The Income Generation Handbook: A Practical Guide for Educational Institutions.

ERIC Educational Resources Information Center

Warner, David; Leonard, Charles

This book sets out the British policy context and theoretical framework for income generation by institutions of higher education and provides practical guidance in this area. Income generation is defined as all income generated over and above the core funding provided by an institution's primary funding body. Chapter 1 offers an overview of…

Dyslexia in the Early Years: A Handbook for Practice

ERIC Educational Resources Information Center

Reid, Gavin

2017-01-01

Research has shown that early identification and intervention is crucial and can in fact minimise, and may even prevent, the challenges of dyslexia from becoming too detrimental at later stages of education. This book offers both research insights and practical guidance for teachers working in Early Years settings on how to create resource…

Spirituality in nursing practice.

PubMed

Rogers, Melanie; Wattis, John

2015-05-27

Spirituality is an important aspect of holistic care that is frequently overlooked. This is because of difficulties in conceptualising spirituality and confusion about how it should be integrated into nursing care. This article explores what is meant by spirituality and spiritually competent practice. It examines attitudes to spirituality, describes factors that might affect the integration of spirituality into nursing care and offers practical guidance to equip nurses to incorporate spirituality into their practice.

Creating Learning Communities: A Practical Guide to Winning Support, Organizing for Change, and Implementing Programs. Jossey-Bass Higher and Adult Education Series.

ERIC Educational Resources Information Center

Shapiro, Nancy S.; Levine, Jodi H.

This book offers guidance for the development of learning communities at the college level. The book analyzes examples of learning communities at a wide variety of institutions, including research universities, commuter campuses, residential campuses, and four- and two-year institutions. Chapter 1 offers definitions and characteristics of learning…

Levels of Interventions for MFTs Working with Family Businesses

ERIC Educational Resources Information Center

Distelberg, Brian; Castanos, Carolina

2012-01-01

Family businesses (FBs) are a significant population in the world and therefore part of most practicing marriage and family therapists (MFTs) clientele; however, little is mentioned about FBs in the training of MFTs. This article offers some guidance to practicing MFTs who service this population, as well as MFTs who wish to expand their practice…

LIFE CYCLE DESIGN FRAMEWORK AND DEMONSTRATION PROJECTS - PROFILES OF AT&T AND ALLIED SIGNAL

EPA Science Inventory

This document offers guidance and practical experience for integrating environmental considerations into product system development. Life cycle design seeks to minimize the environmental burden associated with a product's life cycle from raw materials acquisition through manufact...

Geotagging Photographs in Student Fieldwork

ERIC Educational Resources Information Center

Welsh, Katharine E.; France, Derek; Whalley, W. Brian; Park, Julian R.

2012-01-01

This resource paper provides guidance for staff and students on the potential educational benefits, limitations and applications of geotagging photographs. It also offers practical advice for geotagging photographs in a range of fieldwork settings and reviews three free smartphone applications (apps) for geotagging photographs (Flickr, Evernote…

Live kidney donations and the ethic of care.

PubMed

Kane, Francis; Clement, Grace; Kane, Mary

2008-09-01

In this paper, we seek to re-conceptualize the ethical framework through which ethicists and medical professionals view the practice of live kidney donations. The ethics of organ donation has been understood primarily within the framework of individual rights and impartiality, but we show that the ethic of care captures the moral situation of live kidney donations in a more coherent and comprehensive way, and offers guidance for practitioners that is more attentive to the actual moral transactions among donors and recipients. A final section offers guidelines for the practice of live kidney transplants that emerge from an ethic of care.

The Role of Coaching in Leadership Development.

PubMed

Yarborough, J Preston

2018-06-01

Leadership coaching can be productive in maximizing a leader's development. But to make leadership coaching work effectively for students, as opposed to executives, this chapter offers guidance on key concepts and practices from the Center for Creative Leadership's Coaching Framework. © 2018 Wiley Periodicals, Inc.

Beyond Individual Effectiveness: Conceptualizing Organizational Leadership for Equity

ERIC Educational Resources Information Center

Ishimaru, Ann M.; Galloway, Mollie K.

2014-01-01

Despite increasing policy focus on individual leadership effectiveness, the literature offers limited guidance regarding how organizational leadership might address persistent opportunity and outcome disparities by student race, class, ethnicity, home language, and/or ability. We propose a conceptual framework of equitable leadership practice,…

School Operations and Maintenance: Best Practices For Controlling Energy Costs. A Guidebook for K-12 School System Business Officers and Facilities Managers

ERIC Educational Resources Information Center

US Department of Energy, 2004

2004-01-01

Operations and maintenance (O&M) offers not only strategies for maintaining facilities, but also opportunities for reducing energy costs and increasing energy efficiency at existing schools, regardless of age. This Guidebook provides detailed and practical guidance on how K-12 school districts can plan and implement enhancements to their current…

Risk management in clinical practice. Part 10. Periodontology.

PubMed

Baker, P; Needleman, I

2010-12-11

A sizeable proportion of patients in clinical practice will have some form of periodontal disease and most of these patients can be well managed in primary care. Unfortunately, dento-legal claims regarding inappropriate periodontal care are increasing rapidly and are now one of the most common reasons for litigation in dentistry. In this paper we will look at aspects of contemporary management of periodontal disease in clinical practice and offer guidance for examination, management and referral.

Guidance for Researchers Developing and Conducting Clinical Trials in Practice-based Research Networks (PBRNs)

PubMed Central

Dolor, Rowena J.; Schmit, Kristine M.; Graham, Deborah G.; Fox, Chester H.; Baldwin, Laura Mae

2015-01-01

Background There is increased interest nationally in multicenter clinical trials to answer questions about clinical effectiveness, comparative effectiveness, and safety in real-world community settings. Primary care practice-based research networks (PBRNs), comprising community- and/or academically affiliated practices committed to improving medical care for a range of health problems, offer ideal settings for these trials, especially pragmatic clinical trials. However, many researchers are not familiar with working with PBRNs. Methods Experts in practice-based research identified solutions to challenges that researchers and PBRN personnel experience when collaborating on clinical trials in PBRNs. These were organized as frequently asked questions in a draft document presented at a 2013 Agency for Health care Research and Quality PBRN conference workshop, revised based on participant feedback, then shared with additional experts from the DARTNet Institute, Clinical Translational Science Award PBRN, and North American Primary Care Research Group PBRN workgroups for further input and modification. Results The “Toolkit for Developing and Conducting Multi-site Clinical Trials in Practice-Based Research Networks” offers guidance in the areas of recruiting and engaging practices, budgeting, project management, and communication, as well as templates and examples of tools important in developing and conducting clinical trials. Conclusion Ensuring the successful development and conduct of clinical trials in PBRNs requires a highly collaborative approach between academic research and PBRN teams. PMID:25381071

Sexual Harassment Victims: Psycholegal and Family Therapy Considerations.

ERIC Educational Resources Information Center

Woody, Robert Henley; Perry, Nancy Walker

1993-01-01

Examines legal proscriptions and practical definitions of sexual harassment, describes psychological effects of sexual harassment (Sexual Harassment Trauma Syndrome) for victim-client and impact on family system, and offers guidance for family therapy. Focuses on vulnerability of victim-client, reconstruction of self-concept as primary goal of…

Build a Creative Leadership Team: Take a Unified Approach to Fostering Arts Education in Your School

ERIC Educational Resources Information Center

Principal, 2012

2012-01-01

Becoming a champion of arts education means establishing a culture that embraces a team approach toward integrating the arts. This article offers some practical guidance for developing a creative leadership team--and cultivating creativity in the whole school.

75 FR 22681 - Supplemental Guidance on Overdraft Protection Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-29

... recommended as a Best Practice that a savings association train customer service or consumer complaint... association should present the program as a customer service that may cover inadvertent consumer overdrafts.... alternatives. Provide information about alternatives when they are offered--Part III.A.2. Train staff to...

Active for Life: Developmentally Appropriate Movement Programs for Young Children.

ERIC Educational Resources Information Center

Sanders, Stephen W.

This book provides guidance on what high-quality movement programs for young children should include, offering a curricular foundation, strategies for teaching, and assessment ideas. It defines and illustrates specific interrelated components of developmentally appropriate practice in providing movement education for young children. There are…

An Introductory Guide to Entrepreneurship for American Indians.

ERIC Educational Resources Information Center

Jones, Enid B.; And Others

Prepared to assist American Indians in initiating entrepreneurial activities, this booklet offers practical guidance on starting and operating a business. Section I defines the term "entrepreneurship," and provides a self-evaluation checklist focusing on the qualities needed by entrepreneurs. Section II briefly discusses four forms of ownership…

In Search of Leading Indicators in Education

ERIC Educational Resources Information Center

Supovitz, Jonathan; Foley, Ellen; Mishook, Jacob

2012-01-01

Data have long been considered a key factor in organizational decision-making (Simon, 1955; Lindblom & Cohen, 1979). Data offer perspective, guidance, and insights that inform policy and practice (Newell & Simon, 1972; Kennedy, 1984). Recently, education policymakers have invested in the use of data for organizational improvement in states…

Educational Resource Management: An International Perspective

ERIC Educational Resources Information Center

Glover, Derek; Levacic, Rosalind

2007-01-01

This book offers practical guidance on management of financial and real resources in schools and college, and critically evaluates current tensions involved in the area of educational resource management. It is essential reading for educational leaders who wish to improve the effectiveness, efficiency and equity of their resource utilisation…

Teaching and Learning Resilience: Building Adaptive Capacity for Rural Practice. A Report and Subsequent Analysis of a Workshop Conducted at the Rural Medical Educators Conference, Savannah, Georgia, May 18, 2010

ERIC Educational Resources Information Center

Longenecker, Randall; Zink, Therese; Florence, Joseph

2012-01-01

Purpose: Resilience, the capacity to endure and overcome hardship, has been suggested as a basic competency for rural medical practice. Unfortunately for physician educators, the medical education literature offers only limited guidance for nurturing this adaptive capacity. We describe the process and subsequent analysis of a daylong curriculum…

Levels of interventions for MFTs working with family businesses.

PubMed

Distelberg, Brian; Castanos, Carolina

2012-06-01

Family businesses (FBs) are a significant population in the world and therefore part of most practicing marriage and family therapists (MFTs) clientele; however, little is mentioned about FBs in the training of MFTs. This article offers some guidance to practicing MFTs who service this population, as well as MFTs who wish to expand their practice into a focused consultation practices with FB systems. This article uses Doherty's Levels of Family Involvement Model as a road map for MFTs to organize the vast amount of literature on FB systems as well as the many ways in which MFTs might serve FBs. We also offer suggestions for the necessary skills, experiences, and levels of engagement required at each level of intervention provided by MFTs. © 2012 American Association for Marriage and Family Therapy.

Safety in the veterinary medical workplace environment. Common issues and concerns.

PubMed

Brody, M D

1993-09-01

This article addresses some of the major areas of concern related to safety in the veterinary workplace. Some practical guidance is offered for setting up programs in areas such as medical waste, hazard communication, general occupational safety and health requirements, shipments of etiologic agents, and pesticides.

Working through PowerPoint: A Global Prism for Local Reflections

ERIC Educational Resources Information Center

Connor, Michael; Wong, Irene F. H.

2004-01-01

Student presentations have assumed such prominence at the Nanyang Business School (NBS), Singapore, that business communication academics have begun conducting workshops on presentations for other faculty members. In addition to guidance on assessing student presentations, the authors offer theoretical and practical perspectives on PowerPoint,…

Internationalizing the Undergraduate Curriculum: A Handbook for Campus Leaders.

ERIC Educational Resources Information Center

Pickert, Sarah; Turlington, Barbara

This handbook offers practical guidance from implemented programs for making the undergraduate curriculum more international in outlook and content. The handbook is divided into five chapters. In the first chapter, presidents of four colleges and universities describe how they encourage curricular change to internationalize their institutions. The…

Ethical Decision Making: What Is Currently the Case?

ERIC Educational Resources Information Center

Welfel, Elizabeth Reynolds; Lipsitz, Neal E.

This paper reviews the current empirical literature on counselor ethics, suggesting that it offers little guidance in understanding why unethical behavior occurs or how to remedy such behavior. The research literature is classified according to four basic areas of concern: (1) documenting the incidence of unethical practice; (2) identifying the…

Leading through Collaboration: Guiding Groups to Productive Solutions

ERIC Educational Resources Information Center

Glaser, John P.

2004-01-01

Any group has the potential for mistrust, suspicion, and rancor, and so effective leadership involves developing attitudes that guide groups to recognize and work through conflict in order to maximize the potential for collaboration. This book offers practical guidance to leaders encountering conflict in their organizations. Based on years of…

Adult Students: Recruitment and Retention. Practice Application Brief No. 18.

ERIC Educational Resources Information Center

Wonacott, Michael E.

How to attract and retain adult students remains an enduring question for adult education providers. Recent research sheds light on adult learners' unique learning goals, needs, and aspirations and offers guidance on recruiting and retaining adult learners. Adult students' participation and persistence in educational activities is a complex…

School Building in Early Development. Part 3. Project Implementation.

ERIC Educational Resources Information Center

Giertz, L. M.; Dijkgraaf, C.

1977-01-01

The first two publications in this series dealt generally with school building problems in developing nations. This third part offers more direct guidance. Described in some detail are organizational fundamentals and tools that depend on universal similarities in building practice and have, therefore, been recommended for use internationally. A…

The "Good Enough" Parent: Implications for Child Protection

ERIC Educational Resources Information Center

Choate, Peter W.; Engstrom, Sandra

2014-01-01

Child protection workers must determine under what conditions a child should be sustained within the family system. A standard that is often referred to is "good enough" parenting or minimal parenting competence. Research and clinical literature fails to offer workers guidance on the practical application of this terminology. Such…

Women and Technical Professions. Leonardo da Vinci Series: Good Practices.

ERIC Educational Resources Information Center

Commission of the European Communities, Brussels (Belgium). Directorate-General for Education and Culture.

This document profiles programs for women in technical professions that are offered through the European Commission's Leonardo da Vinci program. The following programs are profiled: (1) Artemis and Diana (vocational guidance programs to help direct girls toward technology-related careers); (2) CEEWIT (an Internet-based information and…

Developing leadership: management skills for small group practices.

PubMed

Brechbill, D D

1998-01-01

The role of group administrators is changing as quickly as is the group practice environment. The results of a survey of physicians and administrators in physician-owned group practices with fewer than 15 physicians offers some guidance. Physicians and administrators, the results show, have similar expectations for administrators. They also agree that physician-administrator teamwork has become more professional. The results also suggest that administrators need the tools to be proactive planners for their organizations, rather than passively responding to change.

How To Talk to Your Kids about Really Important Things: For Children Four to Twelve. Specific Questions and Answers and Useful Things To Say.

ERIC Educational Resources Information Center

Schaefer, Charles E.; DiGeronimo, Theresa Foy

Intended to help parents find the words they need to talk to their children and answer their children's practical questions, this book offers practical guidance on a wide range of life's experiences, from family changes such as divorce and remarriage, to controversial subjects such as child abuse and AIDS. The major focus is on children ages 4 to…

What Matters for Elementary Literacy Coaching? Guiding Principles for Instructional Improvement and Student Achievement

ERIC Educational Resources Information Center

L'Allier, Susan; Elish-Piper, Laurie; Bean, Rita M.

2010-01-01

Literacy coaches provide job-embedded professional development for teachers, and the number of literacy coaches in elementary schools is increasing. Although literacy coaching offers promise in terms of improving teacher practice and student achievement, guidance is needed regarding the qualifications, activities, and roles of literacy coaches.…

ADHD in the Schools: Assessment and Intervention Strategies. Second Edition

ERIC Educational Resources Information Center

DuPaul, George J.; Stoner, Gary

2004-01-01

This popular reference and text provides essential guidance for school-based professionals meeting the challenges of ADHD at any grade level. Comprehensive and practical, the book includes several reproducible assessment tools and handouts. A team-based approach to intervention is emphasized in chapters offering research-based guidelines for: (1)…

Examining How Activity Shapes Students' Interactions While Creating Representations in Early Elementary Science

ERIC Educational Resources Information Center

Danish, Joshua Adam; Saleh, Asmalina

2014-01-01

It is common practice in elementary science classrooms to have students create representations, such as drawings, as a way of exploring new content. While numerous studies suggest the benefits of representation in science, the majority focus on specific, canonical representations, such as graphs. Few offer insight or guidance regarding how…

Teaching Students with Special Needs in the 21st-Century Classroom. A Scarecrow Education Book.

ERIC Educational Resources Information Center

Mayberry, Sally Cox; Lazarus, Brenda Belson

This book offers educators both background information and practical guidance for implementing the inclusion of students with special needs in their classrooms. Part 1 provides background information with chapters on what inclusion is, an historical perspective and the laws, the rationale for inclusion, definitions of specific disabilities, and…

Getting Political: An Action Guide for Librarians and Library Supporters.

ERIC Educational Resources Information Center

Turner, Anne M.

In order to meet today's financial challenges, libraries must be ready, willing, and able to enter the arena of politics and compete for scarce public funding. This book offers librarians, library workers, trustees, and friends' organizations practical advice, case studies, and step-by-step guidance for evaluating the existing local political…

Building Culturally & Linguistically Competent Services to Support Young Children, Their Families, and School Readiness

ERIC Educational Resources Information Center

Hepburn, Kathy Seitzinger

2004-01-01

The purpose of this tool kit is to provide guidance, tools, and resources that will assist communities in building culturally and linguistically competent services, supports, programs, and practices related to young children, their families. By offering services in culturally and linguistically meaningful ways, communities can engage all families…

The Connection Between Forms of Guidance for Inquiry-Based Learning and the Communicative Approaches Applied—a Case Study in the Context of Pre-service Teachers

NASA Astrophysics Data System (ADS)

Lehtinen, Antti; Lehesvuori, Sami; Viiri, Jouni

2017-09-01

Recent research has argued that inquiry-based science learning should be guided by providing the learners with support. The research on guidance for inquiry-based learning has concentrated on how providing guidance affects learning through inquiry. How guidance for inquiry-based learning could promote learning about inquiry (e.g. epistemic practices) is in need of exploration. A dialogic approach to classroom communication and pedagogical link-making offers possibilities for learners to acquire these practices. The focus of this paper is to analyse the role of different forms of guidance for inquiry-based learning on building the communicative approach applied in classrooms. The data for the study comes from an inquiry-based physics lesson implemented by a group of five pre-service primary science teachers to a class of sixth graders. The lesson was video recorded and the discussions were transcribed. The data was analysed by applying two existing frameworks—one for the forms of guidance provided and another for the communicative approaches applied. The findings illustrate that providing non-specific forms of guidance, such as prompts, caused the communicative approach to be dialogic. On the other hand, providing the learners with specific forms of guidance, such as explanations, shifted the communication to be more authoritative. These results imply that different forms of guidance provided by pre-service teachers can affect the communicative approach applied in inquiry-based science lessons, which affects the possibilities learners are given to connect their existing ideas to the scientific view. Future research should focus on validating these results by also analysing inservice teachers' lessons.

The translation research in a dental setting (TRiaDS) programme protocol

PubMed Central

2010-01-01

Background It is well documented that the translation of knowledge into clinical practice is a slow and haphazard process. This is no less true for dental healthcare than other types of healthcare. One common policy strategy to help promote knowledge translation is the production of clinical guidance, but it has been demonstrated that the simple publication of guidance is unlikely to optimise practice. Additional knowledge translation interventions have been shown to be effective, but effectiveness varies and much of this variation is unexplained. The need for researchers to move beyond single studies to develop a generalisable, theory based, knowledge translation framework has been identified. For dentistry in Scotland, the production of clinical guidance is the responsibility of the Scottish Dental Clinical Effectiveness Programme (SDCEP). TRiaDS (Translation Research in a Dental Setting) is a multidisciplinary research collaboration, embedded within the SDCEP guidance development process, which aims to establish a practical evaluative framework for the translation of guidance and to conduct and evaluate a programme of integrated, multi-disciplinary research to enhance the science of knowledge translation. Methods Set in General Dental Practice the TRiaDS programmatic evaluation employs a standardised process using optimal methods and theory. For each SDCEP guidance document a diagnostic analysis is undertaken alongside the guidance development process. Information is gathered about current dental care activities. Key recommendations and their required behaviours are identified and prioritised. Stakeholder questionnaires and interviews are used to identify and elicit salient beliefs regarding potential barriers and enablers towards the key recommendations and behaviours. Where possible routinely collected data are used to measure compliance with the guidance and to inform decisions about whether a knowledge translation intervention is required. Interventions are theory based and informed by evidence gathered during the diagnostic phase and by prior published evidence. They are evaluated using a range of experimental and quasi-experimental study designs, and data collection continues beyond the end of the intervention to investigate the sustainability of an intervention effect. Discussion The TRiaDS programmatic approach is a significant step forward towards the development of a practical, generalisable framework for knowledge translation research. The multidisciplinary composition of the TRiaDS team enables consideration of the individual, organisational and system determinants of professional behaviour change. In addition the embedding of TRiaDS within a national programme of guidance development offers a unique opportunity to inform and influence the guidance development process, and enables TRiaDS to inform dental services practitioners, policy makers and patients on how best to translate national recommendations into routine clinical activities. PMID:20646275

Surrogate decision making: reconciling ethical theory and clinical practice.

PubMed

Berger, Jeffrey T; DeRenzo, Evan G; Schwartz, Jack

2008-07-01

The care of adult patients without decision-making abilities is a routine part of medical practice. Decisions for these patients are typically made by surrogates according to a process governed by a hierarchy of 3 distinct decision-making standards: patients' known wishes, substituted judgments, and best interests. Although this framework offers some guidance, it does not readily incorporate many important considerations of patients and families and does not account for the ways in which many patients and surrogates prefer to make decisions. In this article, the authors review the research on surrogate decision making, compare it with normative standards, and offer ways in which the 2 can be reconciled for the patient's benefit.

What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review.

PubMed

Foy, R; Eccles, M P; Jamtvedt, G; Young, J; Grimshaw, J M; Baker, R

2005-07-13

Improving the quality of health care requires a range of evidence-based activities. Audit and feedback is commonly used as a quality improvement tool in the UK National Health Service [NHS]. We set out to assess whether current guidance and systematic review evidence can sufficiently inform practical decisions about how to use audit and feedback to improve quality of care. We selected an important chronic disease encountered in primary care: diabetes mellitus. We identified recommendations from National Institute for Clinical Excellence (NICE) guidance on conducting audit and generated questions which would be relevant to any attempt to operationalise audit and feedback in a healthcare service setting. We explored the extent to which a systematic review of audit and feedback could provide practical guidance about whether audit and feedback should be used to improve quality of diabetes care and, if so, how audit and feedback could be optimised. National guidance suggests the importance of securing the right organisational conditions and processes. Review evidence suggests that audit and feedback can be effective in changing healthcare professional practice. However, the available evidence says relatively little about the detail of how to use audit and feedback most efficiently. Audit and feedback will continue to be an unreliable approach to quality improvement until we learn how and when it works best. Conceptualising audit and feedback within a theoretical framework offers a way forward.

What about the Children? Dealing with Death. Project Enlightenment.

ERIC Educational Resources Information Center

Helms, Rose; Blazer, Doris

This pamphlet offers practical guidance to parents of young children who have experienced the death of a close relative or other loved one. It is intended to explain the child's emotional needs and assist the parent in planning for the child's involvement in the various stages of the death-funeral-mourning process. The text is presented as answers…

Recent technological advances in computed tomography and the clinical impact therein.

PubMed

Runge, Val M; Marquez, Herman; Andreisek, Gustav; Valavanis, Anton; Alkadhi, Hatem

2015-02-01

Current technological advances in CT, specifically those with a major impact on clinical imaging, are discussed. The intent was to provide for both medical physicists and practicing radiologists a summary of the clinical impact of each advance, offering guidance in terms of utility and day-to-day clinical implementation, with specific attention to radiation dose reduction.

What Do Professional Conference Planners Consider the Most Important Elements for Continuing Professional Education Conference Planning?

ERIC Educational Resources Information Center

Phillips, Virginia B.

2011-01-01

Many adults attend and rely on continuing professional education (CPE) throughout their careers, and CPE is big business for associations. One way associations deliver CPE is through educational conferences. While adult education theories and frameworks offer developmental and operational guidance and advice, there is little practice data to…

Helping Foster Children in School: A Guide for Foster Parents, Social Workers and Teachers

ERIC Educational Resources Information Center

DeGarmo, John

2015-01-01

"Helping Foster Children in School" explores the challenges that foster children face in schools and offers positive and practical guidance tailored to help the parents, teachers and social workers supporting them. Children in care often perform poorly at school both in terms of their behavior and their academic performance, with many…

Internationalizing Teacher Education in the United States: A Teacher Educator's Journey from Conceptualization to Implementation

ERIC Educational Resources Information Center

DeCuir, Erica

2017-01-01

This article offers guidance to teacher educators who seek to internationalize courses or curriculum in higher education. Through reflective practice (Bolton, 2010), I describe my process for internationalizing an undergraduate course for pre-service teachers enrolled in an early childhood education program. The research question that guided this…

U.S. Department of Education Indirect Cost Determination Guidance for State and Local Government Agencies.

ERIC Educational Resources Information Center

Department of Education, Washington, DC. Office of the Chief Financial and Chief Information Officer.

This guide provides new direction in financial management and oversight practices for accounting and charging administrative costs as they relate to programs administered by the U.S. Department of Education. The document is divided into six sections. Section 1, which presents general information, offers details on definitions; indirect-cost rates;…

Workplace Learning & Leadership: A Handbook for Library and Nonprofit Trainers

ERIC Educational Resources Information Center

Reed, Lori; Signorelli, Paul

2011-01-01

The best kind of learning is that which never ends--and a culture of training means that staff will be more flexible and responsive to new ideas and strategies, imperative in today's libraries. In this practical resource, leading workplace trainers Reed and Signorelli offer guidance on improving the effectiveness of training programs. Their book…

Listening to the Community: Guidance from Native Community Members for Emerging Culturally Responsive Educators

ERIC Educational Resources Information Center

Rogers, Christine A.; Jaime, Angela M.

2010-01-01

Critical race theory (CRT) emphasizes the importance of listening to the counter-narratives of people from marginalized groups. However, the applicability of CRT in practical settings often remains unclear for educators and scholars. This project offers not only a place for Native community members to share their experiences and ideas, it also…

Getting started on your research: practical advice for medical educators.

PubMed

Markert, Ronald J

2010-10-01

Guidance and mentorship benefit faculty who having little or no background conducting research in medical education. From his experience the author suggests three characteristics that distinguish medical educators who are especially productive in their scholarly activities: intrinsic rather than extrinsic motivation, collaboration with colleagues, and the personal qualities of patience and organization. He then expands on these characteristics by offering practical advice in the form of eight tips for faculty seeking to acquire or improve their medical education research skills.

"Just Give Me a Number!" Practical Values for the Social Discount Rate

ERIC Educational Resources Information Center

Moore, Mark A.; Boardman, Anthony E.; Vining, Aidan R.; Weimer, David L.; Greenberg, David H.

2004-01-01

A major reason the quality of cost-benefit analysis (CBA) varies widely is inconsistent use of the social discount rate (SDR). This article offers guidance about the choice of the SDR. Namely, we recommend the following procedures: If the project is intragenerational (does not have effects beyond 50 years) and there is no crowding out of private…

Home Alone and Doing Fine: A Guide for Young People in Self-Care.

ERIC Educational Resources Information Center

Lobb, Nancy

Many kids with working parents must take care of themselves before and after school. This activity text offers such children practical instruction and reassuring guidance that can help them be prepared, safe, and confident when they stay alone. The text includes a pullout section for parents that helps them determine if their child is mature…

Holy Lemons! Learning from Children's Uses of the Internet in Out-of-School contexts

ERIC Educational Resources Information Center

Burnett, Cathy; Wilkinson, Jeff

2005-01-01

The Internet offers new possibilities for engaging with information and is associated with a wide range of literacy practices. National guidance in the United Kingdom on "reading the web", however, has focused largely on the different skills children may need to learn in school to navigate web-based texts successfully. Here it is argued…

Questions Parents Ask about Schools = Preguntas que hacen los padres sobre las escuelas. Revised.

ERIC Educational Resources Information Center

Department of Education, Washington, DC. Office of Intergovernmental and Interagency Affairs.

Noting that parents play an important role in the school success of their elementary- and middle-school-aged children, this booklet offers research-based tips to provide both practical guidance and information about a range of education-related topics. Presented in a question-answer format in both English and Spanish versions, the booklet provides…

Different and Wonderful: Raising Black Children in a Race-Conscious Society.

ERIC Educational Resources Information Center

Hopson, Darlene Powell; Hopson, Derek S.

This book offers practical guidance to black parents on how to raise children with positive racial identities and self-identities. Part 1 explains the development of racial identity in the various phases of childhood as it is fostered in the family. Part 2 discusses how to help children navigate the larger world during the school years and beyond.…

What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review

PubMed Central

Foy, R; Eccles, MP; Jamtvedt, G; Young, J; Grimshaw, JM; Baker, R

2005-01-01

Background Improving the quality of health care requires a range of evidence-based activities. Audit and feedback is commonly used as a quality improvement tool in the UK National Health Service [NHS]. We set out to assess whether current guidance and systematic review evidence can sufficiently inform practical decisions about how to use audit and feedback to improve quality of care. Methods We selected an important chronic disease encountered in primary care: diabetes mellitus. We identified recommendations from National Institute for Clinical Excellence (NICE) guidance on conducting audit and generated questions which would be relevant to any attempt to operationalise audit and feedback in a healthcare service setting. We explored the extent to which a systematic review of audit and feedback could provide practical guidance about whether audit and feedback should be used to improve quality of diabetes care and, if so, how audit and feedback could be optimised. Results National guidance suggests the importance of securing the right organisational conditions and processes. Review evidence suggests that audit and feedback can be effective in changing healthcare professional practice. However, the available evidence says relatively little about the detail of how to use audit and feedback most efficiently. Conclusion Audit and feedback will continue to be an unreliable approach to quality improvement until we learn how and when it works best. Conceptualising audit and feedback within a theoretical framework offers a way forward. PMID:16011811

Evaluation of all African clinical practice guidelines for hypertension: Quality and opportunities for improvement.

PubMed

Okwen, Patrick Mbah; Maweu, Irene; Grimmer, Karen; Margarita Dizon, Janine

2018-06-14

Good-quality clinical practice guidelines (CPGs) provide recommendations based on current best-evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension. Their quality was assessed by using Appraisal of Guidelines for Research & Evaluation (AGREE) II, scored by 2 independent reviewers. Differences in domain scores were compared between documents written prior to 2011 and 2011 onward. Findings were compared with earlier African CPG reviews. Guidelines and protocols were provided by 26 countries. Six used country-specific stand-alone hypertension guidelines, and 10 used protocols embedded in Standard Treatment Guidelines for multiple conditions. Six used guidelines developed by the World Health Organization, and 4 indicated ad hoc use of international guidance (US, Portugal, and Brazil). Only 1 guidance document met CPG construction criteria, and none scored well on all AGREE domain scores. The lowest-scoring domain was rigour of development. There was no significant quality difference between pre-2011 and post-2011 guidance documents, and there were variable AGREE II scores for the same CPGs when comparing the African reviews. The quality of hypertension guidance used by African nations could be improved. The need for so many guidance documents is questioned. Adopting a common evidence base from international good-quality CPGs and layering it with local contexts offer 1 way to efficiently improve African hypertension CPG quality and implementation. © 2018 John Wiley & Sons, Ltd.

Clinical guidance of community physiotherapists regarding people with MS: professional development and continuity of care.

PubMed

Normann, Britt; Sørgaard, Knut W; Salvesen, Rolf; Moe, Siri

2014-03-01

Clinical guidance to community physiotherapists (cPTs) is an integral part of physiotherapy service offered in hospital outpatient (OP) clinics for people with multiple sclerosis (PwMS). There is currently a lack of knowledge on the significance of such guidance. The aims of this study were 1) to identify the features that cPTs perceive to be significant in clinical guidance and 2) how this guidance may affect the cPTs' subsequent treatment of PwMS. A phenomenological-hermeneutical framework was selected, and qualitative research interviews were performed and complemented with non-participating observations of a strategic sample of nine cPTs who received clinical guidance for their patients. The interviews were recorded and transcribed, and content analysis was conducted by using systematic text condensation, using theories of practice knowledge as analytic perspectives. The results indicate that cPTs identify participation in authentic movement analysis of a familiar patient as significant for professional development. Vital features are evaluation of the interplay between body parts, exploration of improvement of movement embedded in the OP clinic physiotherapist's explanations, followed by discussion. These elements provide access to dynamic elements in practice knowledge that are available only through first-hand experience and promote clinical reasoning through enhanced reflection during action as well as following action. Such guidance suggests direction for subsequent treatment and may enhance the continuity of care, particularly if the cPTs are experienced. Mutual information flow implementing the cPTs' perspective is requested, as are the use of plain language and supervision of the cPTs handling skills. Professional guidance for cPTs in OP clinics for PwMS should be considered when programmes aiming to develop competency in neurological physiotherapy are designed and when continuity of care for PwMS is discussed. More research regarding potential long-term impact of professional guidance in these clinics is requested. Copyright © 2013 John Wiley & Sons, Ltd.

Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part III--Practitioners and Programs

ERIC Educational Resources Information Center

Poulin, David; Martinez, David; Aenchbacher, Amy; Aiello, Rocco; Doyle, Mike; Hilgenbrinck, Linda; Busse, Sean; Cappuccio, Jim

2013-01-01

In Part III of the feature, physical educators and adapted physical educators offer current best practices as models of implementation for readers. Contributions included are: (1) Answer to the Dear Colleague Letter from the Anchorage School District's Adapted Sport Program (David Poulin); (2) Georgia's Adapted Physical Educators Response to the…

The Dangers of Test Preparation: What Students Learn (And Don't Learn) about Reading Comprehension from Test-Centric Literacy Instruction

ERIC Educational Resources Information Center

Davis, Dennis S.; Vehabovic, Nermin

2018-01-01

The authors offer guidance on recognizing and resisting test-centric instruction in reading comprehension. They posit that five practices indicate a test-centric view of comprehension: when the tested content is privileged, when the test becomes the text, when annotation requirements replace strategic thinking, when test items frame how students…

Liability and Safety in Physical Education and Sport: A Practitioner's Guide to the Legal Aspects of Teaching and Coaching in Elementary and Secondary Schools.

ERIC Educational Resources Information Center

Hart, James E.; Ritson, Robert J.

This second edition contains updated information and new case studies, offering guidance for safer programs and management of risk while reinforcing sound educational practices. The book features overviews of legal concepts and presents examples of situations from the trenches. Case studies illustrate a variety of teacher, coach, and administrator…

Liability and Safety in Physical Education and Sport: A Practitioner's Guide to the Legal Aspects of Teaching and Coaching in Elementary and Secondary Schools.

ERIC Educational Resources Information Center

Hart, James E.; Ritson, Robert J.

Physical education and athletic staffs have numerous opportunities to become entangled in legal disputes. The information in this guide offers guidance for safer athletic programs and management of risk while reinforcing sound educational practice. The guide provides an overview of tort liability and negligence theory, followed by a discussion of…

How to Reach and Teach Children with ADD/ADHD: Practical Techniques, Strategies, and Interventions. Third Edition

ERIC Educational Resources Information Center

Rief, Sandra F.

2016-01-01

The third edition of "How to Reach and Teach Children and Teens with ADD/ADHD" has been completely revised to offer the most updated and comprehensive guidance to everyone engaged in the positive education of children and teens who have been diagnosed with ADHD or show signs and symptoms of the disorder. This valuable resource contains…

Establishing a Virtual Community of Practice in Simulation: The Value of Social Media.

PubMed

Thoma, Brent; Brazil, Victoria; Spurr, Jesse; Palaganas, Janice; Eppich, Walter; Grant, Vincent; Cheng, Adam

2018-04-01

Professional development opportunities are not readily accessible for most simulation educators, who may only connect with simulation experts at periodic and costly conferences. Virtual communities of practice consist of individuals with a shared passion who communicate via virtual media to advance their own learning and that of others. A nascent virtual community of practice is developing online for healthcare simulation on social media platforms. Simulation educators should consider engaging on these platforms for their own benefit and to help develop healthcare simulation educators around the world. Herein, we describe this developing virtual community of practice and offer guidance to assist educators to engage, learn, and contribute to the growth of the community.

A framework for developing rural academic general practices: a qualitative case study in rural Victoria.

PubMed

Brown, J B; Morrison, Tracy; Bryant, Melanie; Kassell, Lisa; Nestel, Debra

2015-01-01

There is increasing pressure for Australian rural general practices to engage in educational delivery as a means of addressing workforce issues and accommodating substantial increases in learners. For practices that have now developed a strong focus on education, there is the challenge to complement this by engaging in research activity. This study develops a rural academic general practice framework to assist rural practices in developing both comprehensive educational activity and a strong research focus thus moving towards functioning as mature academic units. A case study research design was used with the unit of analysis at the level of the rural general practice. Purposively sampled practices were recruited and individual interviews conducted with staff (supervisors, practice managers, nurses), learners (medical students, interns and registrars) and patients. Three practices hosted 'multi-level learners', two practices hosted one learner group and one had no learners. Forty-four individual interviews were conducted with staff, learners and patients. Audio recordings were transcribed for thematic analysis. After initial inductive coding, deductive analysis was undertaken with reference to recent literature and the expertise of the research team resulting in the rural academic general practice framework. Three key themes emerged with embedded subthemes. For the first theme, organisational considerations, subthemes were values/vision/culture, patient population and clinical services, staffing, physical infrastructure/equipment, funding streams and governance. For the second theme, educational considerations, subthemes were processes, clinical supervision, educational networks and learner presence. Third, for research considerations, there were the subthemes of attitude to research and research activity. The framework maps the development of a rural academic practice across these themes in four progressive stages: beginning, emerging, consolidating and established. The data enabled a framework to be constructed to map rural general practice activity with respect to activity characteristic of an academic general practice. The framework offers guidance to practices seeking to transition towards becoming a mature academic practice. The framework also offers guidance to educational institutions and funding bodies to support the development of academic activity in rural general practices. The strengths and limitations of the study design are outlined.

Effectiveness of different interventions in public nurseries based on food and nutrition education: promoting breast-feeding and healthy complementary feeding.

PubMed

Cândido, Naiara Abrantes; de Sousa, Taciana Maia; Dos Santos, Luana Caroline

2018-05-10

Food practices in the early years of life are important to form healthy eating habits; therefore, it is essential for the caregivers of infants to receive appropriate guidance. The present study aimed to investigate the effectiveness of different nutritional interventions on complementary feeding practices in municipal nurseries. Non-randomized controlled intervention study with education professionals and parents of infants (<2 years). Participants were divided into: control group (CG), standard food and nutrition education in writing; and intervention group (IG), the same information as the CG and face-to-face meetings (professionals, 8 h; parents, 5 h). Changes in professionals' knowledge on the subject and alterations in parents' beliefs, attitudes and intentions were assessed using questionnaires before and after the educational activities. Ten public nurseries in Nova Lima, Belo Horizonte, Minas Gerais, Brazil, 2015. Ninety professionals (fifty in CG; forty in IG) and 169 parents (ninety-seven in CG; seventy-two in IG). After the intervention, there was a significant increase in the mean number of correct responses given by professionals in the IG (12·2 v. 10·7; P=0·001). In addition, there were improvements among the parents of the IG in relation to beliefs (soups and broths do not nourish my child: P=0·012), attitudes (offer meat from the sixth month: P=0·032) and intentions (do not offer soups and broths: P=0·003; offer vegetables: P=0·018; offer meat: P<0·001). Face-to-face nutritional intervention had a significantly greater effect on the parameters evaluated, indicating the importance of adequate guidance in childcare services to support the introduction of complementary feeding.

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...

Identifying dentists' attitudes towards prevention guidance using Q-sort methodology.

PubMed

Witton, R V; Moles, D R

2015-06-01

To gain insight into the attitudes and motivating factors of dentists working in the English National Health Service (NHS) towards prevention guidance. Q-methodology: an established hybrid quantitative/qualitative technique used in the social sciences to categorise subjects based on their views by considering factors as part of their overall decision-making profile. General Dental Practices offering care under an NHS contract. NHS dentists (n = 26) placed 36 statements about prevention guidance derived from an earlier study into a distribution grid that ranked the statements from "most agree" to "most disagree". Principal components factor analysis was applied to determine the principal patterns in the rankings of statements. Analysis indicated a total of six distinct profiles within the responses, of which three profiles had at least six dentists loading onto them. The first profile was strongly characterised by dentists who appear motivated to provide prevention but financial and time constraints prevent them from doing so. The second was characterised by dentists using prevention guidance but restricting its use to only certain patients. The third was characterised by dentists who appeared "health-focused". They placed importance on working to prevention guidance, but were keen to have greater patient and professional support in achieving this. In this group of dentists Q-methodology identified three main profiles to the delivery of prevention guidance.

Neurologists and technology: The changing "Facebook" of practice.

PubMed

Potts, Daniel C; Hohler, Anna D

2013-04-01

Social and traditional media are revolutionizing health care. Medicine, once an art practiced behind closed doors, is now part of the public domain. This article will help neurologists navigate a complex maze of technology to optimize patient care without compromising privacy. We offer ideas for improving our digital "footprint." Guidance is given on maintaining professional demeanor in all private and public interactions to help us avoid personal or patient insult and injury. Acknowledging that neurology is becoming a specialty of increased personal and social education, we outline ways to proactively improve our patient care and education locally and globally.

Management of hyperthyroidism due to Graves' disease: frequently asked questions and answers (if any).

PubMed

Bartalena, L; Chiovato, L; Vitti, P

2016-10-01

Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Although progress has been made in our understanding of the pathogenesis of the disease, no treatment targeting pathogenic mechanisms of the disease is presently available. Therapies for Graves' hyperthyroidism are largely imperfect because they are bound to either a high rate of relapsing hyperthyroidism (antithyroid drugs) or lifelong hypothyroidism (radioiodine treatment or thyroidectomy). Aim of the present article is to offer a practical guidance to the reader by providing evidence-based answers to frequently asked questions in clinical practice.

Guidelines clarify managed care accounting procedures.

PubMed

Cheramy, S J; Garner, M

1989-08-01

Two new documents offer guidance for accounting issues involved in managed care programs. The American Institute of Certified Public Accountants' Statement of Position 89-5 and HFMA's Principles and Practices Board Statement No. 11 address risk contracting from the perspective of the managed care program and the healthcare provider, respectively. One key issue addressed in the documents is the timing of expense recognition of the costs of providing health services to members of managed care plans.

I Don't Feel Good: A Guide to Childhood Complaints and Diseases. Suggestions for Teachers, Parents, and Other Care Providers of Children to Age 10.

ERIC Educational Resources Information Center

Lammers, Jane W.

This handbook discusses the most common childhood conditions that teachers, parents, and caregivers see in children between the ages of 4 and 10; describes signs and symptoms of over 30 common childhood health problems; provides practical strategies for getting children back to the well state once they are ill; and offers guidance as to when…

Implementing AORN recommended practices for selection and use of packaging systems for sterilization.

PubMed

Morton, Paula J; Conner, Ramona

2014-04-01

The delivery of sterile products to the sterile field is essential to perioperative practice. The use of protective packaging for sterilized items is crucial to helping ensure that patients receive sterile items for surgical procedures. AORN's "Recommended practices for selection and use of packaging systems for sterilization" offers guidance to perioperative team members in evaluating, selecting, and using packaging systems that permit sterilization of the contents, prevent contamination of sterilized items until the package is opened for use, protect the items from damage during transport and storage, and permit aseptic delivery of the items to the sterile field. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

["Dual Guidance"? - parallel combination of ultrasound-guidance and nerve stimulation - Contra].

PubMed

Maecken, Tim

2015-07-01

Sonography is a highly user-dependent technology. It presupposes a considerable degree of sonoanatomic and sonographic knowledge and requires good practical skills of the examiner. Sonography allows the identification of the puncture target, observes the needle feed and assesses the spread pattern of the local anesthetic in real time. Peripheral electrical nerve stimulation (PNS) cannot offer these advantages to the same degree, but may allow nerve localization under difficult sonographic conditions. The combination of the two locating techniques is complex in its practical implementation. Partially, the use of one location technique is made even more difficult by the combination with the second. PNS in parallel to sonography serves primarily as a warning technology in the case of an invisible cannula tip. It should not be construed as a compensation technique for the lack of sonographic skills or knowledge. However, PNS may be helpful in the sense of a bridging technology as long as the user is aware of its limitations. © Georg Thieme Verlag Stuttgart · New York.

A practical field guide to conducting nursing research in low- and middle-income countries.

PubMed

LeBaron, Virginia T; Iribarren, Sarah J; Perri, Seneca; Beck, Susan L

2015-01-01

The purpose of this report is to offer practical guidance to nurse investigators interested in international research in low- and middle-income countries (LMICs). Lessons learned and strategies for planning and implementing an international research project are addressed. Four nurse researchers who conducted studies in diverse international settings (Argentina, India, South Africa, and Tanzania) describe their collective experiences regarding study planning and implementation; data collection using a variety of methods; and cultural, contextual and ethical considerations. Nurses who undertake international health research projects, particularly in LMICs, can face unique challenges and opportunities. Recommendations for success include advance planning, remaining flexible, having a backup plan, cultivating an attitude of curiosity and cultural humility, establishing collaborative and respectful partnerships, and budgeting adequate time. Nurse scientists often receive little training and support to conduct international research. Guidance to undertake research projects in LMICs can build capacity for nurses to make significant contributions to global health. Copyright © 2015 Elsevier Inc. All rights reserved.

The use of lithium for the treatment of bipolar disorder: Recommendations from clinical practice guidelines.

PubMed

Malhi, Gin S; Gessler, Danielle; Outhred, Tim

2017-08-01

Lithium is an effective mood stabilizer that is used principally for the management of bipolar disorder (BD). Its administration is complex and often requires sophisticated management and assiduous monitoring. When considering the use of lithium therapy for bipolar disorder, clinicians are advised to refer to recommendations outlined in clinical practice guidelines (CPGs); but because of varying emphases placed by different international CPGs, recommendations addressing the practical use of lithium lack consistency. In order to inform clinicians of optimal lithium therapy for bipolar disorder, we compared and synthesized recommendations for the treatment of bipolar disorder made by recognized CPGs internationally. We conducted a search of the literature and extracted guidance across multiple clinical issues, including clinical indications, disorder subtypes, additional uses, special populations, practical aspects, and side effects. Collectively, CPGs consider lithium most robustly as a first-line intervention for maintenance treatment of bipolar disorder and strongly for the treatment of mania, with relatively modest support for the management of acute bipolar depression. Additionally, there is consensus across the CPGs that lithium tangibly reduces the risk of suicide. Generally, CPGs provide guidance on the many facets of initiating and maintaining patients on lithium therapy, but individually the CPGs varied in terms of depth and practical guidance they provide across these areas. However, consensus was established across many key areas of practice such as the ideal lithium plasma concentration for maintenance and monitoring (0.6-0.8mmol/L), along with the need for regular monitoring of renal and endocrine function. However, with more complex aspects (e.g., atypical presentations) and in special populations (e.g., youth; pregnancy and post-partum; older adults), guidance varied considerably and clear consensus recommendations were more difficult to achieve. In younger adults desirable plasma lithium levels of 0.6-0.8mmol/L can perhaps be achieved with comparatively lower doses and in the very elderly it may be prudent to target lower plasma levels in the first instance. These are important practical points for consideration that, along with many others offered throughout the article, should assist clinicians in dissecting the more complex aspects of management with greater precision. This review was limited to CPGs written in English. CPGs are themselves limited by reliance on evidence that often has little resemblance to real-world presentations. An important area that is not sufficiently addressed in the CPGs is clear guidance on the cessation of lithium therapy. Further research is needed on many aspects of lithium therapy and this alongside existing knowledge needs to be used more consistently to inform CPGs, which should also incorporate empirical evidence and clinical experience. The recommendations in this paper provide a useful synthesis of guidance available currently. Copyright © 2017 Elsevier B.V. All rights reserved.

Parental spirituality in life-threatening pediatric cancer.

PubMed

Nicholas, David B; Barrera, Maru; Granek, Leeat; D'Agostino, Norma Mammone; Shaheed, Jenny; Beaune, Laura; Bouffet, Eric; Antle, Beverley

2017-01-01

This study addressed parental spirituality in the context of pediatric cancer with a poor prognosis. Drawing upon previous research implementing a longitudinal grounded theory design examining parental hope, 35 parents were interviewed regarding their experiences with an emergent description of the role of spirituality in parents' daily lives. Spirituality included religious beliefs and practices, notions of a higher force or cosmos, relationship with a divine being, as well as elements emerging from meaning-making and relationships. Parental expectations of spirituality remained relatively constant across data collection time points (3-9 months postdiagnosis), although limited variation occurred relative to shifting circumstance (e.g., deterioration of the child's condition). Spirituality appeared to offer: greater acceptance of parents' inability to protect their child from harm related to her/his life-threatening illness, guidance and emotion decompression, and support from one's faith community. Recommendations for integrating spiritual assessment in clinical care practice are offered.

