived experience of practicing physiotherapy in primary care, focusing on clinical reasoning and decision-making in the case of a patient we call Eva. The material presented derives from a larger study involving two women participants, both with a protracted history of neck and shoulder pain. A total of eight sessions, all of them conducted by the first author, a professional physiotherapist, in his own practice room, were videotaped, after which the first author transcribed the sessions and added reflective notes. One session emerged as particularly stressful for both parties and is explored in detail in this article. In our analysis, we seek to be attentive to the experiences of physiotherapy displayed and to explore their meaning, significance and uniqueness from a phenomenological perspective. Our research reveals the complexity of integrating multiple theoretical perspectives of practice in clinical decision-making and suggests that a phenomenological perspective can provide insights into clinical encounters through its recognition of embodied knowledge. We argue that good physiotherapy practice demands tactfulness, sensitivity, and the desire to build a cooperative patient-therapist relationship. Informed by theoretical and practical knowledge from multiple disciplines, patient management can evolve and unfold beyond rehearsed routines and theoretical principles.

Targeted case finding for chronic obstructive pulmonary disease versus routine practice in primary care (TargetCOPD): a cluster-randomised controlled trial.

PubMed

Jordan, Rachel E; Adab, Peymané; Sitch, Alice; Enocson, Alexandra; Blissett, Deirdre; Jowett, Sue; Marsh, Jen; Riley, Richard D; Miller, Martin R; Cooper, Brendan G; Turner, Alice M; Jolly, Kate; Ayres, Jon G; Haroon, Shamil; Stockley, Robert; Greenfield, Sheila; Siebert, Stanley; Daley, Amanda J; Cheng, K K; Fitzmaurice, David

2016-09-01

Many individuals with chronic obstructive pulmonary disease (COPD) remain undiagnosed worldwide. Health-care organisations are implementing case-finding programmes without good evidence of which are the most effective and cost-effective approaches. We assessed the effectiveness and cost-effectiveness of two alternative approaches to targeted case finding for COPD compared with routine practice. In this cluster-randomised controlled trial, participating general practices in the West Midlands, UK, were randomly assigned (1:1), via a computer-generated block randomisation sequence, to either a targeted case-finding group or a routine care group. Eligible patients were ever-smokers aged 40-79 years without a previously recorded diagnosis of COPD. Patients in the targeted case-finding group were further randomly assigned (1:1) via their household to receive either a screening questionnaire at the general practitioner (GP) consultation (opportunistic) or a screening questionnaire at the GP consultation plus a mailed questionnaire (active). Respondents reporting relevant respiratory symptoms were invited for post-bronchodilator spirometry. Patients, clinicians, and investigators were not masked to allocation, but group allocation was concealed from the researchers who performed the spirometry assessments. Primary outcomes were the percentage of the eligible population diagnosed with COPD within 1 year (defined as post-bronchodilator forced expiratory volume in 1 s [FEV1] to forced vital capacity [FVC] ratio <0·7 in patients with symptoms or a new diagnosis on their GP record) and cost per new COPD diagnosis. Multiple logistic and Poisson regression were used to estimate effect sizes. Costs were obtained from the trial. This trial is registered with ISRCTN, number ISRCTN14930255. From Aug 10, 2012, to June 22, 2014, 74 818 eligible patients from 54 diverse general practices were randomly assigned and completed the trial. At 1 year, 1278 (4%) cases of COPD were newly detected in 32 789 eligible patients in the targeted case-finding group compared with 337 (1%) cases in 42 029 patients in the routine care group (adjusted odds ratio [OR] 7·45 [95% CI 4·80-11·55], p<0·0001). The percentage of newly detected COPD cases was higher in the active case-finding group (822 [5%] of 15 378) than in the opportunistic case-finding group (370 [2%] of 15 387; adjusted OR 2·34 [2·06-2·66], p<0·0001; adjusted risk difference 2·9 per 100 patients [95% CI 2·3-3·6], p<0·0001). Active case finding was more cost-effective than opportunistic case finding (£333 vs £376 per case detected, respectively). In this well established primary care system, routine practice identified few new cases of COPD. An active targeted approach to case finding including mailed screening questionnaires before spirometry is a cost-effective way to identify undiagnosed patients and has the potential to improve their health. National Institute for Health Research. Copyright © 2016 Elsevier Ltd. All rights reserved.

How to Allow Conscientious Objection in Medicine While Protecting Patient Rights.

PubMed

Ancell, Aaron; Sinnott-Armstrong, Walter

2017-01-01

Paradigmatic cases of conscientious objection in medicine are those in which a physician refuses to provide a medical service or good because doing so would conflict with that physician's personal moral or religious beliefs. Should such refusals be allowed in medicine? We argue that (1) many conscientious objections to providing certain services must be allowed because they fall within the range of freedom that physicians have to determine which services to offer in their practices; (2) at least some conscientious objections to serving particular groups of patients should be allowed because they are not invidiously discriminatory; and (3) even in cases of invidiously discriminatory conscientious objections, legally prohibiting individual physicians from refusing to serve patients on the basis of such objections is not always the best solution.