Interprofessional Education and Practice Guide No. 8: Team-based interprofessional practice placements.

PubMed

Brewer, Margo L; Barr, Hugh

2016-11-01

Whilst interest in interprofessional learning (IPL) in practice contexts has grown in recent years, the complexities involved have led many universities to rely on IPL in the classroom, online, and/or simulated contexts. Curtin University's Faculty of Health Sciences has successfully implemented a multi-award winning, large-scale Interprofessional Practice Programme. This programme, which began with five small pilots in 2009, provides team-based interprofessional practice placements for over 550 students from nine professions per annum. Drawing on both the literature and Curtin University's experience, this Interprofessional Education and Practice Guide aims to assist university and practice-based educators to "weigh the case" for introducing team-based interprofessional placements. The key lessons learned at Curtin University are identified to offer guidance to others towards establishing a similar programme for students during their prequalifying courses in health, social care, and related fields.

Closing the translation gap for justice requirements in international research.

PubMed

Pratt, Bridget; Zion, Deborah; Lwin, Khin Maung; Cheah, Phaik Yeong; Nosten, Francois; Loff, Bebe

2012-09-01

Bioethicists have long debated the content of sponsors and researchers' obligations of justice in international clinical research. However, there has been little empirical investigation as to whether and how obligations of responsiveness, ancillary care, post-trial benefits and research capacity strengthening are upheld in low- and middle-income country settings. In this paper, the authors argue that research ethics guidelines need to be more informed by international research practice. Practical guidance on how to fulfil these obligations is needed if research groups and other actors are to successfully translate them into practice because doing so is often a complicated, context-specific process. Case study research methods offer one avenue for collecting data to develop this guidance. The authors describe how such methods have been used in relation to the Shoklo Malaria Research Unit's vivax malaria treatment (VHX) trial (NCT01074905). Relying on the VHX trial example, the paper shows how information can be gathered from not only international clinical researchers but also trial participants, community advisory board members and research funder representatives in order to: (1) measure evidence of responsiveness, provision of ancillary care, access to post-trial benefits and research capacity strengthening in international clinical research; and (2) identify the contextual factors and roles and responsibilities that were instrumental in the fulfilment of these ethical obligations. Such empirical work is necessary to inform the articulation of obligations of justice in international research and to develop guidance on how to fulfil them in order to facilitate better adherence to guidelines' requirements.

An evaluation of a toolkit for the early detection, management, and control of carbapenemase-producing Enterobacteriaceae: a survey of acute hospital trusts in England.

PubMed

Coope, C M; Verlander, N Q; Schneider, A; Hopkins, S; Welfare, W; Johnson, A P; Patel, B; Oliver, I

2018-03-09

Following hospital outbreaks of carbapenemase-producing Enterobacteriaceae (CPE), Public Health England published a toolkit in December 2013 to promote the early detection, management, and control of CPE colonization and infection in acute hospital settings. To examine awareness, uptake, implementation and usefulness of the CPE toolkit and identify potential barriers and facilitators to its adoption in order to inform future guidance. A cross-sectional survey of National Health Service (NHS) acute trusts was conducted in May 2016. Descriptive analysis and multivariable regression models were conducted, and narrative responses were analysed thematically and informed using behaviour change theory. Most (92%) acute trusts had a written CPE plan. Fewer (75%) reported consistent compliance with screening and isolation of CPE risk patients. Lower prioritization and weaker senior management support for CPE prevention were associated with poorer compliance. Awareness of the CPE toolkit was high and all trusts with patients infected or colonized with CPE had used the toolkit either as provided (32%), or to inform (65%) their own local CPE plan. Despite this, many respondents (80%) did not believe that the CPE toolkit guidance offered an effective means to prevent CPE or was practical to follow. CPE prevention and control requires robust IPC measures. Successful implementation can be hindered by a complex set of factors related to their practical execution, insufficient resources and a lack of confidence in the effectiveness of the guidance. Future CPE guidance would benefit from substantive user involvement, processes for ongoing feedback, and regular guidance updates. Copyright © 2018 The Healthcare Infection Society. All rights reserved.

The exercise prescription for enhancing overall health of midlife and older women.

PubMed

Woodward, Miriam J; Lu, Chi Wei; Levandowski, Richard; Kostis, John; Bachmann, Gloria

2015-09-01

For midlife and older women, this period of their life is associated with an increase in risk factors for the development of chronic medical conditions. Data confirms the importance of regular exercise for both prevention and management of cardiovascular and other non-communicable diseases, unwanted weight gain, worsening metabolic profile and osteoporosis. However, in most clinical practices, midlife and older women patients are not offered specific exercise guidance. This review assessed the current environment of what exercise advice is being offered to women at clinical encounters and suggests ways of incorporating an exercise prescription into clinical practice. A PubMed review of the literature from the past 20 years was conducted. A universal template for an exercise prescription for aging women does not exist. Globally, there are scant programs that offer exercise advice and interventions to patients at the end of clinical encounters. Although most aging women know the benefits of engaging in a regular exercise program, many do not establish a regular routine. By the clinician offering an exercise prescription, this not only reinforces the importance of exercise but also provides simple guidelines on how women can commence an exercise routine in their life. Copyright © 2015. Published by Elsevier Ireland Ltd.

Ethical Guidance for Disaster Response, Specifically Around Crisis Standards of Care: A Systematic Review.

PubMed

Leider, Jonathon P; DeBruin, Debra; Reynolds, Nicole; Koch, Angelica; Seaberg, Judy

2017-09-01

Terrorism, disease outbreaks, and other natural disasters and mass casualty events have pushed health care and public health systems to identify and refine emergency preparedness protocols for disaster response. Ethical guidance, alongside legal and medical frameworks, are increasingly common components of disaster response plans. To systematically review the prevalence and content of ethical guidance offered for disaster response, specifically around crisis standards of care (CSCs). We systematically indexed academic literature from PubMed, Google Scholar, and ISI Web of Science from 2012 to 2016. We searched for peer-reviewed articles that substantively engaged in discussion of ethical guidance for CSCs. Researchers screened potential articles for identification and discussion of ethical issues in CSC planning. We categorized and cataloged ethical concepts and principles. Of 580 peer-reviewed articles mentioning ethics and CSCs or disaster planning, 38 (6%) met selection criteria. The systematic review of the CSC ethics literature since 2012 showed that authors were primarily focused on the ethical justifications for CSC (n = 20) as well as a need for ethics guidelines for implementing CSCs; the ethical justifications for triage (n = 19), both as to which criteria to use and the appropriate processes by which to employ triage; and international issues (n = 17). In addition to these areas of focus, the scholarly literature included discussion of a number of other ethical issues, including duty to care (n = 11), concepts of a duty to plan (n = 8), utilitarianism (n = 5), moral distress (n = 4), professional norms (n = 3), reciprocity (n = 2), allocation criteria (n = 4), equity (n = 4), research ethics (n = 2), duty to steward resources (n = 2), social utility and social worth (n = 2), and a number of others (n = 20). Although public health preparedness efforts have paid increasing attention to CSCs in recent years, CSC plans have rarely been implemented within the United States to date, although some components are common (e.g., triage is used in US emergency departments regularly). Conversely, countries outside the United States more commonly implement CSCs within a natural disaster or humanitarian crisis response, and may offer significant insight into ethics and disaster response for US-based practitioners. This systematic review identifies the most oft-used and -discussed ethical concepts and principles used in disaster planning around CSCs. Although discussion of more nuanced issues (e.g., health equity) are present, the majority of items substantively engaging in ethical discussion around disaster planning do so regarding triage and why ethics is needed in disaster response generally. Public health implications. A significant evolution in disaster planning has occurred within the past decade; ethical theories and frameworks have been put to work. For ethical guidance to be useful, it must be practical and implementable. Although high-level, abstract frameworks were once prevalent in disaster planning-especially in the early days of pandemic planning-concerns about the ethically difficult concept of CSCs pervade scholarly articles. Ethical norms must be clearly stated and justified and practical guidelines ought to follow from them. Ethical frameworks should guide clinical protocols, but this requires that ethical analysis clarifies what strategies to use to honor ethical commitments and achieve ethical objectives. Such implementation issues must be considered well ahead of a disaster. As governments and health care systems plan for mass casualty events, ethical guidance that is theoretically sound and practically useful can-and should-form an important foundation from which to build practical guidance for responding to disasters with morally appropriate means.

Managing Your Team's Weakest Link.

PubMed

Hills, Laura

2015-01-01

Do you have a poor-performing employee on your medical practice team? If so, you're not alone. Unfortunately, this is a problem that many medical practice managers face. This article describes the best strategies for managing your team's weakest link. It explores common yet very difficult circumstances that cause low employee performance and that test the patience, heart, and skills of a practice manager. It guides readers through a process of self-discovery to determine whether their negative biases or grudges may be causing employees to perform poorly. It suggests several possible other reasons for weak employee performance, including problems with the job, practice, leadership, communication, and fit between the employee and the job. This article also suggests the best strategy for communicating concerns about performance to the weakest-link employee. It offers guidance to practice managers about protecting their time and energy when handling a poor performer. It provides a simple formula for calculating the cost of a low-performing employee, 10 possible personal reasons for the employee's poor work performance, specific questions to ask to uncover the reasons for poor performance, and an eight-rule strategy for confronting poor performance effectively. Finally, this article offers practice managers a practical strategy for handling resistance from their weakest link, illustrated with a sample dialogue.

The fair factor in matters of trust.

PubMed

Williams, Lauren L

2006-01-01

Communities are bound together by trust among their members. Trust thrives when a pervasive sense of fairness exists. Evidence suggests that trust has social, professional, and economic value for today's organizations, making it worthy of attention. Matters of trust and justice are important and timely for nurse leaders to consider given the challenge to improve practice settings in a manner that enhances nurse satisfaction. The aim of this article is to make explicit the value in building organizational justice and trust within an organization's nursing community. Nursing leadership strategies are integrated, thus offering practical guidance in creating a culture of justice, making trust explicit, and establishing trustworthiness.

The art of co-production of knowledge in environmental sciences and management: lessons from international practice

NASA Astrophysics Data System (ADS)

Djenontin, Ida Nadia S.; Meadow, Alison M.

2018-06-01

This review paper addresses the challenging question of "how to" design and implement co-production of knowledge in climate science and other environmental and agricultural sciences. Based on a grounded theory review of nine (9) published case studies of transdisciplinary and collaborative research projects, the paper offers a set of common themes regarding specific components and processes for the design, implementation, and achievement of co-production of knowledge work, which represent the "Modus Operandi" of knowledge co-production. The analysis focuses on practical methodological guidance based on lessons from how different research teams have approached the challenges of complex collaborative research. We begin by identifying broad factors or actions that inhibit or facilitate the process, then highlight specific practices associated with co-production of knowledge and necessary competencies for undertaking co-production. We provide insights on issues such as the integration of social and professional cultures, gender and social equity, and power dynamics, and illustrate the different ways in which researchers have addressed these issues. By exploring the specific practices involved in knowledge co-production, this paper provides guidance to researchers on how to navigate different possibilities of the process of conducting transdisciplinary and co-production of knowledge research projects that best fit their research context, stakeholder needs, and research team capacities.

The art of co-production of knowledge in environmental sciences and management: lessons from international practice.

PubMed

Djenontin, Ida Nadia S; Meadow, Alison M

2018-06-01

This review paper addresses the challenging question of "how to" design and implement co-production of knowledge in climate science and other environmental and agricultural sciences. Based on a grounded theory review of nine (9) published case studies of transdisciplinary and collaborative research projects, the paper offers a set of common themes regarding specific components and processes for the design, implementation, and achievement of co-production of knowledge work, which represent the "Modus Operandi" of knowledge co-production. The analysis focuses on practical methodological guidance based on lessons from how different research teams have approached the challenges of complex collaborative research. We begin by identifying broad factors or actions that inhibit or facilitate the process, then highlight specific practices associated with co-production of knowledge and necessary competencies for undertaking co-production. We provide insights on issues such as the integration of social and professional cultures, gender and social equity, and power dynamics, and illustrate the different ways in which researchers have addressed these issues. By exploring the specific practices involved in knowledge co-production, this paper provides guidance to researchers on how to navigate different possibilities of the process of conducting transdisciplinary and co-production of knowledge research projects that best fit their research context, stakeholder needs, and research team capacities.

Current Practice of Therapeutic Mammaplasty: A Survey of Oncoplastic Breast Surgeons in England

PubMed Central

Aggarwal, Shweta; Marla, Sekhar; Nyanhongo, Donald; Kotecha, Sita; Basu, Narendra Nath

2016-01-01

Introduction. Therapeutic mammaplasty (TM) is a useful technique in the armamentarium of the oncoplastic breast surgeon (OBS). There is limited guidance on patient selection, technique, coding, and management of involved margins. The practices of OBS in England remain unknown. Methods. Questionnaires were sent to all OBS involved with the Training Interface Group. We assessed the number of TM cases performed per surgeon, criteria for patient selection, pedicle preference, contralateral symmetrisation, use of routine preoperative MRI, management of involved margins, and clinical coding. Results. We had an overall response rate of 43%. The most common skin resection technique utilised was wise pattern followed by vertical scar. Superior-medial pedicle was preferred by the majority of surgeons (62%) followed by inferior pedicle (34%). Twenty percent of surgeons would always proceed to a mastectomy following an involved margin, whereas the majority would offer reexcision based on several parameters. The main absolute contraindication to TM was tumour to breast ratio >50%. One in five surgeons would not perform TM in smokers and patients with multifocal disease. Discussion. There is a wide variation in the practice of TM amongst OBS. Further research and guidance would be useful to standardise practice, particularly management of involved margins and coding for optimal reimbursement. PMID:27110398

State-Level Guidance and District-Level Policies and Practices for Food Marketing in US School Districts.

PubMed

Merlo, Caitlin L; Michael, Shannon; Brener, Nancy D; Blanck, Heidi

2018-06-07

State agencies play a critical role in providing school districts with guidance and technical assistance on school nutrition issues, including food and beverage marketing practices. We examined associations between state-level guidance and the policies and practices in school districts regarding food and beverage marketing and promotion. State policy guidance was positively associated with districts prohibiting advertisements for junk food or fast food restaurants on school property. Technical assistance from states was negatively associated with 2 district practices to restrict marketing of unhealthy foods and beverages, but positively associated with 1 practice to promote healthy options. These findings may help inform the guidance that states provide to school districts and help identify which districts may need additional assistance to address marketing and promotion practices.

Self-transcendence in Alzheimer's disease: the application of theory to practice.

PubMed

Vitale, Susan Ann; Shaffer, Cheryl M; Acosta Fenton, Holly R

2014-12-01

The middle-range nursing theory of self-transcendence may be applicable to individuals in the early stages of Alzheimer's disease. Full cognitive ability may not be necessary for the essential principles of this theory to be implemented. The theory can offer guidance to families and health care providers in attempting to facilitate a meaningful aging process. A case scenario of an elderly woman with Alzheimer's disease demonstrates how family and caregivers can initiate interventions based on the theoretical concepts. © The Author(s) 2014.

[Development process of Evidence-based "Return-to-work Guidance in Occupational Health 2017"].

PubMed

Kojimahara, Noriko; Fukumoto, Masakatsu; Yoshikawa, Etsuko; Shinada, Kayoko; Tsuiki, Hirokazu

2018-06-05

Objective"Return-to-work Guidance in Occupational Health 2017 (RTW Guidance 2017) " is the first occupational health guide in Japan that evaluates the quality of evidence and offers recommendations based on results of the systematic review of randomized controlled trials. Details of the systematic review of each review question (RQs) will be described separately. This article presents an overview of the method and process of developing the "RTW Guidance 2017."Materials and MethodsThe guidance was developed following the previously-published "Method for developing evidence based occupational health guidance," which included the composition of a highly-transparent guidance developing group as well as the recruitment and selection of RQs. Using the Cochrane Library, PubMed, and Ichushi-Web, a literature search for the six RQs was conducted in January 2016 by partly modifying the search terms of the existing systematic review. Articles were selected according to the inclusion criteria, and the quality of evidence was evaluated using the GRADE approach. Meta-analysis was conducted for RQ2 and RQ4, and a qualitative systematic review was conducted for RQ5, RQ6, and cost-effectiveness. Recommendations were subsequently made after a thorough consideration for feasibility in Japan by examining the costs and available resources.ResultsBased on a comprehensive literature search, eleven RQ2, four RQ4, one RQ5, and three RQ6 were selected. Support program for returning to work, such as "Re-work" for those who are temporarily not working due to musculoskeletal disorders or mental health disorder, was recommended based on moderate evidence (RQ2). For RQ4, the collaboration between occupational health practice and clinical practice was weakly recommended based on low evidence. For RQ5 that evaluated the usefulness of social support, intervention by the manager/co-worker was proposed as a "best practice statement" without indicating it as a recommendation. Work accommodation was weakly recommended based on low evidence in RQ6.Discussion and ConclusionFrom the result of systematic reviews, it was recommended for workers on sick leave more than four weeks regardless of sick leave and sickness absence that interventions during leave would improve work-related outcomes, such as earlier reinstatement. Although there is limited evidence regarding occupational health in Japan, it is important for many occupational health professionals to learn the method of developing guidance and to identify issues for future studies with priority in Japan.

Advice for running a successful research team.

PubMed

Stanley, David; Anderson, Judith

2015-11-01

To explore what is meant by a 'research team' and offer practical suggestions for supporting an effective and productive, collaborative research team. Collaborative research has become one of the main objectives of most higher education institutions and running effective research teams is central to achieving this aim. However, there is limited guidance in the literature about how to run or steer a research team. Search engines/databases used: CINAHL, Nursing and Allied Health Source, Primo search, Google search and Health Collection to access research articles and publications to support this topic. Literature search was extended to the end of 2014. Publications were reviewed for relevance to the topic via standard literature search. Research teams vary in size and composition, however they all require effective collaboration if they are to establish successful and flexible working relationships and produce useful and trustworthy research outputs. This article offers guidance for establishing and managing successful collaborative research relationships, building trust and a positive research team culture, clarifying team member roles, setting the teams' research agenda and managing the teams' functions so that team members feel able to contribute fully to the research goals and build a culture of support and apply 'emotional intelligence' throughout the process of building and running a successful research team. Collaboration is a central component of establishing successful research teams and enabling productive research outputs. This article offers guidance for research teams to help them to function more effectively and allow all members to contribute fully to each team's goals. Research teams that have established trust and a positive team culture will result in more efficient working relationships and potentially greater productivity. The advice offered reinforces the value of having research teams with diverse members from different disciplines, philosophical roots and backgrounds. Each of these members should be able to contribute skills and expertise so that the parts of the team are able to develop 'synergy' and result in more productive, positive and rewarding research experiences, as well as more effective research.

Planning for and surviving a BCM audit.

PubMed

Freestone, Mandy; Lee, Michael

2008-01-01

Business continuity management (BCM) is moving progressively higher up the agendas of boardroom executives due to growing regulator, insurer and investor interest in risk management and BCM activity. With increasing pressure across all sectors, BCM has become an integral part of any effective corporate governance framework. Boardroom executives and senior management are thus now expected to provide an appropriate level of business continuity preparedness to better protect shareholder, investor and other stakeholder interests. The purpose of this paper is to build a link across the 'chasm' that separates the auditee from the auditor. The paper attempts to illuminate understanding about the process undertaken by an auditor when reviewing the BCM process. It details the steps the BCM auditor typically undertakes, and provides practical guidance as to the types of documentation and other supporting evidence required during the process. Additionally, the paper attempts to dispel commonly-held misconceptions about the BCM audit process. Executives, senior management and BCM practitioners will all benefit from the practical guidance offered in this paper, to assist in planning for and surviving a BCM audit.

Finding and estimating chemical property data for environmental assessment.

PubMed

Boethling, Robert S; Howard, Philip H; Meylan, William M

2004-10-01

The ability to predict the behavior of a chemical substance in a biological or environmental system largely depends on knowledge of the physicochemical properties and reactivity of that substance. We focus here on properties, with the objective of providing practical guidance for finding measured values and using estimation methods when necessary. Because currently available computer software often makes it more convenient to estimate than to retrieve measured values, we try to discourage irrational exuberance for these tools by including comprehensive lists of Internet and hard-copy data resources. Guidance for assessors is presented in the form of a process to obtain data that includes establishment of chemical identity, identification of data sources, assessment of accuracy and reliability, substructure searching for analogs when experimental data are unavailable, and estimation from chemical structure. Regarding property estimation, we cover estimation from close structural analogs in addition to broadly applicable methods requiring only the chemical structure. For the latter, we list and briefly discuss the most widely used methods. Concluding thoughts are offered concerning appropriate directions for future work on estimation methods, again with an emphasis on practical applications.

Factors influencing behavior guidance: a survey of practicing pediatric dentists.

PubMed

Juntgen, Laura M; Sanders, Brian J; Walker, Laquia A; Jones, James E; Weddell, James A; Tomlin, Angela M; Eckert, George; Maupome, Gerardo

2013-01-01

The purpose of this study was to identify factors influencing behavior guidance technique utilization among practicing pediatric dentists and explore potential barriers to the incorporation of previously unused techniques. The data for this study were obtained from a web-based survey containing 15 multiple choice questions concerning the practitioners' past, current, and anticipated future behavior guidance technique utilization. Most respondents received hands-on training in 10 of the American Academy of Pediatric Dentistry behavior guidance techniques. The type of training was associated with the practitioners' level of comfort using a given technique upon graduation and with the current frequency of technique utilization. Residency type impacted hands-on behavior guidance training, with 39 percent of respondents reporting no intravenous sedation training. The type of practice was associated with the frequency of behavior guidance technique utilization, as was graduation decade. Currently practicing dentists cited legal concerns, parental acceptance to change, and limited resources as perceived obstacles in the incorporation of new techniques. Behavior guidance technique selection and utilization among practicing pediatric dentists was influenced by multiple factors, including advanced education training, residency type, graduation decade, and practice type. Obstacles to the incorporation of previously unused techniques appear to be multifactorial.

Use of Online Sources of Information by Dental Practitioners: Findings from The Dental Practice-Based Research Network

PubMed Central

Funkhouser, Ellen; Agee, Bonita S.; Gordan, Valeria V.; Rindal, D. Brad; Fellows, Jeffrey L.; Qvist, Vibeke; McClelland, Jocelyn; Gilbert, Gregg H.

2013-01-01

Objectives Estimate the proportion of dental practitioners who use online sources of information for practice guidance. Methods From a survey of 657 dental practitioners in The Dental Practice Based Research Network, four indicators of online use for practice guidance were calculated: read journals online, obtained continuing education (CDE) through online sources, rated an online source as most influential, and reported frequently using an online source for guidance. Demographics, journals read, and use of various sources of information for practice guidance in terms of frequency and influence were ascertained for each. Results Overall, 21% (n=138) were classified into one of the four indicators of online use: 14% (n=89) rated an online source as most influential and 13% (n=87) reported frequently using an online source for guidance; few practitioners (5%, n=34) read journals online, fewer (3%, n=17) obtained CDE through online sources. Use of online information sources varied considerably by region and practice characteristics. In general, the 4 indicators represented practitioners with as many differences as similarities to each other and to offline users. Conclusion A relatively small proportion of dental practitioners use information from online sources for practice guidance. Variation exists regarding practitioners’ use of online source resources and how they rate the value of offline information sources for practice guidance. PMID:22994848

Using a cultural-ecological framework to explore dietary beliefs and practices during pregnancy and lactation among women in Adivasi communities in the Nilgiris Biosphere Reserve, India.

PubMed

Craig, Hope C; Jeyanthi, R; Pelto, Gretel; Willford, Andrew C; Stoltzfus, Rebecca J

2018-01-01

This article explores maternal dietary beliefs and practices gathered through interviews with mothers of infants and young children in Adivasi communities in the Nilgiris Biosphere Reserve, India. Guided by focused ethnographic study methods, interviews were conducted with 33 key informants. We used a cultural-ecological framework to analyze and interpret the texts that were elicited from women about dietary beliefs and eating patterns during pregnancy and lactation. We identify differences between what women were advised to eat, felt they should eat, and reported consuming. The findings offer guidance for interventions to improve maternal diets in this vulnerable population.

How much guidance is given in the operating room? Factors influencing faculty self-reports, resident perceptions, and faculty/resident agreement.

PubMed

Torbeck, Laura; Williams, Reed G; Choi, Jennifer; Schmitz, Connie C; Chipman, Jeffrey G; Dunnington, Gary L

2014-10-01

Guidance in the operating room impacts resident confidence and ability to function independently. The purpose of this study was to explore attending surgeon guidance practices in the operating room as reported by faculty members themselves and by junior and senior residents. This was an exploratory, cross-sectional survey research study involving 91 categorical residents and 82 clinical faculty members at two academic general surgery training programs. A series of analyses of variance along with descriptive statistics were performed to understand the impact of resident training year, program, and surgeon characteristics (sex and type of surgery performed routinely) on guidance practices. Resident level (junior versus senior) significantly impacted the amount of guidance given as reported by faculty and as perceived by residents. Within each program, junior residents perceived less guidance than faculty reported giving. For senior guidance practices, however, the differences between faculty and resident practices varied by program. In terms of the effects of surgeon practice type (mostly general versus mostly complex cases), residents at both institutions felt they were more supervised closely by the faculty who perform mostly complex cases. More autonomy is given to senior than to junior residents. Additionally, faculty report a greater amount of change in their guidance practices over the training period than residents perceive. Faculty and resident agreement about the need for guidance and for autonomy are important for achieving the goals of residency training. Copyright © 2014 Elsevier Inc. All rights reserved.

A strategy for selecting sexual partners believed to pose little/no risks for HIV: serosorting and its implications for HIV transmission.

PubMed

Eaton, Lisa A; Kalichman, Seth C; O'Connell, Daniel A; Karchner, William D

2009-10-01

A common HIV/AIDS risk reduction strategy among men who have sex with men (MSM) is to limit their unprotected sex partners to those who are of the same HIV status, a practice referred to as serosorting. Decisions to serosort for HIV risk reduction are based on personal impressions and beliefs, and there is limited guidance offered on this community derived strategy from public health services. This paper reviews research on serosorting for HIV risk reduction and offers an evidence-based approach to serosorting guidance. Following a comprehensive electronic and manual literature search, we reviewed 51 studies relating to the implications of serosorting. Studies showed that HIV negative MSM who select partners based on HIV status are inadvertently placing themselves at risk for HIV. Infrequent HIV testing, lack of HIV status disclosure, co-occurring sexually transmitted infections, and acute HIV infection impede the potential protective benefits of serosorting. Public health messages should continue to encourage reductions in numbers of sexual partners and increases in condom use. Risk reduction messages should also highlight the limitations of relying on one's own and partner's HIV status in making sexual risk decisions.

Comparing 2 National Organization-Level Workplace Health Promotion and Improvement Tools, 2013–2015

PubMed Central

Lang, Jason E.; Davis, Whitney D.; Jones-Jack, Nkenge H.; Mukhtar, Qaiser; Lu, Hua; Acharya, Sushama D.; Molloy, Meg E.

2016-01-01

Creating healthy workplaces is becoming more common. Half of employers that have more than 50 employees offer some type of workplace health promotion program. Few employers implement comprehensive evidence-based interventions that reach all employees and achieve desired health and cost outcomes. A few organization-level assessment and benchmarking tools have emerged to help employers evaluate the comprehensiveness and rigor of their health promotion offerings. Even fewer tools exist that combine assessment with technical assistance and guidance to implement evidence-based practices. Our descriptive analysis compares 2 such tools, the Centers for Disease Control and Prevention’s Worksite Health ScoreCard and Prevention Partners’ WorkHealthy America, and presents data from both to describe workplace health promotion practices across the United States. These tools are reaching employers of all types (N = 1,797), and many employers are using a comprehensive approach (85% of those using WorkHealthy America and 45% of those using the ScoreCard), increasing program effectiveness and impact. PMID:27685429

The Practice of Health Program Evaluation.

PubMed

Lewis, Sarah R

2017-11-01

The Practice of Health Program Evaluation provides an overview of the evaluation process for public health programs while diving deeper to address select advanced concepts and techniques. The book unfolds evaluation as a three-phased process consisting of identification of evaluation questions, data collection and analysis, and dissemination of results and recommendations. The text covers research design, sampling methods, as well as quantitative and qualitative approaches. Types of evaluation are also discussed, including economic assessment and systems research as relative newcomers. Aspects critical to conducting a successful evaluation regardless of type or research design are emphasized, such as stakeholder engagement, validity and reliability, and adoption of sound recommendations. The book encourages evaluators to document their approach by developing an evaluation plan, a data analysis plan, and a dissemination plan, in order to help build consensus throughout the process. The evaluative text offers a good bird's-eye view of the evaluation process, while offering guidance for evaluation experts on how to navigate political waters and advocate for their findings to help affect change.

17 CFR Appendix B to Part 38 - Guidance on, and Acceptable Practices in, Compliance With Core Principles

Code of Federal Regulations, 2010 CFR

2010-04-01

... Practices in, Compliance With Core Principles B Appendix B to Part 38 Commodity and Securities Exchanges...—Guidance on, and Acceptable Practices in, Compliance With Core Principles 1. This appendix provides guidance on complying with the core principles, both initially and on an ongoing basis, to maintain...

The use of depth interviewing with vulnerable subjects: lessons from a research study of parents with learning difficulties.

PubMed

Booth, T; Booth, W

1994-08-01

This paper explores the practicalities of using the technique of depth interviewing with people who have learning difficulties. The authors set out to provide other researchers with guidance in the use of the life story approach and to demonstrate its utility with this vulnerable and devalued group of informants. They conclude that depth interviewing can provide new knowledge not accessible through other methods of data collection, and offers a way of giving people with learning difficulties a voice in the making of their own history.

Practical Aspects of Discussing Marijuana in a New Era.

PubMed

Lenoue, Sean R; Wongngamnit, Narin; Thurstone, Christian

2016-11-01

The use of marijuana for the treatment of medical conditions is a highly controversial topic. Misconceptions by both patients and providers concerning the safety of and evidence-based indications for marijuana can complicate treatment planning and outcomes. Maintaining skills such as motivational interviewing, providing evidence-based informed consent, and increasing access to care remain top priorities for providing quality patient care. The goal of this article is to offer guidance to clinical providers who are adapting to the changing realities of medical marijuana and legalized recreational marijuana.

Nurses and Twitter: the good, the bad, and the reluctant.

PubMed

Wilson, Rhonda; Ranse, Jamie; Cashin, Andrew; McNamara, Paul

2014-01-01

Nurses and other health professionals are adopting social media to network with health care professionals and organizations, support health education, deliver health promotion messages, enhance professional development and employment opportunities, and communicate within political forums. This paper explores the growing use of social media, and examines the current dynamics of Twitter as an example of the uptake of social media. This paper also offers practical guidance for new Twitter users who are interested in using this social media approach in clinical or educational settings, and for professional development.

Social dreaming: competition or complementation to individual dreaming?

PubMed

Noack, Amélie

2010-11-01

Social dreaming is presented as a method to explore the unconscious dimension of the social world. The theoretical position of social dreaming and its historical development is described. Two examples are given for the practical application of social dreaming, a professional meeting of psychotherapists and an experiential workshop dealing with the aftermath of trauma. It is suggested that social dreaming is complementary to individual dreaming and offers insights and explanations, as well as guidance on various levels for applications in clinical, organizational, institutional and social settings. © 2010, The Society of Analytical Psychology.

Community-Based Career Guidance Practices. Vol. III--Postsecondary Level.

ERIC Educational Resources Information Center

Manatee Junior Coll., Bradenton, FL.

This collection of sixty postsecondary-level career guidance practices contains the following nine types of activities: novel practices such as games and role enactment, volunteering, field trips, special career emphases, intern/extern practices, work experience and exploration practices, exchanges, mobile practices, and educator inservices. A…

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.

Verification and quality control of routine hematology analyzers.

PubMed

Vis, J Y; Huisman, A

2016-05-01

Verification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and linearity throughout the expected range of results. Yet, which standard should be met or which verification limit be used is at the discretion of the laboratory specialist. This paper offers practical guidance on verification and quality control of automated hematology analyzers and provides an expert opinion on the performance standard that should be met by the contemporary generation of hematology analyzers. Therefore (i) the state-of-the-art performance of hematology analyzers for complete blood count parameters is summarized, (ii) considerations, challenges, and pitfalls concerning the development of a verification plan are discussed, (iii) guidance is given regarding the establishment of reference intervals, and (iv) different methods on quality control of hematology analyzers are reviewed. © 2016 John Wiley & Sons Ltd.

Audit of healthcare professionals’ attitudes towards patients who self-harm and adherence to national guidance in a UK burns and plastic surgery department

PubMed Central

Heyward-Chaplin, Jessica; Shepherd, Laura; Arya, Reza; O’Boyle, Ciaran P

2018-01-01

Background: Rates of self-harm injuries are considered to be increasing. The attitudes of healthcare staff towards patients who self-harm may be negative and a small amount of research specifically investigating burns and plastic surgery healthcare professionals has recently been conducted exploring this issue. This study aimed to determine attitudes towards and adherence to national guidance by healthcare professionals in a UK burns and plastic surgery department with respect to patients who self-harm. Method: An audit questionnaire, completed in a designated Burns Unit and plastic surgery department, within a UK hospital with a major trauma centre. Results: Data were obtained from 59 healthcare professionals. The majority of responders held positive attitudes towards those who had self-harmed. However, a significant minority held negative attitudes, stating that they found it difficult to be compassionate (10%; n = 6) and believing that patients usually self-harm to get attention (9%; n = 5). One-fifth (n = 12) agreed that, on a departmental level, conservative management (as opposed to surgery) was offered more frequently for self-harm injuries compared with accidental injuries, contrary to national guidance. Awareness of national guidance in relation to self-harm injuries was markedly lacking, in only 12% (n = 7/59) and the frequency of completing relevant training was low (34%, n = 20/59). Conclusion: Education among healthcare professionals is important, to ensure adherence to best practice. The findings of this study strongly suggest that many healthcare professionals do not know the current best practice. As a result, these highly vulnerable patients may be receiving sub-optimal care, with consequentially poor outcomes. PMID:29873329

Audit of healthcare professionals' attitudes towards patients who self-harm and adherence to national guidance in a UK burns and plastic surgery department.

PubMed

Heyward-Chaplin, Jessica; Shepherd, Laura; Arya, Reza; O'Boyle, Ciaran P

2018-01-01

Rates of self-harm injuries are considered to be increasing. The attitudes of healthcare staff towards patients who self-harm may be negative and a small amount of research specifically investigating burns and plastic surgery healthcare professionals has recently been conducted exploring this issue. This study aimed to determine attitudes towards and adherence to national guidance by healthcare professionals in a UK burns and plastic surgery department with respect to patients who self-harm. An audit questionnaire, completed in a designated Burns Unit and plastic surgery department, within a UK hospital with a major trauma centre. Data were obtained from 59 healthcare professionals. The majority of responders held positive attitudes towards those who had self-harmed. However, a significant minority held negative attitudes, stating that they found it difficult to be compassionate (10%; n = 6) and believing that patients usually self-harm to get attention (9%; n = 5). One-fifth (n = 12) agreed that, on a departmental level, conservative management (as opposed to surgery) was offered more frequently for self-harm injuries compared with accidental injuries, contrary to national guidance. Awareness of national guidance in relation to self-harm injuries was markedly lacking, in only 12% (n = 7/59) and the frequency of completing relevant training was low (34%, n = 20/59). Education among healthcare professionals is important, to ensure adherence to best practice. The findings of this study strongly suggest that many healthcare professionals do not know the current best practice. As a result, these highly vulnerable patients may be receiving sub-optimal care, with consequentially poor outcomes.

Community-Based Career Guidance Practices. Vol. II--Secondary Level.

ERIC Educational Resources Information Center

Manatee Junior Coll., Bradenton, FL.

This collection of eighty-six secondary level career guidance practices contains the following nine types of activities: novel practices such as games and role enactments, volunteering, field trips, special career emphases, intern/extern practices, work experience and exploration practices, exchanges, mobile practices, and educator in-services. A…

75 FR 36395 - Guidance on Sound Incentive Compensation Policies

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-25

... response to comments. For example, the final guidance includes several provisions designed to reduce burden..., FDIC and OTS (collectively, the Agencies) are adopting final guidance designed to help ensure that... risks that are not consistent with the long-term health of the organization. For example, offering large...

The development of clinical practice guidelines and guidance statements of the American College of Physicians: summary of methods.

PubMed

Qaseem, Amir; Snow, Vincenza; Owens, Douglas K; Shekelle, Paul

2010-08-03

The American College of Physicians (ACP) established its evidence-based clinical practice guidelines program in 1981. The ACP's Guidelines Committee and the staff of the Clinical Programs and Quality of Care Department develop the clinical recommendations. The ACP develops 2 different types of clinical recommendations: clinical practice guidelines and clinical guidance statements. The ACP clinical practice guidelines and guidance statements follow a multistep development process that includes a systematic review of the evidence, deliberation of the evidence by the committee, summary recommendations, and evidence and recommendation grading. All ACP clinical practice guidelines and clinical guidance statements, if not updated, are considered automatically withdrawn or invalid 5 years after publication or once an update has been issued.

Implementing AORN recommended practices for care of patients undergoing pneumatic tourniquet-assisted procedures.

PubMed

Hicks, Rodney W; Denholm, Bonnie

2013-10-01

Perioperative nurses are likely to encounter the use of pneumatic tourniquets in a variety of operative and invasive extremity procedures. Use of a pneumatic tourniquet offers an opportunity to obtain a near-bloodless surgical field; however, the use of tourniquets is not without risk. Unfavorable outcomes include pain, thrombotic events, nerve compression injuries, and disruption of skin integrity. Perioperative nurses should be familiar with the indications, contraindications, and changes in physiology associated with pneumatic tourniquet use. The revised AORN "Recommended practices for care of patients undergoing pneumatic tourniquet-assisted procedures" is focused on the perioperative nurse's role in patient care and provides guidance for developing, implementing, and evaluating practices that promote patient safety and improve the likelihood of positive outcomes. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Loneliness at the Top: Ten Ways Medical Practice Administrators Can Manage the Isolation of Leadership.

PubMed

Hills, Laura

2016-01-01

Medical practice.managers spend their days surrounded by people, so the last thing they may expect to feel is lonely. Yet for many, being the manager of a medical practice can lead to feelings of isolation from the rest of the staff, and loneliness. This article explores the many reasons that managing a medical practice can be a lonely business. It considers the risks when a practice manager's loneliness goes unchecked, both to the individual and to the practice. It suggests 10 effective and healthy strategies for preventing and managing the leadership loneliness that medical practice managers sometimes experience. Next, this article argues that acceptance is the first step in overcoming loneliness in the workplace. It offers guidance for medical practice managers who wish to help lonely members of their teams. It describes the benefits of having a confidant to help support the medical practice manager, and the characteristics of an ideal confidant. Finally, this article suggests a strategy for combatting loneliness by interacting with the staff more frequently.

[Care guidance and management of cooperative healthcare networks].

PubMed

Eble, S; Rampoldt, T

2013-04-01

Selective agreements offer the possibility to the health insurers to influence the control of care, a chance that they urgently need because of cost pressure. The concepts of care can be developed top-down and then a health insurer can make an offer. Or these concepts are developed bottom-up that means a chance for the healthcare providers who want to actively shape the medical care. An essential component for all these concepts is to be able to calculate and administrate funding and control. Pathways are necessary for controlling the treatment which not only have to be developed but also have to be put into practice. The pathway acute sacroiliac pain developed by the Lübeck doctors' network will be described here as an example of a successful implementation.

Development of Animal Physiology Practical Guidance Oriented Guided Inquiry for Student of Biology Department

NASA Astrophysics Data System (ADS)

Putra, Z. A. Z.; Sumarmin, R.; Violita, V.

2018-04-01

The guides used for practicing animal physiology need to be revised and adapted to the lecture material. This is because in the subject of Animal Physiology. The guidance of animal physiology practitioners is still conventional with prescription model instructions and is so simple that it is necessary to develop a practical guide that can lead to the development of scientific work. One of which is through practice guided inquiry guided practicum guide. This study aims to describe the process development of the practical guidance and reveal the validity, practicality, and effectiveness Guidance Physiology Animals guided inquiry inferior to the subject of Animal Physiology for students Biology Department State University of Padang. This type of research is development research. This development research uses the Plomp model. Stages performed are problem identification and analysis stage, prototype development and prototyping stage, and assessment phase. Data analysis using descriptive analysis. The instrument of data collection using validation and practical questionnaires, competence and affective field of competence observation and psychomotor and cognitive domain competence test. The result of this research shows that guidance of Inquiry Guided Initiative Guided Physiology with 3.23 valid category, practicality by lecturer with value 3.30 practical category, student with value 3.37 practical criterion. Affective effectiveness test with 93,00% criterion is very effective, psychomotor aspect 89,50% with very effective criteria and cognitive domain with value of 67, pass criterion. The conclusion of this research is Guided Inquiry Student Guided Protoxial Guidance For Students stated valid, practical and effective.

Ethics of clinician communication in a changing communication landscape: guidance from professional societies.

PubMed

Gollust, Sarah E; Dwyer, Anne M

2013-12-01

Cancer experts engage in public communication whenever they promote their research or practice, respond to media inquiries, or use social media. In a changing communication landscape characterized by new technologies and heightened attention to cancer controversies, these activities may pose ethical challenges. This study was designed to evaluate existing resources to help clinicians navigate their public communication activities. We conducted a systematic, qualitative content analysis of codes of ethics, policy statements, and similar documents disseminated by professional medical and nursing societies for their members. We examined these documents for four types of content related to public communication: communication via traditional media; communication via social media; other communication to the public, policy, and legal spheres; and nonspecific language regarding public communication. We identified 46 documents from 23 professional societies for analysis. Five societies had language about traditional news media communication, five had guidance about social media, 11 had guidance about other communication domains, and 15 societies offered general language about public communication. The limited existing guidance focused on ethical issues related to patients (such as privacy violations) or clinicians (such as accuracy and professional boundaries), with less attention to population or policy impact of communication. Cancer-related professional societies might consider establishing more specific guidance for clinicians concerning their communication activities in light of changes to the communication landscape. Additional research is warranted to understand the extent to which clinicians face ethical challenges in public communication.

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...

75 FR 59263 - Agency Information Collection Activities: Proposed Collection Renewal; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

...: Interagency Guidance on Sound Incentive Compensation Practices. (3064-0175). DATES: Comments must be submitted...: Interagency Guidance on Sound Incentive Compensation Practices. OMB Number: 3064-0175. Form Number: None... Collection: The Guidance would help ensure that incentive compensation policies at insured state non-member...

Rethinking Careers Education and Guidance: Theory, Policy and Practice.

ERIC Educational Resources Information Center

Watts, A. G.; Law, Bill; Killeen, John; Kidd, Jennifer M.; Hawthorn, Ruth

This book contains 21 papers on the theory, context, provision, practice, and development of career counseling and guidance in Great Britain. The following papers are included: "Preface" (Tony Watts et al.); "The Social Context of Guidance" (John Killeen); "Career Theory" (John Killeen); "A Career-Learning…

Educating Career Guidance Practitioners in the Twenty-First Century

ERIC Educational Resources Information Center

Gough, John

2017-01-01

Rapidly changing policy contexts in England have dramatically affected the provision of career guidance, and the training and development of its practitioners. This paper takes an autoethnographic and self-reflexive approach to exploring the experience of a Senior Lecturer in Career Guidance who manages a centre that offers the Qualification in…

Balancing your personal and professional lives: help for busy medical practice employees.

PubMed

Hills, Laura Sachs

2008-01-01

It is extremely difficult for most people to balance work and home life. This is especially true of employees who work in fast-paced medical practices where they are on the go all day. Each medical practice employee must find his or her own way to balance work and life, but fortunately, the process can usually be boiled down to some basics. This article outlines a strategy for establishing the top five priorities in the medical practice employee's life. It suggests that medical practice personnel can develop and use a personal mission statement as a life guide. This article also suggests specific strategies medical practice employees can use to protect and make the best use of their private time. It provides examples of how medical practice personnel have changed their lives by dropping unnecessary activities from their daily schedules. Finally, this article offers guidance about getting children to help working parents balance their work and private lives, 10 additional tips for work/life balance, a work/life balance self-assessment quiz, and a template the medical practice employee can use to create a customized personal mission statement.

A framework for performing workplace hazard and risk analysis: a participative ergonomics approach.

PubMed

Morag, Ido; Luria, Gil

2013-01-01

Despite the unanimity among researchers about the centrality of workplace analysis based on participatory ergonomics (PE) as a basis for preventive interventions, there is still little agreement about the necessary of a theoretical framework for providing practical guidance. In an effort to develop a conceptual PE framework, the authors, focusing on 20 studies, found five primary dimensions for characterising an analytical structure: (1) extent of workforce involvement; (2) analysis duration; (3) diversity of reporter role types; (4) scope of analysis and (5) supportive information system for analysis management. An ergonomics analysis carried out in a chemical manufacturing plant serves as a case study for evaluating the proposed framework. The study simultaneously demonstrates the five dimensions and evaluates their feasibility. The study showed that managerial leadership was fundamental to the successful implementation of the analysis; that all job holders should participate in analysing their own workplace and simplified reporting methods contributed to a desirable outcome. This paper seeks to clarify the scope of workplace ergonomics analysis by offering a theoretical and structured framework for providing practical advice and guidance. Essential to successfully implementing the analytical framework are managerial involvement, participation of all job holders and simplified reporting methods.

Forced guidance and distribution of practice in sequential information processing.

NASA Technical Reports Server (NTRS)

Decker, L. R.; Rogers, C. A., Jr.

1973-01-01

Distribution of practice and forced guidance were used in a sequential information-processing task in an attempt to increase the capacity of human information-processing mechanisms. A reaction time index of the psychological refractory period was used as the response measure. Massing of practice lengthened response times while forced guidance shortened them. Interpretation was in terms of load reduction upon the response-selection stage of the information-processing system.-

Implementing and evaluating an interprofessional minority health conference for social work and healthcare professionals.

PubMed

Washington, Tiffany R; Ward, Trina Salm; Young, Henry N; Orpinas, Pamela; Cornelius, Llewellyn J

2017-11-01

Interprofessional education (IPE) is one strategy for addressing health inequities; however, little attention has been paid to continuing IPE for practicing social work and healthcare professionals. This article offers guidance to faculty in social work and health-related academic units on offering continuing IPE on the topic of minority health. An interprofessional group of faculty offered a day-long conference on minority health, ethics, and social justice. The conference goal was to promote interprofessional communication in a co-learning environment and promote dialogue on social determinants of health and health equity in the state. Data were obtained from surveys and analysis of work plans developed during the conference. Workshop participants were majority White (62%), social workers (79%), and practiced for 14 years on average. The most useful topics were dementia and polypharmacy. Takeaway strategies included interprofessional work, being mindful of access to resources, and engagement in continuing education. Lessons learned include plan in advance for all professions; recruit faculty and students from multiple departments to increase interprofessional diversity; offer strategies and incentives to increase student participation; be strategic about conference location and format; and identify a strategic format and theme. IPE is a means of preparing learners for working together in their future careers to provide high-quality patient-centred care and reduce health disparities. Professional development can provide an opportunity to enhance skills to address health disparities, and learning can be significantly enhanced when participants connect with colleagues from different professions, discuss diverse opinions, and share successful practices.

Evaluation of a bespoke training to increase uptake by midwifery teams of NICE Guidance for membrane sweeping to reduce induction of labour: a stepped wedge cluster randomised design.

PubMed

Kenyon, Sara; Dann, Sophie; Hope, Lucy; Clarke, Paula; Hogan, Amanda; Jenkinson, David; Hemming, Karla

2017-07-27

National guidance recommends pregnant women are offered membrane sweeping at term to reduce induction of labour. Local audit suggested this was not being undertaken routinely across two maternity units in the West Midlands, UK between March and November 2012. Bespoke training session for midwifery teams (nine community and one antenatal clinic) was developed to address identified barriers to encourage offer of membrane sweeping, together with an information leaflet for women and appointment of a champion within each team. The timing of training session on membrane sweeping to ten midwifery teams was randomly allocated using a stepped wedge cluster randomised design. All women who gave birth in the Trusts after 39 + 3/40 weeks gestation within the study time period were eligible. Relevant anonymised data were extracted from maternity notes for three months before and after training. Data were analysed using a generalised linear mixed model, allowing for clustering and adjusting for temporal effects. Primary outcomes were number of women offered and accepting membrane sweeping and average number of sweeps per woman. Sub-group comparisons were undertaken for adherence to Trust guidance and potential influence of pre-specified maternal characteristics. Data included whether sweeping was offered but declined and no record of membrane sweeping. Training was given to all teams as planned. Analyses included data from 2787 of the 2864 (97%) eligible low-risk women over 39 + 4 weeks pregnant. Characteristics of the women were similar before and after training. No evidence of difference in proportion of women being offered and accepting membrane sweeping (44.4% before training versus 46.8% after training (adjusted relative risk [aRR] = 0.90, 95% confidence interval [CI] = 0.71-1.13), nor in average number of sweeps per woman (0.603 versus 0.627, aRR = 0.83, 95% CI = 0.67-1.01). No differences in any secondary outcomes nor influence of maternal characteristics were demonstrated. The midwives evaluated training positively. This stepped wedge cluster trial enabled randomised evaluation within a natural roll-out and demonstrates the importance of robust evaluation in circumstances in which it is rarely undertaken. While the midwives evaluated the training positively, it did not appear to change practice. ISRCTN14300475 . Registered on 23 August 2016.

12 CFR 34.21 - General rule.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and sound banking practices as described in published OCC guidance, including appropriate diligence... sound banking practices as described in published OCC guidance, including appropriate diligence...

Radioguided surgery and the GOSTT concept: From pre-operative image and intraoperative navigation to image-assisted excision.

PubMed

Bowles, H; Sánchez, N; Tapias, A; Paredes, P; Campos, F; Bluemel, C; Valdés Olmos, R A; Vidal-Sicart, S

Radio-guided surgery has been developed for application in those disease scheduled for surgical management, particularly in areas of complex anatomy. This is based on the use of pre-operative scintigraphic planar, tomographic and fused SPECT/CT images, and the possibility of 3D reconstruction for the subsequent intraoperative locating of active lesions using handheld devices (detection probes, gamma cameras, etc.). New tracers and technologies have also been incorporated into these surgical procedures. The combination of visual and acoustic signals during the intraoperative procedure has become possible with new portable imaging modalities. In daily practice, the images offered by these techniques and devices combine perioperative nuclear medicine imaging with the superior resolution of additional optical guidance in the operating room. In many ways they provide real-time images, allowing accurate guidance during surgery, a reduction in the time required for tissue location and an anatomical environment for surgical recognition. All these approaches have been included in the concept known as (radio) Guided intraOperative Scintigraphic Tumour Targeting (GOSTT). This article offers a general view of different nuclear medicine and allied technologies used for several GOSTT procedures, and illustrates the crossing of technological frontiers in radio-guided surgery. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Training needs for toxicity testing in the 21st century: a survey-informed analysis.

PubMed

Lapenna, Silvia; Gabbert, Silke; Worth, Andrew

2012-12-01

Current training needs on the use of alternative methods in predictive toxicology, including new approaches based on mode-of-action (MoA) and adverse outcome pathway (AOP) concepts, are expected to evolve rapidly. In order to gain insight into stakeholder preferences for training, the European Commission's Joint Research Centre (JRC) conducted a single-question survey with twelve experts in regulatory agencies, industry, national research organisations, NGOs and consultancies. Stakeholder responses were evaluated by means of theory-based qualitative data analysis. Overall, a set of training topics were identified that relate both to general background information and to guidance for applying alternative testing methods. In particular, for the use of in silico methods, stakeholders emphasised the need for training on data integration and evaluation, in order to increase confidence in applying these methods for regulatory purposes. Although the survey does not claim to offer an exhaustive overview of the training requirements, its findings support the conclusion that the development of well-targeted and tailor-made training opportunities that inform about the usefulness of alternative methods, in particular those that offer practical experience in the application of in silico methods, deserves more attention. This should be complemented by transparent information and guidance on the interpretation of the results generated by these methods and software tools. 2012 FRAME.

Nonvisual Route Following with Guidance from a Simple Haptic or Auditory Display

ERIC Educational Resources Information Center

Marston, James R.; Loomis, Jack M.; Klatzky, Roberta L.; Golledge, Reginald G.

2007-01-01

A path-following experiment, using a global positioning system, was conducted with participants who were legally blind. On- and off-course confirmations were delivered by either a vibrotactile or an audio stimulus. These simple binary cues were sufficient for guidance and point to the need to offer output options for guidance systems for people…

Review of the role of NICE in promoting the adoption of innovative cardiac technologies.

PubMed

Groves, Peter H; Pomfrett, Chris; Marlow, Mirella

2018-05-17

The National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme (MTEP) promotes the adoption of innovative diagnostic and therapeutic technologies into National Health Service (NHS) clinical practice through the publication of guidance and briefing documents. Since the inception of the programme in 2009, there have been 7 medical technologiesguidance, 3 diagnostics guidance and 23 medtechinnovation briefing documents published that are relevant to the heart and circulation. Medical technologies guidance is published by NICE for selected single technologies if they offer plausible additional benefits to patients and the healthcare system. Diagnostic guidance is published for diagnostic technologies if they have the potential to improve health outcomes, but if their introduction may be associated with an increase in overall cost to the NHS. Medtechinnovation briefings provide evidence-based advice to those considering the implementation of new medical devices or diagnostic technologies. This review provides reference to all of the guidance and briefing medical technology documents that NICE has published that are relevant to the heart and circulation and reflect on their diverse recommendations. The interaction of MTEP with other NICE programmes is integral to its effectiveness and the means by which consistency is ensured across the different NICE programmes is described. The importance of the input of clinical experts from the cardiovascular professional community and the engagement by NICE with cardiovascular professional societies is highlighted as being fundamental to ensuring the quality of guidance outputs as well as to promoting their implementation and adoption. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Solar Power Use Claims Guidance

EPA Pesticide Factsheets

The Toolbox for Renewable Energy Project Development's Solar Power Use Claims Guidance page helps electricity consumers understand the legal right that RECs offer their owners when making solar power use claims and provides resources for making claims.

16 CFR 1500.230 - Guidance for lead (Pb) in consumer products.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Guidance for lead (Pb) in consumer products. 1500.230 Section 1500.230 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS... § 1500.230 Guidance for lead (Pb) in consumer products. (a) Summary. (1) The U.S. Consumer Product Safety...

A right to confidentiality or a duty to disclose? Ethical guidance for conducting prevention research with children and adolescents.

PubMed

Hiriscau, Ioana E; Stingelin-Giles, Nicola; Stadler, Christina; Schmeck, Klaus; Reiter-Theil, Stella

2014-06-01

Conducting prevention research with children and adolescents raises ethical challenges especially regarding confidentiality. Research with children and adolescents often applies methodologies which aims at the disclosure of sensitive information about practices that impact on adolescent mental and physical health such as sexual activity, smoking, alcohol consumption, illegal drug use, self-damaging and suicidal behaviour (ideation and attempts). The scope of the article is to review normative documents that cover topics relevant for confidentiality when conducting research with children and adolescents. A systematic literature search in MEDLINE was performed to identify relevant international and European guidelines and codes of ethics that cover health, behavioural and social science research. Additionally, the European Research Ethics website was consulted for double check. However, none of the documents aimed at biomedical, behavioural or social research offers concrete support in resolving practical research ethics problems regarding confidentiality. The codes show a lack of clarity in any circumstances in which the researcher might have an obligation to breach confidentiality by disclosing sensitive information. Only little information is given on what kind of disclosed information, if disclosed, might justify breaching confidentiality. The findings prove a need for normative documents to address the ethical questions regarding confidentiality arising in research practice explicitly and specifically. Moreover, further forms of ethical guidance should be developed to support ethical research with children and adolescents.

Series: Pragmatic trials and real world evidence: Paper 7. Safety, quality and monitoring.

PubMed

Irving, Elaine; van den Bor, Rutger; Welsing, Paco; Walsh, Veronica; Alfonso-Cristancho, Rafael; Harvey, Catherine; Garman, Nadia; Grobbee, Diederick E

2017-11-01

Pragmatic trials offer the opportunity to obtain real-life data on the relative effectiveness and safety of a treatment before or after market authorization. This is the penultimate paper in a series of eight, describing the impact of design choices on the practical implementation of pragmatic trials. This paper focuses on the practical challenges of collecting and reporting safety data and of monitoring trial conduct while maintaining routine clinical care practice. Current ICH guidance recommends that all serious adverse events and all drug-related events must be reported in an interventional trial. In line with current guidance, we propose a risk-based approach to the collection of non-drug-related non-serious adverse events and even serious events not related to treatment based on the risk profile of the medicine/class in the patient population of interest. Different options available to support the collection and reporting of safety data while minimizing study-related follow-up visits are discussed. A risk-based approach to monitoring trial conduct is also discussed, highlighting the difference in the balance of risks likely to occur in a pragmatic trial compared to traditional clinical trials and the careful consideration that must be given to the mitigation and management of these risks to maintain routine care. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance, K-12 Schools (Book)

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

Not Available

The U.S. Department of Energy developed the Advanced Energy Retrofit Guides (AERGs) to provide specific methodologies, information, and guidance to help energy managers and other stakeholders plan and execute energy efficiency improvements. Detailed technical discussion is fairly limited. Instead, we emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluations of the most promising retrofit energy efficiency measures for each building type. A series of AERGs is under development, addressing key segments of the commercial building stock. K-12 schools were selected as one of the highest priority building sectors, because schools affect the lives of most Americans. They alsomore » represent approximately 8% of the energy use and 10% of the floor area in commercial buildings nationwide. U.S. K-12 school districts spend more than $8 billion each year on energy - more than they spend on computers and textbooks combined. Most occupy older buildings that often have poor operational performance - more than 30% of schools were built before 1960. The average age of a school is about 42 years - which is nearly the expected serviceable lifespan of the building. K-12 schools offer unique opportunities for deep, cost-effective energy efficiency improvements, and this guide provides convenient and practical guidance for exploiting these opportunities in the context of public, private, and parochial schools.« less

Embracing change: practical and theoretical considerations for successful implementation of technology assisting upper limb training in stroke

PubMed Central

2012-01-01

Background Rehabilitation technology for upper limb training of stroke patients may play an important role as therapy tool in future, in order to meet the increasing therapy demand. Currently, implementation of this technology in the clinic remains low. This study aimed at identifying criteria and conditions that people, involved in development of such technology, should take into account to achieve a (more) successful implementation of the technology in the clinic. Methods A literature search was performed in PubMed and IEEE databases, and semi-structured interviews with therapists in stroke rehabilitation were held, to identify criteria and conditions technology should meet to facilitate (implementation of) technology-assisted arm-hand skills training in rehabilitation therapy of stroke patients. In addition, an implementation strategy frequently applied in general health care was used to compose a stepwise guidance to facilitate successful implementation of this technology in therapy of stroke patients. Implementation-related criteria mentioned by therapists during the interviews were integrated in this guidance. Results Results indicate that, related to therapy content, technology should facilitate repetition of task-related movements, tailored to the patient and patient’s goals, in a meaningful context. Variability and increasing levels of difficulty in exercises should be on offer. Regarding hardware and software design of technology, the system should facilitate quick familiarisation and be easily adjustable to individual patients during therapy by therapists (and assistants). The system should facilitate adaptation to individual patients’ needs and their progression over time, should be adjustable as to various task-related variables, should be able to provide instructions and feedback, and should be able to document patient’s progression. The implementation process of technology in the clinic is provided as a stepwise guidance that consists of five phases therapists have to go through. The guidance includes criteria and conditions that motivate therapists, and make it possible for them, to actually use technology in their daily clinical practice. Conclusions The reported requirements are important as guidance for people involved in the development of rehabilitation technology for arm-hand therapy of stroke patients. The stepwise guide provides a tool for facilitating successful implementation of technology in clinical practice, thus meeting future therapy demand. PMID:22856548

Psychodrama groups for girls coping with trauma.

PubMed

Carbonell, D M; Parteleno-Barehmi, C

1999-07-01

This study evaluated the effectiveness of psychodrama groups with traumatized middle-school girls. Comparisons of treatment and control group members' pre- and postintervention adjustment revealed significant decreases in group participants' self-reported difficulties in withdrawn behavior and anxiety/depression. Interviews with the participants reinforced the value of psychodrama group participation in the resolution of trauma and in increasing a sense of competence and self-efficacy. A brief outline of the group structure and a description of the process offer examples that illustrate the practice methodology and provide guidance for conducting psychodrama groups with vulnerable populations. Concerns with safety and containment are addressed.

Plant-Based Diets: A Physician’s Guide

PubMed Central

Hever, Julieanna

2016-01-01

Because of the ever-increasing body of evidence in support of the health advantages of plant-based nutrition, there is a need for guidance on implementing its practice. This article provides physicians and other health care practitioners an overview of the myriad benefits of a plant-based diet as well as details on how best to achieve a well-balanced, nutrient-dense meal plan. It also defines notable nutrient sources, describes how to get started, and offers suggestions on how health care practitioners can encourage their patients to achieve goals, adhere to the plan, and experience success. PMID:27400178

The Emergency Department: Challenges and Opportunities for Suicide Prevention.

PubMed

Asarnow, Joan Rosenbaum; Babeva, Kalina; Horstmann, Elizabeth

2017-10-01

Emergency departments (EDs) can offer life-saving suicide prevention care. This article focuses on the ED and emergency services as service delivery sites for suicide prevention. Characteristics of EDs, models of emergency care, ED screening and brief intervention models, and practice guidelines and parameters are reviewed. A care process model for youths at risk for suicide and self-harm is presented, with guidance for clinicians based on the scientific evidence. Strengthening emergency infrastructure and integrating effective suicide prevention strategies derived from scientific research are critical for advancing suicide prevention objectives. Copyright © 2017 Elsevier Inc. All rights reserved.

Neurologists and technology

PubMed Central

Potts, Daniel C.; Hohler, Anna D.

2013-01-01

Summary Social and traditional media are revolutionizing health care. Medicine, once an art practiced behind closed doors, is now part of the public domain. This article will help neurologists navigate a complex maze of technology to optimize patient care without compromising privacy. We offer ideas for improving our digital “footprint.” Guidance is given on maintaining professional demeanor in all private and public interactions to help us avoid personal or patient insult and injury. Acknowledging that neurology is becoming a specialty of increased personal and social education, we outline ways to proactively improve our patient care and education locally and globally. PMID:29473595

Surgical guidance system using hand-held probe with accompanying positron coincidence detector

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

Majewski, Stanislaw; Weisenberger, Andrew G.

A surgical guidance system offering different levels of imaging capability while maintaining the same hand-held convenient small size of light-weight intra-operative probes. The surgical guidance system includes a second detector, typically an imager, located behind the area of surgical interest to form a coincidence guidance system with the hand-held probe. This approach is focused on the detection of positron emitting biomarkers with gamma rays accompanying positron emissions from the radiolabeled nuclei.

GUIDANCE FOR LANDFILLING WASTE IN ECONOMICALLY DEVELOPING COUNTRIES

EPA Science Inventory

The report offers guidance on all aspects of the planning, design, and implementation of landfills in economically developing countries. The intended audience includes municipal officials, solid waste managers, engineers, and planners. The report's 18 chapters include critical ...

Reporting Research: A Biologist's Guide to Articles, Talks, and Posters

NASA Astrophysics Data System (ADS)

Clymo, R. S.

2014-12-01

Want to learn how to present your research successfully? This practical guide for students and postdoctoral scholars offers a unique step-by-step approach to help you avoid the worst, yet most common, mistakes in biology communication. Covering irritants such as sins of ambiguity, circumlocution, inconsistency, vagueness and verbosity, misuse of words and quantitative matters, it also provides guidance to design your next piece of work effectively. Learn how to write scientific articles and get them published, prepare posters and talks that will capture your audience and develop a critical attitude towards your own work as well as that of your colleagues. With numerous practical examples, comparisons among disciplines, valuable tips and real-life anecdotes, this must-read guide will be a valuable resource to both new graduate students and their supervisors.

A practical guide to self-sustaining point-of-care ultrasound education programs in resource-limited settings.

PubMed

Henwood, Patricia C; Mackenzie, David C; Rempell, Joshua S; Murray, Alice F; Leo, Megan M; Dean, Anthony J; Liteplo, Andrew S; Noble, Vicki E

2014-09-01

The value of point-of-care ultrasound education in resource-limited settings is increasingly recognized, though little guidance exists on how to best construct a sustainable training program. Herein we offer a practical overview of core factors to consider when developing and implementing a point-of-care ultrasound education program in a resource-limited setting. Considerations include analysis of needs assessment findings, development of locally relevant curriculum, access to ultrasound machines and related technological and financial resources, quality assurance and follow-up plans, strategic partnerships, and outcomes measures. Well-planned education programs in these settings increase the potential for long-term influence on clinician skills and patient care. Copyright © 2014 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Sharing organs with foreign nationals.

PubMed

Bruni, Rebecca; Wright, Linda

2011-03-01

Organs for transplantation are an absolute scarcity throughout the world, and many countries do not offer transplantation. Developed countries with transplant programs receive requests to list foreign nationals for transplantation. Any national standard deserves justification by a thorough exploration of the issues. In this article, the issues regarding organ transplantation for foreign nationals in Canada are explored. Currently Canada has no policy on listing foreign nationals for transplantation. Three topics are reviewed: (1) arguments for and against the transplantation of organs from deceased donors to foreign nationals, (2) relevant legislation and position statements, and (3) relevant practices in other countries. Finally, practical policy options are suggested. This article's analysis of the issues will provide guidance for health care professionals and policy makers in Canada and developed countries exploring listing foreign nationals for transplantation.

Community-Based Career Guidance Practices. Vol. I--Elementary Level.

ERIC Educational Resources Information Center

Manatee Junior Coll., Bradenton, FL.

This collection of twelve elementary-level career guidance practices consists of four activities which may be grouped under the heading of novel practices, three activities involving community volunteers, a field trip, a career day activity, and three mobile activities. A standard format (including a description of the practice, its objectives, a…

Study on the Status Quo and Reform Measures of Employment Guidance in Universities

ERIC Educational Resources Information Center

He, Liping

2011-01-01

As a new discipline, employment guidance is aimed at the study of employment and how to solve the problem in employment every individual meets. It offers an effective approach to the problem in employment for university graduates. This article starts with the importance of conducting employment guidance and makes an analysis of the status quo as…

Vocational Guidance for the Deaf; A Classified Guide to the Basic Requirements for Occupations Open to the Profoundly Deaf.

ERIC Educational Resources Information Center

Montgomery, G.W.G.

Published in Britain for use by counselors and placement officials, the book offers a systematic attack on occupational placement problems of the prelingually deaf. The system is based on a vocational guidance profile, which is developed from intelligence and achievement test scores. The vocational guidance profile is explained, and occupational…

Promoting information literacy through collaborative service learning in an undergraduate research course.

PubMed

Janke, Robert; Pesut, Barbara; Erbacker, Lynnelle

2012-11-01

Information literacy is an important foundation for evidence-based nursing practice. Librarians, the experts in information literacy, are important collaborators in the process of teaching nursing students information literacy skills. In this article we describe a service learning project, offered in a third year nursing research course, designed to teach information literacy and to enhance students' appreciation of the role of evidence in nursing practice. Students worked in groups, and under the guidance of a nursing instructor and librarian, to answer a question posed by practice-based partners. Through the project students learned essential skills of refining a question, identifying systematic search strategies, gleaning essential information from a study and using a bibliographic management tool. Evaluation of the project indicated that although the project was challenging and labour intensive students felt they learned important skills for their future practice. Several recommendations for further enhancing the collaboration are made. Copyright © 2011 Elsevier Ltd. All rights reserved.

Implications of Weltanschauungen for Value Formulation by Guidance Personnel

ERIC Educational Resources Information Center

Weinstock, Henry R.; O'Dowd, Peter S.

1970-01-01

Examines two divergent world-views (empiricism and ration alism) of human values, presenting definitions from many philosophers. Anticipates possibility of confluence of beliefs on nature of man which may offer guidance personnel more accurate tools for direction. (CJ)

Resources for Guidance Program Improvement. Volume 2.

ERIC Educational Resources Information Center

Frenza, Mary C., Comp.; and Others

This guide, for guidance personnel and teachers, is designed to provide ready access to current, practical programs, activities, and references for improving guidance programs. The resources are organized in four sections representing areas of basic concern for guidance personnel. Section 1 presents selected portions of guidance programs from…

What results when firms implement practices: the differential relationship between specific practices, firm financial performance, customer service, and quality.

PubMed

Gibson, Cristina B; Porath, Christine L; Benson, George S; Lawler, Edward E

2007-11-01

Previous research on organizational practices is replete with contradictory evidence regarding their effects. Here, the authors argue that these contradictory findings may have occurred because researchers have often examined complex practice combinations and have failed to investigate a broad variety of firm-level outcomes. Thus, past research may obscure important differential effects of specific practices on specific firm-level outcomes. Extending this research, the authors develop hypotheses about the effects of practices that (a) enable information sharing, (b) set boundaries, and (c) enable teams on 3 different firm-level outcomes: financial performance, customer service, and quality. Relationships are tested in a sample of observations from over 200 Fortune 1000 firms. Results indicate that information-sharing practices were positively related to financial performance 1 year following implementation of the practices, boundary-setting practices were positively related to firm-level customer service, and team-enabling practices were related to firm-level quality. No single set of practices predicted all 3 firm-level outcomes, indicating practice-specific effects. These findings help resolve the theoretical tension in the literature regarding the effects of organizational practices and offer guidance as to how to best target practices to increase specific work-related outcomes. Implications for theory, research, and practice are discussed. (c) 2007 APA

Variation in the Viral Hepatitis and HIV Policies and Practices of Methadone Maintenance Programs.

PubMed

Jessop, Amy B; Hom, Jeffrey K; Burke, Monika

Patients prescribed methadone maintenance treatment (MMT) demonstrate elevated prevalence of hepatitis B virus (HBV), hepatitis C virus, and HIV. Government agencies recommend testing for these infections in MMT programs, but uptake is limited. We audited infection-related policies and practices of all 14 MMT programs in Philadelphia, Pennsylvania, in 2015. Results were tabulated and compared with the results from a 2010 audit of 10 of 12 MMT programs. The audit focused on which patients are tested, timing and frequency, specific tests ordered, vaccination, and communication of test results. Written policies were nonspecific, offering little guidance on appropriate testing. The principal change in policy between 2010 and 2015 involved adding clearer guidance for communication of results to patients. In 2010 and 2015, all MMT programs tested new patients for hepatitis C virus antibodies, although retesting of existing patients varied. HBV testing increased from 2010 to 2015, though it was not uniform, with 5 programs testing for HBV surface antibodies and 10 programs testing for HBV surface antigens. Six programs assessed hepatitis vaccination status, but only 1 administered vaccines. In 2010, city-sponsored HIV antibody testing was available at all MMT programs. Without this program in 2015, few MMT programs conducted HIV testing. Despite limited hepatitis and HIV screening in MMT programs nationally, this study shows that testing can be incorporated into routine procedures. MMT programs are positioned to play an integral role in the identification of patients with chronic infections, but additional guidance and resources are required to maximize their impact.

Guidance on How to Move from Current Practice to Recommended Practice in Life Cycle Impact Assessment (UNEP/SETAC Life Cycle Initiative Publication)

EPA Science Inventory

The report provides guidance on how to move from current practice to recommended practice in Life Cycle Impact Assessment. It is composed of three complementary parts elaborated in the first task force (TFI) of the LCIA programme, with contribution of the other three task forces:

STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 2 - VEGETATIVE BIOFILTERS

EPA Science Inventory

This document is Volume 2 of a three volume document that provides guidance on the selection and design of stormwater management Best Management Practices (BMPs). This second volume provides specific design guidance for a group of onsite BMP control practices that are referred t...

Research-Based Knowledge: Researchers' Contribution to Evidence-Based Practice and Policy Making in Career Guidance

ERIC Educational Resources Information Center

Haug, Erik Hagaseth; Plant, Peter

2016-01-01

To present evidence for the outcomes of career guidance is increasingly seen as pivotal for a further professionalization of policy making and service provision. This paper puts an emphasis on researchers' contribution to evidence-based practice and policy making in career guidance. We argue for a broader and more pluralistic research strategy to…

Constituent Aspects of Workplace Guidance in Secondary VET

ERIC Educational Resources Information Center

Swager, Robert; Klarus, Ruud; van Merriënboer, Jeroen J. G.; Nieuwenhuis, Loek F. M.

2015-01-01

Purpose: This paper aims to present an integrated model of workplace guidance to enhance awareness of what constitutes good guidance, to improve workplace guidance practices in vocational education and training. Design/methodology/approach: To identify constituent aspects of workplace guidance, a systematic search of Web of Science was conducted,…

RESEARCH VISIBILITY. VOCATIONAL EDUCATION IS SERVICE--VOCATIONAL GUIDANCE.

ERIC Educational Resources Information Center

LAW, GORDON F.

NINETEEN REVIEWS IN THIS ISSUE PERTAIN TO VOCATIONAL GUIDANCE AND ARE ORGANIZED BY TOPICS--(1) "SYSTEMS TECHNOLOGY IN GUIDANCE" REVIEWS AN EXPLORATORY STUDY OF INFORMATION PROCESSING PROCEDURES AND COMPUTER APPLICATIONS IN GUIDANCE, AND A CONFERENCE ON SYSTEMS DEVELOPMENT FOR VOCATIONAL GUIDANCE, (2) "CAREER DEVELOPMENT THEORY AND PRACTICE" TREATS…

General Guidance on Innovative and Voluntary Air Pollution Control Strategies

EPA Pesticide Factsheets

State and Local Transporation Resources is an EPA/OTAQ web page for state and local air quality regulators and transportation planners that offers guidance on how to reduce air pollution from cars, diesel trucks, city and school buses.

Missing: Prototype Vocational Guidance System.

ERIC Educational Resources Information Center

Weltin, Mary M.; Johnson, Richard M.

1985-01-01

Describes Army research in recruitment and vocational counseling. Discusses the Joint Optical Information Network, which offers career opportunity information, and the Army Research Institute's investigations of vocational counseling for high school and community college students and its prototype vocational guidance system. Encourages community…

GUIDANCE AVAILABLE FOR LANDFILLING WASTE IN ECONOMICALLY DEVELOPING COUNTRIES

EPA Science Inventory

The paper provides a brief summary of a report that offers guidance on all aspects of the planning, design, and implementation of landfills in economically developing countries. The intended audience includes municipal officials, solid waste managers, engineers, and planners. T...

78 FR 47217 - Proposed Supervisory Guidance on Implementing Dodd-Frank Act Company-Run Stress Tests for Banking...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

..., that are designed to ensure that its stress testing processes are effective in meeting the requirements... specific methodological practices. Consistent with this approach, this guidance sets general supervisory... use any specific methodological practices for their stress tests. Companies may use various practices...

Nutrition in Medicine: Nutrition Education for Medical Students and Residents

PubMed Central

Adams, Kelly M.; Kohlmeier, Martin; Powell, Margo; Zeisel, Steven H.

2015-01-01

Proper nutrition plays a key role in disease prevention and treatment. Many patients understand this link and look to physicians for guidance diet and physical activity. Actual physician practice, however, is often inadequate in addressing the nutrition aspects of diseases such as cancer, obesity, and diabetes. Physicians do not feel comfortable, confident, or adequately prepared to provide nutrition counseling, which may be related to suboptimal knowledge of basic nutrition science facts and understanding of potential nutrition interventions. Historically, nutrition education has been underrepresented at many medical schools and residency programs. Our surveys over a decade show that most medical schools in the United States are still not ensuring adequate nutrition education, and they are not producing graduates with the nutrition competencies required in medical practice. Physicians, residents, and medical students clearly need more training in nutrition assessment and intervention. The Nutrition in Medicine (NIM) project, established to develop and distribute a core nutrition curriculum for medical students, offers a comprehensive online set of courses free of charge to medical schools. The NIM medical school curriculum is widely used in the United States and abroad. A new initiative, Nutrition Education for Practicing Physicians, offers an innovative online medical nutrition education program for residents and other physicians-in-training, but with targeted, practice-based educational units designed to be completed in 15 minutes or less. The NIM project is strengthening medical nutrition practice by providing a free, comprehensive, online nutrition curriculum with clinically relevant, evidence-based medical education for undergraduate and postgraduate learners. PMID:20962306

The Use of ICT in School Guidance: Attitudes and Practices of Guidance Counselors in Metro Manila, the Philippines

ERIC Educational Resources Information Center

Vinluan, Lorelei R.

2011-01-01

A survey was conducted among a sample of school guidance counselors in Metro Manila, the Philippines, to determine their level of awareness, attitudes, and extent of practice of ICT in the conduct of their work. The respondents showed a higher level of awareness of communication technologies than of information technologies. They spent an average…

Pneumococcal Vaccination Guidance for Post-Acute and Long-Term Care Settings: Recommendations From AMDA's Infection Advisory Committee.

PubMed

Nace, David A; Archbald-Pannone, Laurie R; Ashraf, Muhammad S; Drinka, Paul J; Frentzel, Elizabeth; Gaur, Swati; Mahajan, Dheeraj; Mehr, David R; Mercer, William C; Sloane, Philip D; Jump, Robin L P

2017-02-01

Efforts at preventing pneumococcal disease are a national health priority, particularly in older adults and especially in post-acute and long-term care settings The Advisory Committee on Immunization Practices recommends that all adults ≥65 years of age, as well as adults 18-64 years of age with specific risk factors, receive both the recently introduced polysaccharide-protein conjugate vaccine against 13 pneumococcal serotypes as well as the polysaccharide vaccine against 23 pneumococcal serotypes. Nursing facility licensure regulations require facilities to assess the pneumococcal vaccination status of each resident, provide education regarding pneumococcal vaccination, and administer the appropriate pneumococcal vaccine when indicated. Sorting out the indications and timing for 13 pneumococcal serotypes and 23 pneumococcal serotypes administration is complex and presents a significant challenge to healthcare providers. Here, we discuss the importance of pneumococcal vaccination for older adults, detail AMDA-The Society for Post-Acute and Long-Term Care Medicine (The Society)'s recommendations for pneumococcal vaccination practice and procedures, and offer guidance to postacute and long-term care providers supporting the development and effective implementation of pneumococcal vaccine policies. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

Two vignettes of adolescent sexual disclosure: guidance for HIV clinical practice

PubMed Central

Lichtenstein, Bronwen; Rodgers, Cynthia; Marefka, Lauren EB; Hinson, Marla D; Cook-Heard, Dayna; Rygiel, Stephen D; Sturdevant, Marsha S

2016-01-01

HIV-positive adolescents are required by law to notify sexual partners, but can find it difficult to achieve this goal. This article offers practice guidance for counselling HIV-positive adolescents about sexual disclosure in clinical settings and for building confidence in managing sexual lives with HIV. We use two vignettes to illustrate key differences between perinatally and sexually infected adolescents in terms of readiness to disclose, and include a set of strategies for both groups that can be tailored to individual circumstances and contexts. The toolbox of strategies we describe include pre-counselling, focused counselling, social support groups and technical support. Pre-counselling helps to identify barriers and motivations to sexual disclosure and is followed by counselling sessions in which the focus is on role playing and sexual scripts for disclosure. Peer-led support groups are designed to boost adolescent confidence, and pre-paid cell phones, text messaging, ready-dial phone numbers and a private Facebook page provide back-up support and out-of-hours contact. Since sexual disclosure can be a risky proposition, safety plans, such as having an emergency contact person, should always be in place. These strategies are designed to empower vulnerable adolescents, foster trust between patient and provider, and reduce HIV transmission to sexual partners. PMID:28989498

Two vignettes of adolescent sexual disclosure: guidance for HIV clinical practice.

PubMed

Lichtenstein, Bronwen; Rodgers, Cynthia; Marefka, Lauren Eb; Hinson, Marla D; Cook-Heard, Dayna; Rygiel, Stephen D; Sturdevant, Marsha S

2017-01-01

HIV-positive adolescents are required by law to notify sexual partners, but can find it difficult to achieve this goal. This article offers practice guidance for counselling HIV-positive adolescents about sexual disclosure in clinical settings and for building confidence in managing sexual lives with HIV. We use two vignettes to illustrate key differences between perinatally and sexually infected adolescents in terms of readiness to disclose, and include a set of strategies for both groups that can be tailored to individual circumstances and contexts. The toolbox of strategies we describe include pre-counselling, focused counselling, social support groups and technical support. Pre-counselling helps to identify barriers and motivations to sexual disclosure and is followed by counselling sessions in which the focus is on role playing and sexual scripts for disclosure. Peer-led support groups are designed to boost adolescent confidence, and pre-paid cell phones, text messaging, ready-dial phone numbers and a private Facebook page provide back-up support and out-of-hours contact. Since sexual disclosure can be a risky proposition, safety plans, such as having an emergency contact person, should always be in place. These strategies are designed to empower vulnerable adolescents, foster trust between patient and provider, and reduce HIV transmission to sexual partners.

Freedom to Tweet? Opportunities and Barriers for Federal Scientists on Social Media

NASA Astrophysics Data System (ADS)

Goldman, G. T.; Bailin, D.; Rogerson, P.; Renaud, A.; Halpern, M.; Grifo, F.

2013-12-01

The recent explosion of social media represents a fundamental shift in how scientists can share their work with the world, and federal scientists are taking advantage of these new tools. A 2009 report by the Chief Information Officers (CIO) Council--an interagency forum on federal information-technology management convened under the E-Government Act of 2002--recommends that all federal agencies develop a social media policy to address security concerns and provide guidance to employees on how they should identify themselves in these venues. In response to this report, and to the changing media landscape in general, many federal agencies have since developed polices to clarify how their employees may engage in social media. But how effective are such policies for federal scientists? Past analysis has looked at agency social media policies with an eye on performance metrics or on security and privacy of government information. Here, we assess the policies from a different angle: Do they provide sufficient guidance to government scientists and other technical experts? Do they adequately guide employees in a way that promotes responsible use while also affording them the freedom to use these tools to share their work? And how do different agencies compare? We analyzed policies, conducted a survey of federal scientists, and utilized Freedom of Information Act requests to assess how well federal policies and practices provide guidance and freedom for federal scientists using social media at 17 federal agencies. We found that some agencies have very thorough policies and practices that clearly guide and encourage their employees' use of social media outlets; while others provide minimal to no guidance to their scientists or discourage use of these tools. From this analysis, we identify opportunities for communication of federal science on social media, as well as barriers currently inhibiting federal scientists from using these tools. Finally, we offer recommendations for steps that agencies can take in order to continue progress toward providing freedom for their technical experts to fully utilize social media tools.

Variations in guideline use and practice relating to diagnosis and management of infection in paediatric burns services in England and Wales: A national survey.

PubMed

Davies, Anna; Spickett-Jones, Francesca; Brock, Paula; Coy, Karen; Young, Amber

2017-02-01

Wound infection causes morbidity and mortality in burns. UK National Burns Care Standards state that guidance should be used to diagnose and treat burn wound infection. However, surveys of senior staff about standard operating procedures or guidance in UK burns services indicate that they are infrequently available (Papini et al., 1995; Lymperopoulos et al., 2015). Staff may have differing views and experiences of guidance use according to their role. This survey investigated the extent to which guidance is available, and current practices used for diagnosis and treatment of burn wound infection, both within and between paediatric burns services. Staff from paediatric burns services in England and Wales were individually interviewed by two nurses about guidance and practices around antibiotic prophylaxis, diagnosis and management of burn wound infection and toxic shock syndrome, and antibiotic use. In each service staff from three categories were interviewed: lead consultant/burns specialist nurse, junior doctor/senior nurse, ward based nurse. Data were subjected to content analysis and reliably coded by two researchers using a coding frame. Guidance documents were also requested. Thirteen services took part. Staff in fewer than half of services reported that they had guidance for antibiotic prophylaxis, diagnosis, and management of burn wound infection. In nine services at least one staff member reported that they had guidance for antibiotic use. Guidance was available for diagnosis and management of toxic shock syndrome in ten services, and staff in five were consistently aware of it. One service routinely used antibiotic prophylaxis, but had no written guidance for it. In five services where at least one member of staff reported that they had guidance for diagnosing infection, at least one interviewed staff member was unaware of it. Swabbing practice varied between and within services, with 10 staff across six services cleaning before swabbing, and four staff in three services cleaning after swabbing. Staff from fewer than half of burns services report that they have guidance for diagnosing and managing burn wound infection, and there is variation between and within services relating to staff awareness of available guidance. There are some consistencies in practice; the majority of services do not use antibiotic prophylaxis, and there is consistent prescribing for suspected infection and tests used for infection diagnosis. Swabbing practices are less consistent. This survey indicates a need for evidence-based guidelines to be developed in order to meet national burns care standards, and for staff to be made aware of them and trained in their use. Guidelines do not need to replace clinical judgement and should be developed with the involvement of those who will implement them. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Predicting risk behaviors: development and validation of a diagnostic scale.

PubMed

Witte, K; Cameron, K A; McKeon, J K; Berkowitz, J M

1996-01-01

The goal of this study was to develop and validate the Risk Behavior Diagnosis (RBD) Scale for use by health care providers and practitioners interested in promoting healthy behaviors. Theoretically guided by the Extended Parallel Process Model (EPPM; a fear appeal theory), the RBD scale was designed to work in conjunction with an easy-to-use formula to determine which types of health risk messages would be most appropriate for a given individual or audience. Because some health risk messages promote behavior change and others backfire, this type of scale offers guidance to practitioners on how to develop the best persuasive message possible to motivate healthy behaviors. The results of the study demonstrate the RBD scale to have a high degree of content, construct, and predictive validity. Specific examples and practical suggestions are offered to facilitate use of the scale for health practitioners.

A longitudinal study of changes in noticing and treating patients' overweight by Dutch GPs between 1997 and 2007.

PubMed

van Dijk, Elske; Kampen, Jarl K; Hiddink, Gerrit J; Renes, Reint Jan; van Binsbergen, Jaap J; van Woerkum, Cees M J

2012-04-01

One of the stakeholders in tackling the rise and health consequences of overweight and obesity is the general practice physician (GP). GPs are in a good position to inform and give nutrition guidance to overweight patients. Assessment of working mechanism of determinants of the nutrition guidance practice: noticing patients' overweight and guidance of treatment by GPs [linear analysis of structural relations (LISREL) path model] in a longitudinal study. This longitudinal study measured data in 1992, 1997 and 2007. The 1992 LISREL path model (Hiddink GJ, Hautvast J, van Woerkum CMJ, Fieren CJ, van t'Hof MA. Nutrition guidance by primary-care physicians: LISREL analysis improves understanding. Prev Med 1997; 26: 29-36.) demonstrated that 'noticing patients' overweight and guidance of treatment' was directly and indirectly influenced by predisposing factors, driving forces and perceived barriers. This article defines and discusses the path analysis of the 2007 data (compared with 1997). This analysis shows both similarity and differences in working mechanism of determinants of noticing patients' overweight and guidance of treatment between 1997 and 2007. The backbone of the mechanism with four predisposing factors is the similarity. The number of driving forces and of paths through intermediary factors to the dependent variable constitutes the difference. The backbone of the working mechanism of determinants of the nutrition guidance practice: noticing patients' overweight and guidance of treatment by GPs was similar in 2007 and 1997. The influence of GPs task perception on noticing patients' overweight and guidance of treatment considerably increased in 2007 compared to 1997. The longitudinal character of this article gives a strong practice-based evidence for weight management by GPs.

Prepared to practice? Perception of career preparation and guidance of recent medical graduates at two campuses of a transnational medical school: a cross-sectional study.

PubMed

Kassim, Sameer S; McGowan, Yvonne; McGee, Hannah; Whitford, David L

2016-02-09

Graduating medical students enter the workforce with substantial medical knowledge and experience, yet little is known about how well they are prepared for the transition to medical practice in diverse settings. We set out to compare perceptions of medical school graduates' career guidance with their perceptions of preparedness to practice as interns. We also set out to compare perceptions of preparedness for hospital practice between graduates from two transnational medical schools. This was a cross-sectional study. A Preparedness for Hospital Practice (PHPQ) survey and career guidance questionnaire was sent to recent medical graduates, incorporating additional free text responses on career preparation. Data was analyzed using descriptive statistics and tests of association including Chi-square, Mann-Whitney U and Kruskal-Wallis H tests. Forty three percent (240/555) of graduates responded to the survey: 39 % of respondents were domestic (Dublin, Ireland or Manama, Kingdom of Bahrain) and interning locally; 15 % were overseas students interning locally; 42 % were overseas students interning internationally and 4 % had not started internship. Two variables explained 13 % of the variation in preparedness for hospital practice score: having planned postgraduate education prior to entering medical school and having helpful career guidance in medical school. Overseas graduates interning internationally were more likely to have planned their postgraduate career path prior to entering medical school. Dublin graduates found their career guidance more helpful than Bahrain counterparts. The most cited shortcomings were lack of structured career advice and lack of advice on the Irish and Bahraini postgraduate systems. This study has demonstrated that early consideration of postgraduate career preparation and helpful medical school career guidance has a strong association with perceptions of preparedness of medical graduates for hospital practice. In an era of increasing globalization of medical education, these findings can direct ongoing efforts to ensure all medical students receive career guidance and preparation for internship appropriate to their destination.

[Adolescence and sexuality: a risky business How best to inform parents ?

PubMed

Yaron, Michal; Soroken, Cindy; Narring, Françoise; Brockmann, Céline; Merglen, Arnaud

2018-04-18

Parents are often reluctant to discuss sexuality and romantic relationships with their teenagers. However, these discussions can have a strong impact on their children's health. Care providers can act as a reliable source of information to support parents in this task. Through repeated short interactions with their child over their adolescence, parents can cover most topics related to sexuality, based on teenagers' questions and the situations that they face (e.g. LGBT bullying at school). This article summarizes current best practice on how to facilitate parental dialogue with adolescents about sexuality and offer care providers guidance in transmitting this information to parents.

A Practitioners Perspective on Verification

NASA Astrophysics Data System (ADS)

Steenburgh, R. A.

2017-12-01

NOAAs Space Weather Prediction Center offers a wide range of products and services to meet the needs of an equally wide range of customers. A robust verification program is essential to the informed use of model guidance and other tools by both forecasters and end users alike. In this talk, we present current SWPC practices and results, and examine emerging requirements and potential approaches to satisfy them. We explore the varying verification needs of forecasters and end users, as well as the role of subjective and objective verification. Finally, we describe a vehicle used in the meteorological community to unify approaches to model verification and facilitate intercomparison.

Practical Guidance and Ethical Considerations for Studies Using Photo-Elicitation Interviews

PubMed Central

Bugos, Eva; Frasso, Rosemary; FitzGerald, Elizabeth; True, Gala; Adachi-Mejia, Anna M.

2014-01-01

Photo-elicitation is a qualitative interviewing technique that has gained popularity in recent years. It is the foundation for photovoice projects and is a tool well-suited for community-based participatory research. Photo-elicitation yields rich data, and interview participants say these interviews encourage community awareness and engagement. This article draws on 9 studies, conducted by researchers at 3 institutions (the University of Pennsylvania, the Philadelphia Veterans Affairs Medical Center, and the Geisel School of Medicine at Dartmouth) in partnership with community-based organizations and students, in which 303 participants completed photo-elicitation interviews. We offer 8 practical suggestions for overcoming challenges encountered during photo-elicitation research and for managing ethical concerns about the use of visual data in public health research. Our guidelines can inform study design, protocol development, and institutional review board approval. PMID:25357257

Truth in Advertising: Disclosure of Participant Payment in Research Recruitment Materials.

PubMed

Gelinas, Luke; Lynch, Holly Fernandez; Largent, Emily A; Shachar, Carmel; Cohen, I Glenn; Bierer, Barbara E

2018-05-01

The practice of paying research participants has received significant attention in the bioethics literature, but the focus has been almost exclusively on consideration of factors relevant to determining acceptable payment amounts. Surprisingly little attention has been paid to what happens once the payment amount is set. What are the ethical parameters around how offers of payment may be advertised to prospective participants? This article seeks to answer this question, focusing on the ethical and practical issues associated with disclosing information about payment, and payment amounts in particular, in recruitment materials. We argue that it is permissible-and indeed typically ethically desirable-for recruitment materials to disclose the amount that participants will be paid. Further, we seek to clarify the regulatory guidance on "emphasizing" payment in a way that can facilitate design and review of recruitment materials.

Introduction to special section of the Journal of Family Psychology, advances in mixed methods in family psychology: integrative and applied solutions for family science.

PubMed

Weisner, Thomas S; Fiese, Barbara H

2011-12-01

Mixed methods in family psychology refer to the systematic integration of qualitative and quantitative techniques to represent family processes and settings. Over the past decade, significant advances have been made in study design, analytic strategies, and technological support (such as software) that allow for the integration of quantitative and qualitative methods and for making appropriate inferences from mixed methods. This special section of the Journal of Family Psychology illustrates how mixed methods may be used to advance knowledge in family science through identifying important cultural differences in family structure, beliefs, and practices, and revealing patterns of family relationships to generate new measurement paradigms and inform clinical practice. Guidance is offered to advance mixed methods research in family psychology through sound principles of peer review.

Reflections as near-peer facilitators of an inquiry project for undergraduate anatomy: Successes and challenges from a term of trial-and-error.

PubMed

Anstey, Lauren M; Michels, Alison; Szymus, Julianna; Law, Wyanne; Edwin Ho, Man-Hymn; Qu, Fei; Yeung, Ralph T T; Chow, Natalie

2014-01-01

Near-peer facilitators (senior students serving as facilitators to their more junior peers) bring a unique student-based perspective to teaching. With fewer years of teaching experience however, students who become involved in a facilitator role typically develop related skills quickly through a process of trial-and-error within the classroom. The aim of this paper is to report on the authors' own experiences and reflections as student near-peer facilitators for an inquiry-based project in an undergraduate anatomy course. Three areas of the facilitator experience are explored: (1) offering adequate guidance as facilitators of inquiry, (2) motivating students to engage in the inquiry process, and (3) fostering creativity in learning. A practical framework for providing guidance to students is discussed which offers facilitators a scaffold for asking questions and assisting students through the inquiry process. Considerations for stimulating intrinsic motivations toward inquiry learning are made, paying attention to ways in which facilitators might influence feelings of motivation towards learning. Also, the role of creativity in inquiry learning is explored by highlighting the actions facilitators can take to foster a creative learning environment. Finally, recommendations are made for the development of formalized training programs that aid near-peer facilitators in the acquisition of facilitation skills before entering into a process of trial-and-error within the classroom. © 2013 American Association of Anatomists.

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients: A Guidance Report and Clinical Checklist by the Consensus on Managing Modifiable Risk in Transplantation (COMMIT) Group.

PubMed

Neuberger, James M; Bechstein, Wolf O; Kuypers, Dirk R J; Burra, Patrizia; Citterio, Franco; De Geest, Sabina; Duvoux, Christophe; Jardine, Alan G; Kamar, Nassim; Krämer, Bernhard K; Metselaar, Herold J; Nevens, Frederik; Pirenne, Jacques; Rodríguez-Perálvarez, Manuel L; Samuel, Didier; Schneeberger, Stefan; Serón, Daniel; Trunečka, Pavel; Tisone, Giuseppe; van Gelder, Teun

2017-04-01

Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes.COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant.The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting.

Practice acquisition: a due diligence checklist. HFMA Principles and Practices Board.

PubMed

1995-12-01

As healthcare executives act to form integrated healthcare systems that encompass entities such as physician-hospital organizations and medical group practices, they often discover that practical guidance on acquiring physician practices is scarce. To address the need for authoritative guidance on practice acquisition, HFMA's Principles and Practices Board has developed a detailed analysis of physician practices acquisition issues, Issues Analysis 95-1: Acquisition of Physician Practices. This analysis includes a detailed due diligence checklist developed to assist both healthcare financial managers involved in acquiring physician practices and physician owners interested in selling their practices.

[Function of the present systematic evaluation in establishment of guidance for clinical practice].

PubMed

Yang, Jin-Hong; Hu, Jing; Yang, Feng-Chun; Zhang, Ning; Wang, Bing; Li, Xin

2012-07-01

Treatment of insomnia with acupuncture is taken as an example to explore the significance and problems existed in the present systematic evaluation in establishment of guidance for clinical practice. Fifteen articles on systematic evaluation of both English and Chinese were retrieved and studied carefully, their basic information was analyzed. Through study on the establishing process of the guidance of clinical practice, researches were focused on the possible significance of the articles to the guidance as well as the notes in the reuse of those articles since problem still existed. It is held that the systematic evaluation has great significance on the establishment of the guidance from the aspects of applicable people, recommended standards of diagnosis and therapeutic evaluation, extended recommendation and methodology. Great importance should also be attached to the direct application of the research result and understanding of the evaluation result. The data should be rechecked when necessary. Great guiding function can be found on the systematic evaluation of articles to the guidance. Moreover, if information needed to be taken into a full play, specific analysis should also be done on the concrete research targets.