Numerical solution to the glancing sidewall oblique shock wave/turbulent boundary layer interaction in three dimension

NASA Technical Reports Server (NTRS)

Anderson, B. H.; Benson, T. J.

1983-01-01

A supersonic three-dimensional viscous forward-marching computer design code called PEPSIS is used to obtain a numerical solution of the three-dimensional problem of the interaction of a glancing sidewall oblique shock wave and a turbulent boundary layer. Very good results are obtained for a test case that was run to investigate the use of the wall-function boundary-condition approximation for a highly complex three-dimensional shock-boundary layer interaction. Two additional test cases (coarse mesh and medium mesh) are run to examine the question of near-wall resolution when no-slip boundary conditions are applied. A comparison with experimental data shows that the PEPSIS code gives excellent results in general and is practical for three-dimensional supersonic inlet calculations.

Numerical solution to the glancing sidewall oblique shock wave/turbulent boundary layer interaction in three-dimension

NASA Technical Reports Server (NTRS)

Anderson, B. H.; Benson, T. J.

1983-01-01

A supersonic three-dimensional viscous forward-marching computer design code called PEPSIS is used to obtain a numerical solution of the three-dimensional problem of the interaction of a glancing sidewall oblique shock wave and a turbulent boundary layer. Very good results are obtained for a test case that was run to investigate the use of the wall-function boundary-condition approximation for a highly complex three-dimensional shock-boundary layer interaction. Two additional test cases (coarse mesh and medium mesh) are run to examine the question of near-wall resolution when no-slip boundary conditions are applied. A comparison with experimental data shows that the PEPSIS code gives excellent results in general and is practical for three-dimensional supersonic inlet calculations.

Enhancing patient well-being: advocacy or negotiation?

PubMed Central

Bird, A W

1994-01-01

The United Kingdom Central Council for Nursing, Midwifery and Health Visitors (UKCC) document, Exercising Accountability, states that the role of patient's advocate is an essential aspect of good professional nursing practice (1). The author examines the case for and against the nurse being the best person to act as advocate, and critically evaluates the criteria of advocacy. The problematic moral issues arising are discussed, and a case made for negotiation between the members of the multidisciplinary team and the patient/client (or a significant person to the patient) in order to promote the well-being of the patient and to minimise suffering. She concludes that the health care professional's (including the nurse's) role is to help people to assert control over the factors which affect their lives, that is empowerment, rather than advocacy. PMID:7996560

Finding clusters of similar events within clinical incident reports: a novel methodology combining case based reasoning and information retrieval

PubMed Central

Tsatsoulis, C; Amthauer, H

2003-01-01

A novel methodological approach for identifying clusters of similar medical incidents by analyzing large databases of incident reports is described. The discovery of similar events allows the identification of patterns and trends, and makes possible the prediction of future events and the establishment of barriers and best practices. Two techniques from the fields of information science and artificial intelligence have been integrated—namely, case based reasoning and information retrieval—and very good clustering accuracies have been achieved on a test data set of incident reports from transfusion medicine. This work suggests that clustering should integrate the features of an incident captured in traditional form based records together with the detailed information found in the narrative included in event reports. PMID:14645892

Quality of leadership in multidisciplinary cancer tumor boards: development and evaluation of a leadership assessment instrument (ATLAS).

PubMed

Jalil, Rozh; Soukup, Tayana; Akhter, Waseem; Sevdalis, Nick; Green, James S A

2018-03-03

High-quality leadership and chairing skills are vital for good performance in multidisciplinary tumor boards (MTBs), but no instruments currently exist for assessing and improving these skills. To construct and validate a robust instrument for assessment of MTB leading and chairing skills. We developed an observational MTB leadership assessment instrument (ATLAS). ATLAS includes 12 domains that assess the leadership and chairing skills of the MTB chairperson. ATLAS has gone through a rigorous process of refinement and content validation prior to use to assess the MTB lead by two urological surgeons (blinded to each other) in 7 real-live (n = 286 cases) and 10 video-recorded (n = 131 cases) MTBs. ATLAS domains were analyzed via descriptive statistics. Instrument content was evaluated for validity using the content validation index (CVI). Intraclass correlation coefficients (ICCs) were used to assess inter-observer reliability. Instrument refining resulted in ATLAS including the following 12 domains: time management, communication, encouraging contribution, ability to summarize, ensuring all patients have treatment plan, case prioritization, keeping meeting focused, facilitate discussion, conflict management, leadership, creating good working atmosphere, and recruitment for clinical trials. CVI was acceptable and inter-rater agreement adequate to high for all domains. Agreement was somewhat higher in real-time MTBs compared to video ratings. Concurrent validation evidence was derived via positive and significant correlations between ATLAS and an established validated brief MTB leadership assessment scale. ATLAS is an observational assessment instrument that can be reliably used for assessing leadership and chairing skills in cancer MTBs (both live and video-recorded). The ability to assess and feedback on team leader performance provides the ground for promotion of good practice and continuing professional development of tumor board leaders.