Breaking the barriers to commercialization of MEMS: a firm's search for competitive advantage

NASA Astrophysics Data System (ADS)

Walsh, Steven T.; Linton, Jonathan D.

1999-08-01

A model of infrastructure development for MEMS manufacturing Technologies is offered. The role of discontinuous innovation in achieving competitive advantage is briefly reviewed. This is followed by the development of a model that describes the stages in the growth of an infrastructure to support Micro-Electro-Mechanical-Systems infrastructure. We briefly describe how an infrastructure gradually grows to support a new industry, resulting from discontinuous innovation. the model indicates the evolving nature of the actions and investments that firms and governments need to make to support the growth of an immature industry. Consequently, we aim to not only offer a descriptive model, but offer guidance to firms on whether their intentions and resources fit with the state of the industry and to offer policy makers guidance on the timing of different types of support.

Comprehensive Career Guidance. Methods Guide. K-6 Career.

ERIC Educational Resources Information Center

Moore, Earl J.; And Others

This methods guide is intended to assist elementary school guidance workers in implementing a comprehensive career guidance program. Three major areas are considered. First, the life career development perspective is examined as a framework for organizing guidance objectives and practices so that there is a developmental, integrative…

Guidance and New Education for Schools.

ERIC Educational Resources Information Center

Sprinthall, Norman A.

1980-01-01

Details rationale for broad-based school reform including examination of old guidance. General curriculum of schools must include psychological growth as direct object of classroom instruction. Effective guidance role can alter classroom teaching strategies and curriculum content. Guidance theory and practice should lead in seeking school reforms.…

Unfinished Business with Feminist Thinking and Counselling and Guidance Practice

ERIC Educational Resources Information Center

Wright, Jeannie

2009-01-01

This article provides a personal view of the influence of feminist theories on counselling and guidance practice over a 30-year period. It is not intended to be a scoping review of the vast literature on feminist theory and practice in relation to the talking therapies. Based on the subjective experience of one researcher/practitioner, its…

Roundabout geometric design guidance.

DOT National Transportation Integrated Search

2007-06-01

This research report is intended to examine the geometric standards, guidelines, and practices used nationally and by other states to develop recommendations on roundabout design guidance for California. This research serves as a guidance tool in sup...

Preventing Alcohol-Related Problems on Campus: Substance-Free Residence Halls.

ERIC Educational Resources Information Center

Finn, Peter

This document offers guidance to college housing officers in implementing substance-free campus housing. The guide offers reasons for supporting the establishment of substance-free residence halls; provides evidence that such living areas benefit both students and the college; and offers suggestions for setting up and maintaining substance-free…

Computerized Vocational Guidance (CVG) Systems: Evaluation for Use in Military Recruiting.

DTIC Science & Technology

1984-02-01

how to relate the two, and how to explore, project, and choose. Whether Rogerian or more directive in nature, the essential counseling ingredient is to...Conference, Princeton, NJ: Educational Testing Service, 1974, 43-69. Katz, M. R., & Shatkin, L. Computer-assisted guidance: Concepts and practices (Res. Rep...Canadian Forces Personnel Applied Research Unit, 1980. Katz, M. R., & Shatkin, L. Computer-assisted guidance: Concepts and practices (Res. Rep. RR-80-1

Improving health visitor emollient prescribing using a CQUIN-based approach.

PubMed

Brooks, Christina; Khatau, Tejas

2015-12-01

Prescribing is an essential element of health visiting practice. This initiative used the payment framework of Commissioning for Quality and Innovation (CQUIN) to develop health visiting practice across a large health visiting workforce in the East Midlands. A focus on emollient prescribing practice was agreed and a guidance booklet regarding preferred emollient products was produced, based on the local formulary Each health visitor benefitted from receiving additional training and was given a guidance booklet to inform their practice. Targets were set for each quarter to demonstrate an improved prescribing adherence to the preferred product list.The targets were achieved for each quarter. Prescribing rates and confidence improved across the service. Therefore, it was demonstrated that specific guidance and ongoing support can improve prescribing practice within the health visiting service.

GUIDANCE IN THE ELEMENTARY SCHOOL--CHILD CENTERED PROCEDURES AND TECHNIQUES.

ERIC Educational Resources Information Center

NELSON, GWEN

SOME CONSIDERATIONS BASIC TO ELEMENTARY GUIDANCE ARE DISCUSSED. THE PURPOSE OF A PROGRAM OF ELEMENTARY GUIDANCE IS TO PROVIDE BOTH CORE AND PREVENTIVE SERVICES WHICH PROMOTE PROPER CHILD GROWTH AND DEVELOPMENT. PRACTICALITY AND ECONOMY SUGGEST THE NECESSITY FOR INCREASED ACTIVITY IN PRIMARY PREVENTION. THE GUIDANCE SPECIALIST MUST WORK DIRECTLY…

76 FR 22903 - Draft Guidance for Industry and Food and Drug Administration Staff; Establishing That a Tobacco...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

... things, dated copies of advertisements, dated catalog pages, and dated promotional material. II. Significance of Guidance This draft guidance is being issued consistent with FDA's good guidance practices... manufacturer provide evidence that may include, among other things, dated copies of advertisements, dated...

How should doctors disclose conflicts of interest to patients? A focus group investigation.

PubMed

Oakes, J Michael; Whitham, Hilary K; Spaulding, Alicen Burns; Zentner, Lynn A; Beccard, Seth R

2015-01-01

Disclosure is often proposed as a strategy for handling financial conflicts of interest in medicine. Yet there has been no guidance on how clinicians should disclose potential conflicts of interest to patients. To discern patients' attitudes toward conflicts of interest in medicine and their opinions about how physicians should disclose possible conflicts in the clinical setting, we conducted six focus groups with patients recruited from three clinics in the Twin Cities area. Investigators reviewed audio recordings of the focus group discussions independently and identified themes. Maintaining patient-doctor trust was critical to all study participants. Most wanted to know only about conflicts of interest that were directly relevant to their care. In addition, most participants said physicians and other health care providers should offer patients an easy-to-read document about any conflict of interest during clinic check-ins and bring up the subject when discussing specific treatment plans for which the conflict of interest is relevant. Our study offers the first insights into patient attitudes toward and opinions about disclosure practices in clinical settings. More research into the practical aspects of managing conflicts of interest is needed as ineffective disclosure may undermine patients' trust in their doctors.

APPLaUD: access for patients and participants to individual level uninterpreted genomic data.

PubMed

Thorogood, Adrian; Bobe, Jason; Prainsack, Barbara; Middleton, Anna; Scott, Erick; Nelson, Sarah; Corpas, Manuel; Bonhomme, Natasha; Rodriguez, Laura Lyman; Murtagh, Madeleine; Kleiderman, Erika

2018-02-17

There is a growing support for the stance that patients and research participants should have better and easier access to their raw (uninterpreted) genomic sequence data in both clinical and research contexts. We review legal frameworks and literature on the benefits, risks, and practical barriers of providing individuals access to their data. We also survey genomic sequencing initiatives that provide or plan to provide individual access. Many patients and research participants expect to be able to access their health and genomic data. Individuals have a legal right to access their genomic data in some countries and contexts. Moreover, increasing numbers of participatory research projects, direct-to-consumer genetic testing companies, and now major national sequencing initiatives grant individuals access to their genomic sequence data upon request. Drawing on current practice and regulatory analysis, we outline legal, ethical, and practical guidance for genomic sequencing initiatives seeking to offer interested patients and participants access to their raw genomic data.

Are nursing codes of practice ethical?

PubMed

Pattison, S

2001-01-01

This article provides a theoretical critique from a particular 'ideal type' ethical perspective of professional codes in general and the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) Code of professional conduct (reprinted on pp. 77-78) in particular. Having outlined a specific 'ideal type' of what ethically informed and aware practice may be, the article examines the extent to which professional codes may be likely to elicit and engender such practice. Because of their terminological inexactitudes and confusions, their arbitrary values and principles, their lack of helpful ethical guidance, and their exclusion of ordinary moral experience, a number of contemporary professional codes in health and social care can be arraigned as ethically inadequate. The UKCC Code of professional conduct embodies many of these flaws, and others besides. Some of its weaknesses in this respect are anatomized before some tentative suggestions are offered for the reform of codes and the engendering of greater ethical awareness among professionals in the light of greater public ethical concerns and values.

Risk management measures for chemicals: the "COSHH essentials" approach.

PubMed

Garrod, A N I; Evans, P G; Davy, C W

2007-12-01

"COSHH essentials" was developed in Great Britain to help duty holders comply with the Control of Substances Hazardous to Health (COSHH) Regulations. It uses a similar approach to that described in the new European "REACH" Regulation (Registration, Evaluation, Authorisation and Restriction of Chemicals; EC No. 1907/2006 of the European Parliament), insofar as it identifies measures for managing the risk for specified exposure scenarios. It can therefore assist REACH duty holders with the identification and communication of appropriate risk-management measures. The technical basis for COSHH essentials is explained in the original papers published in the Annals of Occupational Hygiene. Its details will, therefore, not be described here; rather, its ability to provide a suitable means for communicating risk-management measures will be explored. COSHH essentials is a simple tool based on an empirical approach to risk assessment and risk management. The output is a "Control Guidance Sheet" that lists the "dos" and "don'ts" for control in a specific task scenario. The guidance in COSHH essentials recognises that exposure in the workplace will depend not just on mechanical controls, but also on a number of other factors, including administrative and behavioural controls, such as systems of work, supervision and training. In 2002, COSHH essentials was made freely available via the internet (http://www.coshh-essentials.org.uk/). This electronic delivery enabled links to be made between product series that share tasks, such as drum filling, and with ancillary guidance, such as setting up health surveillance for work with a respiratory sensitiser. COSHH essentials has proved to be a popular tool for communicating good control practice. It has attracted over 1 million visits to its site since its launch. It offers a common benchmark of good practice for chemical users, manufacturers, suppliers and importers, as well as regulators and health professionals.

The administration of rescue medication to children with prolonged acute convulsive seizures in the community: what happens in practice?

PubMed

Wait, Suzanne; Lagae, Lieven; Arzimanoglou, Alexis; Beghi, Ettore; Bennett, Christine; Cross, J Helen; Mifsud, Janet; Schmidt, Dieter; Harvey, Gordon

2013-01-01

This paper presents the findings of a review of existing clinical and non-clinical guidance on the management of children with prolonged acute convulsive seizures (PCS) and the administration of rescue medication in community settings. Findings are based on desk- and web-based research in 6 countries. Published clinical guidelines are mostly limited to the hospital setting and offer few explicit recommendations for community settings. Non-clinical guidance on the management of medicines at school exists at the national or regional level in all 6 countries, however rescue epilepsy medication is often not mentioned specifically. Existing legal frameworks are vague and open to interpretation. As a result, whether a child receives rescue medication at school depends primarily on the availability of a willing teacher who accepts responsibility for administering it to that child during school hours. Comprehensive guidelines are clearly needed that provide practical guidance to ensure that children with PCS are treated as quickly as possible in all community settings. Recommendations for future action include: providing clearer information on PCS and rescue medication to parents and schools; putting in place an individual healthcare plan for every child with a history of PCS at his or her school; collecting more empirical data to gain a better understanding of the experience of children with PCS at school, their parents and teachers; and finally, implementing systematic training for all carers of children with PCS. The epilepsy specialist may play an important role in ensuring that these recommendations are put into place for their patients. Copyright © 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Selection of and Evidentiary Considerations for Wearable Devices and Their Measurements for Use in Regulatory Decision Making: Recommendations from the ePRO Consortium.

PubMed

Byrom, Bill; Watson, Chris; Doll, Helen; Coons, Stephen Joel; Eremenco, Sonya; Ballinger, Rachel; Mc Carthy, Marie; Crescioni, Mabel; O'Donohoe, Paul; Howry, Cindy

2018-06-01

Wearable devices offer huge potential to collect rich sources of data to provide insights into the effects of treatment interventions. Despite this, at the time of writing this report, limited regulatory guidance on the use of wearables in clinical trial programs has been published. To present recommendations from the Critical Path Institute's Electronic Patient-Reported Outcome Consortium regarding the selection and evaluation of wearable devices and their measurements for use in regulatory trials and to support labeling claims. The evaluation group was composed of Critical Path Institute's clinical outcome assessment (COA) scientists and COA specialists from pharmaceutical trial eCOA solution providers, including COA development and validation specialists. The resulting recommendations were drawn from a broad range of backgrounds, perspectives, and expertise that enriched the development of this report. Recommendations were developed through analysis of existing regulatory guidance relating to COA development and use in clinical trials, medical device certification/clearance regulations, literature-reported best practice, and practical experience of wearable technology application in clinical trials. We identify the essential properties of fit-for-purpose wearables and propose evidence needed to support their use. In addition, we overview the activities required to establish clinical endpoints derived from wearables data. Using this framework, we believe there is enough current understanding to promote the appropriate use of wearables in study protocols. We hope this will provide a basis for discussion among clinical trial stakeholders and catalyze the development of more robust regulatory guidance. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Assessing Enterprise Capability: Guidance for Schools

ERIC Educational Resources Information Center

National Foundation for Educational Research, 2007

2007-01-01

This document offers guidance to schools on how assessment can support enterprise education. It presents the interim findings from research carried out by the National Foundation for Educational Research (NFER) for the Department for Education and Skills (DfES) in secondary schools in England. Enterprise capability is the key outcome of enterprise…

The Schools Transgender Students Need

ERIC Educational Resources Information Center

Kahn, Ellen

2016-01-01

In May 2016, the U.S. Department of Justice and the U.S. Department of Education issued guidance to schools intended to provide transgender students with safe and inclusive learning environments. On the heels of this guidance, Ellen Kahn, the Human Rights Campaign's director of Children, Youth, and Families Program, offers advice for educators…

Second Annual Career Guidance Institute: Final Report.

ERIC Educational Resources Information Center

Schenck, Norma Elaine

The document reports on the organization and implementation plans for Indiana's Second Annual Career Guidance Institute and the sound/slide programs developed on six career cluster areas. An extensive evaluation analyzes the Institute in light of its objectives, offers insights gained on career opportunities, gives changes in attitude regarding…

Using trauma informed care as a nursing model of care in an acute inpatient mental health unit: A practice development process.

PubMed

Isobel, Sophie; Edwards, Clair

2017-02-01

Without agreeing on an explicit approach to care, mental health nurses may resort to problem focused, task oriented practice. Defining a model of care is important but there is also a need to consider the philosophical basis of any model. The use of Trauma Informed Care as a guiding philosophy provides a robust framework from which to review nursing practice. This paper describes a nursing workforce practice development process to implement Trauma Informed Care as an inpatient model of mental health nursing care. Trauma Informed Care is an evidence-based approach to care delivery that is applicable to mental health inpatient units; while there are differing strategies for implementation, there is scope for mental health nurses to take on Trauma Informed Care as a guiding philosophy, a model of care or a practice development project within all of their roles and settings in order to ensure that it has considered, relevant and meaningful implementation. The principles of Trauma Informed Care may also offer guidance for managing workforce stress and distress associated with practice change. © 2016 Australian College of Mental Health Nurses Inc.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 5: how to assess adequacy of data.

PubMed

Glenton, Claire; Carlsen, Benedicte; Lewin, Simon; Munthe-Kaas, Heather; Colvin, Christopher J; Tunçalp, Özge; Bohren, Meghan A; Noyes, Jane; Booth, Andrew; Garside, Ruth; Rashidian, Arash; Flottorp, Signe; Wainwright, Megan

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations; (2) coherence; (3) adequacy of data; and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's adequacy of data component. We developed the adequacy of data component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual adequacy of data component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define adequacy of data as an overall determination of the degree of richness and the quantity of data supporting a review finding. In this paper, we describe the adequacy component and its rationale and offer guidance on how to assess data adequacy in the context of a review finding as part of the CERQual approach. This guidance outlines the information required to assess data adequacy, the steps that need to be taken to assess data adequacy, and examples of adequacy assessments. This paper provides guidance for review authors and others on undertaking an assessment of adequacy in the context of the CERQual approach. We approach assessments of data adequacy in terms of the richness and quantity of the data supporting each review finding, but do not offer fixed rules regarding what constitutes sufficiently rich data or an adequate quantity of data. Instead, we recommend that this assessment is made in relation to the nature of the finding. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.

Guiding Development Based Approach Practicum Vertebrates Taxonomy Scientific Study Program for Students of Biology Education

NASA Astrophysics Data System (ADS)

Arieska, M.; Syamsurizal, S.; Sumarmin, R.

2018-04-01

Students having difficulty in identifying and describing the vertebrate animals as well as less skilled in science process as practical. Increased expertise in scientific skills, one of which is through practical activities using practical guidance based on scientific approach. This study aims to produce practical guidance vertebrate taxonomy for biology education students PGRI STKIP West Sumatra valid. This study uses a model of Plomp development consisting of three phases: the initial investigation, floating or prototype stage, and the stage of assessment. Data collection instruments used in this study is a validation sheet guiding practicum. Data were analyzed descriptively based on data obtained from the field. The result of the development of practical guidance vertebrate taxonomic validity value of 3.22 is obtained with very valid category. Research and development has produced a practical guide based vertebrate taxonomic scientific approach very valid.

Defense Information Systems Agency (DISA) GIG Convergence Master Plan 2012 (GCMP 2012). Volume 1

DTIC Science & Technology

2012-08-02

mapping, the complete DISA technical baseline, and the GIG Technical Guidance ( GTG ). The Department of Defense (DoD), as part of its IT Effectiveness...Guidance ( GTG ) to guide their development of service offerings, which are added to the technical baseline when approved by the CEP. 1.2. Background...corresponding hyperlinks; the complete set of GTPs is called the GIG Technical Guidance ( GTG ). These appendices also contain linkages between the GCMP

Passive Sampling Methods for Contaminated Sediments: Practical Guidance for Selection, Calibration, and Implementation

EPA Science Inventory

This article provides practical guidance on the use of passive sampling methods(PSMs) that target the freely dissolved concentration (Cfree) for improved exposure assessment of hydrophobic organic chemicals in sediments. Primary considerations for selecting a PSM for a specific a...

Guidance and Counseling Personnel and Programs in Nevada.

ERIC Educational Resources Information Center

Nevada Univ., Reno. Research and Educational Planning Center.

Data were collected on guidance and counseling programs and guidance personnel in Nevada schools. Questionnaires were mailed to all 309 practicing school counselors in Nevada; the response rate was 72%. Guidance counselors in Nevada were primarily female, Caucasian, and middle-aged. Mean number of years as a counselor was 9 years, and most…

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home

PubMed Central

Flieger, Signe Peterson

2017-01-01

Background This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. Purpose The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Methodology/Approach Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Findings Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. Practice Implications (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and will ultimately help foster a relationship-centered PCMH. PMID:26939031

Climate-smart conservation: putting adaption principles into practice

USGS Publications Warehouse

Stein, Bruce A.; Glick, Patty; Edelson, Naomi; Staudt, Amanda

2014-01-01

Climate change already is having significant impacts on the nation’s species and ecosystems, and these effects are projected to increase considerably over time. As a result, climate change is now a primary lens through which conservation and natural resource management must be viewed. How should we prepare for and respond to the impacts of climate change on wildlife and their habitats? What should we be doing differently in light of these climatic shifts, and what actions continue to make sense? Climate-Smart Conservation: Putting Adaptation Principles into Practice offers guidance for designing and carrying out conservation in the face of a rapidly changing climate. Addressing the growing threats brought about or accentuated by rapid climate change requires a fundamental shift in the practice of natural resource management and conservation. Traditionally, conservationists have focused their efforts on protecting and managing systems to maintain their current state, or to restore degraded systems back to a historical state regarded as more desirable. Conservation planners and practitioners will need to adopt forward-looking goals and implement strategies specifically designed to prepare for and adjust to current and future climatic changes, and the associated impacts on natural systems and human communities—an emerging discipline known as climate change adaptation. The field of climate change adaptation is still in its infancy. Although there is increasing attention focused on the subject, much of the guidance developed to date has been general in nature, concentrating on high-level principles rather than specific actions. It is against this backdrop that this guide was prepared as a means for helping put adaptation principles into practice, and for moving adaptation from planning to action.

A qualitative study in parental perceptions and understanding of SIDS-reduction guidance in a UK bi-cultural urban community.

PubMed

Crane, Denise; Ball, Helen L

2016-01-30

Differences in both Sudden Infant Death Syndrome (SIDS) rates and infant care practices between white British and South Asians in UK are well known, but research has not yet examined how these two groups understand and implement SIDS-reduction guidance. This study aimed to discover how white British and Pakistani mothers in Bradford recall, understand and interpret SIDS-reduction guidance, and to explore whether and how they implement this guidance in caring for their infants. In-depth narrative interviews with 46 mothers (25 white British origin and 21 Pakistani origin) of 8-12 week old infants recruited from the pool of participants enrolled in the 'Born in Bradford' (BiB) cohort study. All mothers were aware of UK SIDS-reduction guidance from leaflets presented to them during antenatal or postnatal interactions with health care providers. Pakistani mothers tended to dismiss the guidance in toto as being irrelevant to their cultural practices; white British mothers dismissed, adapted and adopted aspects of the guidance to suit their preferred parenting decisions and personal circumstances. Many mothers misunderstood or misinterpreted the guidance given and explained their infant care behaviour according to their social and cultural circumstances. Current SIDS reduction information in the UK does not meet the needs of immigrant families, and is easily misinterpreted or misunderstood by mothers from all sections of the community. Tailored information acknowledging cultural differences in infant care practices is vital, as is greater discussion with all mothers about the reasons for SIDS reduction guidance.

Transforming State-of-the-Art into Best Practice: A Guide for High-Performance Energy Efficient Buildings in India

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

Singh, Reshma; Ravache, Baptiste; Sartor, Dale

India launched the Energy Conservation Building Code (ECBC) in 2007, and a revised version in 2017 as ambitious first steps towards promoting energy efficiency in the building sector. Pioneering early adopters—building owners, A&E firms, and energy consultants—have taken the lead to design customized solutions for their energy-efficient buildings. This Guide offers a synthesizing framework, critical lessons, and guidance to meet and exceed ECBC. Its whole-building lifecycle assurance framework provides a user-friendly methodology to achieve high performance in terms of energy, environmental, and societal impact. Class A offices are selected as a target typology, being a high-growth sector, with significant opportunitiesmore » for energy savings. The practices may be extrapolated to other commercial building sectors, as well as extended to other regions with similar cultural, climatic, construction, and developmental contexts« less

Conceptual model for partnership and sustainability in global health.

PubMed

Leffers, Jeanne; Mitchell, Emma

2011-01-01

Although nursing has a long history of service to the global community, the profession lacks a theoretical and empirical base for nurses to frame their global practice. A study using grounded theory methodology to investigate partnership and sustainability for global health led to the development of a conceptual model. Interviews were conducted with 13 global health nurse experts. Themes from the interviews were: components for engagement, mutual goal setting, cultural bridging, collaboration, capacity building, leadership, partnership, ownership, and sustainability. Next, the identified themes were reviewed in the literature in order to evaluate their conceptual relationships. Finally, careful comparison of the interview transcripts and the supporting literature led to the Conceptual Framework for Partnership and Sustainability in Global Health Nursing. The model posits that engagement and partnership must precede any planning and intervention in order to create sustainable interventions. This conceptual framework will offer nurses important guidance for global health nursing practice. © 2010 Wiley Periodicals, Inc.

Blood Tests for People with Severe Learning Disabilities Receiving Dental Treatment under General Anaesthesia.

PubMed

Clough, Stacey; Shehabi, Zahra; Morgan, Claire; Sheppey, Claire

2016-11-01

People with learning disabilities (LDs) have poorer health than their non-disabled peers due to failures in reasonable adjustments. One hundred patients with severe LD and challenging behaviour attended for dental treatment under GA, during which routine blood testing was provided. Communication with general medical practitioners (GMPs) and blood test results were evaluated, showing poor communication with GMPs and significant undiagnosed disease among this group. Blood tests generate similar costs in primary and secondary care but a holistic approach to care under GA reduces expenses brought by lost clinical time and resources due to complex behaviours in an out-patient setting. Clinical relevance: This article discusses a holistic approach to healthcare for people with severe LD, including patient outcomes, financial and resource implications, and offers practical guidance on venepuncture technique, which is relevant to many aspects of both community and hospital dental practice.

Harvesting NASA's Common Metadata Repository (CMR)

NASA Technical Reports Server (NTRS)

Shum, Dana; Durbin, Chris; Norton, James; Mitchell, Andrew

2017-01-01

As part of NASA's Earth Observing System Data and Information System (EOSDIS), the Common Metadata Repository (CMR) stores metadata for over 30,000 datasets from both NASA and international providers along with over 300M granules. This metadata enables sub-second discovery and facilitates data access. While the CMR offers a robust temporal, spatial and keyword search functionality to the general public and international community, it is sometimes more desirable for international partners to harvest the CMR metadata and merge the CMR metadata into a partner's existing metadata repository. This poster will focus on best practices to follow when harvesting CMR metadata to ensure that any changes made to the CMR can also be updated in a partner's own repository. Additionally, since each partner has distinct metadata formats they are able to consume, the best practices will also include guidance on retrieving the metadata in the desired metadata format using CMR's Unified Metadata Model translation software.

Harvesting NASA's Common Metadata Repository

NASA Astrophysics Data System (ADS)

Shum, D.; Mitchell, A. E.; Durbin, C.; Norton, J.

2017-12-01

As part of NASA's Earth Observing System Data and Information System (EOSDIS), the Common Metadata Repository (CMR) stores metadata for over 30,000 datasets from both NASA and international providers along with over 300M granules. This metadata enables sub-second discovery and facilitates data access. While the CMR offers a robust temporal, spatial and keyword search functionality to the general public and international community, it is sometimes more desirable for international partners to harvest the CMR metadata and merge the CMR metadata into a partner's existing metadata repository. This poster will focus on best practices to follow when harvesting CMR metadata to ensure that any changes made to the CMR can also be updated in a partner's own repository. Additionally, since each partner has distinct metadata formats they are able to consume, the best practices will also include guidance on retrieving the metadata in the desired metadata format using CMR's Unified Metadata Model translation software.

World Cup 2010 planning: an integration of public health and medical systems.

PubMed

Yancey, Arthur H; Fuhri, Peter D; Pillay, Yogan; Greenwald, Ian

2008-10-01

To present crucial stages of planning and the resources involved in the medical and health care that will address issues affecting the health and safety of all participants in the 2010 World Cup. Relevant literature reviews of mass gathering medical care supplemented experience of the authors in planning for previous similar events. Attention is focused on issues wherein effective planning requires the integration of public health practices with those of clinical emergency medical services. The tables that are included serve to illustrate the depth and breadth of planning as well as the organizational relationships required to execute care of a universally acceptable standard. This article offers guidance in planning for the 2010 World Cup health and emergency medical care, emphasizing the need for integration of public health and medical practices. It depicts the span of planning envisioned, the organizational relationships crucial to it, and emphasizes the necessity of an early start.

75 FR 76079 - Sound Incentive Compensation Guidance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-07

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Sound Incentive Compensation Guidance... on the following information collection. Title of Proposal: Sound Incentive Compensation Guidance... Sound Compensation Practices adopted by the Financial Stability Board (FSB) in April 2009, as well as...

75 FR 50770 - Guidance for Industry on Organ-Specific Warnings: Internal Analgesic, Antipyretic, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-17

... labeling requirements in plain language and provides answers to common questions on how to comply with the... consistent with FDA's good guidance practices regulation (21 CFR 10.115). The guidance represents the agency...

A Practical Protocol for Situating Evidence-Based Mental Health Programs and Practices within School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Runge, Timothy J.; Knoster, Timothy P.; Moerer, Deanna; Breinich, Todd; Palmiero, James

2017-01-01

Schools have limited experience and little guidance to identify and install evidence-based and promising programs and practices/interventions (EBPs) within advanced tiers of School-Wide Positive Behavioral Intervention and Supports (SWPBIS). One form of guidance is the Hexagon Tool which can be used to ensure a match between the EBP and student…

Best practice guidance for the use of strategies to improve retention in randomized trials developed from two consensus workshops

PubMed Central

Brueton, Valerie; Stenning, Sally P.; Stevenson, Fiona; Tierney, Jayne; Rait, Greta

2017-01-01

Objectives To develop best practice guidance for the use of retention strategies in randomized clinical trials (RCTs). Study Design and Setting Consensus development workshops conducted at two UK Clinical Trials Units. Sixty-six statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs participated. The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions. Workshops commenced with a presentation of the evidence for incentives, communication, questionnaire format, behavioral, case management, and methodological retention strategies identified by a Cochrane review and associated qualitative study. Three simultaneous group discussions followed focused on (1) how convinced the workshop participants were by the evidence for retention strategies, (2) barriers to the use of effective retention strategies, (3) types of RCT follow-up that retention strategies could be used for, and (4) strategies for future research. Summaries of each group discussion were fed back to the workshop. Coded content for both workshops was compared for agreement and disagreement. Agreed consensus on best practice guidance for retention was identified. Results Workshop participants agreed best practice guidance for the use of small financial incentives to improve response to postal questionnaires in RCTs. Use of second-class post was thought to be adequate for postal communication with RCT participants. The most relevant validated questionnaire was considered best practice for collecting RCT data. Barriers identified for the use of effective retention strategies were: the small improvements seen in questionnaire response for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face-to-face and electronic follow-up technologies were identified as retention strategies for further research. Conclusions We developed best practice guidance for the use of retention strategies in RCTs and identified potential barriers to the use of effective strategies. The extent of agreement on best practice is limited by the variability in the currently available evidence. This guidance will need updating as new retention strategies are developed and evaluated. PMID:28546093

Best practice guidance for the use of strategies to improve retention in randomized trials developed from two consensus workshops.

PubMed

Brueton, Valerie; Stenning, Sally P; Stevenson, Fiona; Tierney, Jayne; Rait, Greta

2017-08-01

To develop best practice guidance for the use of retention strategies in randomized clinical trials (RCTs). Consensus development workshops conducted at two UK Clinical Trials Units. Sixty-six statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs participated. The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions. Workshops commenced with a presentation of the evidence for incentives, communication, questionnaire format, behavioral, case management, and methodological retention strategies identified by a Cochrane review and associated qualitative study. Three simultaneous group discussions followed focused on (1) how convinced the workshop participants were by the evidence for retention strategies, (2) barriers to the use of effective retention strategies, (3) types of RCT follow-up that retention strategies could be used for, and (4) strategies for future research. Summaries of each group discussion were fed back to the workshop. Coded content for both workshops was compared for agreement and disagreement. Agreed consensus on best practice guidance for retention was identified. Workshop participants agreed best practice guidance for the use of small financial incentives to improve response to postal questionnaires in RCTs. Use of second-class post was thought to be adequate for postal communication with RCT participants. The most relevant validated questionnaire was considered best practice for collecting RCT data. Barriers identified for the use of effective retention strategies were: the small improvements seen in questionnaire response for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face-to-face and electronic follow-up technologies were identified as retention strategies for further research. We developed best practice guidance for the use of retention strategies in RCTs and identified potential barriers to the use of effective strategies. The extent of agreement on best practice is limited by the variability in the currently available evidence. This guidance will need updating as new retention strategies are developed and evaluated. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Technology Management Education for Students with Educational Background of Engineering

NASA Astrophysics Data System (ADS)

Aoyama, Atsushi; Abe, Atsushi

Japanese industry has been encouraged to transform from a mode of ‘recovery’ to one of 'front-runner' in effective innovation and creation of new businesses and markets based in accomplishments of basic research. Graduate School of Technology Management at Ritsumeikan University strives to not only offer knowledge and skills, but also business experiences to its students so that they may acquire the abilities to discover and solve practical problems logically, analytically and systematically. To achieve these aims, it has inaugurated the Ritsumeikan University Practicum Program by enhancing existing internship programs. Under the guidance of its faculties, this program will allow its students a chance to set and solve actual problems in real world business environments.

Education for sustainable development - Resources for physics and sciences teachers

NASA Astrophysics Data System (ADS)

Miličić, Dragana; Jokić, Ljiljana; Blagdanić, Sanja; Jokić, Stevan

2016-03-01

With this article we would like to stress science teachers must doing practical work and communicate on the basis of scientific knowledge and developments, but also allow their students opportunity to discover knowledge through inquiry. During the last five years Serbian project Ruka u testu (semi-mirror of the French project La main á la pâte), as well as European FIBONACCI and SUSTAIN projects have offered to our teachers the wide-scale learning opportunities based on Inquiry Based Science Education (IBSE) and Education for Sustainable Development (ESD). Our current efforts are based on pedagogical guidance, several modules and experimental kits, the website, exhibitions, and trainings and workshops for students and teachers.

Twelve tips for successful e-tutoring using electronic portfolios.

PubMed

Deketelaere, Ann; Degryse, Jan; De Munter, Agnes; De Leyn, Paul

2009-06-01

E-tutoring by means of a digital portfolio offers personal guidance in a context in which regular face-to-face contact between supervisor and student is difficult. However, implementing e-tutoring in practice is not always straightforward. This article investigates the conditions for successful e-tutoring of electronic portfolios. A combination of three methods is used: our own experience with e-tutoring, interviews with 14 tutors using an e-portfolio and the answers on questionnaires by 107 students. We present 12 tips to increase the chances of successful e-tutoring when using electronic portfolios. E-tutoring by means of electronic portfolios can be a feasible alternative in contexts in which face-to-face tutoring is difficult.

On making things the best - Aeronautical uses of optimization /Wright Bros. lecture/

NASA Technical Reports Server (NTRS)

Ashley, H.

1981-01-01

The paper's purpose is to summarize and evaluate the results of an investigation into the degree to which formal optimization methods have contributed practically to the design and operation of atmospheric flight vehicles. The nature of this technology is reviewed and illustrated with simple structural examples. A series of published successful applications is described, from the fields of aerodynamics, structures, guidance and control, optimal trajectories and vehicle configuration optimization. The corresponding improvements over conventional analysis are assessed. Speculations are offered as to why these tools have made such little headway toward acceptance by designers. The growing need for their use in the future is explained; they hold out an unparalleled opportunity for improved efficiencies.

Interactions between parents of technology-dependent children and providers: an integrative review.

PubMed

Jachimiec, Jennifer A; Obrecht, Jennifer; Kavanaugh, Karen

2015-03-01

This article is a review of the literature on the experiences of parents and their interactions with healthcare providers while caring for their technology-dependent child(ren) in their homes. Results are presented in the following themes: information needs, respect and partnership with healthcare providers, care coordination, and experiences with home healthcare nurses. Parents needed information and guidance and felt supported when providers recognized parents' expertise with the child's care, and offered reassurance and confirmation about their practices. Home healthcare clinicians provided supportive care in the home, but their presence created challenges for the family. By acknowledging and valuing the parents' expertise, healthcare providers can empower parents to confidently care for their child.

Effective learner-centered strategies for teaching adults: using visual media to engage the adult learner.

PubMed

Myers, Dennis R; Sykes, Catherine; Myers, Scott

2008-01-01

This article offers practical guidance for educators as they prepare specialists to enhance the lives and communities of older persons through the strategic use of visual media in age-related courses. Advantages and disadvantages of this learning innovation are provided as well as seven approaches for enriching instruction. Resources are included for locating effective visual media, matching course content with video resources, determining fair use of copyrighted media, and inserting video clips into PowerPoint presentations. Strategies for accessing assistive services for implementing visual media in the classroom are also addressed. This article promotes the use of visual media for the purpose of enriching gerontological and geriatrics instruction for the adult learner.

Winning market positioning strategies for long term care facilities.

PubMed

Higgins, L F; Weinstein, K; Arndt, K

1997-01-01

The decision to develop an aggressive marketing strategy for its long term care facility has become a priority for the management of a one-hundred bed facility in the Rocky Mountain West. Financial success and lasting competitiveness require that the facility in question (Deer Haven) establish itself as the preferred provider of long term care for its target market. By performing a marketing communications audit, Deer Haven evaluated its present market position and created a strategy for solidifying and dramatizing this position. After an overview of present conditions in the industry, we offer a seven step process that provides practical guidance for positioning a long term care facility. We conclude by providing an example application.

Recommendations for adaptation and validation of commercial kits for biomarker quantification in drug development.

PubMed

Khan, Masood U; Bowsher, Ronald R; Cameron, Mark; Devanarayan, Viswanath; Keller, Steve; King, Lindsay; Lee, Jean; Morimoto, Alyssa; Rhyne, Paul; Stephen, Laurie; Wu, Yuling; Wyant, Timothy; Lachno, D Richard

2015-01-01

Increasingly, commercial immunoassay kits are used to support drug discovery and development. Longitudinally consistent kit performance is crucial, but the degree to which kits and reagents are characterized by manufacturers is not standardized, nor are the approaches by users to adapt them and evaluate their performance through validation prior to use. These factors can negatively impact data quality. This paper offers a systematic approach to assessment, method adaptation and validation of commercial immunoassay kits for quantification of biomarkers in drug development, expanding upon previous publications and guidance. These recommendations aim to standardize and harmonize user practices, contributing to reliable biomarker data from commercial immunoassays, thus, enabling properly informed decisions during drug development.

The Inter-Life project: researching the potential of art, design and virtual worlds as a vehicle for assisting young people with key life changes and transitions.

PubMed

Lally, Victor; Sclater, Madeleine

2013-06-01

Careers work in the twenty-first century faces a key challenge in terms of digital technologies: to evaluate their potential for careers work in challenging settings. Given the rapidity of developments, technologies require evaluation in research innovations and naturalistic settings. Virtual worlds offer potential for careers and guidance work, and the therapeutic domain. To illustrate this, we present examples in which young people explore their feelings and ideas, plans and difficulties, while preparing for film-making. During this they develop important life transition skills. We argue that the power of virtual worlds - to support emotional and cognitive engagement - could be utilised in practice settings. We conclude that they are serious candidates as digital tools in the careers and guidance domain. We need intermediate runaway objects which are less spectacular and more inviting… bringing together the big and the small, the impossible and the possible, the future-oriented activity level vision and the here and now consequential action. (Engeström, 2009, p. 305 and p. 328).

The Inter-Life project: researching the potential of art, design and virtual worlds as a vehicle for assisting young people with key life changes and transitions

PubMed Central

Lally, Victor; Sclater, Madeleine

2013-01-01

Careers work in the twenty-first century faces a key challenge in terms of digital technologies: to evaluate their potential for careers work in challenging settings. Given the rapidity of developments, technologies require evaluation in research innovations and naturalistic settings. Virtual worlds offer potential for careers and guidance work, and the therapeutic domain. To illustrate this, we present examples in which young people explore their feelings and ideas, plans and difficulties, while preparing for film-making. During this they develop important life transition skills. We argue that the power of virtual worlds – to support emotional and cognitive engagement – could be utilised in practice settings. We conclude that they are serious candidates as digital tools in the careers and guidance domain. We need intermediate runaway objects which are less spectacular and more inviting… bringing together the big and the small, the impossible and the possible, the future-oriented activity level vision and the here and now consequential action. (Engeström, 2009, p. 305 and p. 328) PMID:24009408

The Dance of Elementary School Classroom Management

ERIC Educational Resources Information Center

Powell, Pamela

2014-01-01

At times, classroom management and guidance elude even the most seasoned teachers. Yet, students need guidance and practice in self-regulatory skills to assist in the learning that occurs in classrooms. Teachers need both practical and research-based classroom management strategies that benefit the environment and help create a space conducive to…

An evaluative review of questionnaires recommended for the assessment of quality of life and symptom severity in women with urinary incontinence.

PubMed

Hewison, Ann; McCaughan, Dorothy; Watt, Ian

2014-11-01

To provide an up-to-date assessment of the quality of commonly recommended questionnaires for measuring symptom severity and quality of life in women with urinary incontinence and also to consider their application to practice. Urinary incontinence is a common problem for women. In addition to various physical symptoms, there is a known effect on quality of life. Psychometrically robust questionnaires are reported to be the best way to measure an individual's perceptions of symptom severity and quality of life, and a number of different ones are recommended for use in international and national guidance, which can be confusing for clinicians. Moreover, there are concerns over the applicability of some of these instruments in clinical practice. An evaluative review was carried out examining selected questionnaires measuring symptom severity and/or quality of life. Selection of questionnaires for inclusion in the review was based on the recommendations of evidence-based guidance, followed by systematic scrutiny of the characteristics of the individual recommended questionnaires. Thirteen questionnaires were included in the review, of which three appeared to 'outperform' the remainder in terms of their psychometric properties and other characteristics. This review provides the most up-to-date and comprehensive analysis of the quality and applicability of the included questionnaires and offers the practitioner advice on which to select for use in practice. This review aims to help the practitioner choose a questionnaire based on a sound evaluation of the quality of the questionnaire and its applicability to the clinical setting. © 2013 John Wiley & Sons Ltd.

Variations in pretransfusion practices.

PubMed

Padget, B J; Hannon, J L

2003-01-01

A variety of pretransfusion tests have been developed to improve the safety and effectiveness of transfusion. Recently, a number of traditional tests have been shown to offer limited clinical benefit and have been eliminated in many facilities. A survey of pretransfusion test practices was distributed to 116 hospital transfusion services. Routine test practices and facility size were analyzed. Ninety-one responses were received. Many smaller laboratories include tests such as anti-A,B, an autocontrol, and DAT, and immediate spin and 37 degrees Celsius microscopic readings. Nine percent never perform an Rh control with anti-D typing on patient samples. Various antibody screening and crossmatch methods are utilized. Individual laboratory test practices should be periodically assessed to ensure that they comply with standards, represent the recognized best practice, and are cost-effective. The survey responses indicate that many laboratories perform tests that are not necessary or cost-effective. These facilities should review their processes to determine which tests contribute to transfusion safety. Smaller facilities may be reluctant to change or lack the expertise necessary for this decision making and often continue to perform tests that have been eliminated in larger facilities. Consultation with larger hospital transfusion services may provide guidance for this change.

Gathering, strategizing, motivating and celebrating: the team huddle in a teaching general practice.

PubMed

Walsh, Allyn; Moore, Ainsley; Everson, Jennifer; DeCaire, Katharine

2018-03-01

To understand how implementing a daily team huddle affected the function of a complex interprofessional team including learners. A qualitative descriptive study using semi-structured interviews in focus groups. An academic general practice teaching practice. All members of one interprofessional team, including nurses, general practitioners, junior doctors, and support staff. Focus group interviews using semi-structured guidance were transcribed and the results analysed using qualitative content analysis. Four interrelated themes were identified: communication and knowledge sharing; efficiency of care; relationship and team building; and shared responsibility for team function. The implementation of the daily team huddle was seen by participants to enhance the collaboration within the team and to contribute to work life enjoyment. Participants perceived that problems were anticipated and solved quickly. Clinical updates and information about patients benefited the team including learners. Junior doctors quickly understood the scope of practice of other team members, but some felt reluctant to offer clinical opinions. The implementation of a daily team huddle was viewed as worthwhile by this large interprofessional general practice team. The delivery of patient care was more efficient, knowledge was readily distributed, and problem solving was shared across the team, including junior doctors.

Defusing the angry patient: 25 tips.

PubMed

Hills, Laura

2010-01-01

Just about every member of the medical practice team will be, at one time or another, on the receiving end of a patient's anger. That's because even the calmest and gentlest patients can reach their boiling point when illness or injury threatens their health, mobility, independence, finances, self-esteem, dreams, and plans. Tempers are also likely to flair whenever anyone is frightened, not feeling well, and/or feeling out of control. Unfortunately, the quick pace of today's medical practice doesn't help much, as time for active listening and individual attention may be in less supply than we'd ideally like. This article offers 25 strategies the medical practice employee can use to defuse the angry patient. Among these are eight focus and mindset strategies to use before taking action, five strategies to use to take immediate control, seven early intervention strategies, and five resolution and closure strategies. This article also includes guidance about choosing an appropriate and safe venue within the medical practice for discussions with angry patients. It also describes why, specifically, it is in every medical practice's self-interest to welcome complaints from its patients, even those who lash out in anger.

Curbside consultation re-imagined: Borrowing from the conflict management toolkit.

PubMed

Edelstein, Lauren M; Lynch, John J; Mokwunye, Nneka O; DeRenzo, Evan G

2010-03-01

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that any guidance offered by the ethics consultant will privilege and empower one party's viewpoint over-and to the exclusion of-other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new "spaces" for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for "clinical ethics conflict coaching" can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes.

75 FR 48179 - Comprehensive List of Guidance Documents at the Food and Drug Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

...The Food and Drug Administration (FDA) is publishing a comprehensive list of all guidance documents currently in use at the agency. This list is being published under FDA's Good Guidance Practices (GGPs). It is intended to inform the public of the existence and availability of all of our current guidance documents. It also provides information on guidance documents that have been added or withdrawn in the past 5 years.

Teacher Educator's and Guidance Teachers' Evaluation of Student Teachers' Teaching Practice: A Qualitative Study = Procjena nastavne prakse studenata--buducih ucitelja--od mentora i savjetnika (kvalitativna studija)

ERIC Educational Resources Information Center

Göçer, Ali

2013-01-01

The aim of this study was to determine whether student teachers are sufficiently prepared for teaching practice in primary schools. In this study, student teachers' teaching practice in real classrooms was evaluated by using observation and interview methods. For this purpose, interviews were conducted with seven guidance teachers, and each…

78 FR 59095 - Agency Information Collection Activities: Information Collection Renewal; Submission for OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... Activities: Information Collection Renewal; Submission for OMB Review; Guidance on Sound Incentive... concerning renewal of an information collection titled, ``Guidance on Sound Incentive Compensation Practices... following collection: Title: Guidance on Sound Incentive Compensation Policies. OMB Number: 1557-0245...

Instructional and Career Guidance in STEM: An Improvement Initiative to Create Opportunities for Female High School Students

NASA Astrophysics Data System (ADS)

Belcher, Aaron Heath

The purpose of this disquisition is to disseminate an improvement initiative in a public high school that addressed female Science, Technology, Engineering and Math (STEM) disparity in STEM classes. In this high school current instructional and career guidance practices were inadequate in providing female STEM students opportunities to experience relevant instruction in STEM through the application of real world practices. The improvement initiative identified four interventions using qualitative research that addressed the question, how do instructional and career guidance practices that emphasize the real world application of STEM impact the academic choices and career aspirations of female STEM students? The interventions include (1) instructional feedback (2) instructional resources, (3) career coaching, and (4) community college partnership. These interventions were chosen as a result of insider research methods that followed a scan, focus, summarize framework for understanding the problem. The aim of the improvement initiative was to develop structured protocols that impact STEM classroom and career guidance practices. An intervention team intended to identify opportunities for female STEM students to experience the real world application of STEM. First, the research context is explained. Then, a review of the literature explains foundation knowledge that led to the conceptual and leadership framework. Next, the research methodology is outlined including design and participants, survey instruments, procedures, timeline, and measures. The research methodology is followed by an analysis of data for instructional and career guidance practice efficacy. Finally, a discussion of the initiative and its outcome are illustrated through the stories of three female STEM students. As a result of these stories, the intervention team developed STEM classroom observation protocols. These protocols can be used by school leaders as a structure for STEM instruction and career guidance.

77 FR 71194 - Draft Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-1038.... DATES: Although you can comment on any guidance at any time (see 21 CFR 10.115(g)(5)), to ensure that... guidance is being issued consistent with FDA's good guidance practices regulation (21 CFR 10.115). The...

Case Studies in Practical Career Guidance, Number 7: Developmental Career Guidance Project Detroit Public Schools, Detroit, Michigan.

ERIC Educational Resources Information Center

Scott, Thelma J.

The Developmental Career Guidance (DCG) project is a K-12 career guidance demonstration project operating at three high schools and 18 feeder schools in the Detroit Public School District. Directed from Wayne State University, DCG has centers at the high schools and each of the feeder schools. From the centers, students voluntarily can draw…

The Role of Learning and Career Guidance for Managing Mid-Career Transitions--Comparing Germany and Denmark

ERIC Educational Resources Information Center

Haasler, Simone R.; Barabasch, Antje

2015-01-01

In Germany and Denmark, the systems of further education and career guidance are well developed, offering a wide range of services and learning opportunities for targeted, specific and also general skills development. Based on an empirical study with mid-career individuals in both countries, the article investigates how the different systems…

How to Improve Collaborative Learning with Video Tools in the Classroom? Social vs. Cognitive Guidance for Student Teams

ERIC Educational Resources Information Center

Zahn, Carmen; Krauskopf, Karsten; Hesse, Friedrich W.; Pea, Roy

2012-01-01

Digital video technologies offer a variety of functions for supporting collaborative learning in classrooms. Yet, for novice learners, such as school students, positive learning outcomes also depend centrally on effective social interactions. We present empirical evidence for the positive effects of instructive guidance on performance and on…

A Critical Analysis of UNESCO's International Technical Guidance on School-Based Education for Puberty and Sexuality

ERIC Educational Resources Information Center

Goldman, Juliette D. G.

2012-01-01

Preparing children and adolescents for sexual safety and reproductive responsibility lies at the heart and purpose of puberty/sexuality education. The document of International Technical Guidance released by UNESCO in December 2009 aims to provide an evidence-based and rights-based platform offering children and adolescents vital knowledge about…

Career Guidance Handbook.

ERIC Educational Resources Information Center

Rowland Unified School District, Rowland Heights, CA.

This handbook, intended to help high school students prepare for further education and careers, is divided into six sections. Section I provides information on high school graduation requirements, department offerings and related careers, the Regional Occupation Program (ROP), and adult school. Section II offers recommendations on planning for…

Shared resources : sharing right-of-way for telecommunications : guidance on legal and institutional issues

DOT National Transportation Integrated Search

1996-03-01

Fiber-optic communications technology offers benefits for government agencies that want to set up communications networks for Intelligent Transportation Systems (ITS). One way to do this efficiently is to offer the public resource of highway right-of...

Adaptation Guidance for Evidence-Based Teen Pregnancy and STI/HIV Prevention Curricula: From Development to Practice

ERIC Educational Resources Information Center

Rolleri, Lori A.; Fuller, Taleria R.; Firpo-Triplett, Regina; Lesesne, Catherine A.; Moore, Claire; Leeks, Kimberly D.

2014-01-01

Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field.…

17 CFR Appendix B to Part 36 - Guidance on, and Acceptable Practices in, Compliance With Core Principles

Code of Federal Regulations, 2013 CFR

2013-04-01

... COMMODITY FUTURES TRADING COMMISSION EXEMPT MARKETS Pt. 36, App. B Appendix B to Part 36—Guidance on, and... contracts to prevent market manipulation, price distortion, and disruptions of the delivery of cash-settlement process through market surveillance, compliance and disciplinary practices and procedures...

17 CFR Appendix B to Part 36 - Guidance on, and Acceptable Practices in, Compliance With Core Principles

Code of Federal Regulations, 2014 CFR

2014-04-01

... COMMODITY FUTURES TRADING COMMISSION EXEMPT MARKETS Pt. 36, App. B Appendix B to Part 36—Guidance on, and... contracts to prevent market manipulation, price distortion, and disruptions of the delivery of cash-settlement process through market surveillance, compliance and disciplinary practices and procedures...

78 FR 28228 - Guidance for Industry and Food and Drug Administration Staff on Best Practices for Conducting and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0057] Guidance for Industry and Food and Drug Administration Staff on Best Practices for Conducting and Reporting Pharmacoepidemiologic Safety Studies Using Electronic Healthcare Data; Availability AGENCY: Food and Drug Administration...

Psycho-Educational Assessment of Specific Learning Disabilities: Views and Practices of Australian Psychologists and Guidance Counsellors

ERIC Educational Resources Information Center

Meteyard, John D.; Gilmore, Linda

2015-01-01

This article reports an investigation of the views and practices of 203 Australian psychologists and guidance counsellors with respect to psycho-educational assessment of students with specific learning disabilities (SLDs). Results from an online survey indicated that practitioners draw upon a wide range of theoretical perspectives when…

Guidance for Organisational Strategy on Knowledge to Action from Conceptual Frameworks and Practice

ERIC Educational Resources Information Center

Willis, Cameron; Riley, Barbara; Lewis, Mary; Stockton, Lisa; Yessis, Jennifer

2017-01-01

This paper aims to provide public health organisations involved in chronic disease prevention with conceptual and practical guidance for developing contextually sensitive knowledge-to-action (KTA) strategies. Methods involve an analysis of 13 relevant conceptual KTA frameworks, and a review of three case examples of organisations with active KTA…

Crash Test Dummies or Knowledgeable Practitioners? Evaluating the Impact of Professional Development.

ERIC Educational Resources Information Center

Harrison, Roger; Edwards, Richard; Brown, Jonathan

2001-01-01

Draws on the authors' experience of developing and presenting an Open University Masters level course: Guidance and Counselling in Learning. Explores the diversity of contexts for guidance practices and the assumptions about the relationship between theory and practice that is embedded in various approaches to professional development. (Contains…

Transition to Postsecondary: New Documentation Guidance for Access to Accommodations

ERIC Educational Resources Information Center

Klotz, Mary Beth

2012-01-01

The Association on Higher Education and Disability (AHEAD) recently developed a conceptual framework that substantially revises its guidance for disability documentation for accommodations in higher education settings. This new document, "Supporting Accommodation Requests: Guidance on Documentation Practices," was written in response to the…

21 CFR 10.115 - Good guidance practices.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., journal articles and editorials, media interviews, press materials, warning letters, memoranda of... document “Guidance Document Submission” and submit it to Division of Dockets Management (HFA-305), 5630... review. (iv) After providing an opportunity for public comment on a Level 1 guidance document, FDA will...

21 CFR 10.115 - Good guidance practices.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., journal articles and editorials, media interviews, press materials, warning letters, memoranda of... document “Guidance Document Submission” and submit it to Division of Dockets Management (HFA-305), 5630... review. (iv) After providing an opportunity for public comment on a Level 1 guidance document, FDA will...

21 CFR 10.115 - Good guidance practices.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., journal articles and editorials, media interviews, press materials, warning letters, memoranda of... document “Guidance Document Submission” and submit it to Division of Dockets Management (HFA-305), 5630... review. (iv) After providing an opportunity for public comment on a Level 1 guidance document, FDA will...

21 CFR 10.115 - Good guidance practices.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., journal articles and editorials, media interviews, press materials, warning letters, memoranda of... document “Guidance Document Submission” and submit it to Division of Dockets Management (HFA-305), 5630... review. (iv) After providing an opportunity for public comment on a Level 1 guidance document, FDA will...

Anticipatory Guidance about Child Diet and Physical Activity for Latino Farmworker Mothers

PubMed Central

Arcury, Thomas A.; Skelton, Joseph A.; Ip, Edward H.; Suerken, Cynthia K.; Trejo, Grisel; Quandt, Sara A.

2016-01-01

Background This analysis describes farmworker child health care utilization, anticipatory guidance for child weight, and the association of anticipatory guidance with personal characteristics, practice characteristics, and child’s health care utilization. Methods Data are from interviews conducted with 221 North Carolina Latino farmworker mothers with a child aged 4–5 years. Results Half of the children were healthy weight, 19.0% were overweight, and 28.5% were obese. Most (56.4%) had been with the usual practice for two years or longer; most had well-child visits less frequently than once per year (71.5%). Fewer children with well-child visits than without were obese (14.8% vs. 35.5%; p=.01). More children with obesity than with healthy weight or overweight received guidance messages; more children without a well-child care visit in the past 12 months received guidance messages. Conclusions Health care providers are addressing anticipatory guidance when the opportunity arises. Creative approaches to address disparate primary care for farmworker families are important. PMID:27524752

Observation Care: Ethical and Legal Considerations for the Emergency Physician.

PubMed

Ali, Nissa J; Jesus, John; Smulowitz, Peter B

2016-03-01

The Medicare observation rules remain controversial despite Centers for Medicare and Medicaid Services revisions and the new 2-midnight rule. The increased financial risks for patients and heightened awareness of the rule have placed emergency physicians (EPs) at the center of the controversy. This article reviews the primary ethical and legal (particularly with respect to the Emergency Medical Treatment and Active Labor Act) implications of the existing observation rule for EPs and offers practical solutions for EPs faced with counseling patients on the meaning and ramifications of the observation rule. We conclude that while we believe it does not violate the intent of the Emergency Medical Treatment and Active Labor Act to respond to patient questions about their admission status, the observation rules challenge the ethical principles of transparency related to the physician-patient relationship and justice as fairness. Guidance for physicians is offered to improve transparency and patient fairness. Copyright © 2016 Elsevier Inc. All rights reserved.

Treatment of encopresis and chronic constipation in young children: clinical results from interactive parent-child guidance.

PubMed

Reid, Helen; Bahar, Ron J

2006-03-01

To describe the source of and treatment for encopresis in a series of 40 children under age 9 years. Referral for psychological based treatment followed upon limited success of standard gastroenterologic intervention. The treatment provided is defined as interactive parent-child family guidance. This includes a variety of specific psychologically based recommendations offered to parents, and, when indicated, direct interventions with the symptomatic child. These are different from various forms of behavioral corrective reward-punishment interventions frequently recommended for young children with encopresis. The pediatric and the psychological literature offer few reports of successful treatment of young children with this syndrome. Also, there are few specific descriptions of psychologically based interventions. The results reported here are of the successful treatment of 38 of 40 cases referred specifically for psychologically based intervention following the prior limited success of standard gastroenterologic treatment. The interactive parent-child family guidance intervention described in this report, differentiated from typical behavior therapies, is a notably successful mode of psychologically based therapy for these children. It offers an important alternative to standard pediatric gastroenterological treatment for encopresis, as well as to reward-punishment oriented behavioral therapies.

After the Liverpool Care Pathway—development of heuristics to guide end of life care for people with dementia: protocol of the ALCP study

PubMed Central

Davies, N; Manthorpe, J; Sampson, E L; Iliffe, S

2015-01-01

Introduction End of life care guidance for people with dementia is lacking and this has been made more problematic in England with the removal of one of the main end of life care guidelines which offered some structure, the Liverpool Care Pathway. This guidance gap may be eased with the development of heuristics (rules of thumb) which offer a fast and frugal form of decision-making. Objective To develop a toolkit of heuristics (rules of thumb) for practitioners to use when caring for people with dementia at the end of life. Method and analysis A mixed-method study using a co-design approach to develop heuristics in three phases. In phase 1, we will conduct at least six focus groups with family carers, health and social care practitioners from both hospital and community care services, using the ‘think-aloud’ method to understand decision-making processes and to develop a set of heuristics. The focus group topic guide will be developed from the findings of a previous study of 46 interviews of family carers about quality end-of-life care for people with dementia and a review of the literature. A multidisciplinary development team of health and social care practitioners will synthesise the findings from the focus groups to devise and refine a toolkit of heuristics. Phase 2 will test the use of heuristics in practice in five sites: one general practice, one community nursing team, one hospital ward and two palliative care teams working in the community. Phase 3 will evaluate and further refine the toolkit of heuristics through group interviews, online questionnaires and semistructured interviews. Ethics and dissemination This study has received ethical approval from a local NHS research ethics committee (Rec ref: 15/LO/0156). The findings of this study will be presented in peer-reviewed publications and national and international conferences. PMID:26338688

PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes

PubMed Central

Eddy, Sarah L.; Converse, Mercedes; Wenderoth, Mary Pat

2015-01-01

There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to increase student outcomes related to achievement, logic development, or other relevant learning goals with college-age students. Thus, this tool both clarifies the research-supported elements of best practices for instructor implementation of active learning in the classroom setting and measures instructors’ alignment with these practices. We describe how we reviewed the discipline-based education research literature to identify best practices in active learning for adult learners in the classroom and used these results to develop an observation tool (Practical Observation Rubric To Assess Active Learning, or PORTAAL) that documents the extent to which instructors incorporate these practices into their classrooms. We then use PORTAAL to explore the classroom practices of 25 introductory biology instructors who employ some form of active learning. Overall, PORTAAL documents how well aligned classrooms are with research-supported best practices for active learning and provides specific feedback and guidance to instructors to allow them to identify what they do well and what could be improved. PMID:26033871

78 FR 62632 - Agency Information Collection Activities; Proposed Collection Renewal; Comment Request Re...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... Collection Renewal; Comment Request Re: Guidance on Sound Incentive Compensation Practices AGENCY: Federal... notice that it is seeking comment on renewal of its information collection, entitled Guidance on Sound... the following currently approved collections of information: Title: Guidance on Sound Incentive...

Best practice in smoking cessation services for pregnant women: results of a survey of three services reporting the highest national returns, and three beacon services.

PubMed

Lee, Michelle; Hajek, Peter; McRobbie, Hayden; Owen, Lesley

2006-09-01

The NHS allocated dedicated funds to establish specialist smoking cessation services for pregnant smokers in England in 2000. An early survey revealed some uncertainty as to how the new services should work and monitor their outcome. The current survey focused on identifying examples of good practice in this difficult new field. Three services with the highest number of successful four-week quitters reported for the 2003/4 monitoring year were identified from Department of Health (DH) monitoring records, and three services were nominated from those known in the field as examples of best practice. There was no overlap between the two groups. All six services provided in-depth interviews. All three highest ranking services that reported close to 100 per cent success rates included unaided quitters identified from hospital wards, rather then smokers actually treated. They had only minimal or average genuine treatment provision for pregnant smokers in place. The three beacon services far exceeded the national throughput and outcome average identified in the previous survey, and provided a wealth of useful information. Although they differed in staffing levels and other aspects of their activities, they all shared several key elements, including a systematic training of midwives in how to refer pregnant smokers, offering nicotine replacement treatment to almost all clients and having an efficient system of providing the prescriptions, offering flexible home visits, and providing intensive multi-session treatment delivered by a small number of dedicated staff. Smoking cessation services for pregnant women may need clearer guidance on what they are expected to provide, and how they should monitor their outcome. The key features of the beacon services can serve as a practical model of current best practice applicable across most PCTs.

Feasibility and impact of a computer-guided consultation on guideline-based management of COPD in general practice.

PubMed

Angus, Robert M; Thompson, Elizabeth B; Davies, Lisa; Trusdale, Ann; Hodgson, Chris; McKnight, Eddie; Davies, Andrew; Pearson, Mike G

2012-12-01

Applying guidelines is a universal challenge that is often not met. Intelligent software systems that facilitate real-time management during a clinical interaction may offer a solution. To determine if the use of a computer-guided consultation that facilitates the National Institute for Health and Clinical Excellence-based chronic obstructive pulmonary disease (COPD) guidance and prompts clinical decision-making is feasible in primary care and to assess its impact on diagnosis and management in reviews of COPD patients. Practice nurses, one-third of whom had no specific respiratory training, undertook a computer-guided review in the usual consulting room setting using a laptop computer with the screen visible to them and to the patient. A total of 293 patients (mean (SD) age 69.7 (10.1) years, 163 (55.6%) male) with a diagnosis of COPD were randomly selected from GP databases in 16 practices and assessed. Of 236 patients who had spirometry, 45 (19%) did not have airflow obstruction and the guided clinical history changed the primary diagnosis from COPD in a further 24 patients. In the 191 patients with confirmed COPD, the consultations prompted management changes including 169 recommendations for altered prescribing of inhalers (addition or discontinuation, inhaler dose or device). In addition, 47% of the 55 current smokers were referred for smoking cessation support, 12 (6%) for oxygen assessment, and 47 (24%) for pulmonary rehabilitation. Computer-guided consultations are practicable in general practice. Primary care COPD databases were confirmed to contain a significant proportion of incorrectly assigned patients. They resulted in interventions and the rationalisation of prescribing in line with recommendations. Only in 22 (12%) of those fully assessed was no management change suggested. The introduction of a computer-guided consultation offers the prospect of comprehensive guideline quality management.

Perinatal Practices & Traditions Among Asian Indian Women.

PubMed

Goyal, Deepika

2016-01-01

As the population in the United States grows more diverse, nurses caring for childbearing women must be aware of the many cultural traditions and customs unique to their patients. This knowledge and insight supports women and their families with the appropriate care, information, and resources. A supportive relationship builds trust, offers guidance, and allows for the new family to integrate information from nurses and other healthcare providers with the practice of certain perinatal cultural traditions. The Asian Indian culture is rich in tradition, specifically during the perinatal period. To support the cultural beliefs and practices of Asian Indian women during this time, nurses need to be aware of and consider multiple factors. Many women are navigating the new role of motherhood while making sense of and incorporating important cultural rituals. The purpose of this article is to provide an overview of perinatal cultural practices and traditions specific to the Asian Indian culture that perinatal nurses may observe in the clinical setting. Cultural traditions and practices specific to the pregnancy and postpartum period are described together with symbolism and implications for nursing practice. It is important to note that information regarding perinatal customs is provided in an effort to promote culturally sensitive nursing care and may not pertain to all Asian Indian women living in the United States.

Clinical teaching based on principles of cognitive apprenticeship: views of experienced clinical teachers.

PubMed

Stalmeijer, Renée E; Dolmans, Diana H J M; Snellen-Balendong, Hetty A M; van Santen-Hoeufft, Marijke; Wolfhagen, Ineke H A P; Scherpbier, Albert J J A

2013-06-01

To explore (1) whether an instructional model based on principles of cognitive apprenticeship fits with the practice of experienced clinical teachers and (2) which factors influence clinical teaching during clerkships from an environmental, teacher, and student level as perceived by the clinical teachers themselves. The model was designed to apply directly to teaching behaviors of clinical teachers and consists of three phases, advocating teaching behaviors such as modeling, creating a safe learning environment, coaching, knowledge articulation, and exploration. A purposive sample of 17 experienced clinical teachers from five different disciplines and four different teaching hospitals took part in semistructured individual interviews. Two researchers independently performed a thematic analysis of the interview transcripts. Coding was discussed within the research team until consensus was reached. All participants recognized the theoretical model as a structured picture of the practice of teaching activities during both regular and senior clerkships. According to participants, modeling and creating a safe learning environment were fundamental to the learning process of both regular and senior clerkship students. Division of teaching responsibilities, longer rotations, and proactive behavior of teachers and students ensured that teachers were able to apply all steps in the model. The theoretical model can offer valuable guidance in structuring clinical teaching activities and offers suggestions for the design of effective clerkships.

Self-guided management of exome and whole-genome sequencing results: changing the results return model.

PubMed

Yu, Joon-Ho; Jamal, Seema M; Tabor, Holly K; Bamshad, Michael J

2013-09-01

Researchers and clinicians face the practical and ethical challenge of if and how to offer for return the wide and varied scope of results available from individual exome sequencing and whole-genome sequencing. We argue that rather than viewing individual exome sequencing and whole-genome sequencing as a test for which results need to be "returned," that the technology should instead be framed as a dynamic resource of information from which results should be "managed" over the lifetime of an individual. We further suggest that individual exome sequencing and whole-genome sequencing results management is optimized using a self-guided approach that enables individuals to self-select among results offered for return in a convenient, confidential, personalized context that is responsive to their value system. This approach respects autonomy, allows individuals to maximize potential benefits of genomic information (beneficence) and minimize potential harms (nonmaleficence), and also preserves their right to an open future to the extent they desire or think is appropriate. We describe key challenges and advantages of such a self-guided management system and offer guidance on implementation using an information systems approach.

Pediatric obesity pharmacotherapy: current state of the field, review of the literature and clinical trial considerations.

PubMed

Kelly, A S; Fox, C K; Rudser, K D; Gross, A C; Ryder, J R

2016-07-01

Despite the increasing number of medications recently approved to treat obesity among adults, few agents have been formally evaluated in children or adolescents for this indication. Moreover, there is a paucity of guidance in the literature addressing best practices with regard to pediatric obesity pharmacotherapy clinical trial design, and only general recommendations have been offered by regulatory agencies on this topic. The purposes of this article are to (1) offer a background of the current state of the field of pediatric obesity medicine, (2) provide a brief review of the literature summarizing pediatric obesity pharmacotherapy clinical trials, and (3) highlight and discuss some of the unique aspects that should be considered when designing and conducting high-quality clinical trials evaluating the safety and efficacy of obesity medications in children and adolescents. Suggestions are offered in the areas of target population and eligibility criteria, clinical trial end-point selection, trial duration, implementation of lifestyle modification therapy and recruitment and retention of participants. Efforts should be made to design and conduct trials appropriately to ensure that high-quality evidence is generated on the safety and efficacy of various medications used to treat pediatric obesity.

Pediatric Obesity Pharmacotherapy: Current State of the Field, Review of the Literature, and Clinical Trial Considerations

PubMed Central

Kelly, Aaron S.; Fox, Claudia K.; Rudser, Kyle D.; Gross, Amy C.; Ryder, Justin R.

2017-01-01

Despite the increasing number of medications recently approved to treat obesity among adults, few agents have been formally evaluated in children or adolescents for this indication. Moreover, there is a paucity of guidance in the literature addressing best practices in regard to pediatric obesity pharmacotherapy clinical trial design, and only general recommendations have been offered by regulatory agencies on this topic. The purposes of this article are to: 1) offer a background of the current state of the field of pediatric obesity medicine; 2) provide a brief review of the literature summarizing pediatric obesity pharmacotherapy clinical trials; and 3) highlight and discuss some of the unique aspects that should be considered when designing and conducting high-quality clinical trials evaluating the safety and efficacy of obesity medications in children and adolescents. Suggestions are offered in the areas of target population and eligibility criteria, clinical trial endpoint selection, trial duration, implementation of lifestyle modification therapy, and recruitment and retention of participants. Efforts should be made to design and conduct trials appropriately to ensure that high-quality evidence is generated on the safety and efficacy of various medications used to treat pediatric obesity. PMID:27113643

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home.

PubMed

Flieger, Signe Peterson

This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and will ultimately help foster a relationship-centered PCMH.

Upholding Equality and Social Justice: A Social Constructivist Perspective on Emancipatory Career Guidance Practice

ERIC Educational Resources Information Center

Bassot, Barbara

2012-01-01

After several years of political agendas focused on social inclusion, career guidance practice needs to return to its roots of promoting equality and social justice. This conceptual article argues that for many years there has been an overreliance on theories focused on the individual, and examines the relationship between social structures and…

76 FR 9027 - Draft Guidance for Industry and Food and Drug Administration Staff on Best Practices for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0057] Draft Guidance for Industry and Food and Drug Administration Staff on Best Practices for Conducting and...: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is...

Children's Television Advertising: The Attitudes and Opinions of Elementary School Guidance Counselors.

ERIC Educational Resources Information Center

Barry, Thomas E.

1978-01-01

Illustrates that guidance counselors from grade schools have negative attitudes about the advertising practices aimed at children. Presents additional evidence that guidance counselors are unaware of the changes being made in advertising aimed at children, such as limiting commercial time during children's television shows. (RL)

Educating Counseling and Guidance Professionals from a Pedagogy Perspective: Experiences from a Latin American Undergraduate Academic Program

ERIC Educational Resources Information Center

Vera, George Davy; Jiménez, Dorelys

2015-01-01

Specialized literature shows that counseling and guidance represents an interdisciplinary profession, practiced differently in various Latin American countries. Likewise, counseling and guidance is understood as being a multicontextual and politically worthy profession that is connected to the personal, socioeconomic, cultural, and collective…

Discussing Diverse Perspectives on Guidance

ERIC Educational Resources Information Center

Gonzalez-Mena, Janet; Shareef, Intisar

2005-01-01

Ideas about discipline and guidance get extremely complex when they intersect with culture and oppression. Some groups of people who are targets of racism have to protect their children from the oppressive practices of racist individuals and institutions. Their methods of guidance and discipline may be different from those of groups for whom…

How Does the Degree of Guidance Support Students' Metacognitive and Problem Solving Skills in Educational Robotics?

ERIC Educational Resources Information Center

Atmatzidou, Soumela; Demetriadis, Stavros; Nika, Panagiota

2018-01-01

Educational robotics (ER) is an innovative learning tool that offers students opportunities to develop higher-order thinking skills. This study investigates the development of students' metacognitive (MC) and problem-solving (PS) skills in the context of ER activities, implementing different modes of guidance in two student groups (11-12 years…

Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part IV--Sport Groups

ERIC Educational Resources Information Center

Lieberman, Lauren; Lucas, Mark; Jones, Jeffery; Humphreys, Dan; Cody, Ann; Vaughn, Bev; Storms, Tommie

2013-01-01

"Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part IV--Sport Groups" provides the the following articles: (1) "Sport Programming Offered by Camp Abilities and the United States Association for Blind Athletes" (Lauren Lieberman and Mark…

Decontamination of breast pump milk collection kits and related items at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society and Infection Prevention Society.

PubMed

Price, E; Weaver, G; Hoffman, P; Jones, M; Gilks, J; O'Brien, V; Ridgway, G

2016-03-01

A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a Joint Working Group of the Healthcare Infection Society and the Infection Prevention Society. The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing and Allied Health Literature, Midwifery and Infant Care, and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources, much of the guidance represents good practice based on the consensus view of the Working Group. This guidance provides practical recommendations to support the safe decontamination of breast pump milk collection kits for healthcare professionals to use and communicate to other groups such as parents and carers. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Turning Bad Press into Prestige.

ERIC Educational Resources Information Center

Wassom, Julie

1995-01-01

Offers guidance to childcare directors on handling public and parent relations during crisis situations (e.g., an outbreak of chicken pox, a child's death, or teacher's dismissal for reasons that cannot be disclosed). Recommends keen observation, risk management, and good planning. Offers suggestions for handling the situation before, during, and…

Hypermedia Design as Learner Scaffolding

ERIC Educational Resources Information Center

Shapiro, Amy M.

2008-01-01

A number of available resources offer guidance about hypermedia design strategies, many of which rely on principles of user-centered design. Many recent efforts, however, have focused more on developing "learner-centered" hypermedia. Learner-centered hypermedia is designed to help learners achieve their educational goals, rather than offer mere…

MO-FG-210-00: US Guided Systems for Brachytherapy

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

NONE

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

MO-FG-210-01: Commissioning An US System for Brachytherapy: An Overview of Physics, Instrumentation, and Techniques

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

Chang, Z.

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

MO-FG-210-02: Implementation of Image-Guided Prostate HDR Brachytherapy Using MR-Ultrasound Fusion

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

Libby, B.

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

MO-FG-210-03: Intraoperative Ultrasonography-Guided Positioning of Plaque Brachytherapy in the Treatment of Choroidal Melanoma

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

Lamb, J.

2015-06-15

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

From a "perfect storm" to "smooth sailing": policymaker perspectives on implementation and sustainment of an evidence-based practice in two states.

PubMed

Willging, Cathleen E; Green, Amy E; Gunderson, Lara; Chaffin, Mark; Aarons, Gregory A

2015-02-01

Policymakers shape implementation and sustainment of evidence-based practices (EBPs), whether they are developing or responding to legislation and policies or negotiating public sector resource constraints. As part of a large mixed-method study, we conducted qualitative interviews with 24 policymakers involved in delivery of the same EBP in two U.S. states. We analyzed transcripts via open and focused coding techniques to identify the commonality, diversity, and complexity of implementation challenges; approaches to overcoming those challenges; and the importance of system-level contextual factors in ensuring successful implementation. Key findings centered on building support and leadership for EBPs; funding and contractual strategies; partnering with stakeholders; tackling challenges via proactive planning and problem solving; and the political, legal, and systemic pressures affecting EBP longevity. The policymaker perspectives offer guidance on nurturing system and organizational practice environments to achieve positive outcomes and for optimally addressing macro-level influences that bear upon the instantiation of EBPs in public sector child welfare systems. © The Author(s) 2014.

Pedagogy, power and practice ethics: clinical teaching in psychiatric/mental health settings.

PubMed

Ewashen, Carol; Lane, Annette

2007-09-01

Often, baccalaureate nursing students initially approach a psychiatric mental health practicum with uncertainty, and even fear. They may feel unprepared for the myriad complex practice situations encountered. In addition, memories of personal painful life events may be vicariously evoked through learning about and listening to the experiences of those diagnosed with mental disorders. When faced with such challenging situations, nursing students often seek counsel from the clinical and/or classroom faculty. Pedagogic boundaries may begin to blur in the face of student distress. For the nurse educator, several questions arise: Should a nurse educator provide counseling to students? How does one best negotiate the boundaries between 'counselor', and 'caring educator'? What are the limits of a caring and professional pedagogic relation? What different knowledges provide guidance and to what differential consequences for ethical pedagogic relationships? This paper offers a comparative analysis of three philosophical stances to examine differences in key assumptions, pedagogic positioning, relationships of power/knowledge, and consequences for professional ethical pedagogic practices. While definitive answers are difficult, the authors pose several questions for consideration in discerning how best to proceed and under what particular conditions.

From a “Perfect Storm” to “Smooth Sailing”: Policymaker Perspectives on Implementation and Sustainment of an Evidence-Based Practice in Two States

PubMed Central

Willging, Cathleen E.; Green, Amy E.; Gunderson, Lara; Chaffin, Mark; Aarons, Gregory A.

2015-01-01

Policymakers shape implementation and sustainment of evidence-based practices (EBPs), whether they are developing or responding to legislation and policies or negotiating public sector resource constraints. As part of a large mixed-method study, we conducted qualitative interviews with 24 policymakers involved in delivery of the same EBP in two U.S. states. We analyzed transcripts via open and focused coding techniques to identify the commonality, diversity, and complexity of implementation challenges; approaches to overcoming those challenges; and the importance of system-level contextual factors in ensuring successful implementation. Key findings centered on building support and leadership for EBPs; funding and contractual strategies; partnering with stakeholders; tackling challenges via proactive planning and problem solving; and the political, legal, and systemic pressures affecting EBP longevity. The policymaker perspectives offer guidance on nurturing system and organizational practice environments to achieve positive outcomes and for optimally addressing macro-level influences that bear upon the instantiation of EBPs in public sector child welfare systems. PMID:25125232

Technology and Quality of Life Outcomes

PubMed Central

Hacker, Eileen Danaher

2010-01-01

Objectives To discuss recent technological advances in quality of life data collection and guidance for use in research and clinical practice. The use of telephone-, computer-, and web/Internet based technologies to collect quality of life data, reliability and validity issues, and cost will be discussed along with the potential pitfalls associated with these technologies. Data Sources Health care literature and web resources. Conclusion Technology has provided researchers and clinicians with an opportunity to collect QOL data from patients that were previously not accessible. Most technologies offer a variety of options, such as language choice, formatting options for the delivery of questions, and data management services. Choosing the appropriate technology for use in research and/or clinical practice primarily depends on the purpose for QOL data collection. Implications for Nursing Practice Technology is changing the way nurses assess quality of life in patients with cancer and provide care. As stakeholders in the health care delivery system and patient advocates, nurses must be intimately involved in the evaluation and use of new technologies that impact quality of life and/or the delivery of care. PMID:20152578

School practices to promote social distancing in K-12 schools: review of influenza pandemic policies and practices.

PubMed

Uscher-Pines, Lori; Schwartz, Heather L; Ahmed, Faruque; Zheteyeva, Yenlik; Meza, Erika; Baker, Garrett; Uzicanin, Amra

2018-03-27

During an evolving influenza pandemic, community mitigation strategies, such as social distancing, can slow down virus transmission in schools and surrounding communities. To date, research on school practices to promote social distancing in primary and secondary schools has focused on prolonged school closure, with little attention paid to the identification and feasibility of other more sustainable interventions. To develop a list and typology of school practices that have been proposed and/or implemented in an influenza pandemic and to uncover any barriers identified, lessons learned from their use, and documented impacts. We conducted a review of the peer-reviewed and grey literature on social distancing interventions in schools other than school closure. We also collected state government guidance documents directed to local education agencies or schools to assess state policies regarding social distancing. We collected standardized information from each document using an abstraction form and generated descriptive statistics on common plan elements. The document review revealed limited literature on school practices to promote social distancing, as well as limited incorporation of school practices to promote social distancing into state government guidance documents. Among the 38 states that had guidance documents that met inclusion criteria, fewer than half (42%) mentioned a single school practice to promote social distancing, and none provided any substantive detail about the policies or practices needed to enact them. The most frequently identified school practices were cancelling or postponing after-school activities, canceling classes or activities with a high rate of mixing/contact that occur within the school day, and reducing mixing during transport. Little information is available to schools to develop policies and procedures on social distancing. Additional research and guidance are needed to assess the feasibility and effectiveness of school practices to promote social distancing.

Achieving high-quality care: a view from NICE.

PubMed

Leng, Gillian; Partridge, Gemma

2018-01-01

The National Institute for Health and Care Excellence (NICE) was established in 1999 to provide evidence-based guidance. The task of producing guidance by reviewing primary research data and using an advisory committee to develop evidence-based recommendations, is not straightforward. Guidance production is, however, less challenging than the task of putting evidence-based recommendations into practice.NICE is very sensitive to this challenge as, since 1999, over 1500 pieces of NICE guidance have been published. A number of pieces of guidance relate to heart disease, including pharmaceutical agents, new medical technologies and clinical guidelines. Examples include guidelines on acute heart failure and atrial fibrillation, and advice on technologies including edoxaban and implantable cardioverter defibrillators.The research evidence is clear that a change in practice rarely comes about as a result of simply disseminating guidance on best practice. Simple dissemination is particularly ineffective if the guidance has not been produced by a well-respected, credible organisation. It is also clear from the literature that implementation is more successful when more than one approach is taken, and when there is alignment between efforts at organisational, local and national levels.At an organisational level, there should be support from the Board for quality improvement, with ongoing measurement of progress. Resources should be provided for targeted change programmes, particularly where new guidance suggests improvements are required. A systematic process for putting change in place should include identifying barriers to change, agreeing interventions to overcome the barriers and drive forward improvement and planning for implementation and evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[New nursing diagnoses in imaging: submission to NANDA International].

PubMed

Juchem, Beatriz Cavalcanti; Almeida, Míriam de Abreu; Lucena, Amália de Fátima

2010-01-01

The present work reports the experiment on the creation and submission to North American Nursing Diagnosis Association International (NANDA-I) of Nursing Diagnosis in the imageology area: "Adverse Reaction to Iodinated Contrast Media" and "Risk of Adverse Reaction to Iodinated Contrast Media". For this experiment the method of integrative revision of literature was utilized associated with the experience in clinical practice. The document for submission was elaborated according to guidance offered by NANDA-I and sent for appreciation to the Diagnosis Development Committee. The risk diagnose was approved and the real diagnose is still in evaluation process by the Diagnosis Development Committee. With this experiment we hope to motivate Brazilian nurses to contribute to the taxonomy of NANDA-I and participate in the building ofnursing knowledge.

Guidelines on product liability for the hospital blood bank. The British Committee for Standards in Haematology.

PubMed

1990-01-01

This report aims to clarify the position of the hospital blood bank in the light of product liability legislation contained in the Consumer Protection Act of 1987. Blood has been defined a 'product' under this Act. The potential for the blood bank to be seen in the role of 'supplier', 'keeper' or even 'producer' in the chain of product supply to the patient is explained and advice given on the resulting implications for blood bank practice. It will be necessary to define, adopt and implement standard operating procedures (SOP) for all blood bank activities. Guidance is given on the format, preparation and content of SOPs and specimen examples offered. The fundamental importance of quality assurance is emphasized.

Using quantitative risk information in decisions about statins: a qualitative study in a community setting.

PubMed

Polak, Louisa; Green, Judith

2015-04-01

A large literature informs guidance for GPs about communicating quantitative risk information so as to facilitate shared decision making. However, relatively little has been written about how patients utilise such information in practice. To understand the role of quantitative risk information in patients' accounts of decisions about taking statins. This was a qualitative study, with participants recruited and interviewed in community settings. Semi-structured interviews were conducted with 34 participants aged >50 years, all of whom had been offered statins. Data were analysed thematically, using elements of the constant comparative method. Interviewees drew frequently on numerical test results to explain their decisions about preventive medication. In contrast, they seldom mentioned quantitative risk information, and never offered it as a rationale for action. Test results were spoken of as objects of concern despite an often-explicit absence of understanding, so lack of understanding seems unlikely to explain the non-use of risk estimates. Preventive medication was seen as 'necessary' either to treat test results, or because of personalised, unequivocal advice from a doctor. This study's findings call into question the assumption that people will heed and use numerical risk information once they understand it; these data highlight the need to consider the ways in which different kinds of knowledge are used in practice in everyday contexts. There was little evidence from this study that understanding probabilistic risk information was a necessary or valued condition for making decisions about statin use. © British Journal of General Practice 2015.

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics

PubMed Central

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A.

2015-01-01

Background and Objectives: In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007–2012). Approach: Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. Results: The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. Conclusion: The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. PMID:26742118

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics.

PubMed

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A; Gill, Kathryn

2015-11-01

In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007-2012). Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. Copyright © 2015 Longwoods Publishing.

Impact of NICE guidance on rates of haemorrhage after tonsillectomy: an evaluation of guidance issued during an ongoing national tonsillectomy audit.

PubMed

Audit, National Prospective Tonsillectomy

2008-08-01

The National Institute for Health and Clinical Excellence (NICE) issued guidance on surgical techniques for tonsillectomy during a national audit of surgical practice and postoperative complications. To assess the impact of the guidance on tonsillectomy practice and outcomes. An interrupted time-series analysis of routinely collected Hospital Episodes Statistics data, and an analysis of longitudinal trends in surgical technique using data from the National Prospective Tonsillectomy Audit. Patients undergoing tonsillectomy in English NHS hospitals between January 2002 and December 2004. Postoperative haemorrhage within 28 days. The rate of haemorrhage increased by 0.5% per year from 2002, reaching 6.4% when the guidance was published. After publication, the rate of haemorrhage fell immediately to 5.7% (difference 0.7%: 95% CI -1.3% to 0.0%) and the rate of increase appeared to have stopped. Data from the National Prospective Tonsillectomy Audit showed that the fall coincided with a shift in surgical techniques, which was consistent with the guidance. NICE guidance influenced surgical tonsillectomy technique and in turn produced an immediate fall in postoperative haemorrhage. The ongoing national audit and strong support from the surgical specialist association may have aided its implementation.

Practice-Based Recommendations from the American Society of Transplantation Liver and Intestine Community of Practice

PubMed Central

Levitsky, J.; O’Leary, J.G.; Asrani, S.; Sharma, P.; Fung, J.; Wiseman, A.; Niemann, C.U.

2016-01-01

Acute and chronic kidney disease after liver transplantation is common and results in significant morbidity and mortality. The introduction of MELD has directly correlated with an increased prevalence of perioperative renal dysfunction and the number of simultaneous liver-kidney transplants performed. Thus, kidney dysfunction in this population is typically multifactorial and related to pre-existing conditions, pre-transplant renal injury, peri-operative events, and post-transplant nephrotoxic immunosuppressive therapies. The management of kidney disease following liver transplantation is challenging, as by the time the serum creatinine is significantly elevated, few interventions impact the course of progression. Also, immunological factors such as antibody-mediated rejection have become of greater interest given the rising liver-kidney transplant population. Therefore this review, assembled by experts in the field and endorsed by the American Society of Transplantation Liver and Intestinal Community of Practice, provides a critical assessment of measures of renal function and interventions aimed at preserving renal function early and late after liver and simultaneous liver-kidney transplantation. Key points and practice-based recommendations for the prevention and management of kidney injury in this population are provided to offer guidance for clinicians and identify gaps in knowledge for future investigations. PMID:26932352

Guidance on the selection of cohorts for the extended one-generation reproduction toxicity study (OECD test guideline 443).

PubMed

Moore, Nigel P; Beekhuijzen, Manon; Boogaard, Peter J; Foreman, Jennifer E; North, Colin M; Palermo, Christine; Schneider, Steffen; Strauss, Volker; van Ravenzwaay, Bennard; Poole, Alan

2016-10-01

The extended one-generation reproduction toxicity study (EOGRTS; OECD test guideline 433) is a new and technically complex design to evaluate the putative effects of chemicals on fertility and development, including effects upon the developing nervous and immune systems. In addition to offering a more comprehensive assessment of developmental toxicity, the EOGRTS offers important improvements in animal welfare through reduction and refinement in a modular study design. The challenge to the practitioner is to know how the modular aspects of the study should be triggered on the basis of prior knowledge of a particular chemical, or on earlier findings in the EOGRTS itself, requirements of specific regulatory frameworks notwithstanding. The purpose of this document is to offer guidance on science-based triggers for these extended evaluations. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Academic-Community Partnership for Medical Missions: Lessons Learned and Practical Guidance for Global Health Service-Learning Experiences.

PubMed

Dang, Yen H; Nice, Frank J; Truong, Hoai-An

2017-01-01

To facilitate an academic-community partnership for sustainable medical mis-sions, a 12-step process was created for an interprofessional, global health educational, and service-learning experience for students and faculty in a school of pharmacy and health professions. Lessons learned and practical guidance are provided to implement similar global health opportunities.

Promoting Student Transition from Entitlement Services to Eligibility Resources

ERIC Educational Resources Information Center

Peterson, Lori Y.; Van Dycke, Jamie L.; Roberson, Rosemary L.; Sedaghat, Jennifer M.

2013-01-01

Disability-related legislation offers two different support systems for youth with disabilities: one of entitlement to services and one of eligibility for resources. This article offers guidance for individuals with disabilities, and the families and service providers who support them, as they prepare to navigate the transition between support…

The Consequences of Fading Instructional Guidance on Delayed Performance: The Case of Financial Services Training

ERIC Educational Resources Information Center

Kissane, Mark; Kalyuga, Slava; Chandler, Paul; Sweller, John

2008-01-01

Empirical studies within a cognitive load framework have determined that for novice learners, worked examples provide appropriate levels of instructional guidance. As learners advance in specific subject domains, worked examples should be gradually replaced by practice problems with limited guidance. This study compared performance, both…

Thinking Differently about Guidance: Power, Children's Autonomy and Democratic Environments

ERIC Educational Resources Information Center

Millei, Zsuzsa

2012-01-01

This article critiques guidance approaches to discipline, that are employed in early childhood environments with an aim to create democratic environments for children, and as part of "good" practices. Advocates of guidance claim that this is a more humane or democratic approach to discipline that empowers children, and therefore, power…

Subjects, Networks and Positions: Thinking Educational Guidance Differently

ERIC Educational Resources Information Center

Usher, Robin; Edwards, Richard G.

2005-01-01

This article explores the ways in which framings drawn from post-structuralism can help to inform the understanding of guidance practices. In particular, it draws upon the later work of Foucault and Actor-Network Theory to question the centrality of the humanistic subject predominant within discourses of contemporary guidance and raise issues of…

Key Competencies and School Guidance Counselling: Learning Alongside Communities of Support

ERIC Educational Resources Information Center

Kotzé, Elmarie; Crocket, Kathie; Burke, Alison; Graham, Judith; Hughes, Colin

2013-01-01

Often the work of school guidance counsellors goes on "behind the scenes" in the privacy and confidentiality of the counselling room. This article makes visible particular aspects of school counselling practice. It illustrates the potential for understanding school guidance counselling as a site of student learning, in particular of key…

The Consideration of a Constructivist Evaluation Framework in Adult Guidance Practice

ERIC Educational Resources Information Center

Hearne, Lucy

2011-01-01

This article explores the findings of a doctoral study that examined the measurement of individual progression in the Irish Adult Education Guidance Initiative. The critical constructivist stance of the study challenges the prevalence of the positivist paradigm to evaluate long-term outcomes in adult guidance. The research highlights the…

Automatic Welding System

NASA Astrophysics Data System (ADS)

1982-01-01

Robotic welding has been of interest to industrial firms because it offers higher productivity at lower cost than manual welding. There are some systems with automated arc guidance available, but they have disadvantages, such as limitations on types of materials or types of seams that can be welded; susceptibility to stray electrical signals; restricted field of view; or tendency to contaminate the weld seam. Wanting to overcome these disadvantages, Marshall Space Flight Center, aided by Hayes International Corporation, developed system that uses closed-circuit TV signals for automatic guidance of the welding torch. NASA granted license to Combined Technologies, Inc. for commercial application of the technology. They developed a refined and improved arc guidance system. CTI in turn, licensed the Merrick Corporation, also of Nashville, for marketing and manufacturing of the new system, called the CT2 Optical Trucker. CT2 is a non-contracting system that offers adaptability to broader range of welding jobs and provides greater reliability in high speed operation. It is extremely accurate and can travel at high speed of up to 150 inches per minute.

78 FR 44806 - Amendments to Regulation D, Form D and Rule 156

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

...The Securities and Exchange Commission, which today in separate releases amended Rule 506 of Regulation D, Form D and Rule 144A under the Securities Act of 1933 to implement Section 201(a) of the Jumpstart Our Business Startups Act and Section 926 of the Dodd- Frank Wall Street Reform and Consumer Protection Act, is publishing for comment a number of proposed amendments to Regulation D, Form D and Rule 156 under the Securities Act. These proposed amendments are intended to enhance the Commission's ability to evaluate the development of market practices in Rule 506 offerings and to address concerns that may arise in connection with permitting issuers to engage in general solicitation and general advertising under new paragraph (c) of Rule 506. Specifically, the proposed amendments to Regulation D would require the filing of a Form D in Rule 506(c) offerings before the issuer engages in general solicitation; require the filing of a closing amendment to Form D after the termination of any Rule 506 offering; require written general solicitation materials used in Rule 506(c) offerings to include certain legends and other disclosures; require the submission, on a temporary basis, of written general solicitation materials used in Rule 506(c) offerings to the Commission; and disqualify an issuer from relying on Rule 506 for one year for future offerings if the issuer, or any predecessor or affiliate of the issuer, did not comply, within the last five years, with Form D filing requirements in a Rule 506 offering. The proposed amendments to Form D would require an issuer to include additional information about offerings conducted in reliance on Regulation D. Finally, the proposed amendments to Rule 156 would extend the antifraud guidance contained in the rule to the sales literature of private funds.

Improving public health evaluation: a qualitative investigation of practitioners' needs.

PubMed

Denford, Sarah; Lakshman, Rajalakshmi; Callaghan, Margaret; Abraham, Charles

2018-01-30

In 2011, the House of Lords published a report on Behaviour Change, in which they report that "a lot more could, and should, be done to improve the evaluation of interventions." This study aimed to undertake a needs assessment of what kind of evaluation training and materials would be of most use to UK public health practitioners by conducting interviews with practitioners about everyday evaluation practice and needed guidance and materials. Semi-structured interviews were conducted with 32 public health practitioners in two UK regions, Cambridgeshire and the South West. Participants included directors of public health, consultants in public health, health improvement advisors, public health intelligence, and public health research officers. A topic guide included questions designed to explore participants existing evaluation practice and their needs for further training and guidance. Data were analysed using thematic analyses. Practitioners highlighted the need for evaluation to defend the effectiveness of existing programs and protect funding provisions. However, practitioners often lacked training in evaluation, and felt unqualified to perform such a task. The majority of practitioners did not use, or were not aware of many existing evaluation guidance documents. They wanted quality-assured, practical guidance that relate to the real world settings in which they operate. Practitioners also mentioned the need for better links and support from academics in public health. Whilst numerous guidance documents supporting public health evaluation exist, these documents are currently underused by practitioners - either because they are not considered useful, or because practitioners are not aware of them. Integrating existing guides into a catalogue of guidance documents, and developing a new-quality assured, practical and useful document may support the evaluation of public health programs. This in turn has the potential to identify those programs that are effective; thus improving public health and reducing financial waste.

The ideal of consumer choice in social services: challenges with implementation in an Ontario injured worker vocational retraining programme.

PubMed

Maceachen, Ellen; Kosny, Agnieszka; Ferrier, Sue; Lippel, Katherine; Neilson, Cynthia; Franche, Renee-Louise; Pugliese, Diana

2013-01-01

Social service programmes that offer consumer choices are intended to guide service efficiency and customer satisfaction. However, little is known about how social service consumers actually make choices and how providers deliver such services. This article details the practical implementation of consumer choice in a Canadian workers' compensation vocational retraining programme. Discourse analysis was conducted of in-depth interviews and focus groups with 71 injured workers and service providers, who discussed their direct experience of a vocational retraining system. Data also included procedural, policy and administrative documents. Consumer choice included workers being offered choices about some service aspects, but not being able to exercise meaningful discretion. Programme cost objectives and restrictive rules and bureaucracy skewed the guidance provided to workers by service providers. If workers did not make the "right" choices, then the service providers were required to make choices for them. This upset workers and created tension for service providers. The ideal of consumer choice in a social service programme was difficult to enact, both for workers and service providers. Processes to increase quality of guidance to social service consumers and to create a systematic feedback look between system designers and consumers are recommended. Implications for Rehabilitation Consumer choice is an increasingly popular concept in social service systems. Vocational case managers can have their own administrative needs and tensions, which do not always align with the client's choices. Rehabilitation programmes need to have processes for considering what choices are important to clients and the resources to support them.

Medical records for animals used in research, teaching, and testing: public statement from the American College of Laboratory Animal Medicine.