Advances in participatory occupational health aimed at good practices in small enterprises and the informal sector.

PubMed

Kogi, Kazutaka

2006-01-01

Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.

The health belief model and determinants of oral hygiene practices and beliefs in preteen children: a pilot study.

PubMed

Walker, Kimberly; Jackson, Richard

2015-01-01

There is limited understanding of children's behavioral decisions for practicing good oral hygiene. The purpose of this study was to identify factors that may motivate children to practice good oral hygiene. Guided by the Health Belief Model (HBM), eight focus groups of 42 American children (second through fifth graders) were interviewed concerning their histories with caries, perceived confidence in brushing, self-perceived susceptibility and vulnerability for caries and/or poor oral health, and perceived benefits and barriers to practicing oral hygiene. Most children equated good oral health as being central to their overall health; however, some viewed poor oral health as occurring only in the elderly while others believed poor oral health could begin at any age. Children cited esthetic appearance of teeth and the desire to please others by brushing without reminders as motivators of good oral hygiene. The greatest barriers to performing oral hygiene were a perceived lack of time and limited access to toothbrushes and dentifrice when away. To motivate children in this age range, emphasis should be placed on the positive aspects of maintaining good oral hygiene for its contribution to appearance and its implication for an overall healthy body and self-image.

Practical ways to facilitate ergonomics improvements in occupational health practice.

PubMed

Kogi, Kazutaka

2012-12-01

Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.

The ethical dimensions of wildlife disease management in an evolutionary context

PubMed Central

Crozier, GKD; Schulte-Hostedde, Albrecht I

2014-01-01

Best practices in wildlife disease management require robust evolutionary ecological research (EER). This means not only basing management decisions on evolutionarily sound reasoning, but also conducting management in a way that actively contributes to the on-going development of that research. Because good management requires good science, and good science is ‘good’ science (i.e., effective science is often science conducted ethically), good management therefore also requires practices that accord with sound ethical reasoning. To that end, we propose a two-part framework to assist decision makers to identify ethical pitfalls of wildlife disease management. The first part consists of six values – freedom, fairness, well-being, replacement, reduction, and refinement; these values, developed for the ethical evaluation of EER practices, are also well suited for evaluating the ethics of wildlife disease management. The second part consists of a decision tree to help identify the ethically salient dimensions of wildlife disease management and to guide managers toward ethically responsible practices in complex situations. While ethical reasoning cannot be used to deduce from first principles what practices should be undertaken in every given set of circumstances, it can establish parameters that bound what sorts of practices will be acceptable or unacceptable in certain types of scenarios. PMID:25469160

Assessment of knowledge and practice of menstrual hygiene among high school girls in Western Ethiopia.

PubMed

Upashe, Shivaleela P; Tekelab, Tesfalidet; Mekonnen, Jalane

2015-10-14

The issue of menstrual hygiene is inadequately acknowledged and has not received proper attention. Use of sanitary pads and washing the genital area are essential practices to keep the menstrual hygiene. Unhygienic menstrual practices can affect the health of the girls and there is an increased vulnerability to reproductive tract infections and pelvic inflammatory diseases and other complications. Therefore, the objective of this study was to assess the knowledge and practice of menstrual hygiene among high school girls at Nekemte town, Oromia region, Western Ethiopia. A school based cross-sectional study design was employed in Nekemte Town, Western Ethiopia. A multi stage sampling technique was used to select 828 female high school students. Data collection was carried out from May 04 to May 30, 2014 using a pre- tested structured questionnaire. The data were entered into a computer using Epi-info version 3.5.1 and then exported to SPSS for Windows version 20.0 for analysis. Bivariate and multivariate logistic regression analysis was done at 95 % confidence interval. In this study, 504 (60.9 %) and 330 (39.9 %) respondents had good knowledge and practice of menstrual hygiene respectively. The findings of the study showed a significant positive association between good knowledge of menstruation and educational status of mothers (AOR = 1.51, 95 % CI = 1.02 - 2.22), having radio/TV (AOR = 2.42, 95 % CI: 1.64 - 3.56). Educational status of the mother (AOR = 2.03, 95 % CI = 1.38 - 2.97) and earning permanent pocket money from parents (AOR = 2.73, 95 % CI = 1.76 - 4.26) revealed significant positive association with good practice of menstrual hygiene. The findings showed that the knowledge and practice of menstrual hygiene is low. Awareness regarding the need for information about good menstrual practices is very important. So, health education program should be setup to create awareness and practice of good menstrual hygiene.

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