PubMed

Field, Karl; Bailey, Michele; Foresman, Larry L; Harris, Robert L; Motzel, Sherri L; Rockar, Richard A; Ruble, Gaye; Suckow, Mark A

2007-01-01

Medical records are considered to be a key element of a program of adequate veterinary care for animals used in research, teaching, and testing. However, prior to the release of the public statement on medical records by the American College of Laboratory Animal Medicine (ACLAM), the guidance that was available on the form and content of medical records used for the research setting was not consistent and, in some cases, was considered to be too rigid. To address this concern, ACLAM convened an ad hoc Medical Records Committee and charged the Committee with the task of developing a medical record guideline that was based on both professional judgment and performance standards. The Committee provided ACLAM with a guidance document titled Public Statements: Medical Records for Animals Used in Research, Teaching, and Testing, which was approved by ACLAM in late 2004. The ACLAM public statement on medical records provides guidance on the definition and content of medical records, and clearly identifies the Attending Veterinarian as the individual who is charged with authority and responsibility for oversight of the institution's medical records program. The document offers latitude to institutions in the precise form and process used for medical records but identifies typical information to be included in such records. As a result, the ACLAM public statement on medical records provides practical yet flexible guidelines to assure that documentation of animal health is performed in research, teaching, and testing situations.

Paying Research Participants: Regulatory Uncertainty, Conceptual Confusion, and a Path Forward.

PubMed

Largent, Emily A; Fernandez Lynch, Holly

The practice of offering payment to individuals in exchange for their participation in clinical research is widespread and longstanding. Nevertheless, such payment remains the source of substantial debate, in particular about whether or the extent to which offers of payment coerce and/or unduly induce individuals to participate. Yet, the various laws, regulations, and ethical guidelines that govern the conduct of human subjects research offer relatively little in the way of specific guidance regarding what makes a payment offer ethically acceptable-or not. Moreover, there is a lack of definitional agreement regarding what the terms coercion and undue inducement mean in the human subjects research context. It is, therefore, unsurprising that investigators and Institutional Review Boards (IRBs) experience confusion about how to evaluate offers of payment, and lean toward conservative approaches. These trends are exemplified by our pilot data regarding the ways in which some IRB members and investigators (mis)understand the concepts of coercion and undue inducement, as well as the ways in which certain research institutions oversee offers of payment at a local level. This article systematically examines the legal and ethical dimensions of offering payment to research participants. It argues that many concerns about offers of payment to research participants can be attributed to the misguided view that such offers ought to be treated differently than offers of payment in other contexts, a form of "research exceptionalism." We show that rejection of research exceptionalism with respect to payment helps settle open debates about both how best to define coercion and undue influence, and how to understand the relation between these concepts and offers of payment. We argue for adoption of our preferred definitions, ideally by regulatory authorities, and against the conventional conservatism toward payment of research participants. Instead, we draw attention to the rarely asked, even radical, question: are research participants paid enough ? We conclude by arguing that we ought to change the default to favor, rather than encourage suspicion of, offers of payment to research participants.

Dysphagia in Duchenne muscular dystrophy: practical recommendations to guide management.

PubMed

Toussaint, Michel; Davidson, Zoe; Bouvoie, Veronique; Evenepoel, Nathalie; Haan, Jurn; Soudon, Philippe

2016-10-01

Duchenne muscular dystrophy (DMD) is a rapidly progressive neuromuscular disorder causing weakness of the skeletal, respiratory, cardiac and oropharyngeal muscles with up to one third of young men reporting difficulty swallowing (dysphagia). Recent studies on dysphagia in DMD clarify the pathophysiology of swallowing disorders and offer new tools for its assessment but little guidance is available for its management. This paper aims to provide a step-by-step algorithm to facilitate clinical decisions regarding dysphagia management in this patient population. This algorithm is based on 30 years of clinical experience with DMD in a specialised Centre for Neuromuscular Disorders (Inkendaal Rehabilitation Hospital, Belgium) and is supported by literature where available. Dysphagia can worsen the condition of ageing patients with DMD. Apart from the difficulties of chewing and oral fragmentation of the food bolus, dysphagia is rather a consequence of an impairment in the pharyngeal phase of swallowing. By contrast with central neurologic disorders, dysphagia in DMD accompanies solid rather than liquid intake. Symptoms of dysphagia may not be clinically evident; however laryngeal food penetration, accumulation of food residue in the pharynx and/or true laryngeal food aspiration may occur. The prevalence of these issues in DMD is likely underestimated. There is little guidance available for clinicians to manage dysphagia and improve feeding for young men with DMD. This report aims to provide a clinical algorithm to facilitate the diagnosis of dysphagia, to identify the symptoms and to propose practical recommendations to treat dysphagia in the adult DMD population. Implications for Rehabilitation Little guidance is available for the management of dysphagia in Duchenne dystrophy. Food can penetrate the vestibule, accumulate as residue or cause aspiration. We propose recommendations and an algorithm to guide management of dysphagia. Penetration/residue accumulation: prohibit solid food and promote intake of fluids. Aspiration: if cough augmentation techniques are ineffective, consider tracheostomy.

Dysphagia in Duchenne muscular dystrophy: practical recommendations to guide management

PubMed Central

Toussaint, Michel; Davidson, Zoe; Bouvoie, Veronique; Evenepoel, Nathalie; Haan, Jurn; Soudon, Philippe

2016-01-01

Abstract Purpose: Duchenne muscular dystrophy (DMD) is a rapidly progressive neuromuscular disorder causing weakness of the skeletal, respiratory, cardiac and oropharyngeal muscles with up to one third of young men reporting difficulty swallowing (dysphagia). Recent studies on dysphagia in DMD clarify the pathophysiology of swallowing disorders and offer new tools for its assessment but little guidance is available for its management. This paper aims to provide a step-by-step algorithm to facilitate clinical decisions regarding dysphagia management in this patient population. Methods: This algorithm is based on 30 years of clinical experience with DMD in a specialised Centre for Neuromuscular Disorders (Inkendaal Rehabilitation Hospital, Belgium) and is supported by literature where available. Results: Dysphagia can worsen the condition of ageing patients with DMD. Apart from the difficulties of chewing and oral fragmentation of the food bolus, dysphagia is rather a consequence of an impairment in the pharyngeal phase of swallowing. By contrast with central neurologic disorders, dysphagia in DMD accompanies solid rather than liquid intake. Symptoms of dysphagia may not be clinically evident; however laryngeal food penetration, accumulation of food residue in the pharynx and/or true laryngeal food aspiration may occur. The prevalence of these issues in DMD is likely underestimated. Conclusions: There is little guidance available for clinicians to manage dysphagia and improve feeding for young men with DMD. This report aims to provide a clinical algorithm to facilitate the diagnosis of dysphagia, to identify the symptoms and to propose practical recommendations to treat dysphagia in the adult DMD population.Implications for RehabilitationLittle guidance is available for the management of dysphagia in Duchenne dystrophy.Food can penetrate the vestibule, accumulate as residue or cause aspiration.We propose recommendations and an algorithm to guide management of dysphagia.Penetration/residue accumulation: prohibit solid food and promote intake of fluids.Aspiration: if cough augmentation techniques are ineffective, consider tracheostomy. PMID:26728920

Examining the implementation of NICE guidance: cross-sectional survey of the use of NICE interventional procedures guidance by NHS Trusts.

PubMed

Lowson, Karin; Jenks, Michelle; Filby, Alexandra; Carr, Louise; Campbell, Bruce; Powell, John

2015-06-30

In the UK, NHS hospitals receive large amounts of evidence-based recommendations for care delivery from the National Institute for Health and Care Excellence (NICE) and other organisations. Little is known about how NHS organisations implement such guidance and best practice for doing so. This study was therefore designed to examine the dissemination, decision-making, and monitoring processes for NICE interventional procedures (IP) guidance and to investigate the barriers and enablers to the implementation of such guidance. A cross-sectional survey questionnaire was developed and distributed to individuals responsible for managing the processes around NICE guidance in all 181 acute NHS hospitals in England, Scotland, Wales and Northern Ireland. A review of acute NHS hospital policies for implementing NICE guidance was also undertaken using information available in the public domain and from organisations' websites. The response rate to the survey was 75 % with 135 completed surveys received. Additionally, policies from 25 % of acute NHS hospitals were identified and analysed. NHS acute hospitals typically had detailed processes in place to implement NICE guidance, although organisations recognised barriers to implementation including organisational process barriers, clinical engagement and poor targeting with a large number of guidance issued. Examples of enablers to, and good practice for, implementation of guidance were found, most notably the value of shared learning experiences between NHS hospitals. Implications for NICE were also identified. These included making improvements to the layout of guidance, signposting on the website and making better use of their shared learning platform. Most organisations have robust processes in place to deal with implementing guidance. However, resource limitations and the scope of guidance received by organisations create barriers relating to organisational processes, clinician engagement and financing of new procedures. Guidance implementation can be facilitated through encouragement of shared learning by organisations such as NICE and open knowledge transfer between organisations.

Influence of evidence-based guidance on health policy and clinical practice in England.

PubMed

Coleman, P; Nicholl, J

2001-12-01

To examine the influence of evidence-based guidance on health care decisions, a study of the use of seven different sources and types of evidence-based guidance was carried out in senior health professionals in England with responsibilities either for directing and purchasing health care based in the health authorities, or providing clinical care to patients in trust hospitals or in primary care. Postal survey. Three health settings: 46 health authorities, 162 acute and/or community trust hospitals, and 96 primary care groups in England. 566 subjects (46 directors of public health, 49 directors of purchasing, 375 clinical directors/consultants in hospitals, and 96 lead general practitioners). Knowledge of selected evidence-based guidance, previous use ever, beliefs in quality, usefulness, and perceived influence on practice. A usable response rate of 73% (407/560) was achieved; 82% (334/407) of respondents had consulted at least one source of evidence-based guidance ever in the past. Professionals in the health authorities were much more likely to be aware of the evidence-based guidance and had consulted more sources (mean number of different guidelines consulted 4.3) than either the hospital consultants (mean 1.9) or GPs in primary care (mean 1.8). There was little variation in the belief that the evidence-based guidance was of "good quality", but respondents from the health authorities (87%) were significantly more likely than either hospital consultants (52%) or GPs (57%) to perceive that any of the specified evidence-based guidance had influenced a change of practice. Across all settings, the least used route to accessing evidence-based guidance was the Internet. For several sources an effect was observed between use ever, the health region where the health professional worked, and the region where the guidance was produced or published. This was evident for some national sources as well as in those initiatives produced locally with predominantly local distribution networks. The evidence-based guidance specified was significantly more likely to be seen to have contributed to the decisions of public health specialists and commissioners than those of consultants in hospitals or of GPs in a primary care setting. Appropriate information support and dissemination systems that increase awareness, access, and use of evidence-based guidance at the clinical interface should be developed.

Improving the Clinical Pharmacologic Assessment of Abuse Potential: Part 1: Regulatory Context and Risk Management.

PubMed

Sellers, Edward M

2018-02-01

This article brings to the attention of drug developers the Food and Drug Administration's (FDA's) recent final Guidance to Industry on Assessment of Abuse Potential and provides practical suggestions about compliance with the Guidance. The Guidance areas are reviewed, analyzed, and placed in the context of current scientific knowledge and best practices to mitigate regulatory risk. The Guidance provides substantial new detail on what needs to be done at all stages of drug development for central nervous system-active drugs. However, because many psychopharmacologic agents have unique preclinical and clinical features, the plan for each agent needs to be not only carefully prepared but also reviewed and approved by the FDA. Examples are provided where assumptions about interpretation of the Guidance can delay development. If the expertise and experience needed for assessing abuse potential during drug development do not exist within a company, external preclinical and clinical expert should be involved. Consultation with the FDA is encouraged and important because the specific requirements for each drug will vary.

Q-Sample Construction: A Critical Step for a Q-Methodological Study.

PubMed

Paige, Jane B; Morin, Karen H

2016-01-01

Q-sample construction is a critical step in Q-methodological studies. Prior to conducting Q-studies, researchers start with a population of opinion statements (concourse) on a particular topic of interest from which a sample is drawn. These sampled statements are known as the Q-sample. Although literature exists on methodological processes to conduct Q-methodological studies, limited guidance exists on the practical steps to reduce the population of statements to a Q-sample. A case exemplar illustrates the steps to construct a Q-sample in preparation for a study that explored perspectives nurse educators and nursing students hold about simulation design. Experts in simulation and Q-methodology evaluated the Q-sample for readability, clarity, and for representativeness of opinions contained within the concourse. The Q-sample was piloted and feedback resulted in statement refinement. Researchers especially those undertaking Q-method studies for the first time may benefit from the practical considerations to construct a Q-sample offered in this article. © The Author(s) 2014.

"Evidence" Under a Magnifying Glass: Thoughts on Safety Argument Epistemology

NASA Technical Reports Server (NTRS)

Graydon, P. J.; Holloway, C. M.

2015-01-01

Common definitions of "safety case" emphasize that evidence is the basis of a safety argument, yet few widely referenced works explicitly define "evidence". Their examples suggest that similar things can be regarded as evidence. But the category evidence seems to contain (1) processes for finding things out, (2) information resulting from such processes, and (3) relevant documents. Moreover, any item of evidence could be replaced by further argument. Normative models of informal argumentation do not offer clear guidance on when a safety argument should cite evidence rather than appeal to a more detailed argument. Disciplines such as the law address the problem with a practical, domain-specific epistemology. In this paper, we explore these problems associated with evidence citations in safety arguments, identify goals for a theory of safety argument evidence and a practical safety argument epistemology, propose a model of safety evidence citation that advances the identified goals, and present a related extension to the Goal Structuring Notation (GSN).

Querying Safety Cases

NASA Technical Reports Server (NTRS)

Denney, Ewen W.; Naylor, Dwight; Pai, Ganesh

2014-01-01

Querying a safety case to show how the various stakeholders' concerns about system safety are addressed has been put forth as one of the benefits of argument-based assurance (in a recent study by the Health Foundation, UK, which reviewed the use of safety cases in safety-critical industries). However, neither the literature nor current practice offer much guidance on querying mechanisms appropriate for, or available within, a safety case paradigm. This paper presents a preliminary approach that uses a formal basis for querying safety cases, specifically Goal Structuring Notation (GSN) argument structures. Our approach semantically enriches GSN arguments with domain-specific metadata that the query language leverages, along with its inherent structure, to produce views. We have implemented the approach in our toolset AdvoCATE, and illustrate it by application to a fragment of the safety argument for an Unmanned Aircraft System (UAS) being developed at NASA Ames. We also discuss the potential practical utility of our query mechanism within the context of the existing framework for UAS safety assurance.

The new statistics: why and how.

PubMed

Cumming, Geoff

2014-01-01

We need to make substantial changes to how we conduct research. First, in response to heightened concern that our published research literature is incomplete and untrustworthy, we need new requirements to ensure research integrity. These include prespecification of studies whenever possible, avoidance of selection and other inappropriate data-analytic practices, complete reporting, and encouragement of replication. Second, in response to renewed recognition of the severe flaws of null-hypothesis significance testing (NHST), we need to shift from reliance on NHST to estimation and other preferred techniques. The new statistics refers to recommended practices, including estimation based on effect sizes, confidence intervals, and meta-analysis. The techniques are not new, but adopting them widely would be new for many researchers, as well as highly beneficial. This article explains why the new statistics are important and offers guidance for their use. It describes an eight-step new-statistics strategy for research with integrity, which starts with formulation of research questions in estimation terms, has no place for NHST, and is aimed at building a cumulative quantitative discipline.

A practical approach to classifying and managing feeding difficulties.

PubMed

Kerzner, Benny; Milano, Kim; MacLean, William C; Berall, Glenn; Stuart, Sheela; Chatoor, Irene

2015-02-01

Many young children are thought by their parents to eat poorly. Although the majority of these children are mildly affected, a small percentage have a serious feeding disorder. Nevertheless, even mildly affected children whose anxious parents adopt inappropriate feeding practices may experience consequences. Therefore, pediatricians must take all parental concerns seriously and offer appropriate guidance. This requires a workable classification of feeding problems and a systematic approach. The classification and approach we describe incorporate more recent considerations by specialists, both medical and psychological. In our model, children are categorized under the 3 principal eating behaviors that concern parents: limited appetite, selective intake, and fear of feeding. Each category includes a range from normal (misperceived) to severe (behavioral and organic). The feeding styles of caregivers (responsive, controlling, indulgent, and neglectful) are also incorporated. The objective is to allow the physician to efficiently sort out the wide variety of conditions, categorize them for therapy, and where necessary refer to specialists in the field. Copyright © 2015 by the American Academy of Pediatrics.

Can a workbook work? Examining whether a practitioner evaluation toolkit can promote instrumental use.

PubMed

Campbell, Rebecca; Townsend, Stephanie M; Shaw, Jessica; Karim, Nidal; Markowitz, Jenifer

2015-10-01

In large-scale, multi-site contexts, developing and disseminating practitioner-oriented evaluation toolkits are an increasingly common strategy for building evaluation capacity. Toolkits explain the evaluation process, present evaluation design choices, and offer step-by-step guidance to practitioners. To date, there has been limited research on whether such resources truly foster the successful design, implementation, and use of evaluation findings. In this paper, we describe a multi-site project in which we developed a practitioner evaluation toolkit and then studied the extent to which the toolkit and accompanying technical assistance was effective in promoting successful completion of local-level evaluations and fostering instrumental use of the findings (i.e., whether programs directly used their findings to improve practice, see Patton, 2008). Forensic nurse practitioners from six geographically dispersed service programs completed methodologically rigorous evaluations; furthermore, all six programs used the findings to create programmatic and community-level changes to improve local practice. Implications for evaluation capacity building are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Friend or Foe in the Pocket? - The Role of the Individual, Peergroup and Parents for (dys)functional Mobile Phone Use].

PubMed

Knop, Karin; Hefner, Dorothée

2018-02-01

Friend or Foe in the Pocket? - The Role of the Individual, Peergroup and Parents for (dys)functional Mobile Phone Use In order to provide consultative support to parents as well as to children and young people, background knowledge regarding the motives of mobile phone use, functions of usage, comprehension of the attraction of this all-round medium also as knowledge about potential hazards are essential. This study offers empirical results about potentials and risks. The peergroup plays an important role for riskful and problematic mobile phone involvement. Parents function as a role model and the explicit parental mediation practices and their impact on the child are in focus. Data was acquired from a quota-sample survey with 500 children between the age of 8 and 14 years and one of their parents, qualitative interviews (20 children and their parents) and eight peergroup-discussions (52 participants). The present paper illuminates the above mentioned aspects and derives implications for guidance practice.

Sexual Harassment in the Workplace: An Ethical Dilemma for Career Guidance Practice?

ERIC Educational Resources Information Center

Bimrose, Jenny

2004-01-01

Sexual harassment in the workplace poses something of an ethical dilemma for career guidance practice. This is because it is now known that about half of all working women in the UK are likely to be victims at some stage of their employment and that the effects on individuals are invariably negative and can be positively harmful. What, therefore,…

Quieter pavements guidance document

DOT National Transportation Integrated Search

2013-02-01

This report provides guidance and better practice recommendations to the National Park : Service for selecting pavement surfaces to minimize tire-pavement noise. The report : contains an overview of common technologies and methods for quieter pavemen...

Building Comprehensive Career Guidance Programs for Secondary Schools: A Handbook of Programs, Practices, and Models. Research and Development Series No. 147.

ERIC Educational Resources Information Center

Campbell, Robert E.; And Others

This handbook presents management techniques, program ideas, and student activities for building comprehensive secondary career guidance programs. Part 1 (chapter 1) traces the history of guidance to set the stage for the current emphasis on comprehensive programs, summarizes four representative models for designing comprehensive programs, and…

Guidance for updating clinical practice guidelines: a systematic review of methodological handbooks.

PubMed

Vernooij, Robin W M; Sanabria, Andrea Juliana; Solà, Ivan; Alonso-Coello, Pablo; Martínez García, Laura

2014-01-02

Updating clinical practice guidelines (CPGs) is a crucial process for maintaining the validity of recommendations. Methodological handbooks should provide guidance on both developing and updating CPGs. However, little is known about the updating guidance provided by these handbooks. We conducted a systematic review to identify and describe the updating guidance provided by CPG methodological handbooks and included handbooks that provide updating guidance for CPGs. We searched in the Guidelines International Network library, US National Guidelines Clearinghouse and MEDLINE (PubMed) from 1966 to September 2013. Two authors independently selected the handbooks and extracted the data. We used descriptive statistics to analyze the extracted data and conducted a narrative synthesis. We included 35 handbooks. Most handbooks (97.1%) focus mainly on developing CPGs, including variable degrees of information about updating. Guidance on identifying new evidence and the methodology of assessing the need for an update is described in 11 (31.4%) and eight handbooks (22.8%), respectively. The period of time between two updates is described in 25 handbooks (71.4%), two to three years being the most frequent (40.0%). The majority of handbooks do not provide guidance for the literature search, evidence selection, assessment, synthesis, and external review of the updating process. Guidance for updating CPGs is poorly described in methodological handbooks. This guidance should be more rigorous and explicit. This could lead to a more optimal updating process, and, ultimately to valid trustworthy guidelines.

Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?

PubMed Central

Home, Philip; Riddle, Matthew; Cefalu, William T.; Bailey, Clifford J.; Bretzel, Reinhard G.; del Prato, Stefano; Leroith, Derek; Schernthaner, Guntram; van Gaal, Luc; Raz, Itamar

2014-01-01

Given the continued interest in defining the optimal management of individuals with type 2 diabetes, the Editor of Diabetes Care convened a working party of diabetes specialists to examine this topic in the context of insulin therapy. This was prompted by recent new evidence on the use of insulin in such people. The group was aware of evidence that the benefits of insulin therapy are still usually offered late, and thus the aim of the discussion was how to define the optimal timing and basis for decisions regarding insulin and to apply these concepts in practice. It was noted that recent evidence had built upon that of the previous decades, together confirming the benefits and safety of insulin therapy, albeit with concerns about the potential for hypoglycemia and gain in body weight. Insulin offers a unique ability to control hyperglycemia, being used from the time of diagnosis in some circumstances, when metabolic control is disturbed by medical illness, procedures, or therapy, as well as in the longer term in ambulatory care. For those previously starting insulin, various other forms of therapy can be added later, which offer complementary effects appropriate to individual needs. Here we review current evidence and circumstances in which insulin can be used, consider individualized choices of alternatives and combination regimens, and offer some guidance on personalized targets and tactics for glycemic control in type 2 diabetes. PMID:24855154

Development and qualitative evaluation of an adapted return to work guideline for the sick-listed unemployed and temporary agency workers with minor psychological problems

PubMed Central

2012-01-01

Background Among the working population, unemployed and temporary agency workers with psychological problems are a particularly vulnerable group, at risk for sickness absence and prolonged work disability. There is a need for the development of a new protocol for this group, because the existing return to work (RTW) interventions, including practice guidelines, do not address the situation when there is no workplace to return to. The purpose of this study was to (1) describe the adaptations needed in the practice guideline for employed workers to enable its use by insurance physicians (IPs) for counselling of sick-listed unemployed and temporary agency workers with minor psychological problems; and (2) evaluate the experiences of IPs when using the new guidance document for minor psychological problems (MPP guidance document). Methods The MPP guidance document for unemployed and temporary agency workers was developed through discussions with nine IPs and with the help of an expert. Semi-structured interviews with five IPs were then held to evaluate the IPs’ field experience using the MPP guidance document, in terms of (a) feasibility and (b) perceived usefulness of the MPP guidance document. Results The main adaptation introduced in the guideline is that interaction with the workplace, which is absent in this population, needed to be established in an alternative way, i.e., through the involvement of vocational rehabilitation agencies and labour experts. Overall, the guideline required minimal changes. In total, nineteen sick-listed workers were counselled using the MPP guidance document. The overall experience of the IPs was that the MPP guidance document was feasible and useful for the IP, while they had mixed responses on its usefulness for the sick-listed worker, in part due to the follow-up period of this study. Conclusions An existing practice guideline for employed workers was adapted for use as a guidance document for unemployed and temporary agency workers with minor psychological problems. IPs were positive about applying the MPP guidance document. The guidance document provides opportunities for RTW counselling for unemployed and temporary agency workers with minor psychological problems. PMID:23014258

A Humanistic Framework for Helping Students

ERIC Educational Resources Information Center

Myers, David M.; Rosenberger, Eric

2012-01-01

Humans, as social creatures, look to others for affiliation, support, and guidance while also having the capacity to offer something of value to someone in need (understanding, compassion, reassurance, hope, etc.). While offering such support can be easy, almost innate, for some and less natural for others, basic helping skills can be learned and…

Story Crafting: Strategies for Facilitating Narrative Career Counselling

ERIC Educational Resources Information Center

McMahon, Mary; Watson, Mark

2012-01-01

Narrative career counselling is a growing force in career guidance and counselling that offers a direction for the field to respond to the needs of increasingly diverse client groups. In this article, we review established and emerging approaches to narrative career counselling, then focus on the emerging story telling approach. We offer examples…

Financing Your Small Business: A Workbook for Financing Small Business.

ERIC Educational Resources Information Center

Compton, Clark W.

Designed to assist established businesspeople with the development of a loan proposal, this workbook offers information on sources of financing and step-by-step guidance on applying for a loan. After chapter I discusses borrowers' and lenders' attitudes towards money, chapter II offers suggestions for determining financial needs. Chapter III lists…

Regulations Under the Americans With Disabilities Act; Genetic Information Nondiscrimination Act. Final rule.

PubMed

2016-05-17

The Equal Employment Opportunity Commission (EEOC or Commission) is issuing its final rule to amend the regulations and interpretive guidance implementing Title I of the Americans with Disabilities Act (ADA) to provide guidance on the extent to which employers may use incentives to encourage employees to participate in wellness programs that ask them to respond to disability-related inquiries and/or undergo medical examinations. This rule applies to all wellness programs that include disability-related inquiries and/or medical examinations whether they are offered only to employees enrolled in an employer-sponsored group health plan, offered to all employees regardless of whether they are enrolled in such a plan, or offered as a benefit of employment by employers that do not sponsor a group health plan or group health insurance. Published elsewhere in this issue of the Federal Register, the EEOC also issued a final rule to amend the regulations implementing Title II of the Genetic Information Nondiscrimination Act (GINA) that addresses the extent to which employers may offer incentives for an employee's spouse to participate in a wellness program.

Checklist Model to Improve Work Practices in Small-Scale Demolition Operations with Silica Dust Exposures

PubMed Central

Muianga, Custodio; Rice, Carol; Lentz, Thomas; Lockey, James; Niemeier, Richard; Succop, Paul

2012-01-01

A systematic approach was developed to review, revise and adapt existing exposure control guidance used in developed countries for use in developing countries. One-page employee and multiple-page supervisor guidance sheets were adapted from existing documents using a logic framework and workers were trained to use the information to improve work practices. Interactive, hands-on training was delivered to 26 workers at five small-scale demolition projects in Maputo City, Mozambique, and evaluated. A pre-and-post walkthrough survey used by trained observers documented work practice changes. Worker feedback indicated that the training was effective and useful. Workers acquired knowledge (84% increase, p < 0.01) and applied the work practice guidance. The difference of proportions between use of work practice components before and after the intervention was statistically significant (p < 0.05). Changes in work practices following training included preplanning, use of wet methods and natural ventilation and end-of-task review. Respirable dust measurements indicated a reduction in exposure following training. Consistency in observer ratings and observations support the reliability and validity of the instruments. This approach demonstrated the short-term benefit of training in changing work practices; follow-up is required to determine the long-term impact on changes in work practices, and to evaluate the need for refresher training. PMID:22470296

The evolution of behavior guidance: a history of professional, practice, corporate and societal influences.

PubMed

Strange, David M

2014-01-01

Behavior guidance in pediatric dentistry is a composite of influences including expert opinion, historical precedent, scientific studies, and social factors including the law and the media. The early icons of pediatric dentistry injected their personal views on child management, and those often reflected the child-rearing norms of the times. The business of pediatric dentistry with its efficiency and quality orientations also shaped approaches to behavior management. Scientific studies contributed minimally. A major influence on behavior guidelines in recent years has been external scrutiny of techniques prompted by media and other exposure of both private practice and corporate management of children. Changing parenting and reaction of society to authority have also had significant impact on behavior. This paper describes in more detail the evolution of behavior guidance and the subsequent codification of practices into professionally derived guidelines.

The ethical practice of psychotherapy: easily within our reach.

PubMed

Barnett, Jeffrey E

2008-05-01

Psychotherapists confront a myriad of ethical dilemmas as they endeavor to provide effective services. This issue of the Journal of Clinical Psychology: In Session on Ethics in Psychotherapy provides psychotherapists with thoughtful reviews, case examples, and practical guidance in the major areas of ethics. Following this brief introduction, the subsequent seven articles cover Informed consent; confidentiality, privilege, and their limits; treatment of minors and their families; business matters of practice (e.g., money, fees, bartering, advertising); clinical competence and scope of practice; boundaries and nonsexual multiple relationships; and termination and abandonment. This issue is designed to promote ethical practice, to provide guidance on common ethical dilemmas, and to prevent ethical challenges before they occur.

Implementing AORN recommended practices for a safe environment of care.

PubMed

Hughes, Antonia B

2013-08-01

Providing a safe environment for every patient undergoing a surgical or other invasive procedure is imperative. AORN's "Recommended practices for a safe environment of care" provides guidance on a wide range of topics related to the safety of perioperative patients and health care personnel. The recommendations are intended to provide guidance for establishing best practices and implementing safety measures in all perioperative practice settings. Perioperative nurses should be aware of risks related to musculoskeletal injuries, fire, equipment, latex, and chemicals, among others, and understand strategies for reducing the risks. Evidence-based recommendations can give practitioners the tools to guide safe practice. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Noninvasive thermal ablation of hepatocellular carcinoma by using magnetic resonance imaging-guided focused ultrasound.

PubMed

Jolesz, Ferenc A; Hynynen, Kullervo; McDannold, Nathan; Freundlich, David; Kopelman, Doron

2004-11-01

A number of minimally invasive methods have been tested for the thermal ablation of liver tumors as an alternative to surgical resection. The use of focused ultrasound transducers to ablate deep tumors offers the first completely noninvasive alternative to these techniques. By increasing the flexibility of this technology with modern phased-array transducer design and by combining it with magnetic resonance imaging for targeting and online guidance, a powerful tool results with the potential to offer treatment to a larger population of patients, to reduce trauma to the patient, and to reduce the cost of treatment. In this article, we review previous work with focused ultrasound in the liver and recent experimental results with magnetic resonance imaging guidance.

Practice Greenhealth Sustainable Purchasing Guidance Profile

EPA Pesticide Factsheets

To help you find the resource that is right for your organization, EPA conducted a scan of the landscape and developed summary profiles of some of the leading sources of sustainable purchasing guidance around the globe.

Conducting systematic reviews of economic evaluations.

PubMed

Gomersall, Judith Streak; Jadotte, Yuri Tertilus; Xue, Yifan; Lockwood, Suzi; Riddle, Dru; Preda, Alin

2015-09-01

In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness. The objective is to present the outcomes of the working group. The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop. The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc.), identifying conditions conducive to lowering costs and maximizing health benefits. The existing critical appraisal tool was included in the new guidance. The new guidance includes the recommendation that a tool designed specifically for the purpose of appraising model-based studies be used together with the generic appraisal tool for economic evaluations assessment to evaluate model-based evaluations. The guidance produced by the group offers reviewers guidance for each step of the systematic review process, which are the same steps followed in JBI reviews of other types of evidence. The updated JBI guidance will be useful for researchers wanting to synthesize evidence about economic questions, either as stand-alone reviews or part of comprehensive or mixed method evidence reviews. Although the updated methodology produced by the work of the working group has improved the JBI guidance for systematic reviews of economic evaluations, there are areas where further work is required. These include adjusting the critical appraisal tool to separate out questions addressing intervention cost and effectiveness measurement; providing more explicit guidance for assessing generalizability of findings; and offering a more robust method for evidence synthesis that facilitates achieving the more ambitious review objectives.

Revitalizing Quality Using Guidance Counseling in Ethiopian Higher Education Institutions: Exploring Students' Views and Attitudes at Haramaya University

ERIC Educational Resources Information Center

Seyoum, Yilfashewa

2011-01-01

This study attempts to scrutinize how guidance counseling is implemented and its impact in enhancing quality in higher education institutions. The sole purpose of the investigation is to explore students' views and attitudes and how the current practices of guidance counseling contribute to foster excellence of the various university academic…

International Conference on Harmonisation; guidance on Q10 Pharmaceutical Quality System; availability. Notice.

PubMed

2009-04-08

The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q10 Pharmaceutical Quality System." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance describes a model for an effective quality management system for the pharmaceutical industry, referred to as the Pharmaceutical Quality System. The guidance is intended to provide a comprehensive approach to an effective pharmaceutical quality system that is based on International Organization for Standardization (ISO) concepts, includes applicable good manufacturing practice (GMP) regulations and complements ICH guidances on "Q8 Pharmaceutical Development" and "Q9 Quality Risk Management."

Law, Ethics, and Conversations between Physicians and Patients about Firearms in the Home.

PubMed

McCourt, Alexander D; Vernick, Jon S

2018-01-01

Firearms in the home pose a risk to household members, including homicide, suicide, and unintentional deaths. Medical societies urge clinicians to counsel patients about those risks as part of sound medical practice. Depending on the circumstances, clinicians might recommend safe firearm storage, temporary removal of the firearm from the home, or other measures. Certain state firearm laws, however, might present legal and ethical challenges for physicians who counsel patients about guns in the home. Specifically, we discuss state background check laws for gun transfers, safe gun storage laws, and laws forbidding physicians from engaging in certain firearm-related conversations with their patients. Medical professionals should be aware of these and other state gun laws but should offer anticipatory guidance when clinically appropriate. © 2018 American Medical Association. All Rights Reserved.

Developing and Optimizing Applications in Hadoop

NASA Astrophysics Data System (ADS)

Kothuri, P.; Garcia, D.; Hermans, J.

2017-10-01

This contribution is about sharing our recent experiences of building Hadoop based application. Hadoop ecosystem now offers myriad of tools which can overwhelm new users, yet there are successful ways these tools can be leveraged to solve problems. We look at factors to consider when using Hadoop to model and store data, best practices for moving data in and out of the system and common processing patterns, at each stage relating with the real world experience gained while developing such application. We share many of the design choices, tools developed and how to profile a distributed application which can be applied for other scenarios as well. In conclusion, the goal of the presentation is to provide guidance to architect Hadoop based application and share some of the reusable components developed in this process.

Communicating about prognosis: ethical responsibilities of pediatricians and parents.

PubMed

Mack, Jennifer W; Joffe, Steven

2014-02-01

Clinicians are sometimes reluctant to discuss prognosis with parents of children with life-threatening illness, usually because they worry about the emotional impact of this information. However, parents often want this prognostic information because it underpins informed decision-making, especially near the end of life. In addition, despite understandable clinician concerns about its emotional impact, prognostic disclosure can actually support hope and peace of mind among parents struggling to live with a child's illness. Children, too, may need to understand what is ahead to manage uncertainty and make plans for the ways their remaining life will be lived. In this article, we describe the ethical issues involved in disclosure of prognostic information to parents and children with life-threatening illness and offer practical guidance for these conversations.

Community-Based Review of Research Across Diverse Community Contexts: Key Characteristics, Critical Issues, and Future Directions

PubMed Central

Ford, Angela; Wat, Eric; Brayboy, Missy; Isaacs, Mei-Ling; Park, Alice; Strelnick, Hal; Seifer, Sarena D.

2015-01-01

A growing number of community-based organizations and community–academic partnerships are implementing processes to determine whether and how health research is conducted in their communities. These community-based research review processes (CRPs) can provide individual and community-level ethics protections, enhance the cultural relevance of study designs and competence of researchers, build community and academic research capacity, and shape research agendas that benefit diverse communities. To better understand how they are organized and function, representatives of 9 CRPs from across the United States convened in 2012 for a working meeting. In this article, we articulated and analyzed the models presented, offered guidance to communities that seek to establish a CRP, and made recommendations for future research, practice, and policy. PMID:25973834

The role of doctors in investigation, prevention and treatment of torture

PubMed Central

McColl, Helen; Bhui, Kamaldeep; Jones, Edgar

2012-01-01

Doctors may assess and treat torture survivors; some may document crucial evidence of torture in medico-legal reports. However, there is a lack of education on torture and related ethical and legal issues at undergraduate and postgraduate level and many doctors are not aware of opportunities to work with organisations for the prevention of torture. This paper defines Torture, describes methods used, and sets out the human rights instruments and codes of ethical practice that mandate efforts to prevent torture. Medical complicity in torture is discussed and the need for national and international medical associations to prevent torture by both supporting doctors and recognising and tackling medial complicity. The paper offers guidance for assessing and documenting torture, and for providing health care for survivors of torture. PMID:23257969

On being supervised: getting value from a clinical supervisor and making the relationship work when it is not.

PubMed

Parker, Stephen; Suetani, Shuichi; Motamarri, Balaji

2017-12-01

The importance of clinical supervision is emphasised in psychiatric training programs. Despite this, the purpose and processes of supervision are often poorly defined. There is limited guidance available for trainees about their role in making supervision work. This paper considers the nature of supervision in psychiatric training and provides practical advice to help supervisees take active steps to make supervision work. In obtaining value from supervision, the active role of the supervisee in seeking feedback, finding value in criticism and building autonomy is emphasised. Additionally, the importance of exploring what value a supervisor can offer and maintaining realistic expectations is considered. Trainees can benefit from taking an active role in planning and managing their supervision to maximise their learning.

A Spiral of Transitions Leading to Broader Influence and Action.

PubMed

Benton, David C

This article describes lessons learned through a reflective analysis of job transitions experienced by a registered nurse from the time of entry into the profession until the current point where the nurse is engaged in state, national, and international policy development work. The centrality and symbiotic nature of the link between policy and practice and the importance of evidence and leadership have emerged as key aspects of the expanding spiral of influence traversed as a result of various career moves. At every stage, lessons have been learned. Some of these are professional in nature, but on occasion, the lessons have been more personal. The importance of mentors cannot be underestimated in terms of the support and guidance they offer but also the challenges they bring to existing patterns of thought and behavior.

An investor perspective on forming and funding your medical device start-up.

PubMed

Mas, Juan-Pablo; Hsueh, Brian

2017-06-01

Novel and transformative medical technologies of all forms have the potential to make a significant positive impact on the lives of patients and on the health care system, and one common pathway for guiding such innovations from concept through commercialization is via the formation of a company. For entrepreneurs looking to build a medical technology company, several common challenges await, including questions around how and where to raise funding. Here, we review key considerations for the formation of medical technology companies as viewed through the lens of an investor. We survey common sources of capital for early-stage companies, including grants, angel investors, and venture capital, and offer insights into how to differentiate among them to select the best partners for your start-up׳s needs. Finally, we discuss the critical components of pitching your ideas to potential investors, and offer guidance on best practices and common mistakes. We hope this primer on fundamental concepts and the various health care funding alternatives will prepare entrepreneurs to achieve their mission to improve patients׳ lives through commercialization of their medical innovations. Copyright © 2017 Elsevier Inc. All rights reserved.

Interim OECA Guidance on Enhancing Regional-State Planning and Communication on Compliance Assurance Work in Authorized States

EPA Pesticide Factsheets

Guidance outlining principles and best practices for State and EPA collaboration in inspections and enforcement. work planning and implementation. National Enforcement Initiatives, and outcome and performance measurement.

76 FR 82306 - Draft Guidance for Industry on Use of Histology in Biomarker Qualification Studies; Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... evolution and reversibility of morphologic changes. Because of the many variations in the practice of..., and other forms of information technology. This draft guidance refers to previously approved...

Vessel-to-Reef Projects

EPA Pesticide Factsheets

Using vessels as artificial reefs is an option for disposal. Artificial reefs serve to benefit the environment. Vessel-to-reef projects can follow the best management practices guidance. Guidance are provided for how to clean up vessels for use as reefs.

Regulatory Guidance for Lightning Protection in Nuclear Power Plants

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

Kisner, Roger A; Wilgen, John B; Ewing, Paul D

2006-01-01

Abstract - Oak Ridge National Laboratory (ORNL) was engaged by the U.S. Nuclear Regulatory Commission (NRC) Office of Nuclear Regulatory Research (RES) to develop the technical basis for regulatory guidance to address design and implementation practices for lightning protection systems in nuclear power plants (NPPs). Lightning protection is becoming increasingly important with the advent of digital and low-voltage analog systems in NPPs. These systems have the potential to be more vulnerable than older analog systems to the resulting power surges and electromagnetic interference (EMI) when lightning strikes facilities or power lines. This paper discusses the technical basis for guidance tomore » licensees and applicants covered in Regulatory Guide (RG) 1.204, Guidelines for Lightning Protection of Nuclear Power Plants, issued August 2005. RG 1.204 describes guidance for practices that are acceptable to the NRC staff for protecting nuclear power structures and systems from direct lightning strikes and the resulting secondary effects.« less

Regulatory guidance for lightning protection in nuclear power plants

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

Kisner, R. A.; Wilgen, J. B.; Ewing, P. D.

2006-07-01

Oak Ridge National Laboratory (ORNL) was engaged by the U.S. Nuclear Regulatory Commission (NRC) Office of Nuclear Regulatory Research (RES) to develop the technical basis for regulatory guidance to address design and implementation practices for lightning protection systems in nuclear power plants (NPPs). Lightning protection is becoming increasingly important with the advent of digital and low-voltage analog systems in NPPs. These systems have the potential to be more vulnerable than older analog systems to the resulting power surges and electromagnetic interference (EMI) when lightning strikes facilities or power lines. This paper discusses the technical basis for guidance to licensees andmore » applicants covered in Regulatory Guide (RG) 1.204, Guidelines for Lightning Protection of Nuclear Power Plants, issued August 2005. RG 1.204 describes guidance for practices that are acceptable to the NRC staff for protecting nuclear power structures and systems from direct lightning strikes and the resulting secondary effects. (authors)« less

Questions from Dad: A Very Cool Way To Communicate with Kids.

ERIC Educational Resources Information Center

Twilley, Dwight

This book offers help and guidance to fathers who have been physically separated from their children by divorce, work, or other factors. It gives methods and ideas to help long-distance fathers better communicate with and stay connected to their children. The methods offered in this book include devising test-like questionnaires for children;…

Preferred Psychological Internet Resources for Addressing Anxiety Disorders, Parenting Problems, Eating Disorders, and Chemical Dependency.

ERIC Educational Resources Information Center

Morse, Laura; Doran, Matt; Simonin, Danielle; Smith, Allyson; Maloney, Colleen; Wright, Cara; Underwood, Michelle; Hoppel, Andrea; O'Donnell, Shannon; Chambliss, Catherine

Although the Internet offers information about psychological problems and support resources for behavioral health problems, the quality of this information varies widely. So as to offer guidance in this area, preferred sites pertaining to anxiety disorders, parenting problems, eating disorders, and chemical dependency were analyzed. A total of 365…

Minimum Competencies for Teaching Undergraduate Sport Philosophy Courses. Guidance Document

ERIC Educational Resources Information Center

National Association for Sport and Physical Education, 2004

2004-01-01

Although sport philosophy is considered to be a sub-discipline with its own unique body of knowledge, sport philosophy is more commonly offered as a single course rather than a degree program. Therefore, these guidelines are offered specifically for the teaching of a single course at the undergraduate level. In order to be effective, the course…

Aspects of dento/medico-legal report writing.

PubMed

Wood, Geoff D

2014-03-01

This paper offers some guidance on aspects of dento/medico-legal report writing, citing anonymized examples from the author's caseload for clarification of the points made, and also serves to illustrate that sometimes not everything is as straightforward as it may initially appear. It provides reference to the current Civil Procedure Rules in England and Wales and its relevance in report writing. To provide guidance on aspects of dento/medico-legal report writing.

Stem Cells for Skeletal Muscle Tissue Engineering.

PubMed

Pantelic, Molly N; Larkin, Lisa M

2018-04-19

Volumetric muscle loss (VML) is a debilitating condition wherein muscle loss overwhelms the body's normal physiological repair mechanism. VML is particularly common among military service members who have sustained war injuries. Because of the high social and medical cost associated with VML and suboptimal current surgical treatments, there is great interest in developing better VML therapies. Skeletal muscle tissue engineering (SMTE) is a promising alternative to traditional VML surgical treatments that use autogenic tissue grafts, and rather uses isolated stem cells with myogenic potential to generate de novo skeletal muscle tissues to treat VML. Satellite cells are the native precursors to skeletal muscle tissue, and are thus the most commonly studied starting source for SMTE. However, satellite cells are difficult to isolate and purify, and it is presently unknown whether they would be a practical source in clinical SMTE applications. Alternative myogenic stem cells, including adipose-derived stem cells, bone marrow-derived mesenchymal stem cells, perivascular stem cells, umbilical cord mesenchymal stem cells, induced pluripotent stem cells, and embryonic stem cells, each have myogenic potential and have been identified as possible starting sources for SMTE, although they have yet to be studied in detail for this purpose. These alternative stem cell varieties offer unique advantages and disadvantages that are worth exploring further to advance the SMTE field toward highly functional, safe, and practical VML treatments. The following review summarizes the current state of satellite cell-based SMTE, details the properties and practical advantages of alternative myogenic stem cells, and offers guidance to tissue engineers on how alternative myogenic stem cells can be incorporated into SMTE research.

State Implementation Plans: Related Resources

EPA Pesticide Factsheets

Guidance, strategies and links are offered for reducing vehicle air pollution, including ozone or smog-forming pollutants, particulate matter and other emissions that pose public health and air quality concerns.

Aerospace engineers: We're tomorrow-minded people

NASA Technical Reports Server (NTRS)

Lewis, M. H.

1981-01-01

Brief job-related autobiographical sketches of engineers working on NASA aerospace projects are presented. Career and educational guidance is offered to students thinking about entering the aerospace field.

48 CFR 27.102 - General guidance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... to its needs. (e) Generally, the Government requires that contractors obtain permission from... REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS General 27.102 General guidance. (a) The Government encourages the maximum practical commercial use of inventions made under Government contracts. (b) Generally, the...

Project Career REACH: Marketing Strategies for Effective Guidance Programs.

ERIC Educational Resources Information Center

Bollendorf, Marsha; And Others

1990-01-01

Outlines the practical marketing strategies used to implement Project Career REACH, a career development program for high school freshmen. Marketing basics for guidance programs are discussed, including mission analysis, market analysis, resource analysis, strategic planning, and evaluation. (TE)

To adopt, to adapt, or to contextualise? The big question in clinical practice guideline development.

PubMed

Dizon, Janine Margarita; Machingaidze, Shingai; Grimmer, Karen

2016-09-13

Developing new clinical practice guidelines (CPGs) can be time-consuming and expensive. A more efficient approach could be to adopt, adapt or contextualise recommendations from existing good quality CPGs so that the resultant guidance is tailored to the local context. The first steps are to search for international CPGs that have a similar purpose, end-users and patients to your situation. The second step is to critically appraise the methodological quality of the CPGs to ensure that your guidance is based on credible evidence. Then the decisions begin. Can you simply 'adopt' this (parent) clinical practice guidelines, and implement the recommendations in their entirety, without any changes, in your setting? If so, then no further work is required. However this situation is rare. What is more likely, is that even if recommendations from the parent clinical practice guidelines can be adopted, how they are implemented needs to address local issues. Thus you may need to 'contextualise' the guidance, by addressing implementation issues such as local workforce, training, health systems, equipment and/or access to services. Generally this means that additional information is required (Practice/Context Points) to support effective implementation of the clinical practice guidelines recommendations. In some cases, you may need to 'adapt' the guidance, where you will make changes to the recommendations so that care is relevant to your local environments. This may involve additional work to search for local research, or obtain local consensus, regarding how best to adapt recommendations. For example, adaptation might reflect substituting one drug for another (drugs have similar effects, but the alternative drug to the recommended one may be cheaper, more easily obtained or more culturally acceptable). There is lack of standardisation of clinical practice guidelines terminology, leading clinical practice guideline activities often being poorly conceptualised or reported. We provide an approach that would help improve efficiency and standardisation of clinical practice guidelines activities.

Establishing evidence-based training in cognitive behavioral therapy: A review of current empirical findings and theoretical guidance.

PubMed

Rakovshik, Sarah G; McManus, Freda

2010-07-01

Cognitive behavior therapy's (CBT) demonstrated efficacy has prompted calls for its increased dissemination to routine clinical practice settings. For the widespread dissemination of CBT to be successful in achieving effects similar to the original efficacy trials, there must also be effective dissemination of CBT training practices. However, as yet, CBT training is not evidence-based. This review examines what can be learned from existing research into the efficacy and effectiveness of CBT training. Due to the paucity of research specifically investigating CBT training, CBT effectiveness and dissemination studies are also examined to glean information about potentially effective training practices. In order to draw conclusions about effective training practices, comparisons are drawn between studies according to the clinical outcomes that they achieved. Training approaches are compared according to dose and active training elements, and theoretical models of learning are applied to interpret the findings. The limitations of the existing literature are discussed, as well as recommendations for improving training research to meet the standards evident in treatment trials (e.g., random allocation, control conditions, self-report and blind assessment, and adherence monitoring). Finally, the process of developing efficacious CBT treatment protocols is offered as a template for developing evidence-based CBT training protocols. 2010 Elsevier Ltd. All rights reserved.

Genetic counselor perceptions of genetic counseling session goals: a validation study of the reciprocal-engagement model.

PubMed

Hartmann, Julianne E; Veach, Patricia McCarthy; MacFarlane, Ian M; LeRoy, Bonnie S

2015-04-01

Although some researchers have attempted to define genetic counseling practice goals, no study has obtained consensus about the goals from a large sample of genetic counselors. The Reciprocal-Engagement Model (REM; McCarthy Veach, Bartels & LeRoy, 2007) articulates 17 goals of genetic counseling practice. The present study investigated whether these goals could be generalized as a model of practice, as determined by a larger group of clinical genetic counselors. Accordingly, 194 genetic counselors were surveyed regarding their opinions about the importance of each goal and their perceptions of how frequently they achieve each goal. Mean importance ratings suggest they viewed every goal as important. Factor analysis of the 17 goals yielded four factors: Understanding and Appreciation, Support and Guidance, Facilitative Decision-Making, and Patient-Centered Education. Patient-Centered Education and Facilitative Decision-Making goals received the highest mean importance ratings. Mean frequency ratings were consistently lower than importance ratings, suggesting genetic counseling goals may be difficult to achieve and/or not applicable in all situations. A number of respondents provided comments about the REM goals that offer insight into factors related to implementing the goals in clinical practice. This study presents preliminary evidence concerning the validity of the goals component of the REM.

International perspectives on social media guidance for nurses: a content analysis.

PubMed

Ryan, Gemma

2016-12-01

Aim This article reports the results of an analysis of the content of national and international professional guidance on social media for the nursing profession. The aim was to consolidate good practice examples of social media guidelines, and inform the development of comprehensive guidance. Method A scoping search of professional nursing bodies' and organisations' social media guidance documents was undertaken using google search. Results 34 guidance documents were located, and a content analysis of these was conducted. Conclusion The results, combined with a review of competency hearings and literature, indicate that guidance should cover the context of social media, and support nurses to navigate and negotiate the differences between the real and online domains to help them translate awareness into actions.

An audit of implant practice websites: content and regulatory compliance.

PubMed

Raimundo, H; Robinson, P K

2014-12-01

To audit the content of dental practice websites offering dental implant services against a framework based on the GDC 2012 Guidelines for Ethical Advertising and other relevant advertising standards. An audit framework was constructed and applied to the top fifty websites resulting from a Google UK search using the search term 'dental implant specialist'. Compliance with many elements of the GDC Guidance remains poor. Sixty-eight percent of websites claimed that the practitioner providing the service was a GDC registered specialist, though examples were found where this claim was unfounded. Fourteen percent of practice websites claimed that the service was being carried out by an 'implant specialist' and 16% claimed the practitioner was an 'implantologist'; the majority of sites using these terms (10%) involved practitioners that had no specialist status. The display of potentially misleading memberships and fellowships of a range of dental associations, academies, societies and foundations remains common (52%), as does the adoption of the title 'Dr' (60%). Comparison with earlier studies indicates that compliance with recent GDC standards is generally improving, though whether the pace of improvement is seen as acceptable or not is something that policymakers and regulatory authorities may need to consider further.

Behavioural informatics for improving water hygiene practice based on IoT environment.

PubMed

Fu, Yang; Wu, Wenyan

2018-02-01

The development of Internet of Things (IoT) and latest Information and Communication Technologies (ICT) have changed the nature of healthcare monitoring and health behaviour intervention in many applications. Water hygiene and water conservation behaviour intervention as important influence factors to human health are gaining much attentions for improving sustained sanitation practice. Based on face-to-face delivery, typical behaviour intervention method is costly and hardly to provide all day access to personalised intervention guidance and feedbacks. In this study, we presented a behavioural information system and water use behaviour model using IoT platform. Using Expanded Theory of Planned Behaviour (ETPB) and adopted structure equation model, this study offers a solution for understanding the behaviour intervention mechanism and methodology for developing empirical model. A case study of behaviour intervention model is presented by utilising residential water conservation behaviour data collected in China. Results suggested that cultural differences have significant influences on the understanding of intervention drivers, promoting projects and increasing awareness, which could improve the behaviour intervention efficiency and further facilitate the improvement of water hygiene practice. The performance evaluation of water saving dimension is discussed as well in the paper. Copyright © 2017 Elsevier Inc. All rights reserved.

Identification of individuals at risk for Lynch syndrome using targeted evaluations and genetic testing: National Society of Genetic Counselors and the Collaborative Group of the Americas on Inherited Colorectal Cancer joint practice guideline.

PubMed

Weissman, Scott M; Burt, Randall; Church, James; Erdman, Steve; Hampel, Heather; Holter, Spring; Jasperson, Kory; Kalady, Matt F; Haidle, Joy Larsen; Lynch, Henry T; Palaniappan, Selvi; Wise, Paul E; Senter, Leigha

2012-08-01

Identifying individuals who have Lynch syndrome (LS) involves a complex diagnostic work up that includes taking a detailed family history and a combination of various genetic and immunohistochemical tests. The National Society of Genetic Counselors (NSGC) and the Collaborative Group of the Americas on Inherited Colorectal Cancer (CGA-ICC) have come together to publish this clinical practice testing guideline for the evaluation of LS. The purpose of this practice guideline is to provide guidance and a testing algorithm for LS as well as recommendations on when to offer testing. This guideline does not replace a consultation with a genetics professional. This guideline includes explanations in support of this and a summary of background data. While this guideline is not intended to serve as a review of LS, it includes a discussion of background information on LS, and cites a number of key publications which should be reviewed for a more in-depth understanding of LS. These guidelines are intended for genetic counselors, geneticists, gastroenterologists, surgeons, medical oncologists, obstetricians and gynecologists, nurses and other healthcare providers who evaluate patients for LS.

The use of computerized image guidance in lumbar disk arthroplasty.

PubMed

Smith, Harvey E; Vaccaro, Alexander R; Yuan, Philip S; Papadopoulos, Stephen; Sasso, Rick

2006-02-01

Surgical navigation systems have been increasingly studied and applied in the application of spinal instrumentation. Successful disk arthroplasty requires accurate midline and rotational positioning for optimal function and longevity. A surgical simulation study in human cadaver specimens was done to evaluate and compare the accuracy of standard fluoroscopy, computer-assisted fluoroscopic image guidance, and Iso-C3D image guidance in the placement of lumbar intervertebral disk replacements. Lumbar intervertebral disk prostheses were placed using three different image guidance techniques in three human cadaver spine specimens at multiple levels. Postinstrumentation accuracy was assessed with thin-cut computed tomography scans. Intervertebral disk replacements placed using the StealthStation with Iso-C3D were more accurately centered than those placed using the StealthStation with FluoroNav and standard fluoroscopy. Intervertebral disk replacements placed with Iso-C3D and FluoroNav had improved rotational divergence compared with standard fluoroscopy. Iso-C3D and FluoroNav had a smaller interprocedure variance than standard fluoroscopy. These results did not approach statistical significance. Relative to both virtual and standard fluoroscopy, use of the StealthStation with Iso-C3D resulted in improved accuracy in centering the lumbar disk prosthesis in the coronal midline. The StealthStation with FluoroNav appears to be at least equivalent to standard fluoroscopy and may offer improved accuracy with rotational alignment while minimizing radiation exposure to the surgeon. Surgical guidance systems may offer improved accuracy and less interprocedure variation in the placement of intervertebral disk replacements than standard fluoroscopy. Further study regarding surgical navigation systems for intervertebral disk replacement is warranted.

Before the experts arrive.

PubMed

Chandley, M

2001-06-01

This article addresses the rare event of the hostage situation in a forensic psychiatric nursing setting. It has a specific focus on the initial response and the accompanying issues for nurses at the clinical interface as the situation emerges. The intention of this article is to both offer guidance and raise the profile of this unique management issue because little attention is drawn to early-stage hostage situations at an organizational level. When a hostage situation occurs, inadequate preparation can mean the difference between life and death for the hostage, negotiator, or hostage taker. This article provides an overview of the relevant literature and offers guidance about the actions required when a nurse suddenly becomes responsible for managing the early stages of such a traumatic event. Responses, safety, and communication factors concerning the hostage taker are covered.

After the Liverpool Care Pathway--development of heuristics to guide end of life care for people with dementia: protocol of the ALCP study.

PubMed

Davies, N; Manthorpe, J; Sampson, E L; Iliffe, S

2015-09-02

End of life care guidance for people with dementia is lacking and this has been made more problematic in England with the removal of one of the main end of life care guidelines which offered some structure, the Liverpool Care Pathway. This guidance gap may be eased with the development of heuristics (rules of thumb) which offer a fast and frugal form of decision-making. To develop a toolkit of heuristics (rules of thumb) for practitioners to use when caring for people with dementia at the end of life. A mixed-method study using a co-design approach to develop heuristics in three phases. In phase 1, we will conduct at least six focus groups with family carers, health and social care practitioners from both hospital and community care services, using the 'think-aloud' method to understand decision-making processes and to develop a set of heuristics. The focus group topic guide will be developed from the findings of a previous study of 46 interviews of family carers about quality end-of-life care for people with dementia and a review of the literature. A multidisciplinary development team of health and social care practitioners will synthesise the findings from the focus groups to devise and refine a toolkit of heuristics. Phase 2 will test the use of heuristics in practice in five sites: one general practice, one community nursing team, one hospital ward and two palliative care teams working in the community. Phase 3 will evaluate and further refine the toolkit of heuristics through group interviews, online questionnaires and semistructured interviews. This study has received ethical approval from a local NHS research ethics committee (Rec ref: 15/LO/0156). The findings of this study will be presented in peer-reviewed publications and national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Practice guidelines for program evaluation in community-based rehabilitation.

PubMed

Grandisson, Marie; Hébert, Michèle; Thibeault, Rachel

2017-06-01

This paper proposes practice guidelines to evaluate community-based rehabilitation (CBR) programs. These were developed through a rigorous three-phase research process including a literature review on good practices in CBR program evaluation, a field study during which a South Africa CBR program was evaluated, and a Delphi study to generate consensus among a highly credible panel of CBR experts from a wide range of backgrounds and geographical areas. The 10 guidelines developed are summarized into a practice model highlighting key features of sound CBR program evaluation. They strongly indicate that sound CBR evaluations are those that give a voice and as much control as possible to the most affected groups, embrace the challenge of diversity, and foster use of evaluation processes and findings through a rigorous, collaborative and empowering approach. The practice guidelines should facilitate CBR evaluation decisions in respect to facilitating an evaluation process, using frameworks and designing methods. Implications for rehabilitation Ten practice guidelines provide guidance to facilitate sound community-based rehabilitation (CBR) program evaluation decisions. Key indications of good practice include: • being as participatory and empowering as possible; • ensuring that all, including the most affected, have a real opportunity to share their thoughts; • highly considering mixed methods and participatory tools; • adapting to fit evaluation context, local culture and language(s); • defining evaluation questions and reporting findings using shared CBR language when possible, which the framework offered may facilitate.

Using the framework of corporate culture in "mergers" to support the development of a cultural basis for integrative medicine - guidance for building an integrative medicine department or service.

PubMed

Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

2015-01-01

An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations - usually companies - are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in "mergers," which could be used to build an integrative medicine department or integrative medicine service. Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation.

Using the framework of corporate culture in “mergers” to support the development of a cultural basis for integrative medicine – guidance for building an integrative medicine department or service

PubMed Central

Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

2015-01-01

Background An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations − usually companies − are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. Purpose The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. Methods A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in “mergers,” which could be used to build an integrative medicine department or integrative medicine service. Results Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). Conclusion The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation. PMID:25632226

Prevention and management of foot problems in diabetes: A Summary Guidance for Daily Practice 2015, based on the IWGDF guidance documents.

PubMed

Schaper, N C; Van Netten, J J; Apelqvist, J; Lipsky, B A; Bakker, K

2017-02-01

Foot problems complicating diabetes are a source of major patient suffering and societal costs. To prevent, or at least reduce, the adverse effects of foot problems in diabetes, the International Working Group on the Diabetic Foot (IWGDF; www.iwgdf.org) was founded in 1996, consisting of experts from almost all the disciplines involved in the care of patients with diabetes and foot problems. An important output of the IWGDF is the international consensus guidance, continuously updated since 1999. To date, the publications have been translated into 26 languages, and more than 100,000 copies have been distributed globally. The "Summary Guidance for Daily Practice" summarises the essentials of prevention and management of foot problems in persons with diabetes for clinicians who work with these patients on a daily basis. This guidance is the result of a long and careful process that started with the empaneling in 2013 of five working groups consisting of 49 international experts. These experts performed seven targeted systematic reviews to provide the evidence supporting the five chapters of the IWGDF Guidance on prevention; footwear and offloading; diagnosis, prognosis and management of peripheral artery disease; diagnosis and management of foot infections; interventions to enhance healing. In total almost 80,000 studies were detected by our literature review. After review of the title and abstract the reviewers of the different working groups selected only studies that fulfilled a minimal set of quality criteria and ended up with 429 articles for complete quality analysis. The GRADE system was used to translate the evidence from the studies into recommendations for daily clinical practice. The rating of each recommendation takes into account both the strength and the quality of the evidence. The IWGDF Guidance 2015 makes a total of 77 recommendations on prevention and management of foot problems in diabetes. These recommendations were condensed by the editorial board into this "Summary Guidance". Encouraging and aiding clinicians to follow the evidence-based recommendations of the IWGDF Guidance 2015, and in particular the principles outlined in the "Summary Guidance", will likely result in a worldwide reduction in, and better outcomes of, foot problems in persons with diabetes, helping to reduce the morbidity and mortality associated with this major health problem. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Overseas Environmental Baseline Guidance Document

DTIC Science & Technology

2007-05-01

The primary purpose of this Overseas Environmental Baseline Guidance Document (OEBGD) is to provide criteria and management practices to be used by ...establishes standards for environmental compliance at Department of Defense controlled or operated installations in countries for which no FGS have been established.

Biosafety principles and practices for the veterinary diagnostic laboratory.

PubMed

Kozlovac, Joseph; Schmitt, Beverly

2015-01-01

Good biosafety and biocontainment programs and practices are critical components of the successful operation of any veterinary diagnostic laboratory. In this chapter we provide information and guidance on critical biosafety management program elements, facility requirements, protective equipment, and procedures necessary to ensure that the laboratory worker and the environment are adequately protected in the challenging work environment of the veterinary diagnostic laboratory in general and provide specific guidance for those laboratories employing molecular diagnostic techniques.

[Evaluation of practices of excisional therapies for CIN: An audit of surgery rooms from Marseilles' area].

PubMed

Einaudi, L; Boubli, L; Carcopino, X

2015-11-01

To evaluate what is the proportion of surgery rooms from Marseilles' area that do perform excisional therapies for CIN without any use of colposcopic guidance. From November 2012 to January 2013, a survey was conducted among all surgery rooms from Marseilles' area practicing excisional therapies for CIN. In addition, answers from gynecologists from Marseilles' area who participated to a national survey that evaluated practices of excisional therapies in France were specifically analyzed. Among the 55 surgery rooms from Marseilles' area practicing excisional therapies, 52 (94.1%) participated to the current survey. A colposcope was available in only 19 (36.5%) surgery rooms and was systematically used for the guidance of excisional therapies in only 4 (21%) of these surgery rooms. Finally, 36 (69.2%) surgery rooms answered performing excisional therapies without any use of colposcopic guidance. Colposcopy was occasionally and systematically used in 12 (23.1%) and 4 (7.7%) surgery rooms, respectively. Among the 116 gynecologists from Marseilles' area who answered to the national survey, 88 (75.9%) answered not using colposcopy when performing excision for CIN. Only 6% answered performing excision systematically under direct colposcopic vision and 18.1% occasionally. No colposcopic guidance is used when performing excision for CIN in the majority of surgery rooms from Marseilles' area. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

An exploratory analysis of the nature of informal knowledge underlying theories of planned action used for public health oriented knowledge translation.

PubMed

Kothari, Anita; Boyko, Jennifer A; Campbell-Davison, Andrea

2015-09-09

Informal knowledge is used in public health practice to make sense of research findings. Although knowledge translation theories highlight the importance of informal knowledge, it is not clear to what extent the same literature provides guidance in terms of how to use it in practice. The objective of this study was to address this gap by exploring what planned action theories suggest in terms of using three types of informal knowledge: local, experiential and expert. We carried out an exploratory secondary analysis of the planned action theories that informed the development of a popular knowledge translation theory. Our sample included twenty-nine (n = 29) papers. We extracted information from these papers about sources of and guidance for using informal knowledge, and then carried out a thematic analysis. We found that theories of planned action provide guidance (including sources of, methods for identifying, and suggestions for use) for using local, experiential and expert knowledge. This study builds on previous knowledge translation related work to provide insight into the practical use of informal knowledge. Public health practitioners can refer to the guidance summarized in this paper to inform their decision-making. Further research about how to use informal knowledge in public health practice is needed given the value being accorded to using informal knowledge in public health decision-making processes.

Transportation Related Documents for State and Local Transportation

EPA Pesticide Factsheets

Guidance and strategies are offered for reducing vehicle air pollution, including ozone or smog-forming pollutants, particulate matter and other emissions that pose public health and air quality concerns.

Aerospace scientists. We're tomorrow-minded people

NASA Technical Reports Server (NTRS)

Lewis, M. H.

1981-01-01

Brief job-related autobiographical sketches of scientists working on NASA space science projects are presented. Career and educational guidance is offered to students thinking about entering the space science field.

Aerospace Technicians: We're Tomorrow-Minded People

NASA Technical Reports Server (NTRS)

Lewis, M. H.

1981-01-01

Brief job-related autobiographical sketches of technicians working on NASA aerospace projects are presented. Career and educational guidance is offered to students thinking about entering the field of aerospace technology.

The Online Teaching Guide: A Handbook of Attitudes, Strategies, and Techniques for the Virtual Classroom.

ERIC Educational Resources Information Center

White, Ken W., Ed.; Weight, Bob H., Ed.

This book presents 14 papers that offer guidance to college teachers venturing into online instruction. It is based on the experiences and ideas of faculty at the University of Phoenix (Arizona) online campus, which has been offering online courses since 1989. Chapters in the book discuss the importance of interaction and feedback, learner…

Deploying Electric Vehicles and Electric Vehicle Supply Equipment: Tiger Teams Offer Project Assistance for Federal Fleets

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

None

To assist federal agencies with the transition to plug-in electric vehicles (PEVs), including battery electric vehicles (BEVs) and plug-in hybrid electric vehicles (PHEVs), FEMP offers technical guidance on electric vehicle supply equipment (EVSE) installations and site-specific planning through partnerships with the National Renewable Energy Laboratory’s EVSE Tiger Teams.

Dynamite Networking for Dynamite Jobs. 101 Interpersonal, Telephone and Electronic Techniques for Getting Job Leads, Interviews and Offers.

ERIC Educational Resources Information Center

Krannich, Caryl Rae; Krannich, Ronald L.

This book guides job seekers in using communication approaches that will generate useful information, advice, and referrals that lead to job interviews and offers. The book provides guidance on how to do the following: organize effective job networks; prospect for job leads; write networking letters; make cold calls; join electronic networks;…

En route position and time control of aircraft using Kalman filtering of radio aid data

NASA Technical Reports Server (NTRS)

Mcgee, L. A.; Christensen, J. V.

1973-01-01

Fixed-time-of-arrival (FTA) guidance and navigation is investigated as a possible technique capable of operation within much more stringent en route separation standards and offering significant advantages in safety, higher traffic densities, and improved scheduling reliability, both en route and in the terminal areas. This study investigated the application of FTA guidance previously used in spacecraft guidance. These FTA guidance techniques have been modified and are employed to compute the velocity corrections necessary to return an aircraft to a specified great-circle reference path in order to exercise en route time and position control throughout the entire flight. The necessary position and velocity estimates to accomplish this task are provided by Kalman filtering of data from Loran-C, VORTAC/TACAN, Doppler radar, radio or barometric altitude,and altitude rate. The guidance and navigation system was evaluated using a digital simulation of the cruise phase of supersonic and subsonic flights between San Francisco and New York City, and between New York City and London.

USAF Development Of Optical Correlation Missile Guidance

NASA Astrophysics Data System (ADS)

Kaehr, Ronald; Spector, Marvin

1980-12-01

In 1965, the Advanced Development Program (ADP)-679A of the Avionics Laboratory initiated development of guidance systems for stand-off tactical missiles. Employing project engineering support from the Aeronautical Systems Division, WPAFB, the Avionics Laboratory funded multiple terminal guidance concepts and related midcourse navigation technology. Optical correlation techniques which utilize prestored reference information for autonomous target acquisition offered the best near-term opportunity for meeting mission goals. From among the systems studied and flight tested, Aimpoint* optical area guidance provided the best and most consistent performance. Funded development by the Air Force ended in 1974 with a MK-84 guided bomb drop test demonstration at White Sands Missile Range and the subsequent transfer of the tactical missile guidance development charter to the Air Force Armament Laboratory, Eglin AFB. A historical review of optical correlation development within the Avionics Laboratory is presented. Evolution of the Aimpoint system is specifically addressed. Finally, a brief discussion of trends in scene matching technology is presented.

Do English NHS Microbiology laboratories offer adequate services for the diagnosis of UTI in children? Healthcare Quality Improvement Partnership (HQIP) Audit of Standard Operational Procedures.

PubMed

McNulty, Cliodna A M; Verlander, Neville Q; Moore, Philippa C L; Larcombe, James; Dudley, Jan; Banerjee, Jaydip; Jadresic, Lyda

2015-09-01

The National Institute of Care Excellence (NICE) 2007 guidance CG54, on urinary tract infection (UTI) in children, states that clinicians should use urgent microscopy and culture as the preferred method for diagnosing UTI in the hospital setting for severe illness in children under 3 years old and from the GP setting in children under 3 years old with intermediate risk of severe illness. NICE also recommends that all 'infants and children with atypical UTI (including non-Escherichia coli infections) should have renal imaging after a first infection'. We surveyed all microbiology laboratories in England with Clinical Pathology Accreditation to determine standard operating procedures (SOPs) for urgent microscopy, culture and reporting of children's urine and to ascertain whether the SOPs facilitate compliance with NICE guidance. We undertook a computer search in six microbiology laboratories in south-west England to determine urine submissions and urine reports in children under 3 years. Seventy-three per cent of laboratories (110/150) participated. Enterobacteriaceae that were not E. coli were reported only as coliforms (rather than non-E. coli coliforms) by 61% (67/110) of laboratories. Eighty-eight per cent of laboratories (97/110) provided urgent microscopy for hospital and 54% for general practice (GP) paediatric urines; 61% of laboratories (confidence interval 52-70%) cultured 1 μl volume of urine, which equates to one colony if the bacterial load is 106 c.f.u. l(-1). Only 22% (24/110) of laboratories reported non-E. coli coliforms and provided urgent microscopy for both hospital and GP childhood urines; only three laboratories also cultured a 5 μl volume of urine. Only one of six laboratories in our submission audit had a significant increase in urine submissions and urines reported from children less than 3 years old between the predicted pre-2007 level in the absence of guidance and the 2008 level following publication of the NICE guidance. Less than a quarter of laboratories were providing a service that would allow clinicians to fully comply with the first line recommendations in the 2007 NICE UTI in children guidance. Laboratory urine submission report figures suggest that the guidance has not led to an increase in diagnosis of UTI in children under 3 years old.

Communication Services and Supports for Individuals With Severe Disabilities: Guidance for Assessment and Intervention.

PubMed

Brady, Nancy C; Bruce, Susan; Goldman, Amy; Erickson, Karen; Mineo, Beth; Ogletree, Bill T; Paul, Diane; Romski, Mary Ann; Sevcik, Rose; Siegel, Ellin; Schoonover, Judith; Snell, Marti; Sylvester, Lorraine; Wilkinson, Krista

2016-03-01

The National Joint Committee for the Communication Needs of People With Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities.

Management of mediastinal syndromes in pediatrics: a new challenge of ultrasound guidance to avoid high-risk general anesthesia.

PubMed

Sola, Chrystelle; Choquet, Olivier; Prodhomme, Olivier; Capdevila, Xavier; Dadure, Christophe

2014-05-01

Adverse events associated with anesthetic management of anterior mediastinal masses in pediatrics are common. To avoid an extremely hazardous general anesthesia, the use of real-time ultrasonography offers an effective alternative in high-risk cases. We report the anesthetic management including a light sedation and ultrasound guidance for regional anesthesia, surgical node biopsy, and placement of a central venous line in two children with an anterior symptomatic mediastinal mass. For pediatric patients with clinical and/or radiologic signs of airway compression, ultrasound guidance provides safety technical assistance to avoid general anesthesia and should be performed for the initial diagnostic and therapeutic procedures. © 2013 John Wiley & Sons Ltd.

75 FR 52308 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-25

... Administration's Tourism Industries Office offers trade fair guidance and assistance to trade fair organizers... exhibits at a fair. Affected Public: Business or other for-profit organizations. Frequency: On occasion...

ICP-MS Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity ofanalytical data generated through the USEPA Contract Laboratory Program Statement ofWork (SOW) ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

Common Practice Lightning Strike Protection Characterization Technique to Quantify Damage Mechanisms on Composite Substrates

NASA Technical Reports Server (NTRS)

Szatkowski, George N.; Dudley, Kenneth L.; Koppen, Sandra V.; Ely, Jay J.; Nguyen, Truong X.; Ticatch, Larry A.; Mielnik, John J.; Mcneill, Patrick A.

2013-01-01

To support FAA certification airworthiness standards, composite substrates are subjected to lightning direct-effect electrical waveforms to determine performance characteristics of the lightning strike protection (LSP) conductive layers used to protect composite substrates. Test results collected from independent LSP studies are often incomparable due to variability in test procedures & applied practices at different organizations, which impairs performance correlations between different LSP data sets. Under a NASA supported contract, The Boeing Company developed technical procedures and documentation as guidance in order to facilitate a test method for conducting universal common practice lightning strike protection test procedures. The procedures obtain conformity in future lightning strike protection evaluations to allow meaningful performance correlations across data sets. This universal common practice guidance provides the manufacturing specifications to fabricate carbon fiber reinforced plastic (CFRP) test panels, including finish, grounding configuration, and acceptable methods for pretest nondestructive inspection (NDI) and posttest destructive inspection. The test operations guidance elaborates on the provisions contained in SAE ARP5416 to address inconsistencies in the generation of damage protection performance data, so as to provide for maximum achievable correlation across capable lab facilities. In addition, the guidance details a direct effects test bed design to aid in quantification of the multi-physical phenomena surrounding a lightning direct attachment supporting validation data requirements for the development of predictive computational modeling. The lightning test bed is designed to accommodate a repeatable installation procedure to secure the test panel and eliminate test installation uncertainty. It also facilitates a means to capture the electrical waveform parameters in 2 dimensions, along with the mechanical displacement and thermal heating parameters which occur during lightning attachment. Following guidance defined in the universal common practice LSP test documents, protected and unprotected CFRP panels were evaluated at 20, 40 and 100KAmps. This report presents analyzed data demonstrating the scientific usefulness of the common practice approach. Descriptions of the common practice CFRP test articles, LSP test bed fixture, and monitoring techniques to capture the electrical, mechanical and thermal parameters during lightning attachment are presented here. Two methods of measuring the electrical currents were evaluated, inductive current probes and a newly developed fiberoptic sensor. Two mechanical displacement methods were also examined, optical laser measurement sensors and a digital imaging correlation camera system. Recommendations are provided to help users implement the common practice test approach and obtain LSP test characterizations comparable across data sets.

Practical guidance on characterizing availability in resource selection functions under a use-availability design

USGS Publications Warehouse

Northrup, Joseph M.; Hooten, Mevin B.; Anderson, Charles R.; Wittemyer, George

2013-01-01

Habitat selection is a fundamental aspect of animal ecology, the understanding of which is critical to management and conservation. Global positioning system data from animals allow fine-scale assessments of habitat selection and typically are analyzed in a use-availability framework, whereby animal locations are contrasted with random locations (the availability sample). Although most use-availability methods are in fact spatial point process models, they often are fit using logistic regression. This framework offers numerous methodological challenges, for which the literature provides little guidance. Specifically, the size and spatial extent of the availability sample influences coefficient estimates potentially causing interpretational bias. We examined the influence of availability on statistical inference through simulations and analysis of serially correlated mule deer GPS data. Bias in estimates arose from incorrectly assessing and sampling the spatial extent of availability. Spatial autocorrelation in covariates, which is common for landscape characteristics, exacerbated the error in availability sampling leading to increased bias. These results have strong implications for habitat selection analyses using GPS data, which are increasingly prevalent in the literature. We recommend researchers assess the sensitivity of their results to their availability sample and, where bias is likely, take care with interpretations and use cross validation to assess robustness.

Defining success with HIV pre-exposure prophylaxis: A prevention-effective adherence paradigm

PubMed Central

Haberer, Jessica E.; Bangsberg, David R.; Baeten, Jared M.; Curran, Kathryn; Koechlin, Florence; Amico, K. Rivet; Anderson, Peter; Mugo, Nelly; Venter, Francois; Goicochea, Pedro; Caceres, Carlos; O’Reilly, Kevin

2015-01-01

Clinical trial data have shown that oral pre-exposure prophylaxis (PrEP) is efficacious when taken as prescribed; however, PrEP adherence is complex and must be understood within the context of variable risk for HIV infection and use of other HIV prevention methods. Different levels of adherence may be needed in different populations to achieve HIV prevention, and the optimal methods for achieving the necessary adherence for both individual and public health benefits are unknown. Guidance for PrEP use must consider these questions to determine the success of PrEP-based HIV prevention programs. In this article, we propose a new paradigm for understanding and measuring PrEP adherence, termed prevention-effective adherence, which incorporates dynamic HIV acquisition risk behaviors and the use of HIV alternative prevention strategies. We discuss the need for daily PrEP use only during periods of risk for HIV exposure, describe key issues for measuring and understanding relevant behaviors, review lessons from another health prevention field (i.e., family planning), and provide guidance for prevention-effective PrEP use. Moreover, we challenge emerging calls for sustained, near perfect PrEP adherence regardless of risk exposure and offer a more practical and public health-focused vision for this prevention intervention. PMID:26103095

Ethical Challenges of Randomized Violence Intervention Trials: Examining the SHARE intervention in Rakai, Uganda

PubMed Central

Wagman, Jennifer A.; Paul, Amy; Namatovu, Fredinah; Ssekubugu, Robert; Nalugoda, Fred

2016-01-01

Objective We identify complexities encountered, including unanticipated crossover between trial arms and inadequate ‘standard of care’ violence services, during a cluster randomized trial (CRT) of a community-level intimate partner violence (IPV) and HIV prevention intervention in Uganda. Methods Concepts in public health ethics - beneficence, social value of research, fairness, standard of care, and researcher responsibilities for post-trial benefits - are used to critically reflect on lessons learned and guide discussion on practical and ethical challenges of violence intervention CRTs. Results Existing ethical guidelines provide incomplete guidance for responding to unexpected crossover in CRTs providing IPV services. We struggled to balance duty of care with upholding trial integrity, and identifying and providing appropriate standard of care. While we ultimately offered short-term IPV services to controls, we faced additional challenges related to sustaining services beyond the ‘short-term’ and post-trial. Conclusion Studies evaluating community-level violence interventions, including those combined with HIV reduction strategies, are limited yet critical for developing evidence-based approaches for effectively preventing IPV. Although CRTs are a promising design, further guidance is needed to implement trials that avoid introducing tensions between validity of findings, researchers’ responsibilities to protect participants, and equitable distribution of CRT benefits. PMID:27453794

Birth Control in Clinical Trials

PubMed Central

Stewart, J.; Beyer, B. K.; Chadwick, K.; De Schaepdrijver, L.; Desai, M.; Enright, B.; Foster, W.; Hui, J. Y.; Moffat, G. J.; Tornesi, B.; Van Malderen, K.; Wiesner, L.; Chen, C. L.

2015-01-01

The Health and Environmental Sciences Institute (HESI) Developmental and Reproductive Toxicology Technical Committee sponsored a pharmaceutical industry survey on current industry practices for contraception use during clinical trials. The objectives of the survey were to improve our understanding of the current industry practices for contraception requirements in clinical trials, the governance processes set up to promote consistency and/or compliance with contraception requirements, and the effectiveness of current contraception practices in preventing pregnancies during clinical trials. Opportunities for improvements in current practices were also considered. The survey results from 12 pharmaceutical companies identified significant variability among companies with regard to contraception practices and governance during clinical trials. This variability was due primarily to differences in definitions, areas of scientific uncertainty or misunderstanding, and differences in company approaches to enrollment in clinical trials. The survey also revealed that few companies collected data in a manner that would allow a retrospective understanding of the reasons for failure of birth control during clinical trials. In this article, suggestions are made for topics where regulatory guidance or scientific publications could facilitate best practice. These include provisions for a pragmatic definition of women of childbearing potential, guidance on how animal data can influence the requirements for male and female birth control, evidence-based guidance on birth control and pregnancy testing regimes suitable for low- and high-risk situations, plus practical methods to ascertain the risk of drug-drug interactions with hormonal contraceptives. PMID:27042398

Animal Disease Import Risk Analysis--a Review of Current Methods and Practice.

PubMed

Peeler, E J; Reese, R A; Thrush, M A

2015-10-01

The application of risk analysis to the spread of disease with international trade in animals and their products, that is, import risk analysis (IRA), has been largely driven by the Sanitary and Phytosanitary (SPS) agreement of the World Trade Organization (WTO). The degree to which the IRA standard established by the World Organization for Animal Health (OIE), and associated guidance, meets the needs of the SPS agreement is discussed. The use of scenario trees is the core modelling approach used to represent the steps necessary for the hazard to occur. There is scope to elaborate scenario trees for commodity IRA so that the quantity of hazard at each step is assessed, which is crucial to the likelihood of establishment. The dependence between exposure and establishment suggests that they should fall within the same subcomponent. IRA undertaken for trade reasons must include an assessment of consequences to meet SPS criteria, but guidance is sparse. The integration of epidemiological and economic modelling may open a path for better methods. Matrices have been used in qualitative IRA to combine estimates of entry and exposure, and consequences with likelihood, but this approach has flaws and better methods are needed. OIE IRA standards and guidance indicate that the volume of trade should be taken into account, but offer no detail. Some published qualitative IRAs have assumed current levels and patterns of trade without specifying the volume of trade, which constrains the use of IRA to determine mitigation measures (to reduce risk to an acceptable level) and whether the principle of equivalence, fundamental to the SPS agreement, has been observed. It is questionable whether qualitative IRA can meet all the criteria set out in the SPS agreement. Nevertheless, scope exists to elaborate the current standards and guidance, so they better serve the principle of science-based decision-making. © 2013 Crown copyright. This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 6: how to assess relevance of the data.

PubMed

Noyes, Jane; Booth, Andrew; Lewin, Simon; Carlsen, Benedicte; Glenton, Claire; Colvin, Christopher J; Garside, Ruth; Bohren, Meghan A; Rashidian, Arash; Wainwright, Megan; Tunςalp, Özge; Chandler, Jacqueline; Flottorp, Signe; Pantoja, Tomas; Tucker, Joseph D; Munthe-Kaas, Heather

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's relevance component. We developed the relevance component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual relevance component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define relevance as the extent to which the body of data from the primary studies supporting a review finding is applicable to the context (perspective or population, phenomenon of interest, setting) specified in the review question. In this paper, we describe the relevance component and its rationale and offer guidance on how to assess relevance in the context of a review finding. This guidance outlines the information required to assess relevance, the steps that need to be taken to assess relevance and examples of relevance assessments. This paper provides guidance for review authors and others on undertaking an assessment of relevance in the context of the CERQual approach. Assessing the relevance component requires consideration of potentially important contextual factors at an early stage in the review process. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 4: how to assess coherence.

PubMed

Colvin, Christopher J; Garside, Ruth; Wainwright, Megan; Munthe-Kaas, Heather; Glenton, Claire; Bohren, Meghan A; Carlsen, Benedicte; Tunçalp, Özge; Noyes, Jane; Booth, Andrew; Rashidian, Arash; Flottorp, Signe; Lewin, Simon

2018-01-25

The GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE working group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) relevance, (3) coherence and (4) adequacy of data. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's coherence component. We developed the coherence component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual coherence component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define coherence as how clear and cogent the fit is between the data from the primary studies and a review finding that synthesises that data. In this paper, we describe the coherence component and its rationale and offer guidance on how to assess coherence in the context of a review finding as part of the CERQual approach. This guidance outlines the information required to assess coherence, the steps that need to be taken to assess coherence and examples of coherence assessments. This paper provides guidance for review authors and others on undertaking an assessment of coherence in the context of the CERQual approach. We suggest that threats to coherence may arise when the data supporting a review finding are contradictory, ambiguous or incomplete or where competing theories exist that could be used to synthesise the data. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.

Ultrasound Guidance for Botulinum Neurotoxin Chemodenervation Procedures.

PubMed

Alter, Katharine E; Karp, Barbara I

2017-12-28

Injections of botulinum neurotoxins (BoNTs) are prescribed by clinicians for a variety of disorders that cause over-activity of muscles; glands; pain and other structures. Accurately targeting the structure for injection is one of the principle goals when performing BoNTs procedures. Traditionally; injections have been guided by anatomic landmarks; palpation; range of motion; electromyography or electrical stimulation. Ultrasound (US) based imaging based guidance overcomes some of the limitations of traditional techniques. US and/or US combined with traditional guidance techniques is utilized and or recommended by many expert clinicians; authors and in practice guidelines by professional academies. This article reviews the advantages and disadvantages of available guidance techniques including US as well as technical aspects of US guidance and a focused literature review related to US guidance for chemodenervation procedures including BoNTs injection.

Good practice statements on safe laboratory testing: A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.

PubMed

Bowie, Paul; Forrest, Eleanor; Price, Julie; Verstappen, Wim; Cunningham, David; Halley, Lyn; Grant, Suzanne; Kelly, Moya; Mckay, John

2015-09-01

The systems-based management of laboratory test ordering and results handling is a known source of error in primary care settings worldwide. The consequences are wide-ranging for patients (e.g. avoidable harm or poor care experience), general practitioners (e.g. delayed clinical decision making and potential medico-legal implications) and the primary care organization (e.g. increased allocation of resources to problem-solve and dealing with complaints). Guidance is required to assist care teams to minimize associated risks and improve patient safety. To identify, develop and build expert consensus on 'good practice' guidance statements to inform the implementation of safe systems for ordering laboratory tests and managing results in European primary care settings. Mixed methods studies were undertaken in the UK and Ireland, and the findings were triangulated to develop 'good practice' statements. Expert consensus was then sought on the findings at the wider European level via a Delphi group meeting during 2013. We based consensus on 10 safety domains and developed 77 related 'good practice' statements (≥ 80% agreement levels) judged to be essential to creating safety and minimizing risks in laboratory test ordering and subsequent results handling systems in international primary care. Guidance was developed for improving patient safety in this important area of primary care practice. We need to consider how this guidance can be made accessible to frontline care teams, utilized by clinical educators and improvement advisers, implemented by decision makers and evaluated to determine acceptability, feasibility and impacts on patient safety.

The infant walker: an unappreciated household hazard.

PubMed

Marcella, S; McDonald, B

1990-03-01

The potential for infant walkers to cause injury to infants was demonstrated by the results of a survey of the practicing pediatricians in the state of Connecticut. There was a significant number of severe injuries reported. In addition, seven cases of infants hospitalized at Bridgeport Hospital because of injuries sustained while using an infant walker are included. The survey indicated adequate knowledge of the apparent danger by the practicing physicians, including discussion during anticipatory guidance. Despite this knowledge and guidance, significant morbidity continues to occur.

ICP-AES Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity ofanalytical data generated through the USEPA Contract Laboratory Program (CLP) Statement ofWork (SOW) ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

Trace Volatile Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity ofanalytical data generated through the USEPA Contract Laboratory Program (CLP) Statement ofWork (SOW) ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

Analytic solution of field distribution and demagnetization function of ideal hollow cylindrical field source

NASA Astrophysics Data System (ADS)

Xu, Xiaonong; Lu, Dingwei; Xu, Xibin; Yu, Yang; Gu, Min

2017-09-01

The Halbach type hollow cylindrical permanent magnet array (HCPMA) is a volume compact and energy conserved field source, which have attracted intense interests in many practical applications. Here, using the complex variable integration method based on the Biot-Savart Law (including current distributions inside the body and on the surfaces of magnet), we derive analytical field solutions to an ideal multipole HCPMA in entire space including the interior of magnet. The analytic field expression inside the array material is used to construct an analytic demagnetization function, with which we can explain the origin of demagnetization phenomena in HCPMA by taking into account an ideal magnetic hysteresis loop with finite coercivity. These analytical field expressions and demagnetization functions provide deeper insight into the nature of such permanent magnet array systems and offer guidance in designing optimized array system.

You can lead a horse to water … what Self-Determination Theory can contribute to our understanding of clinical policy implementation.

PubMed

Smith, Geoffrey P; Williams, Theresa M

2017-01-01

There has been increasing reliance on policy directives as instruments for shaping clinical practice in health care, despite it being widely recognized that there is a significant translation gap between clinical policy and its implementation. Self-Determination Theory, a widely researched and empirically validated theory of human needs' fulfilment and motivation, offers a potentially valuable theoretical framework for understanding not only why the current policy environment has not led to the anticipated improvement in the quality and safety of clinical care but, importantly, also provides guidance about how organizations can create an environment that can nurture behavioural change in the workforce. We describe an alternative approach to clinical policy-making underpinned by Self-Determination Theory, which we believe has broad application for the science of clinical implementation theory.

When should managed care firms terminate private benefits for chronically mentally ill patients?

PubMed

Gerson, S N

1994-01-01

Corporate America's healthcare cost crisis and the country's budget deficit are forcing limits on the resources used to finance healthcare, including mental healthcare. At the same time, the 1990 Americans with Disabilities Act bars discrimination against patients with chronic illnesses, including chronic mental illness. Therefore, corporate benefits managers need guidance on how to ethically and rationally allocate scarce clinical resources to those high-morbidity insureds who utilize disproportionate amounts of these resources. In particular, how should we define the public/private interface: When do patients who repeatedly fail to respond to treatment fall out of the private sector's responsibility? The author, medical director for a leading behavioral healthcare utilization management company, offers the following guidelines recommending reasonable and practical limitations on trials of treatment for seven common categories of difficult psychiatric patients.

Analytic solution of magnetic induction distribution of ideal hollow spherical field sources

NASA Astrophysics Data System (ADS)

Xu, Xiaonong; Lu, Dingwei; Xu, Xibin; Yu, Yang; Gu, Min

2017-12-01

The Halbach type hollow spherical permanent magnet arrays (HSPMA) are volume compacted, energy efficient field sources, and capable of producing multi-Tesla field in the cavity of the array, which have attracted intense interests in many practical applications. Here, we present analytical solutions of magnetic induction to the ideal HSPMA in entire space, outside of array, within the cavity of array, and in the interior of the magnet. We obtain solutions using concept of magnetic charge to solve the Poisson's and Laplace's equations for the HSPMA. Using these analytical field expressions inside the material, a scalar demagnetization function is defined to approximately indicate the regions of magnetization reversal, partial demagnetization, and inverse magnetic saturation. The analytical field solution provides deeper insight into the nature of HSPMA and offer guidance in designing optimized one.

Modifying behaviour to reduce over-speeding in work-related drivers: an objective approach.

PubMed

Newnam, Sharon; Lewis, Ioni; Warmerdam, Amanda

2014-03-01

The goal of this study was to utilise an objective measurement tool, via an on-board Diagnostic tool (OBDII), to explore the effectiveness of a behaviour modification intervention designed to reduce over-speed violations in a group of work-related drivers. It was predicted that over-speed violations would be decreased following participation in a behaviour modification intervention where drivers received weekly feedback on their speeding performance and goal setting exercises. The final analysis included the on-road behaviour of 16 drivers, all of whom completed each stage of the intervention programme. As predicted, over-speed violations significantly decreased from pre-test to post-test, after controlling for kilometres driven. These findings offer practical guidance for industry in developing interventions designed to improve work-related driving behaviour. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using climate models to estimate the quality of global observational data sets.

PubMed

Massonnet, François; Bellprat, Omar; Guemas, Virginie; Doblas-Reyes, Francisco J

2016-10-28

Observational estimates of the climate system are essential to monitoring and understanding ongoing climate change and to assessing the quality of climate models used to produce near- and long-term climate information. This study poses the dual and unconventional question: Can climate models be used to assess the quality of observational references? We show that this question not only rests on solid theoretical grounds but also offers insightful applications in practice. By comparing four observational products of sea surface temperature with a large multimodel climate forecast ensemble, we find compelling evidence that models systematically score better against the most recent, advanced, but also most independent product. These results call for generalized procedures of model-observation comparison and provide guidance for a more objective observational data set selection. Copyright © 2016, American Association for the Advancement of Science.

Conducting field studies for testing pesticide leaching models

USGS Publications Warehouse

Smith, Charles N.; Parrish, Rudolph S.; Brown, David S.

1990-01-01

A variety of predictive models are being applied to evaluate the transport and transformation of pesticides in the environment. These include well known models such as the Pesticide Root Zone Model (PRZM), the Risk of Unsaturated-Saturated Transport and Transformation Interactions for Chemical Concentrations Model (RUSTIC) and the Groundwater Loading Effects of Agricultural Management Systems Model (GLEAMS). The potentially large impacts of using these models as tools for developing pesticide management strategies and regulatory decisions necessitates development of sound model validation protocols. This paper offers guidance on many of the theoretical and practical problems encountered in the design and implementation of field-scale model validation studies. Recommendations are provided for site selection and characterization, test compound selection, data needs, measurement techniques, statistical design considerations and sampling techniques. A strategy is provided for quantitatively testing models using field measurements.

Chinese National Optical Education Small Private Online Course system

NASA Astrophysics Data System (ADS)

Zhang, XiaoJie; Lin, YuanFang; Liu, Xu; Liu, XiangDong; Cen, ZhaoFeng; Li, XiaoTong; Zheng, XiaoDong; Wang, XiaoPing

2017-08-01

In order to realize the sharing of high quality course resources and promote the deep integration of `Internet+' higher education and talent training, a new on-line to off-line specialized courses teaching mode was explored in Chinese colleges and universities, which emphasized different teaching places, being organized asynchronously and localized. The latest progress of the Chinese National Optical Education Small Private On-line Course (CNOESPOC) system set up by Zhejiang University and other colleges and universities having disciplines in the field of optics and photonics under the guidance of the Chinese National Steering Committee of Optics and Photonics (CNSCOP) was introduced in this paper. The On-line to Off-line (O2O) optical education teaching resource sharing practice offers a new good example for higher education in China under the background of Internet +.

STRengthening Analytical Thinking for Observational Studies: the STRATOS initiative

PubMed Central

Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

2014-01-01

The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even ‘standard’ analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. PMID:25074480

Paying Research Participants: Regulatory Uncertainty, Conceptual Confusion, and a Path Forward

PubMed Central

Largent, Emily A; Lynch, Holly Fernandez

2017-01-01

The practice of offering payment to individuals in exchange for their participation in clinical research is widespread and longstanding. Nevertheless, such payment remains the source of substantial debate, in particular about whether or the extent to which offers of payment coerce and/or unduly induce individuals to participate. Yet, the various laws, regulations, and ethical guidelines that govern the conduct of human subjects research offer relatively little in the way of specific guidance regarding what makes a payment offer ethically acceptable—or not. Moreover, there is a lack of definitional agreement regarding what the terms coercion and undue inducement mean in the human subjects research context. It is, therefore, unsurprising that investigators and Institutional Review Boards (IRBs) experience confusion about how to evaluate offers of payment, and lean toward conservative approaches. These trends are exemplified by our pilot data regarding the ways in which some IRB members and investigators (mis)understand the concepts of coercion and undue inducement, as well as the ways in which certain research institutions oversee offers of payment at a local level. This article systematically examines the legal and ethical dimensions of offering payment to research participants. It argues that many concerns about offers of payment to research participants can be attributed to the misguided view that such offers ought to be treated differently than offers of payment in other contexts, a form of “research exceptionalism.” We show that rejection of research exceptionalism with respect to payment helps settle open debates about both how best to define coercion and undue influence, and how to understand the relation between these concepts and offers of payment. We argue for adoption of our preferred definitions, ideally by regulatory authorities, and against the conventional conservatism toward payment of research participants. Instead, we draw attention to the rarely asked, even radical, question: are research participants paid enough? We conclude by arguing that we ought to change the default to favor, rather than encourage suspicion of, offers of payment to research participants. PMID:29249912

21 CFR 10.115 - Good guidance practices.

Code of Federal Regulations, 2010 CFR

2010-04-01

... understanding, or other communications directed to individual persons or firms. (c) What other terms have a... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... communication that are excluded from the definition of guidance document to informally communicate new or...

DOE standard 3009 - a reasoned, practical approach to integrating criticality safety into SARs

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

Vessard, S.G.

1995-12-31

In the past there have been efforts by the U.S. Department of Energy (DOE) to provide guidance on those elements that should be included in a facility`s safety analysis report (SAR). In particular, there are two DOE Orders (5480.23, {open_quotes}Nuclear Safety Analysis Reports,{close_quotes} and 5480.24, {open_quotes}Nuclear Criticality Safety{close_quotes}), an interpretive guidance document (NE-70, Interpretive Guidance for DOE Order 5480.24, {open_quotes}Nuclear Criticality Safety{close_quotes}), and DOE Standard DOE-STD-3009-94 {open_quotes}Preparation Guide for U.S. Department of Energy Nonreactor Nuclear Facility Safety Analysis Reports.{close_quotes} Of these, the most practical and useful (pertaining to the application of criticality safety) is DOE-STD-3009-94. This paper is a reviewmore » of Chapters 3, 4, and 6 of this standard and how they provide very clear, helpful, and reasoned criticality safety guidance.« less

The International Safety Framework for nuclear power source applications in outer space-Useful and substantial guidance

NASA Astrophysics Data System (ADS)

Summerer, L.; Wilcox, R. E.; Bechtel, R.; Harbison, S.

2015-06-01

In 2009, the International Safety Framework for Nuclear Power Source Applications in Outer Space was adopted, following a multi-year process that involved all major space faring nations under the auspices of a partnership between the UN Committee on the Peaceful Uses of Outer Space and the International Atomic Energy Agency. The Safety Framework reflects an international consensus on best practices to achieve safety. Following the 1992 UN Principles Relevant to the Use of Nuclear Power Sources in Outer Space, it is the second attempt by the international community to draft guidance promoting the safety of applications of nuclear power sources in space missions. NPS applications in space have unique safety considerations compared with terrestrial applications. Mission launch and outer space operational requirements impose size, mass and other space environment limitations not present for many terrestrial nuclear facilities. Potential accident conditions could expose nuclear power sources to extreme physical conditions. The Safety Framework is structured to provide guidance for both the programmatic and technical aspects of safety. In addition to sections containing specific guidance for governments and for management, it contains technical guidance pertinent to the design, development and all mission phases of space NPS applications. All sections of the Safety Framework contain elements directly relevant to engineers and space mission designers for missions involving space nuclear power sources. The challenge for organisations and engineers involved in the design and development processes of space nuclear power sources and applications is to implement the guidance provided in the Safety Framework by integrating it into the existing standard space mission infrastructure of design, development and operational requirements, practices and processes. This adds complexity to the standard space mission and launch approval processes. The Safety Framework is deliberately generic to remain relevantly independent of technological progress, of national organisational setups and of space mission types. Implementing its guidance therefore leaves room for interpretation and adaptation. Relying on reported practices, we analyse the guidance particularly relevant to engineers and space mission designers.

Asymmetrical booster ascent guidance and control system design study. Volume 5: Space shuttle powered explicit guidance. [space shuttle development

NASA Technical Reports Server (NTRS)

Jaggers, R. F.

1974-01-01

An optimum powered explicit guidance algorithm capable of handling all space shuttle exoatospheric maneuvers is presented. The theoretical and practical basis for the currently baselined space shuttle powered flight guidance equations and logic is documented. Detailed flow diagrams for implementing the steering computations for all shuttle phases, including powered return to launch site (RTLS) abort, are also presented. Derivation of the powered RTLS algorithm is provided, as well as detailed flow diagrams for implementing the option. The flow diagrams and equations are compatible with the current powered flight documentation.

Management of occupational health risks in small-animal veterinary practices.

PubMed

D'Souza, Eva; Barraclough, Richard; Fishwick, David; Curran, Andrew

2009-08-01

Small-animal work is a major element of veterinary practice in the UK and may be hazardous, with high levels of work-related injuries and ill-health reported in Australia and USA. There are no studies addressing the management of occupational health risks arising from small-animal work in the UK. To investigate the sources of health and safety information used and how health and safety and 12 specific occupational health risks are managed by practices. A cross-sectional postal survey of all small-animal veterinary practices in Hampshire. A response was mandatory as this was a Health & Safety Executive (HSE) inspection activity. A total of 118 (100%) practices responded of which 93 were eligible for inclusion. Of these, 99 and 86%, respectively, were aware of the Royal College of Veterinary Surgeons (RCVS) practice standards and had British Small Animal Veterinary Association (BSAVA) staff members, while only 51% had previous contact with HSE (publications, advice and visit). Ninety per cent had health and safety policies, but only 31% had trained responsible staff in health and safety. Specific health hazards such as occupational allergens and computer use were relatively overlooked both by practices and the RCVS/BSAVA guidance available in 2002. Failings in active health risk management systems could be due to a lack of training to ensure competence in those with responsibilities. Practices rely on guidance produced by their professional bodies. Current RCVS guidance, available since 2005, has remedied some previous omissions, but further improvements are recommended.

Birth Control in Clinical Trials: Industry Survey of Current Use Practices, Governance, and Monitoring.

PubMed

Stewart, J; Breslin, W J; Beyer, B K; Chadwick, K; De Schaepdrijver, L; Desai, M; Enright, B; Foster, W; Hui, J Y; Moffat, G J; Tornesi, B; Van Malderen, K; Wiesner, L; Chen, C L

2016-03-01

The Health and Environmental Sciences Institute (HESI) Developmental and Reproductive Toxicology Technical Committee sponsored a pharmaceutical industry survey on current industry practices for contraception use during clinical trials. The objectives of the survey were to improve our understanding of the current industry practices for contraception requirements in clinical trials, the governance processes set up to promote consistency and/or compliance with contraception requirements, and the effectiveness of current contraception practices in preventing pregnancies during clinical trials. Opportunities for improvements in current practices were also considered. The survey results from 12 pharmaceutical companies identified significant variability among companies with regard to contraception practices and governance during clinical trials. This variability was due primarily to differences in definitions, areas of scientific uncertainty or misunderstanding, and differences in company approaches to enrollment in clinical trials. The survey also revealed that few companies collected data in a manner that would allow a retrospective understanding of the reasons for failure of birth control during clinical trials. In this article, suggestions are made for topics where regulatory guidance or scientific publications could facilitate best practice. These include provisions for a pragmatic definition of women of childbearing potential, guidance on how animal data can influence the requirements for male and female birth control, evidence-based guidance on birth control and pregnancy testing regimes suitable for low- and high-risk situations, plus practical methods to ascertain the risk of drug-drug interactions with hormonal contraceptives.

Mercury and Cyanide Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity ofanalytical data generated through the USEPA Contract Laboratory Program (CLP) Statement ofWork (SOW) ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

Grants and Funding for State and Local Transportation

EPA Pesticide Factsheets

State and Local Transportation resources are for air quality and transportation government and community leaders. Guidance, strategies and links to grant opportunities are offered for reducing vehicle air pollution, including ozone or smog.

Low/Medium Volatile Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity of analytical data generated through the US EPA Contract Laboratory Program Statement of Work ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

The perspectives and practices of alberta chiropractors regarding the sale of health care products in chiropractic offices.

PubMed

Page, Stacey A; Grod, Jaroslaw P; McMorland, D Gordon

2011-09-01

The purpose of this study is to describe the practices and perspectives of doctors of chiropractic in Alberta, Canada, regarding the sale of health products. This practice is considered in terms of ethical principles and professional practice standards. Chiropractic Web sites in Alberta were identified using the publically available Web site of the Alberta College and Association of Chiropractors. A random sample of chiropractors was drawn and mailed a brief 4-page survey and return envelope. There was a follow-up mail out to nonrespondents 3 weeks later. Practitioners provided responses regarding their personal and professional characteristics and their perspectives and practices regarding health product sales. A total of 265 responses were received (response rate, 51.2%). Most practitioners endorsed health product sales by chiropractors (95%), and most were engaged in the practice (89%). Orthotics (77%) and pillows (69%) were sold most often, followed by nutritional supplements (68%), hot/cold packs (68%), and vitamins (52%). Some respondents identified areas of potential ethical concern, including product safety and efficacy, professional influence on consumer product purchase, and potential conflict of interest. Codes of ethics and conduct offer some guidance to practitioners, but their awareness of standards varied. The chiropractic profession within Alberta condones product sales, and most of its membership engages in the practice. Individual members differ in their perspectives on this practice and in their awareness of the national code of ethics and conduct. Copyright © 2011 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

EHR Learning - It's about Nursing, Leadership and Long-Term Commitments.

PubMed

Furlong, Karen E

2016-01-01

Despite a global commitment to the adoption of technologies, such as electronic health records (EHRs), to support the delivery of health services, there is little empirical guidance to support effective planning for the integration of these tools into practice settings (Suter et al. 2009). In particular, although EHR learning is known to positively influence integration (Byrne 2012), individual perspectives are often overlooked because of investigative designs that devalue such viewpoints by exploring the utility of technologies rather than the lived experiences of individual users of the technology. Therefore, this qualitative study offered nurse participants opportunities to make sense of EHR learning through talking about their experiences. This narrative inquiry was a collaborative interpretive method of discovery: stories and thematic analysis were the two separate yet complementary frames used to support data analysis. Finally, several practice implications and recommendations about EHR learning are presented with an emphasis placed upon patient safety as a way to impart accountability on behalf of learners, educators and those charged with governing responsibilities during times of EHR integration. Copyright © 2016 Longwoods Publishing.

Determining problems experienced by student nurses in their work with clinical educators in Turkey.

PubMed

Elcigil, Ayfer; Yildirim Sari, Hatice

2007-07-01

Clinical education is considered an indispensable and vital part of nursing education. Educators have an important role in the successful completion of a student's clinical education. The clinical educator's approach, experience and knowledge have an influence on the students. Students encounter certain problems during their clinical practice under the supervision of educators. This study was conducted to determine the nature of the problems student nurses encounter during clinical training in Turkey. The focus-group interviews were used for this study. Three groups of 8, a total group of 24, composed of students completing their third year were included in the interviews. The students in this study had completed their practical training in the departments of internal medicine, surgery, pediatrics, psychiatry and public health. Among the problems mostly encountered by students, as established by the study, were inadequate assessment by the clinical educator, judgment, negative feedback, communication problems, inadequate guidance and overload. At the end of the research, recommendations were that educators should offer information in the direction of student expectations, increase their positive feedback and lighten the academic workload of these students.

Social media guidelines and best practices: recommendations from the Council of Residency Directors Social Media Task Force.

PubMed

Pillow, Malford T; Hopson, Laura; Bond, Michael; Cabrera, Daniel; Patterson, Leigh; Pearson, David; Sule, Harsh; Ankel, Felix; Fernández-Frackelton, Madonna; Hall, Ronald V; Kegg, Jason A; Norris, Donald; Takenaka, Katrin

2014-02-01

Social media has become a staple of everyday life among over one billion people worldwide. A social networking presence has become a hallmark of vibrant and transparent communications. It has quickly become the preferred method of communication and information sharing. It offers the ability for various entities, especially residency programs, to create an attractive internet presence and "brand" the program. Social media, while having significant potential for communication and knowledge transfer, carries with it legal, ethical, personal, and professional risks. Implementation of a social networking presence must be deliberate, transparent, and optimize potential benefits while minimizing risks. This is especially true with residency programs. The power of social media as a communication, education, and recruiting tool is undeniable. Yet the pitfalls of misuse can be disastrous, including violations in patient confidentiality, violations of privacy, and recruiting misconduct. These guidelines were developed to provide emergency medicine residency programs leadership with guidance and best practices in the appropriate use and regulation of social media, but are applicable to all residency programs that wish to establish a social media presence.

Social Media Guidelines and Best Practices: Recommendations from the Council of Residency Directors Social Media Task Force

PubMed Central

Pillow, Malford T.; Hopson, Laura; Bond, Michael; Cabrera, Daniel; Patterson, Leigh; Pearson, David; Sule, Harsh; Ankel, Felix; Fernández-Frackelton, Madonna; Hall, Ronald V.; Kegg, Jason A.; Norris, Donald; Takenaka, Katrin

2014-01-01

Social media has become a staple of everyday life among over one billion people worldwide. A social networking presence has become a hallmark of vibrant and transparent communications. It has quickly become the preferred method of communication and information sharing. It offers the ability for various entities, especially residency programs, to create an attractive internet presence and “brand” the program. Social media, while having significant potential for communication and knowledge transfer, carries with it legal, ethical, personal, and professional risks. Implementation of a social networking presence must be deliberate, transparent, and optimize potential benefits while minimizing risks. This is especially true with residency programs. The power of social media as a communication, education, and recruiting tool is undeniable. Yet the pitfalls of misuse can be disastrous, including violations in patient confidentiality, violations of privacy, and recruiting misconduct. These guidelines were developed to provide emergency medicine residency programs leadership with guidance and best practices in the appropriate use and regulation of social media, but are applicable to all residency programs that wish to establish a social media presence. PMID:24578765

Ethics and Oncofertility: A Call for Religious Sensitivity.

PubMed

Hanselin, Michele R; Roybal, Deborah L; Leininger, Thomas B

2017-07-01

For patients of reproductive age, treating cancer may come at the price of infertility. Literature regarding fertility preservation recommendations in this population has increased significantly, but this literature too often overlooks or insufficiently considers the relevance of religious preferences. Similarly, practice guidelines do not address the role of religion in the oncofertility discussion. The acceptance of oncofertility practices varies significantly among Christianity, Judaism, and Islam. A patient's faith-based spirituality or secular morality may enhance his or her interpretation of the meaning of illness and should be incorporated into the informed-consent process. In this article, we describe the role of religious sensitivity in oncofertility care and argue for its importance in such care. We briefly summarize the views and moral reasoning about oncofertility in a few religions commonly encountered in many patient populations today. We recommend that clinicians discuss fertility options early in the decision process and, when relevant, incorporate the patient's moral and religious preferences into the treatment plan. We encourage providers to be prepared to offer resources to patients who desire moral and spiritual guidance about fertility preservation options. Hospital chaplains should be able to provide such resources.

Technology and quality of life outcomes.

PubMed

Hacker, Eileen Danaher

2010-02-01

To discuss recent technological advances in quality of life (QOL) data collection and guidance for use in research and clinical practice. The use of telephone-, computer-, and web/internet-based technologies to collect QOL data, reliability and validity issues, and cost will be discussed, along with the potential pitfalls associated with these technologies. Health care literature and web resources. Technology has provided researchers and clinicians with an opportunity to collect QOL data from patients that were previously not accessible. Most technologies offer a variety of options, such as language choice, formatting options for the delivery of questions, and data management services. Choosing the appropriate technology for use in research and/or clinical practice primarily depends on the purpose for QOL data collection. Technology is changing the way nurses assess QOL in patients with cancer and provide care. As stakeholders in the health care delivery system and patient advocates, nurses must be intimately involved in the evaluation and use of new technologies that impact QOL and/or the delivery of care. Copyright (c) 2010 Elsevier Inc. All rights reserved.

[Process of institutional child guidance counseling reflected by the Central Continuing Education of the Federal Conference for Child Guidance Counseling].

PubMed

Pfeifer, W K

2000-12-01

The Bundeskonferenz für Erziehungsberatung (bke) is the federation for child guidance and family-counseling in Germany. Members are the working groups for child guidance and family-counseling of the Länder, where the employees of the child guidance are organized. The federation was founded in 1962. It is sponsored by the Federal Ministry for Family, Seniors, Women and Youth. Further education for professional youth workers is central mission of bke. The constitution of the federation lais down these contents. Every autumn the bke publishes the program for further education for the following year in a brochure called Zentrale Weiterbildung--the program for child guidance, family counseling and youth counseling. A special Kommission Zentrale Weiterbildung acquires the contents of the program for further education und selects the referents. Since 1968 the Zentrale Weiterbildung of Bundeskonferenz für Erziehungsberatung offers events for professional youth workers in child guidance, family counseling. The program for further education contributes the quality of the institution of child guidance. After a time with above average use of the program for further education with therapeutical focal point, the orientation of the program changes to child and youth services. A constant number of counselors use the program. Beside the change of contents there was a change to effectiveness of contents and a reduction of participants.

COMPREHENSIVE ASSESSMENT OF COMPLEX TECHNOLOGIES: INTEGRATING VARIOUS ASPECTS IN HEALTH TECHNOLOGY ASSESSMENT.

PubMed

Lysdahl, Kristin Bakke; Mozygemba, Kati; Burns, Jacob; Brönneke, Jan Benedikt; Chilcott, James B; Ward, Sue; Hofmann, Bjørn

2017-01-01

Despite recent development of health technology assessment (HTA) methods, there are still methodological gaps for the assessment of complex health technologies. The INTEGRATE-HTA guidance for effectiveness, economic, ethical, socio-cultural, and legal aspects, deals with challenges when assessing complex technologies, such as heterogeneous study designs, multiple stakeholder perspectives, and unpredictable outcomes. The objective of this article is to outline this guidance and describe the added value of integrating these assessment aspects. Different methods were used to develop the various parts of the guidance, but all draw on existing, published knowledge and were supported by stakeholder involvement. The guidance was modified after application in a case study and in response to feedback from internal and external reviewers. The guidance consists of five parts, addressing five core aspects of HTA, all presenting stepwise approaches based on the assessment of complexity, context, and stakeholder involvement. The guidance on effectiveness, health economics and ethics aspects focus on helping users choose appropriate, or further develop, existing methods. The recommendations are based on existing methods' applicability for dealing with problems arising with complex interventions. The guidance offers new frameworks to identify socio-cultural and legal issues, along with overviews of relevant methods and sources. The INTEGRATE-HTA guidance outlines a wide range of methods and facilitates appropriate choices among them. The guidance enables understanding of how complexity matters for HTA and brings together assessments from disciplines, such as epidemiology, economics, ethics, law, and social theory. This indicates relevance for a broad range of technologies.

Some data processing requirements for precision Nap-Of-the-Earth (NOE) guidance and control of rotorcraft

NASA Technical Reports Server (NTRS)

Clement, Warren F.; Mcruer, Duane T.; Magdeleno, Raymond E.

1987-01-01

Nap-Of-the-Earth (NOE) flight in a conventional helicopter is extremely taxing for two pilots under visual conditions. Developing a single pilot all-weather NOE capability will require a fully automatic NOE navigation and flight control capability for which innovative guidance and control concepts were examined. Constrained time-optimality provides a validated criterion for automatically controlled NOE maneuvers if the pilot is to have confidence in the automated maneuvering technique. A second focus was to organize the storage and real-time updating of NOE terrain profiles and obstacles in course-oriented coordinates indexed to the mission flight plan. A method is presented for using pre-flight geodetic parameter identification to establish guidance commands for planned flight profiles and alternates. A method is then suggested for interpolating this guidance command information with the aid of forward and side looking sensors within the resolution of the stored data base, enriching the data content with real-time display, guidance, and control purposes. A third focus defined a class of automatic anticipative guidance algorithms and necessary data preview requirements to follow the vertical, lateral, and longitudinal guidance commands dictated by the updated flight profiles and to address the effects of processing delays in digital guidance and control system candidates. The results of this three-fold research effort offer promising alternatives designed to gain pilot acceptance for automatic guidance and control of rotorcraft in NOE operations.

75 FR 54627 - Best Management Practices for Unused Pharmaceuticals at Health Care Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... at Health Care Facilities AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: EPA... Unused Pharmaceuticals at Health Care Facilities. The guidance is targeted at hospitals, medical clinics... drafted a guidance document for health care facilities, which describes: Techniques for reducing or...

Facilitating Young Children's Use of the Web in Preschool

ERIC Educational Resources Information Center

Davidson, Christina; Danby, Susan J.; Given, Lisa M.; Thorpe, Karen J.

2016-01-01

Current perspectives on young children's use of digital technology suggest that preschool teachers need to provide more effective guidance for children. There is still little research, however, to inform how guidance might be understood and practiced during interactions with digital technology. This article employs an ethnomethodological…

Creating a Framework of Guidance for Building Good Digital Collections.

ERIC Educational Resources Information Center

Cole, Timothy W.

2002-01-01

Presents the Framework of Guidance for Building Good Digital Collections that was developed by the Institute of Museum and Library Services with other organizations to guide museums and libraries in digitization collection practices. Highlights digital collections, digital objects, and metadata, and discusses reusability, persistence,…

Communication Services and Supports for Individuals with Severe Disabilities: Guidance for Assessment and Intervention

PubMed Central

Brady, Nancy C.; Bruce, Susan; Goldman, Amy; Erickson, Karen; Mineo, Beth; Ogletree, Bill T.; Paul, Diane; Romski, Mary Ann; Sevcik, Rose; Siegel, Ellin; Schoonover, Judith; Snell, Marti; Sylvester, Lorraine; Wilkinson, Krista

2015-01-01

The National Joint Committee for the Communication Needs of People with Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities. PMID:26914467

Guidance for research-practice partnerships (R-PPs) and collaborative research.

PubMed

Ovretveit, John; Hempel, Susanne; Magnabosco, Jennifer L; Mittman, Brian S; Rubenstein, Lisa V; Ganz, David A

2014-01-01

The purpose of this paper is to provide evidence based guidance to researchers and practice personnel about forming and carrying out effective research partnerships. A review of the literature, interviews and discussions with colleagues in both research and practice roles, and a review of the authors' personal experiences as researchers in partnership research. Partnership research is, in some respects, a distinct "approach" to research, but there are many different versions. An analysis of research publications and of their research experience led the authors to develop a framework for planning and assessing the partnership research process, which includes defining expected outcomes for the partners, their roles, and steps in the research process. This review and analysis provides guidance that may reduce commonly-reported misunderstandings and help to plan more successful partnerships and projects. It also identifies future research which is needed to define more precisely the questions and purposes for which partnership research is most appropriate, and methods and designs for specific types of partnership research. As more research moves towards increased participation of practitioners and patients in the research process, more precise and differentiated understanding of the different partnership approaches is required, and when each is most suitable. This article describes research approaches that have the potential to reduce "the research-practice gap". It gives evidence- and experience-based guidance for choosing and establishing a partnership research process, so as to improve partnership relationship-building and more actionable research.

Scientific and Regulatory Policy Committee Review: Review of the Organisation for Economic Co-operation and Development (OECD) Guidance on the GLP Requirements for Peer Review of Histopathology.

PubMed

Fikes, James D; Patrick, Daniel J; Francke, Sabine; Frazier, Kendall S; Reindel, James F; Romeike, Annette; Spaet, Robert H; Tomlinson, Lindsay; Schafer, Kenneth A

2015-10-01

In 2014, the Organisation for Economic Co-operation and Development (OECD) issued guidance no. 16, Guidance on the GLP Requirements for Peer Review of Histopathology. The stated purpose of the guidance document is "to provide guidance to pathologists, test facility management, study directors and quality assurance personnel on how the peer review of histopathology should be planned, managed, documented, and reported in order to meet Good Laboratory Practice (GLP) expectations and requirements." On behalf of and in collaboration with the global societies of toxicologic pathology, the Society of Toxicologic Pathology initiated a review of OECD guidance no. 16. The objectives of this review are to provide a unified interpretation of the guidance, to recommend compliant processes for organizations to implement, and to avoid inconsistent process adaptations across the industry. This review of the guidance document is the product of a global collaboration with other societies of toxicologic pathology and provides a section-by-section international consensus view and interpretation of the OECD guidance on peer review. © 2015 by The Author(s).

Ecological compensation: From general guidance and expertise to specific proposals for road developments

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

Villarroya, Ana, E-mail: avillarroya@alumni.unav.es; Persson, Jesper, E-mail: jesper.persson@slu.se; Puig, Jordi, E-mail: jpbaguer@unav.es

The main scientific bibliography addressing the rationale behind ecological compensation is reviewed in order to examine general guidelines. This contains interesting general guidance on how to implement compensation, and provides the basis for future developments in compensation practice. On this basis, we propose a further step in compensation practice, advancing compensation proposals or rules for specific kinds of projects and contexts, focusing on road projects in the Spanish Environmental Impact Assessment (EIA). Three main residual impacts of roads are identified which usually remain uncompensated for: the loss of natural and semi-natural land use, the increase in emissions resulting from anymore » new road, and the fragmentation, severance or barrier effect on the landscape and its wildlife. To counteract these, four proposals, or “rules”, are advanced: conservation of natural and semi-natural land use area, conservation of dominant plant species physiognomy, compensation for emissions, and the rule of positive defragmentation. -- Highlights: • Ecological compensation theory does not specify guidelines for types of projects. • EIA practitioners lack valuable specific guidance on how to implement compensation. • Specific guidance for road project ecological compensation is proposed. • Compensation proposals should have in mind present-day compensation practice level. • Specific ways to compensate for habitat loss, emissions, and fragmentation are shown.« less

Quality and content of dental practice websites.

PubMed

Nichols, L C; Hassall, D

2011-04-09

To investigate the quality and content of dental practice websites by constructing an audit framework based on regulations, guidance and expert advice, and applying this framework to a random sample of UK dental practices' websites. An audit framework was constructed and in-depth data collected from a random sample of 150 UK dental practices. Thirty-five percent of dental practices in this study were found to have websites. Compliance with rules and regulations regarding dental practice websites was generally poor. Use of advised content for practice promotion was variable. Many websites were poorly optimised. Eighty-nine percent of the websites advertised tooth whitening, despite the issues surrounding its legality; 25% of the websites advertised Botox even though advertising of prescription only medicines is illegal. Some websites gave misleading information about the specialist status of their dentists. Those responsible for dental practice websites need to be aware of a wide range of regulations and guidance, and are advised to follow expert advice on content and optimisation in order to maximise the potential of their websites.

Identifying characteristics and practices of multidisciplinary team reviews for patients with severe mental illness: a systematic review.

PubMed

Woody, Charlotte A; Baxter, Amanda J; Harris, Meredith G; Siskind, Dan J; Whiteford, Harvey A

2018-06-01

Multidisciplinary teams in mental health receive limited guidance, leading to inconsistent practices. We undertook a systematic review of the characteristics and practices of multidisciplinary team reviews for patients with severe mental illness or in relevant mental health service settings. Sources published since 2000 were located via academic database and web searches. Results were synthesised narratively. A total of 14 sources were analysed. Important characteristics and practices identified included routine monitoring and evaluation, good communication, equality between team members, and clear documentation practices. Success factors included defined leadership and clear team goals. Four sources described considerations for patients with complex clinical needs, including allocating sufficient time for discussion, maintaining connections with community providers, and ensuring culturally sensitive practices. No single best practice model was found, due to variations in team caseload, casemix, and resourcing levels. However, key ingredients for success were proposed. Sources were mostly descriptive; there remains a lack of evidence-based guidance regarding multidisciplinary team review characteristics and practices.

Ultrasound Imaging in Radiation Therapy: From Interfractional to Intrafractional Guidance

PubMed Central

Western, Craig; Hristov, Dimitre

2015-01-01

External beam radiation therapy (EBRT) is included in the treatment regimen of the majority of cancer patients. With the proliferation of hypofractionated radiotherapy treatment regimens, such as stereotactic body radiation therapy (SBRT), interfractional and intrafractional imaging technologies are becoming increasingly critical to ensure safe and effective treatment delivery. Ultrasound (US)-based image guidance systems offer real-time, markerless, volumetric imaging with excellent soft tissue contrast, overcoming the limitations of traditional X-ray or computed tomography (CT)-based guidance for abdominal and pelvic cancer sites, such as the liver and prostate. Interfractional US guidance systems have been commercially adopted for patient positioning but suffer from systematic positioning errors induced by probe pressure. More recently, several research groups have introduced concepts for intrafractional US guidance systems leveraging robotic probe placement technology and real-time soft tissue tracking software. This paper reviews various commercial and research-level US guidance systems used in radiation therapy, with an emphasis on hardware and software technologies that enable the deployment of US imaging within the radiotherapy environment and workflow. Previously unpublished material on tissue tracking systems and robotic probe manipulators under development by our group is also included. PMID:26180704

The role of chief executive officers in a quality improvement initiative: a qualitative study

PubMed Central

Parand, Anam; Dopson, Sue; Vincent, Charles

2013-01-01

Objectives To identify the critical dimensions of hospital Chief Executive Officers’ (CEOs) involvement in a quality and safety initiative and to offer practical guidance to assist CEOs to fulfil their leadership role in quality improvement (QI). Design Qualitative interview study. Setting 20 organisations participating in the main phase of the Safer Patients Initiative (SPI) programme across the UK. Participants 17 CEOs overseeing 19 organisations participating in the main phase of the SPI programme and 36 staff (20 workstream leads, 10 coordinators and 6 managers) involved in SPI across all 20 participating organisations. Main outcome measure Self-reported perceptions of CEOs on their contribution and involvement within the SPI programme, supplemented by staff peer-reports. Results The CEOs recognised the importance of their part in the SPI programme and gave detailed accounts of the perceived value that their involvement had brought at all stages of the process. In exploring the parts played by the CEOs, five dimensions were identified: (1) resource provision; (2) staff motivation and engagement; (3) commitment and support; (4) monitoring progress and (5) embedding programme elements. Staff reports confirmed these dimensions; however, the weighting of the dimensions differed. The findings stress the importance of particular actions of support and monitoring such as constant communication through leadership walk rounds and reviewing programme progress and its related clinical outcomes at Board meetings. Conclusions This study addressed the call for more research-informed practical guidance on the role of senior management in QI initiatives. The findings show that the CEOs provided key participation considered to significantly contribute towards the SPI programme. CEOs and staff identified a number of clear and consistent themes essential to organisation safety improvement. Queries raised include the tangible benefits of executive involvement in changing structures and embedding for sustainability and the practical steps to creating the ‘right’ environment for QI. PMID:23293245

A conceptual framework toward identifying and analyzing challenges to the advancement of pharmacy.

PubMed

Bader, Lina R; McGrath, Simon; Rouse, Michael J; Anderson, Claire

Pharmacists and health care professionals are faced with increasing and changing health care needs around the world. To meet these demands, they are required to continuously upgrade and develop their professions. Reprofessionalization is therefore crucial to the successful delivery of health services, but traditional theories might provide little practical guidance to evaluating the overall status of a profession. This study proposes a new conceptual framework of three interrelated professional sectors: education, regulation and practice, and uses it to identify and analyze challenges facing the pharmacy profession in Jordan. A multiple-method qualitative study comprised of semi-structured interviews and focus groups was conducted in Amman, Jordan. To explore and identify the challenges, a purposively recruited cross-sector sample of 53 key informants, stakeholders and pharmacists were interviewed. Interview transcripts were translated and analyzed using QSR NVivo 10. Thematic analysis identified eight main challenges facing pharmacy in Jordan. The original participants were then invited to participate in focus groups, the purpose of which was to validate the interview findings, map them against the conceptual framework and discuss recommendations for development. The eight validated challenges span the following areas: graduates preparedness for practice, pharmacy education accreditation and quality assurance, pre-registration requirements, workforce development, workforce planning, remuneration and wage rate, pharmacy assistants, and Pharm.D. pharmacists. Focus group participants used the framework to map each of the challenges to the primary sector-to-sector disconnect that they perceived to explain it. A list of recommendations addressing each of the challenges was also devised. The framework was found to offer valuable insight as an explanatory and diagnostic tool in policy-relevant research. By emphasizing the processual and contextual nature of reprofessionalization, the framework presents an alternative approach to traditional theories. This study also raises important questions regarding the status of pharmacy in Jordan and aims to provide guidance for local development and much-needed reprofessionalization drives. Copyright © 2016 Elsevier Inc. All rights reserved.

A conceptual and practical guide to the behavioural evaluation of animal models of the symptomatology and therapy of schizophrenia

PubMed Central

Yee, Benjamin K.; Singer, Philipp

2013-01-01

Schizophrenia is a chronic debilitating brain disorder characterized by a complex set of perceptual and behavioural symptoms that severely disrupt and undermine the patient’s psychological well-being and quality of life. Since the exact disease mechanisms remain essentially unknown, holistic animal models are indispensable tools for any serious investigation into the neurobiology of schizophrenia, including the search of remedies, prevention, and possible biological markers. This review provides some practical advice to those confronted with the task of evaluating their animal models for relevance to schizophrenia that inevitably involves behavioural tests with animals. To a novice, this challenge is not only a technical one, as it also entails attention to interpretative issues concerning validity and translational power. Here, we attempt to offer some guidance to help overcome these obstacles by drawing on our experience on diverse animal models of schizophrenia based on genetics, strain difference, brain lesions, pharmacological induction, and early life developmental manipulations. The review pays equal emphasis on the general (theoretical) considerations in experimental design and the illustration of the problematics related to test parameters and data analysis of selected exemplar behavioural tests. Finally, the individual difference of behavioural expression in relevant tests observed in wild type animals may offer an alternative approach to explore the mechanism of schizophrenia-related behavioural dysfunction at the molecular, cellular and structural levels that are of more immediate relevance to cell and tissue research. PMID:23579553

Accuracy of percutaneous soft-tissue interventions using a multi-axis, C-arm CT system and 3D laser guidance.

PubMed

Kostrzewa, Michael; Rathmann, Nils; Kara, Kerim; Schoenberg, Stefan O; Diehl, Steffen J

2015-10-01

Purpose of this phantom study was to compare the accuracy of needle placement using a multi-axis, C-arm-based, flat-panel, cone-beam computed tomography system (CBCT guidance) with that under multi-detector computed tomography guidance (MDCT guidance). In an abdominal phantom, eight lesions (six lesions in the liver and two in the renal pelvises, respectively) were each punctured in-plane and off-plane with a 20G needle under CBCT and MDCT guidance. Access paths were initially defined and reproduced identically on the two systems. In total, 32 interventions were conducted. CBCT and MDCT guidance was compared prospectively with respect to technical success, accuracy, and overall procedural time. All 32 interventions were technically successful in that it was possible to hit the respective lesion in each procedure. When comparing the accuracy of MDCT to CBCT guidance there was no significant difference in absolute, angular, and longitudinal deviation for either in- or off-plane interventions. Overall procedural duration was significantly longer under CBCT guidance for in-plane interventions (888 vs 527s, p=0.00005), whereas, for off-plane procedures there was no significant difference between CBCT and MDCT guidance (920 vs 701s, p=0.08). Off-plane interventions took significantly longer than in-plane interventions under MDCT guidance (701 vs 527s, p=0.03), whereas under CBCT guidance no significant difference could be found between off- and in-plane procedures (920 vs. 888s, p=0.2). In this phantom study, we could show that percutaneous soft-tissue interventions under CBCT guidance can be conducted with an accuracy comparable to that under MDCT guidance. Although overall procedural duration is in general shorter using MDCT guidance, CBCT-guided interventions offer the advantage of more degrees of freedom, which is of particular importance for off-plane procedures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Good Cell Culture Practice for stem cells and stem-cell-derived models.

PubMed

Pamies, David; Bal-Price, Anna; Simeonov, Anton; Tagle, Danilo; Allen, Dave; Gerhold, David; Yin, Dezhong; Pistollato, Francesca; Inutsuka, Takashi; Sullivan, Kristie; Stacey, Glyn; Salem, Harry; Leist, Marcel; Daneshian, Mardas; Vemuri, Mohan C; McFarland, Richard; Coecke, Sandra; Fitzpatrick, Suzanne C; Lakshmipathy, Uma; Mack, Amanda; Wang, Wen Bo; Yamazaki, Daiju; Sekino, Yuko; Kanda, Yasunari; Smirnova, Lena; Hartung, Thomas

2017-01-01

The first guidance on Good Cell Culture Practice (GCCP) dates back to 2005. This document expands this to include aspects of quality assurance for in vitro cell culture focusing on the increasingly diverse cell types and culture formats used in research, product development, testing and manufacture of biotechnology products and cell-based medicines. It provides a set of basic principles of best practice that can be used in training new personnel, reviewing and improving local procedures, and helping to assure standard practices and conditions for the comparison of data between laboratories and experimentation performed at different times. This includes recommendations for the documentation and reporting of culture conditions. It is intended as guidance to facilitate the generation of reliable data from cell culture systems, and is not intended to conflict with local or higher level legislation or regulatory requirements. It may not be possible to meet all recommendations in this guidance for practical, legal or other reasons. However, when it is necessary to divert from the principles of GCCP, the risk of decreasing the quality of work and the safety of laboratory staff should be addressed and any conclusions or alternative approaches justified. This workshop report is considered a first step toward a revised GCCP 2.0.

Adherence to best practice consensus guidelines for implant-based breast reconstruction: Results from the iBRA national practice questionnaire survey.

PubMed

Mylvaganam, Senthurun; Conroy, Elizabeth J; Williamson, Paula R; Barnes, Nicola L P; Cutress, Ramsey I; Gardiner, Matthew D; Jain, Abhilash; Skillman, Joanna M; Thrush, Steven; Whisker, Lisa J; Blazeby, Jane M; Potter, Shelley; Holcombe, Christopher

2018-05-01

The 2008 National Mastectomy and Breast Reconstruction Audit demonstrated marked variation in the practice and outcomes of breast reconstruction in the UK. To standardise practice and improve outcomes for patients, the British professional associations developed best-practice guidelines with specific guidance for newer mesh-assisted implant-based techniques. We explored the degree of uptake of best-practice guidelines within units performing implant-based reconstruction (IBBR) as the first phase of the implant Breast Reconstruction Evaluation (iBRA) study. A questionnaire developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Simple summary statistics were calculated for each survey item to assess compliance with current best-practice guidelines. 81 units from 79 NHS Trusts completed the questionnaire. Marked variation was observed in adherence to guidelines, especially those relating to clinical governance and infection prevention strategies. Less than half (n = 28, 47%) of units obtained local clinical governance board approval prior to offering new mesh-based techniques and prospective audit of the clinical, cosmetic and patient-reported outcomes of surgery was infrequent. Most units screened for methicillin-resistant staphylococcus aureus prior to surgery but fewer than 1 in 3 screened for methicillin-sensitive strains. Laminar-flow theatres (recommended for IBBR) were not widely-available with less than 1 in 5 units having regular access. Peri-operative antibiotics were widely-used, but the type and duration were highly-variable. The iBRA national practice questionnaire has demonstrated variation in reported practice and adherence to IBBR guidelines. High-quality evidence is urgently required to inform best practice. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Conversation Analysis and Applied Linguistics.

ERIC Educational Resources Information Center

Schegloff, Emanuel A.; Koshik, Irene; Jacoby, Sally; Olsher, David

2002-01-01

Offers biographical guidance on several major areas of conversation-analytic work--turn-taking, repair, and word selection--and indicates past or potential points of contact with applied linguistics. Also discusses areas of applied linguistic work. (Author/VWL)

Rail capacity improvement study for heavy rail transit operations.

DOT National Transportation Integrated Search

2012-10-01

This study offers a combination of considerations and evaluation tools pertaining to relevant means of capacity improvements (technology, operations, route, and vehicle upgrades), both conventional and emerging. Guidance regarding the economics is of...

Adequacy Review of State Implementation Plan (SIP) Submissions for Conformity

EPA Pesticide Factsheets

This page is for state and local air quality regulators and transportation planners that offers guidance on how to reduce air pollution from cars, diesel trucks, city and school buses, construction equipme

Improve FREQ macroscopic freeway analysis model

DOT National Transportation Integrated Search

2008-07-01

The primary objectives of this project have been to provide technical assistance on district freeway analysis projects, enhance the FREQ model based on guidance and suggestions from Caltrans staff members, and offer three freeway analysis workshops f...

Pediatric Anthrax Clinical Management

PubMed Central

Bradley, John S.; Peacock, Georgina; Krug, Steven E.; Bower, William A.; Cohn, Amanda C.; Meaney-Delman, Dana; Pavia, Andrew T.

2015-01-01

Anthrax is a zoonotic disease caused by Bacillus anthracis, which has multiple routes of infection in humans, manifesting in different initial presentations of disease. Because B anthracis has the potential to be used as a biological weapon and can rapidly progress to systemic anthrax with high mortality in those who are exposed and untreated, clinical guidance that can be quickly implemented must be in place before any intentional release of the agent. This document provides clinical guidance for the prophylaxis and treatment of neonates, infants, children, adolescents, and young adults up to the age of 21 (referred to as “children”) in the event of a deliberate B anthracis release and offers guidance in areas where the unique characteristics of children dictate a different clinical recommendation from adults. PMID:24777226

Progreen online engineering diploma in the Middle East: assessment of the educational experience

NASA Astrophysics Data System (ADS)

Baytiyeh, Hoda

2018-03-01

Little is known about the status of online learning in the Middle East. This study investigates educational experiences of engineers enrolled in the new joint online ProGreen diploma programme offered by three universities, two in Lebanon and one in Egypt. Forty-eight working engineers responded to an online survey based on the three components of the community of inquiry model: social presence, teaching presence, and cognitive presence. Exploratory factor analysis identified five factors: sense of belonging, self-directedness, self-actualisation, interaction, and instructional guidance. The findings showed that sense of belonging was the factor engineers rated highest but it did not correlate with instructional guidance. However, instructional guidance highly correlated with self-directedness and self-actualisation.

76 FR 4360 - Guidance for Industry on Process Validation: General Principles and Practices; Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

... elements of process validation for the manufacture of human and animal drug and biological products... process validation for the manufacture of human and animal drug and biological products, including APIs. This guidance describes process validation activities in three stages: In Stage 1, Process Design, the...

College Counselors' Perceptions and Practices regarding Anticipatory Guidance on Firearms

ERIC Educational Resources Information Center

Price, James; Mrdjenovich, Adam J.; Thompson, Amy; Dake, Joseph A.

2009-01-01

Objectives: This study assessed college counselors' anticipatory guidance on firearms for student clients. Participants: The membership of the Association for University and College Counseling Center Directors was used to identify a national random sample of counseling centers (n = 361). One counselor from each center was selected to survey.…

Guidance Manual: Asbestos Operations & Maintenance Work Practices. Second Edition.

ERIC Educational Resources Information Center

National Inst. of Building Sciences, Washington, DC.

This technical manual provides detailed guidance to building owners, asbestos program managers, and operations and maintenance (O&M) workers for managing asbestos-containing materials (ACM) in buildings. The manual addresses four different types of ACM found in buildings and three different levels of precaution which may be warranted by…

Laboratory Biosafety and Biosecurity Risk Assessment Technical Guidance Document

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

Astuto-Gribble, Lisa M; Caskey, Susan Adele

2014-07-01

The purpose of this document is threefold: 1) to describe the laboratory bio safety and biosecurity risk assessment process and its conceptual framework; 2) provide detailed guidance and suggested methodologies on how to conduct a risk assessment; and 3) present some practical risk assessment process strategies using realistic laboratory scenarios.

Developing & Managing Your School Guidance & Counseling Program. Fifth Edition

ERIC Educational Resources Information Center

Gysbers, Norman C.; Henderson, Patricia

2012-01-01

Five phases for establishing and improving Pre-K-12 comprehensive guidance and counseling programs serve as the organizational framework for this enduring, influential textbook written for counselor educators and their students, school leaders, practicing school counselors, and state or district supervisors. The fifth edition of this bestseller…

76 FR 23824 - Guidance for Industry: “Computer Crossmatch” (Computerized Analysis of the Compatibility Between...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... the Compatibility Between the Donor's Cell Type and the Recipient's Serum or Plasma Type... Crossmatch' (Computerized Analysis of the Compatibility between the Donor's Cell Type and the Recipient's... donor's cell type and the recipient's serum or plasma type. The guidance describes practices that we...

Planning for Your Second Accounting Job

ERIC Educational Resources Information Center

Mucenski-Keck, Lynn; Hintz, Arthur F.; Fedoryshyn, Michael W.

2012-01-01

For many accounting students the focus of their fourth or fifth years is finding a job to start them on an exciting and financially rewarding career. Colleges provide significant guidance and direction to these students in the form of internship assistance, resume writing workshops, interview practice, networking events and career guidance. At…

16 CFR 1500.231 - Guidance for hazardous liquid chemicals in children's products.

Code of Federal Regulations, 2010 CFR

2010-01-01

... children's products. 1500.231 Section 1500.231 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION.... The U.S. Consumer Product Safety Commission issues this guidance to manufacturers, importers... subsequent hand-to-mouth or hand-to-eye activity. The specific type and frequency of behavior that a child...

Guidance on maintaining personal hygiene in nail care.

PubMed

Malkin, Bridget; Berridge, Pat

Nail care is important in the maintenance of personal hygiene and is an essential aspect of patient care. Confusion about who should perform nail care for patients has resulted in poor practice and cycles of non-activity. This article provides guidance for nurses on performing routine nail care.

78 FR 17943 - Draft Program-Specific Guidance About Fixed Gauge Licenses

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

... is requesting public comment on draft NUREG-1556, Volume 4, Revision 1, ``Consolidated Guidance About... sensitive information, and changes in regulatory policies and practices. This document is intended for use...-415- 4737, or by email to [email protected] . The draft NUREG-1556, Volume 4, Revision 1, is...

School-Based Peer Mediation Programs: A Natural Extension of Developmental Guidance Programs.

ERIC Educational Resources Information Center

Robertson, Gwendolyn

School-based peer mediation programs are natural extensions of the kindergarten-grade 12 developmental guidance programs. Peer mediation programs not only provide schools with alternatives to traditional discipline practices, but also teach students important life skills. Existing research on peer mediation is very limited, yet promising. This…

76 FR 33409 - Guidance on Deposit-Related Consumer Credit Products

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... OCC's application of principles of safe and sound banking practices in connection with deposit-related... guidance details the principles that the OCC expects national banks to follow in connection with any... without dictating specific product terms. The OCC expects national banks to apply the principles set forth...

An Accommodations Model for the Secondary Inclusive Classroom

ERIC Educational Resources Information Center

Scanlon, David; Baker, Diana

2012-01-01

Despite expectations for accommodations in inclusive classrooms, little guidance for effective practice is available. Most accommodations policies and evidence-based practices address assessments. High school regular and special educators collaborated in focus groups to articulate a model based on their practices and perceptions of best practice.…

Workshop for Early Career Geoscience Faculty: Providing resources and support for new faculty to succeed

NASA Astrophysics Data System (ADS)

Hill, T. M.; Beane, R. J.; Macdonald, H.; Manduca, C. A.; Tewksbury, B. J.; Allen-King, R. M.; Yuretich, R.; Richardson, R. M.; Ormand, C. J.

2015-12-01

A vital strategy to educate future geoscientists is to support faculty at the beginning of their careers, thus catalyzing a career-long impact on the early-career faculty and on their future students. New faculty members are at a pivotal stage in their careers as they step from being research-focused graduate students and post-doctoral scholars, under the guidance of advisors, towards launching independent careers as professors. New faculty commonly, and not unexpectedly, feel overwhelmed as they face challenges to establish themselves in a new environment, prepare new courses, begin new research, and develop a network of support. The workshop for Early Career Geoscience Faculty: Teaching, Research, and Managing Your Career has been offered annually in the U.S. since 1999. The workshop is currently offered through the National Association of Geoscience Teachers On the Cutting Edge professional development program with support from the NSF, AGU and GSA. This five-day workshop, with associated web resources, offers guidance for incorporating evidence-based teaching practices, developing a research program, and managing professional responsibilities in balance with personal lives. The workshop design includes plenary and concurrent sessions, individual consultations, and personalized feedback from workshop participants and leaders. Since 1999, more than 850 U.S. faculty have attended the Early Career Geoscience Faculty workshop. Participants span a wide range of geoscience disciplines, and are in faculty positions at two-year colleges, four-year colleges, comprehensive universities and research universities. The percentages of women (~50%) and underrepresented participants (~8%) are higher than in the general geoscience faculty population. Multiple participants each year are starting positions after receiving all or part of their education outside the U.S. Collectively, participants report that they are better prepared to move forward with their careers as a result of the workshop, that they plan to incorporate evidence-based teaching in their classrooms, and that they leave the workshop with a network of support and the resources needed to enable them succeed. http://serc.carleton.edu/NAGTWorkshops/earlycareer